This site is an archive of a closed Robert Wood Johnson Foundation program, provided for educational and historical purposes. Please note that this content is not routinely updated and that contact information and social links may not work.

Recent Research Publications and Funding

  •  | September 1, 2007 4:00AM

    Nurse turnover is a recurring problem for health care organizations. Nurse retention focuses on preventing nurse turnover and keeping nurses in an organization’s employment. However, decisions about nurse turnover and retention are often made without the support of full and complete knowledge of their associated costs and benefits. This article identifies common nurse turnover and retention costs and benefits, discusses the use of benefit-cost and cost-effectiveness analysis relevant to nurse turnover and retention, and calls for the construction of a business case for nurse retention. It also provides a foundation for including the costs and benefits of nurse turnover and retention in estimating the economic value of nursing.

  •  | September 1, 2007 4:00AM

    OBJECTIVE: This study examined the extent to which public health nurses (PHNs) see value in credentialing and perceive specific barriers related to a community/public health nursing (C/PHN) credential.

    DESIGN: A cross-sectional exploratory survey was used to examine the perceived value of credentialing for PHNs and the perceived barriers to obtaining or maintaining the C/PHN credential as the primary variables of interest.

    SAMPLE: Data were collected from 655 PHN members of national public health nursing organizations who participated in an online survey.

    MEASUREMENT: Responses related to the perceived value of credentialing were analyzed using factor analysis and descriptive statistics. Data regarding perceived barriers to the C/PHN credential were analyzed through descriptive statistics and through the Borda Count Method for analysis of ranked data (Tannenbaum, 1995).

    RESULTS: Similar to nurses in other specialties, study participants perceived that credentialing has a high personal value for PHNs, but that certification provides less value in terms of extrinsic recognition. Respondents identified issues related to the lack of external recognition as particular barriers to the C/PHN credential.

    CONCLUSIONS: These findings provide guidance to public health nursing leaders and inform discussions regarding the development of credentialing systems within the field of public health  

  •  | August 14, 2007 4:00AM

    This article describes the experiences of men who experienced intraparental homicide (one parent killing the other parent) when they were boys. Twenty-one men were interviewed twice and data were analyzed using a hermeneutic approach. In this article we examine a topic that emerged as a core problem for these men, specifically, how they talked (or did not talk) about the homicide. Understanding intraparental homicide may provide information to guardians and professionals about what some male children need after such an event.  

  •  | August 1, 2007 4:00AM

    According to reported global estimates, 15 million people suffer from a stroke each year, resulting in 5.5 million deaths, with 5 million left permanently disabled. Typical disabilities following stroke include poor neuromuscular control, hemodynamic imbalance, and negative mood state. Tai Chi (TC) is associated with better balance, lower blood pressure, and improved mood, which are important for stroke survivors. An overview of the philosophy and principles of TC exercise is provided, followed by a literature review of reported TC studies examining balance, blood pressure, and mood. Finally, the potential application of TC exercise to stroke rehabilitation is discussed.

  •  | August 1, 2007 4:00AM

    The purpose of this study was to determine the utility of the Stanford Brief Activity Survey (SBAS) as a quick screening tool in a clinical population, where no other measure of physical activity was available. The SBAS was administered to 500 younger cases in the Atherosclerotic Disease Vascular Function and Genetic Epidemiology (ADVANCE) study, a case-control genetic association study, between December 2001 and January 2004. Younger cases in the ADVANCE study included men (<46 years old) and women (<56 years old) diagnosed with early-onset coronary artery disease. Frequency distributions of the SBAS and associations between SBAS activity categories and selected cardiovascular disease risk factors by sex were calculated. RESULTS: Subjects were 45.9 +/- 6.4 years old, 68% married, 61% women, 51% white, and 21% college graduates. Clinical diagnoses for early-onset coronary artery disease included 61% myocardial infarction, 23% coronary revascularization procedure, and 16% angina pectoris. In women, associations between all cardiovascular disease risk factors examined across SBAS categories were statistically significant (P trend < .01). In men, the associations across SBAS categories were statistically significant (P trend < .01), except for body mass index (P trend = .065). Adjustment for body mass index, age, ethnicity, and education with interactions by sex did not change the results. CONCLUSION: Subjects in the higher SBAS activity categories had more favorable cardiovascular disease risk profiles than did their less active counterparts, regardless of sex. The SBAS can be recommended for use in clinical populations providing immediate feedback on current physical activity level.

  •  | August 1, 2007 4:00AM

     Screening for thyroid hormone levels in the first week of life is extremely important to identify infants with Congenital Hypothyroidism. Worldwide neonatal screening programs have been successful in decreasing childhood mental retardation related to CH by early detection and treatment. To successfully screen for CH, nurses must understand how to draw blood that will yield valid results on the metabolic screening filter paper. It is also important for the nurse to understand that thyroid levels are normally decreased in preterm infants and that regular follow-up of those low thyroid levels is crucial because levels may return to normal and eventual treatment is necessary. Early follow-up testing and treatment are essential. A thyroid scan or ultrasonography is optional and decided on by evaluating the risk-benefit ratio.

  •  | July 15, 2007 12:00AM

    Current rates of intimate partner homicide of females are approximately 4 to 5 times the rate for male victims, although the rates for both have decreased during the past 25 years. The major risk factor for intimate partner homicide, no matter if a female or male partner is killed, is prior domestic violence. This review presents and critiques the evidence supporting the other major risk factors for intimate partner homicide in general, and for intimate partner homicide of women (femicide) in particular, namely guns, estrangement, stepchild in the home, forced sex, threats to kill, and nonfatal strangulation (choking). The demographic risk factors are also examined and the related phenomena of pregnancy-related homicide, attempted femicide, and intimate partner homicide-suicide  

  •  | July 1, 2007 4:00AM

     The concept of pediatric palliative care should be analyzed to gain a better understanding of how to address the needs of children living with life-threatening illnesses. According to Walker and Avant, this article identifies uses of the concept, defines its critical attributes, describes a model case, describes additional cases, and identifies antecedents, consequences, and empirical referents. The analysis is useful to researchers and clinicians with a focus on pediatric palliative care. Hypotheses can then accurately reflect relationships among variables in the field, and new tools can be developed to determine the presence of pediatric palliative care.

  •  | July 1, 2007 12:00AM

    HIV-related fatigue is a debilitating and disabling symptom that persists for months and years. In 743 HIV/AIDS patients from Southern Africa, the authors found ratings of HIV-related fatigue to be highly prevalent. The authors conducted a secondary data analysis within the theoretical context of the University of California, San Francisco Symptom Management Model. The analysis focused on 538 patients who reported fatigue to investigate correlates and predictors of fatigue severity in relationship to demographic and HIV/AIDS illness indicators, as well as HIV-specific physical and psychological symptoms. A hierarchical regression model explored the contributions of those five blocks on fatigue severity. Of the 47% of the total variance in fatigue severity, a combination of variables within the health and illness block (6%), the physical symptoms block (7%) and the psychological symptom block (2%) contributed significantly to the increase in fatigue severity scores. Fatigue severity in Southern Africa was moderate, and the factors contributing to the perceived fatigue were most likely related to symptoms of acute HIV disease (such as fever and gastrointestinal problems). In conclusion, fatigue severity is less impacted by demographic or environmental variables but much more by co-occurring symptoms and HIV disease severity. The results of this study imply the need for more research to understand if improvements in water quality and access to food would prevent infection and diarrhea and whether sufficient access to antiretroviral treatments to manage the HIV infection would improve fatigue and co-occurring symptom profiles.  

  •  | July 1, 2007 12:00AM

    OBJECTIVE: To promote evidence-based decision making regarding hospital staffing, the authors examined the characteristics of supplemental nurses, as well as the relationship of supplemental staff to nurse outcomes and adverse events. BACKGROUND: The use of supplemental nurses to bolster permanent nursing staff in hospitals is widespread but controversial. Quality concerns have been raised regarding the use of supplemental staff. METHODS: Data from the 2000 National Sample Survey of Registered Nurses were used to determine whether the qualifications of supplemental nurses working in hospitals differed from permanent staff nurses. Data from Pennsylvania nurse surveys were analyzed to examine whether nurse outcomes and adverse events differed in hospitals with varying proportions of nonpermanent nurses. RESULTS: Temporary nurses have qualifications similar to permanent staff nurses. Deficits in patient care environments in hospitals employing more temporary nurses explain the association between poorer quality and temporary nurses. CONCLUSION: Negative perceptions of temporary nurses may be unfounded.