Nurses need to be able to make drug calculations competently. In this study, involving 229 second year British nursing students, we explored the influence of mathematics anxiety, self-efficacy, and numerical ability on drug calculation ability and determined which factors would best predict this skill. Strong significant relationships (p < .001) existed between anxiety, self-efficacy, and ability. Students who failed the numerical and/or drug calculation ability tests were more anxious (p < .001) and less confident (p ≤ .002) in performing calculations than those who passed. Numerical ability made the strongest unique contribution in predicting drug calculation ability (beta = 0.50, p < .001) followed by drug calculation self-efficacy (beta = 0.16, p = .04). Early testing is recommended for basic numerical skills. Faculty are advised to refresh students' numerical skills before introducing drug calculations. © 2012 Wiley Periodicals, Inc. Res Nurs Health

Most adolescents do not meet national recommendations regarding physical activity and/or the intake of fruits and vegetables. The purpose of this study was to explore whether variables in the information, motivation, behavioral skills (IMB) model of health promotion predicted physical activity and fruit and vegetable intake in 404 adolescents from 2 high schools in the Southwest United States using structural equation modeling (SEM). The SEM models included theoretical constructs, contextual variables, and moderators. The theoretical relationships in the IMB model were confirmed and were moderated by gender and race. Interventions that incorporate cognitive-behavioral skills building may be a key factor for promoting physical activity as well as fruit and vegetable intake in adolescents. © 2012 Wiley Periodicals, Inc. Res Nurs Health

Certified nursing assistants (CNAs) provide the majority of direct care in nursing homes, yet recruiting and retaining CNAs has been difficult. Retaining CNAs is important because it has been linked to the better quality of resident care in nursing homes. In this study, the investigators examined the relationships of work-related and personal factors to CNA job satisfaction and intent to leave. Linked data from the 2004 National Nursing Home Survey and the 2004 National Nursing Assistant Survey were analyzed using multilevel logistic regression. Personal factors such as age, education, and job history, were related to intent to leave but not to job satisfaction. Supportive supervision was a significant predictor of both job satisfaction and intent to leave. © 2012 Wiley Periodicals, Inc. Res Nurs Health

Maternal–fetal attachment (MFA) has been associated with health practices during pregnancy, but less is known about this relationship in low-income women, and no identified studies have examined this relationship to neonatal outcomes. This longitudinal descriptive study was conducted to examine the relationships among MFA, health practices during pregnancy, and neonatal outcomes in a sample of low-income, predominantly African-American women and their neonates. MFA was associated with health practices during pregnancy and adverse neonatal outcomes. Health practices during pregnancy mediated the relationships of MFA and adverse neonatal outcomes. The results support the importance of examining MFA in our efforts to better understand the etiology of health disparities in neonatal outcomes. © 2012 Wiley Periodicals, Inc. Res Nurs Health

The purpose of this study was to investigate combat-related post-traumatic stress symptoms (PTSS) and couple relationships in Army couples. US Army combat veteran couples (N = 66 couples) completed self-report questionnaires on couple functioning, coercion, resilience, and PTSS. In 23% of the couples (n = 15), both members had PTSS above the clinical cut-off for suspected Post-traumatic Stress Disorder (PTSD). Higher levels of PTSS were associated with lower couple functioning and resilience. Individuals with high resilience scores reported higher couple functioning scores, regardless of PTSS (p = .004). Future researchers should focus on the role of resilience in relation to couple functioning, and ways to amplify resilience in military couples. Published 2011. This article is a U.S. Government work and is in the public domain in the USA. Res Nurs Health.

The aims of this cross-sectional study were to examine (a) the developmental status and home environments of children (6–24 months) of immigrant women married to Taiwanese men, and (b) the association of child developmental status with parental socio-demographics, maternal language abilities, and home environment qualities. Participants were 61 children and their mothers from China and Vietnam. Data were collected with interviews, home observations, and developmental testing. The children had lower cognitive and language but higher motor and social development scores compared with native norms. Home environment and maternal perceived language ability were positively associated with child development. The association of home environment and maternal language ability with early childhood development was supported for immigrant populations in Taiwan. © 2011 Wiley Periodicals, Inc. Res Nurs Health

In this prospective, descriptive study, we used a repeated-measures design to explore the 24-hour effects of caregiving and positioning on preterm infants' states and the factors associated with state changes. Thirty preterm infants (gestational age 27.6–36.1 weeks) were observed for 3 days in the neonatal intensive care unit to record six states: quiet sleep (QS), active sleep, transition, active awake, quiet awake, and fussy or crying. The occurrences of QS increased when infants received no caregiving, social interaction, non-nutritive sucking (NNS), and were laterally positioned. However, QS significantly decreased and fussy or crying state increased when infants received routine and intrusive caregiving. These results suggest that caregiving, NNS, and positioning should be appropriately provided to facilitate infants' sleep, and reduce fussiness or crying. © 2011 Wiley Periodicals, Inc. Res Nurs Health

The purpose of this study was to examine whether women's experiences of sexual pressure moderated the relationship between sexual empowerment determinants and condom use in a sample of 100 high-risk women, ages 19–25. Five sexual empowerment determinants of condom use were identified from the literature: HIV knowledge, self-esteem, condom self-efficacy, positive attitudes toward condom use, and condom negotiation skills. Linear and logistic regression analyses revealed that positive attitudes toward condom use and condom negotiation skills were significant predictors of condom use. These relationships, however, were moderated by sexual pressure. Findings indicate that women's experiences with sexual pressure have the potential to decrease the likelihood of condom use, even though other sexually protective behaviors may be exhibited. © 2011 Wiley Periodicals, Inc. Res Nurs Health 35:4–14, 2012

Measurement of beliefs about sexually transmitted diseases (STDs) is important to understanding sexual health behaviors. The purpose of this study was to develop and test the psychometric properties of the Representations of STDs (RoSTD) Scale. The RoSTD was developed to measure young women's representations of STDs, and it is intended to be used to measure beliefs about any of the seven most common STDs. Confirmatory factor analysis indicated a four-factor structure for the 40-item RoSTD: Future Perspective, Cause, Psychosocial Consequence, and Identity. Internal consistency for the subscales (measured for each of seven different STDs) ranged from .67 to .93 and 2-week test–retest correlations ranged from .69 to .90. The RoSTD shows evidence of reliability and validity in young women. © 2011 Wiley Periodicals, Inc. Res Nurs Health 35:15–29, 2012

The changes in and relationships among stress, maternal role competence, and satisfaction in the perinatal period were examined using a longitudinal design. A convenience sample of 78 first-time Chinese mothers completed assessments of stress and maternal role competence during pregnancy and at 6 weeks and 6 months postpartum. Maternal stress increased and role competence declined during early motherhood, which highlighted the potential influence of stress on maternal role competence and satisfaction in the perinatal period. Culturally competent health care interventions should be developed to promote maternal competence and satisfaction, in particular during early motherhood, and to equip women with effective coping skills to deal with the stress of maternal role transition. © 2011 Wiley Periodicals, Inc. Res Nurs Health 35:30–39, 2012

Few researchers have longitudinally examined families caring for technology-dependent children at home. We tested a theoretically and empirically based conceptual model by examining family functioning and normalization in 82 mothers (female primary caregivers) twice over 12 months. Time 1 and Time 2 cross-sectional findings were consistent; the only predictor of family functioning was mothers' depressive symptoms. Contrary to the proposed model, normalization, caregiving duration, and home nursing hours were not directly related to family functioning. Baseline family functioning significantly predicted future family functioning. Also, mothers whose children were no longer technology-dependent at Time 2 reported significant improvements in family functioning and normalization. An intervention to address high levels of depressive symptoms of these mothers is essential to optimizing family functioning. © 2011 Wiley Periodicals, Inc. Res Nurs Health 35:40–54, 2012

Veterans' health care has shifted towards outpatient treatment, and because of the high prevalence of chronic illness in veterans, more caregiving has been required of their families. The purpose of this study was to identify predictors of caregiver (CG) strain and satisfaction associated with caring for veterans with chronic illness. Data were collected using telephone interviews of 120 dyads. Strain was associated with helping with instrumental activities of daily living, using counseling and prayer for coping, accompanying veteran to appointments, help/advice from friends, paid help, exercising, and depression. Satisfaction was associated with veteran health, CG social support, age, and depression. Innovative and easily accessible interventions are needed to mitigate sources of strain in CGs of chronically ill veterans. Published 2011. This article is a U.S. Government work and is in the public domain in the USA. Res Nurs Health 35:55-69, 2012

This article presents the efficacy of the recruitment framework used for a clinical trial with sedentary family caregivers of persons with Alzheimer's disease. An integrated social marketing approach with principles of community-based participatory research provided the theoretical framework for organizing recruitment activities. This multi-pronged approach meant that caregivers were identified from a range of geographic locations and numerous sources including a federally funded Alzheimer's disease center, health care providers, community based and senior organizations, and broad-based media. Study enrollment projections were exceeded by 11% and resulted in enrolling n = 211 caregivers into this clinical trial. We conclude that social marketing and community-based approaches provide a solid foundation for organizing recruitment activities for clinical trials with older adults. © 2011 Wiley Periodicals, Inc. Res Nurs Health 35:70–81, 2012

In intervention studies in which randomization to groups is not possible, researchers typically use quasi-experimental designs. Time series designs are strong quasi-experimental designs but are seldom used, perhaps because of technical and analytic hurdles. Statistical process control (SPC) is an alternative analytic approach to testing hypotheses about intervention effects using data collected over time. SPC, like traditional statistical methods, is a tool for understanding variation and involves the construction of control charts that distinguish between normal, random fluctuations (common cause variation), and statistically significant special cause variation that can result from an innovation. The purpose of this article is to provide an overview of SPC and to illustrate its use in a study of a nursing practice improvement intervention. © 2011 Wiley Periodicals, Inc. Res Nurs Health 35:82–93, 2012

Correctional facilities are prime targets for nursing interventions to decrease health disparities, but challenges to post-release follow-up limit use of the longitudinal research designs needed to fully examine intervention effects. Using an adapted version of the Behavioral Model for Vulnerable Populations, we determined predictors of 1-year post-release study retention and subsequent reenrollment an average of 3 years later in 88 mother and child dyads recruited from a state prison nursery. Predisposing characteristics and enabling factors emerged as strong predictors of loss to follow-up. Female research participants can be successfully retained years after release from a correctional facility. Understanding the barriers and facilitators to post-release follow-up supports the creation of theoretically informed strategies to retain formerly incarcerated populations. © 2011 Wiley Periodicals, Inc. Res Nurs Health 35:94–104, 2012