A qualitative case study of the processes of peer education in a young adult tobacco control initiative, Leave the Pack Behind

Peer education involves peers offering credible and reliable information about sensitive life issues through the means of an informal peer group setting (Topping & Ehly, 1998). The purpose of this instrumental case study was to examine the processes of peer education through the exploration of two teams within a young adult tobacco control initiative, Leave the Pack Behind (LTPB). This qualitative case study examined two peer education teams over an eight-month period. Interviews, focus groups and observations were conducted with 12 participants across two peer education teams. Findings show the complexities of the processes of peer education including a connection between the stages of change and the changing role of the peer educator across stages of the empowerment process. Peer education teams and factors in the macro environment were also found to impact the process of peer education. This study provides a new definition for the process of peer education: peer education is a fluid process of knowledge exchange in which peer educators adopt different styles of facilitation as people move through stages of empowerment and change. This study contributes to the academic hterature upon the processes of peer education by providing a definition, a model and an overall understanding through an ecological and empowerment framework. The findings from this study suggest peer educators can be further trained to: use specific peer educational approaches that fit with student smoker's stage of change; better understand their position as a peer educator on the LTPB team; understand the reciprocal relationship between the macro environment and the peer education teams having an effect on one another.

Improving the use of the nursing process: the impact of charting methodology developed from King's conceptual framework on the use of the nursing process

The purpose of this study was to assess the effects of changing a nursing documentation system, developed from King's Conceptual Framework, on the use of the nursing process. The null hypothesis was that there would be no significant increase in the reflection of the use of the nursing process on the nursing care plan or nurses' notes, as a result of using a nursing documentation system developed using King's Conceptual Framework (1981). The design involved the development of a questionnaire that was used to review health records pre and post implementation of a documentation system developed based on King's Conceptual Framework and Theory of Goal Attainment (1981). A Record Completeness Score was obtained from some of the questions. The null hypothesis was rejected. The results of the study have implications for nursing administration and the evaluation of nursing practice. If the use of a documentation system developed from a conceptual framework increases the reflection of the nursing process on the patient's health record, nursing will have the means to measure patient outcomes/goal attainment. All health care organizations and levels of government are focusing on methods to monitor and control the health-care dollar. In order for nursing to clearly determine the costs associated with nursing care, measurement of patient outcomes/goal attainment will need to be possible. In order to measure patient outcomes/goals attainment nurses will need to be able to collect data on their practice. It will be critical that nursing have a documentation system in place which facilitates the reflection of the nursing process within a theoretical framework.

The Importance and achievement of work values and locus of control as factors in work motivation

The present research study examined the relationships in a work motivation context among perceived importance and achievement of work values, locus of control and internal work motivation. The congruence of a work value was considered to be the discrepancy between the importance of a work value and the perceived achievement of that value. The theoretical framework utilized was based on a self-perpetuating cycle of motivation which included the perceived importance and achievement of work values and internal work motivation as separate and distinct, yet interrelated factors. It was hypothesized that individuals who experienced high congruence of work values would experience higher levels of internal work motivation than individuals who had low congruence of work values. It was also hypothesized that individuals who had an internal locus of control would experience more internal work motivation individuals well, the and have higher congruence of work values than who had an external locus of control. As possibility of locus of control as a moderator between importance of work values and internal work motivation was explored. Survey data were collected from 184 managerial level employees of the XYZ company during an ongoing training session. The following instruments were employed to measure the variables: Elizur's (1984) Importance of Work Values, Hunt and Saul's (1985) Achievement of Work Values, Hatfield, Robinson and Huseman's (1975) Job Perception Scale, a modified version of Rotter's (1966) I-E Locus of Control Scale and the Internal Work Motivation Scale (Hackman & Oldham, 1980) which is a part of the Job Diagnostic Survey. The findings indicated that locus of control was not a significant factor in determining congruence between work values or internal work motivation for this sample. Furthermore, locus of control was also found not to be a moderator between the importance of work values and internal work motivation. All individuals in this study had relatively high levels of internal work motivation. However, individuals who had higher congruence of work values did have significantly higher internal work motivation than those who had low congruence of work values for a majority of the 21 values. This was particularly true for the intrinsic values which included responsibility, meaningfulness and use of abilities. In addition, the data were analysed into a hierarchy of needs to indicate possible organizational development or human resource development needs for the XYZ corporation.

Autonomic and Electrophysiological Correlates of Cognitive Control in Aging

This thesis tested a model of neurovisceral integration (Thayer & Lane, 2001) wherein parasympathetic autonomic regulation is considered to play a central role in cognitive control. We asked whether respiratory sinus arrhythmia (RSA), a parasympathetic index, and cardiac workload (rate pressure product, RPP) would influence cognition and whether this would change with age. Cognitive control was measured behaviourally and electrophysiologically through the error-related negativity (ERN) and error positivity (Pe). The ERN and Pe are thought to be generated by the anterior cingulate cortex (ACC), a region involved in regulating cognitive and autonomic control and susceptible to age-related change. In Study 1, older and younger adults completed a working memory Go/NoGo task. Although RSA did not relate to performance, higher pre-task RPP was associated with poorer NoGo performance among older adults. Relations between ERN/Pe and accuracy were indirect and more evident in younger adults. Thus, Study 1 supported the link between cognition and autonomic activity, specifically, cardiac workload in older adults. In Study 2, we included younger adults and manipulated a Stroop task to clarify conditions under which associations between RSA and performance will likely emerge. We varied task parameters to allow for proactive versus reactive strategies, and motivation was increased via financial incentive. Pre-task RSA predicted accuracy when response contingencies required maintenance of a specific item in memory. Thus, RSA was most relevant when performance required proactive control, a metabolically costly strategy that would presumably be more reliant on autonomic flexibility. In Study 3, we included older adults and examined RSA and proactive control in an additive factors framework. We maintained the incentive and measured fitness. Higher pre-task RSA among older adults was associated with greater accuracy when proactive control was needed most. Conversely, performance of young women was consistently associated with fitness. Relations between ERN/Pe and accuracy were modest; however, isolating ACC activity via independent component analysis allowed for more associations with accuracy to emerge in younger adults. Thus, performance in both groups appeared to be differentially dependent on RSA and ACC activation. Altogether, these data are consistent with a neurovisceral integration model in the context of cognitive control.