Implications of a theoretical framework on stress and burnout for the development of graduate nursing education curricula

This study had two purposes: (a) to develop a theoretical framework integrating and synthesizing findings of prior research regarding stress and burnout among critical care nurses (CCRNs), and (b) to validate the theoretical framework with an empirical study to assure a theory/research based teaching-learning process for graduate courses preparing nursing clinical specialists and administrators.^ The methods used to test the theoretical framework included: (a) adopting instruments with reported validity, (b) conducting a pilot study, (c) revising instruments using results of the pilot study and following concurrence of a panel of experts, and (d) establishing correlations within predetermined parameters. The reliability of the tool was determined through the use of Cronbach's Alpha Coefficient with a resulting range from.68 to.88 for all measures.^ The findings supported all the research hypotheses. Correlations were established at r =.23 for statistically significant alphas at the.01 level and r =.16 for alphas.05. The conclusions indicated three areas of strong correlation among the theoretical variables: (a) work environment stressor antecedents and specific stressor events were correlated significantly with subjective work stress and burnout; (b) subjective work stress (perceived work related stress) was a function of the work environment stressor antecedents and specific stressor events, and (c) emotional exhaustion, the first phase of burnout, was confirmed to be related to stressor antecedents and specific stressor events. This dimension was found to be a function of the work environment stressor antecedents, modified by the individual characteristics of work and non-work related social support, non-work daily stress, and the number of hours worked per week. The implications of the study for nursing graduate curricula, nursing practice and nursing education were discussed. Recommendations for further research were enumerated. ^

The usefulness and appropriateness of a federalist perspective as a theoretical construct for the study of government and civics at the secondary level

This dissertation is the formulation of an argument for the incorporation of a liberated federalism perspective as the foundational theoretical construct for the teaching and study of American government and civics at the secondary level. The argument asserts that the history of the nation, in terms of its basic view of government, has developed from a traditional federalist view to a natural rights view. Instruction of government and politics has paralleled that development. The argument further asserts that the current dependence on the natural rights perspective has contributed and helped legitimize, however unintentionally, the excessive levels of individualism, self-absorption, and uncivil behavior that is being experienced in our society today.^ The argumentation follows the dialectic form presented by Hegel of thesis, antithesis, and synthesis. That is, the thesis argues that the traditional federalist perspective would serve as a viable construct for the teaching of government and civics. In this portion of the argument, the republican model of political reality is presented. The antithesis promotes the natural rights perspective and relies on the political systems model for its theoretical approach. Finally, the synthesis argues that a liberated federalism perspective should be the foundational construct. Here, the argument presents its own model as a theoretical construct that is designed to assist teachers and curriculum materials writers in the development of American government and civics lessons and materials. ^

The relationship between the teacher's experience, the teacher's college major, and the teacher's level of education in predicting classroom attitudes in high school science students

A review of the literature reveals few research has attempted to demonstrate if a relationship exists between the type of teacher training a science teacher has received and the perceived attitudes of his/her students. Some of the teacher preparation factors examined in this study include the college major chosen by the science teacher, the highest degree earned, the number of years of teaching experience, the type of science course taught, and the grade level taught by the teacher. This study examined how the various factors mentioned, could influence the behaviors which are characteristic of the teacher, and how these behaviors could be reflective in the classroom environment experienced by the students.^ The instrument used in the study was the Classroom Environment Scale (CES), Real Form. The measured classroom environment was broken down into three separate dimensions, with three components within each dimension in the CES. Multiple Regression statistical analyses examined how components of the teachers' education influenced the perceived dimensions of the classroom environment from the students.^ The study occurred in Miami-Dade County Florida, with a predominantly urban high school student population. There were 40 secondary science teachers involved, each with an average of 30 students. The total number of students sampled in the study was 1200. The teachers who participated in the study taught the entire range of secondary science courses offered at this large school district. All teachers were selected by the researcher so that a balance would occur in the sample between teachers who were education major versus science major. Additionally, the researcher selected teachers so that a balance occurred in regards to the different levels of college degrees earned among those involved in the study.^ Several research questions sought to determine if there was significant difference between the type of the educational background obtained by secondary science teachers and the students' perception of the classroom environment. Other research questions sought to determine if there were significant differences in the students' perceptions of the classroom environment for secondary science teachers who taught biological content, or non-biological content sciences. An additional research question sought to evaluate if the grade level taught would affect the students' perception of the classroom environment. (Abstract shortened by UMI.) ^

The effect of vocational education on high school students in a large urban multicultural school district

The completion of and graduation from high school is a major problem that must be resolved. A 6% random sample of the students (1,059) who were in the 9th grade in Miami-Dade Public Schools, a large urban school district, September 1992, were selected for this study. The sample was divided into 2 groups, advanced academic and general track students. Each group was then divided into vocational and non-vocational. A causal comparative design was used to evaluate the results for graduate vs. non-graduate. The indicators were the program of study, attendance, standardized test scores, grade point average, ethnicity and gender. It was found that both advanced academic and general track students had significantly higher graduation rates at the .01 level when a vocational education program was part of their studies. All of the other indicators did not show any significant differences. If we arc to improve students educational outcomes and reduce the dropout rate, vocational education should be part of every student's education.^

A study of leadership behaviors for Breaking Ranks leaders in public secondary schools

This research will investigate what it will take to develop principals who will embrace the recommendations of reform as proposed by National Association of Secondary School Principals (NASSP, 1996) in the Breaking Ranks document. Breaking Ranks is based on the belief that it is within the dynamics of the school culture that principals must gain insight into strategies for improving the schools for which they are held responsible. Given this context, it is important to examine perspectives that are held by principals who lead schools that embrace the concepts of reform as proposed by NASSP, thereby, could be deemed “Breaking Ranks” schools. It is within these schools that the new role of the principal develops. NASSP has identified seven key recommendations for leadership development; “attributes that need nourishing” (p. 12) for the success of school reform. The seven recommendations are included in Breaking Ranks. ^ The purpose of this study is to identify and describe how principals put the seven recommendations into practice as they function in their schools. In addition, this study will gather information on the characteristics, support, skills, and training these principals identify as critical aspects and components of their success. This is a study of principal leadership at four high school sites where “Breaking Ranks” principals have been identified. ^ This research plan will be designed to utilize an inquiry-based process with a panel of experts and four “Breaking Ranks” principals. This study will describe: (1) how a panel of experts identify what they believe needs to be done in order to put the recommendations of the Breaking Ranks document into practice and their identification of principals who are breaking ranks; (2) how identified principals say they have been able to put the recommendations of the Breaking Ranks document into practice; (3) How both groups identify and describe: (a) the characteristics and behaviors of a “Breaking Ranks” principal; (b) the new leadership skills as described by the seven recommendations identified in the Breaking Ranks document; (c) the support necessary in order to meet the recommendations in the Breaking Ranks document; and (d) The training needed in order to become “Breaking Ranks” principals; and (4) how the process of creating “Breaking Ranks” principals can be described by experts who have studied it theoretically and principals who have demonstrated it in their schools. ^

What secondary English to speakers of other languages (ESOL) teachers know about social and academic language and instructional strategies for limited English proficient students

The purpose of this study was to examine what secondary English to Speakers of Other Languages (ESOL) teachers understand about social and academic language, what instructional strategies they use for Limited English Proficient (LEP) students, and how these concepts are operationalized in their daily practice. ^ This was a mixed method study incorporating both quantitative and qualitative data collection and interpretation. Written questionnaires and individual interviews addressed the questions on teachers' definitions of social and academic language and their strategy use. Classroom observations provided verification of their definitions and their descriptions of instruction for academic language. ^ Findings indicated that teachers' definitions of social and academic language were still developing and that there were ambiguities in identifying examples of social and academic language. The use of graphic organizers or visual supports, groups or peer partners, role play or drama, and modeling were the strategies teachers consistently listed for beginner, intermediate, advanced and multiple level classes. Additionally, teachers' descriptions of their instruction were congruent with what was observed in their classroom practice. ^ It appeared that this population of secondary ESOL teachers was in the process of evolving their definitions of social and academic language and were at different stages in this evolution. Teachers' definitions of language influenced their instruction. Furthermore, those who had clear constructs of language were able to operationalize them in their classroom instruction. ^

Effect of performance feedback on perceived knowledge and likelihood to pursue continuing education

The purpose of this study was to assess the effect of performance feedback on Athletic Trainers’ (ATs) perceived knowledge (PK) and likelihood to pursue continuing education (CE). The investigation was grounded in the theories of “the definition of the situation” (Thomas & Thomas, 1928) and the “illusion of knowing,” (Glenberg, Wilkinson, & Epstein, 1982) suggesting that PK drives behavior. This investigation measured the degree to which knowledge gap predicted CE seeking behavior by providing performance feedback designed to change PK. A pre-test post-test control-group design was used to measure PK and likelihood to pursue CE before and after assessing actual knowledge. ATs (n=103) were randomly sampled and assigned to two groups, with and without performance feedback. Two independent samples t-tests were used to compare groups on the difference scores of the dependent variables. Likelihood to pursue CE was predicted by three variables using multiple linear regression: perceived knowledge, pre-test likelihood to pursue CE, and knowledge gap. There was a 68.4% significant difference (t101=2.72, p=0.01, ES=0.45) between groups in the change scores for likelihood to pursue CE because of the performance feedback (Experimental group=13.7% increase; Control group=4.3% increase). The strongest relationship among the dependent variables was between pre-test and post-test measures of likelihood to pursue CE (F2,102=56.80, p<0.01, r=0.73, R2=0.53). The pre- and post-test predictive relationship was enhanced when group was included in the model. In this model [YCEpost=0.76XCEpre-0.34 Xgroup+2.24+E], group accounted for a significant amount of unique variance in predicting CE while the pre-test likelihood to pursue CE variable was held constant (F3,102=40.28, p<0.01, r=0.74, R2=0.55). Pre-test knowledge gap, regardless of group allocation, was a linear predictor of the likelihood to pursue CE (F1,102=10.90, p=.01, r=.31, R2=.10). In this investigation, performance feedback significantly increased participants’ likelihood to pursue CE. Pre-test knowledge gap was a significant predictor of likelihood to pursue CE, regardless if performance feedback was provided. ATs may have self-assessed and engaged in internal feedback as a result of their test-taking experience. These findings indicate that feedback, both internal and external, may be necessary to trigger CE seeking behavior.

The relationship between spirituality, knowledge and tuberculosis (TB) medication adherence among African Americans and Haitians

Tuberculosis (TB) is an infectious disease and nonadherence to medication can lead to new cases, multi-drug resistant TB, or potential death. Additionally, healthcare professionals and individuals with TB’s knowledge of the disease and medication adherence are crucial for successful completion of medication therapy. Patient education is one of the most important aspects of care provided in healthcare settings (CDC, 1994). TB tends to disproportionately affect minority and economically disadvantaged patient populations. The purpose of this mixed method study was to explore the relationship between spirituality, knowledge, and TB medication adherence among African Americans and Haitians. The primary research question was: What is the relationship between spirituality, knowledge and TB medication adherence among African Americans and Haitians? Quantitative data were gathered from 33 questionnaires and analyzed by two ANOVAs and four chi square analyses. The null hypothesis was not rejected; there was not a statistically significant relationship between spirituality and TB medication adherence (p =.208) among the study’s African Americans and Haitians. Qualitative data concerning participants’ knowledge of TB, gathered from 16 individual interviews further informed this analysis. Secondary research questions examined the role of spirituality, knowledge of TB and medication adherence among African Americans and Haitians. Four common themes emerged across both groups to answer the secondary research questions. Interviews revealed the themes: (a) God is in control, (b) stigmatization of TB, (c) lack of knowledge, and (d) fear of death. The theme lack of knowledge about TB was found to contribute to stigmatization of TB patients. However, in this study stigma and lack of knowledge were related to initial denial of symptoms and delayed diagnosis, but not found to be related to TB medication adherence. This study could help adult educators and health educators enhance their educational interventions, develop a better understanding of adult learning, resulting in early diagnosis and treatment ultimately decreasing transmission of TB, drug resistance, and potential death. Educators should be aware that TB patients’ spirituality may be an important part of how they cope with having TB. A larger scale study, conducted at multiple locations should be conducted to extend the findings of this small scale exploratory study. Further studies should be done to better determine what patient, healthcare provider and health care system factors might mediate relationships that may exist between lack of knowledge of TB, stigma and TB medication adherence.

Secondary school inclusion rates: The relationship between the training and beliefs of school site principals and the implementation of inclusion

Programs require strong support and guidance from those in leadership positions to ensure proper implementation (Fullen, 2001). Consequently, school site principals must rely on the training they have received to support them in making appropriate decisions. It is the school site principal’s leadership that is pivotal in the success of students with disabilities (DiPaola & Walther-Thomas, 2003; Monteith, 2000). In fact, the principal has a moral obligation to provide an environment that supports social justice in schools (Grogan & Andrews, 2002). The inclusion of students with disabilities does just that—it ensures that these students are not segregated to a “separate but equal” education. This study utilized a participant survey to collect data on principals’ beliefs and training in special education. This information was compared to the percentage of time students with disabilities spent with their non-disabled peers in the principals’ respective schools. An analysis was conducted to identify if a linear relationship exists between the selected variables and the inclusion percentages. Open-ended questions were included in the original survey which allowed for a thematic analysis of the responses. These responses were utilized to allow participants to further express their thoughts on the identified variables. Results indicated that there were no statistically significant relationships identified between the beliefs and training of secondary school site principals and the percentage of time that their students in special education spend with their non-disabled peers. Although the original research questions were not supported, further post hoc analysis indicated that the results obtained did support that the principals believed inclusion had a social benefit to students. Additional investigation into the academic benefits of inclusion is still needed. In addition, principals who indicated that they had some type of training in special education indicated a higher percentage that the individual student should be the focal point when making placement decisions. These results support the need for further research in the area of principal preparation programs and their relationships to the daily practice of school site principals.

The effectiveness of a conceptually-based health and wellness course in developing health related factors, exercise self-efficacy and knowledge of health issues and exercise performance among diverse college students

The purpose of the study was to investigate the physiological and psychological benefits provided by a self-selected health and wellness course on a racially and ethnically diverse student population. It was designed to determine if students from a 2-year Hispanic serving institution (HIS) from a large metropolitan area would enhance their capacity to perform physical activities, increase their knowledge of health topics and raise their exercise self-efficacy after completing a course that included educational and activity components for a period of 16 weeks. A total of 185 students voluntarily agreed to participate in the study. An experimental group was selected from six sections of a health and wellness course, and a comparison group from students in a student life skills course. All participants were given anthropometric tests of physical fitness, a knowledge test, and an exercise self-efficacy scale was given at the beginning and at the conclusion of the semester. An ANCOVA analyses with the pretest scores being the covariate and the dependent variable being the difference score, indicated a significant improvement of the experimental group in five of the seven anthropometric tests over the comparison group. In addition, the experimental group increased in two of the three sections of the exercise self-efficacy scale indicating greater confidence to participate in physical activities in spite of barriers over the comparison group. The experimental group also increased in knowledge of health related topics over the comparison group at the .05 significance level. Results indicated beneficial outcomes gained by students enrolled in a 16-week health and wellness course. The study has several implications for practitioners, faculty members, educational policy makers and researchers in terms of implementation of strategies to promote healthy behaviors in college students and, to encourage them to engage in regular physical activities throughout their college years.

Using Critical Race Theory: An Analysis of Cultural Differences in Healthcare Education

This paper is a literature review of articles published from 1992 to 2002 in the American Journal of Health Education using critical race theory as a lens of analysis of culture differences in healthcare.

Secondary Teachers’ Knowledge, Beliefs, and Self-Efficacy to Teach Reading in the Content Areas: Voices Following Professional Development

This study explored 24 content area teachers’ knowledge, beliefs, and self-efficacy about teaching reading in the content areas at the end of a state-wide professional development experience. The findings suggest that the participating teachers held positive beliefs, gained valuable knowledge, and were confident about teaching reading in their content areas.

Differential effects of single -sex versus coed education on the mathematical reasoning ability, verbal reasoning ability, and self-concept of high school girls

This study explored the differential effects of single-sex versus coed education on the cognitive and affective development of young women in senior year of high school. The basic research question was: What are the differential effects of single-sex versus coed education on the development of mathematical reasoning ability, verbal reasoning ability, or self-concept of high school girls?^ This study was composed of two parts. In the first part, the SAT verbal and mathematical ability scores were recorded for those subjects in the two schools from which the sample populations were drawn. The second part of the study required the application of the Piers-Harris Children's Self-Concept Scale to subjects in each of the two sample populations. The sample schools were deliberately selected to minimize between group differences in the populations. One was an all girls school, the other coeducational.^ The research design employed in this study was the causal-comparative method, used to explore causal relationships between variables that already exist. Based on a comprehensive analysis of the data produced by this research, no significant difference was found to exist between the mean scores of the senior girls in the single-sex school and the coed school on the SAT 1 verbal reasoning section. Nor was any significant difference found to exist between the mean scores of the senior girls in the single-sex school and the coed school on the SAT 1 mathematical reasoning section. Finally, no significant difference between the mean total scores of the senior girls in the single-sex school and the coed school on the Piers-Harris Children's Self-Concept Scale was found to exist.^ Contrary to what many other studies have found in the past about single-sex schools and their advantages for girls, this study found no support for such advantages in the cognitive areas of verbal and mathematical reasoning as measured by the SAT or in the affective area of self-concept as measured by the Piers-Harris Children's Self-Concept Scale. ^

Norm-based comparison of SF -12 physical and mental health scale scores for a sample of employees of Broward County

In the new health paradigm, the connotation of health has extended beyond the measures of morbidity and mortality to include wellness and quality of life. Comprehensive assessments of health go beyond traditional biological indicators to include measures of physical and mental health status, social role-functioning, and general health perceptions. To meet these challenges, tools for assessment and outcome evaluation are being designed to collect information about functioning and well-being from the individual's point of view.^ The purpose of this study was to profile the physical and mental health status of a sample of county government employees against U.S. population norms. A second purpose of the study was to determine if significant relationships existed between respondent characteristics and personal health practices, lifestyle and other health how the tools and methods used in this investigation can be used to guide program development and facilitate monitoring of health promotion initiatives.^ The SF-12 Health Survey (Ware, Kosinski, & Keller, 1995), a validated measure of health status, was administered to a convenience sample of 450 employees attending one of nine health fairs at an urban worksite. The instrument has been utilized nationally which enabled a comparative analysis of findings of this study with national results.^ Results from this study demonstrated that several respondent characteristics and personal health practices were associated with a greater percentage of physical and/or mental scale scores that were significantly "worse" or significantly "better" than the general population. Respondent characteristics that were significantly related to the SF-12 physical and/or mental health scale scores were gender, age, education, ethnicity, and income status. Personal health practices that were significantly related to SF-12 physical and/or mental scale scores were frequency of vigorous exercise, presence of chronic illness, being at one's prescribed height and weight, eating breakfast, smoking and drinking status. This study provides an illustration of the methods used to analyze and interpret SF-12 Health Survey data, using norm-based interpretation guidelines which are useful for purposes of program development and collecting information on health at the community level. ^

Forgotten Women: Incarceration and Health Concerns of Minority Women

Paper Presentation