The foc~s of this study was the· female's ret~rn to school and her petception of its effect·on the family system. A tota~ of ·twenty females, selected through a snowball effect,· were interviewed ·in their homes. An interview technique· with demographic questionnaire 'Was utilized. The results of the st.udy indicated that the return to school had various similarities for the female. The suppoit 6f . . ·. spouse and f~mily was viewe~ as crucial. Di.~ision.of · labor d-id not change drastically nor did. t'ime spent with families. Quality of time with family.became more important and.the most positive effect of the return to school was seen as the increased interqction between husband and children. The study has implications for educators, counselors, health car~ providers and the families~ The greatest implication of the. study is the fact that the return to school. was viewed by most women in this study as being positive.

A study of value· orientation in Ufe goals and activity interests was conducted to explore how culture influences thes_e two variables. The relationship between value· orientation and activity interests was also investigated to explore the theoretical framework of human occupation. The human occupation model borrowed the general system theory and assumed that t Man as an open system, interacted with the environment through a process of input, throughput , output and feedback. The environment is physical, social and cultural phenomena. Output information results in purposeful occupation or human occupation. A descriptive survey was designed using two questionnaires to measure the value orientation and activity interests in two cultural g~oups, American occupational therapy students at the Medical College of Georgia, Augusta, GA, U. S. A. and Chinese occupational therapy students at the National Taiwan University, Taipei, Taiwan,· R. 0. C .. The questionnaires were translated into Chinese for the Chinese subjects. The California Life Goals Evaluation Schedules was administered to measure the value orientation in life goals. It included 150 statements categorized into 10 categories: esteem, profit, power, fame, leadership, security, social service, interesting experiences, self expression and independence. Matsutsuyu's Neuropsychiatric Institution Interest Checklist was used to measure activity interests which were categorized with the assistance of occupational therapy faculty at the Medical College of Georgia. The 80 activity items were categorized as active, passive, cooperative, competitive, creative, structured, solitary and group activities. A total.of 35 questionnaires was sent out for the Chinese subjects. All of them were returned , but one of them was not completed. A total of 50 questionnaires was distributed for the American subjects. Thirty·questionnaires were returned, 20 of them were completed. ·Data were analyzed using "STATGRAPHICS" computer package. The statistical tests utilized were_ Student's t-test and Pearson product moment Correlations. Findings indicated that the value orientation in these two groups had .statistically significant differences in fame, power, leadership, security, interesting experiences, and independence. But, there were no significant differences in the activity interests except-in the category of structured activities. A further finding was that the American group in this study tended to prefer passive, cooperative, creative and group activities. The Chinese group tended to prefer passive, and cooperative activities and had no significant preferences in creative versus structured and solitary versus group activities. Considering the correlation of value and activity interests in each cultural group, the results showed that there existed some correlations of value and activity interests. These findings did not supp·ort all the hypotheses, but did provide clues of relationship in value and activity interests.

The purpose of this study was to utilize Herzbe~g's approach to deter~ine the factors within a nursers job and.work environment ·that are most important to the registered. nurse. A convenience sample of 107 registered nurses from two acute care hospitals in the southeast United States participated in this survey and answered questions on the Longest (1974) questionnaire. This instrument is a 6-point Likert type tool designed to.1determine the nurses' pe~ception of the importance of Herzberg's ten motivation/hygiene factors to job satisfaction. A pilot study indicated that the instrument was understandable and easily com~leted. Face and content validity of the instrument were established by a review panel of three experts. A reliability coefficient of 0.5 was obtained. Dat~ analysis showed that these nurses rated both the motivation and hygiene factors as moderately important to very important in terms of job satisfaction. Using the paired t-test to compare mean· ratings of each subject on each factor, there was no significant difference between the means of the hygiene and motivation factors. A comparison of overall .job satisfaction .between medical/surgical nurses and those employed in other clinical areas of practice was conducted. A chi square test produced significant findings between the two practice groups. Nurses in medical/surgical areas reported more dissatisfaction in their jobs than did nurses working non-medical/surgical areas. Recommendations for further resea~ch include ./ further testing and refinement of the Longest questionnaire so that reliability is enhanced and further terminology/vocabulary·specific to the nursing profes~ion can be incorporated.,~ . Results of this study . should be utilized proactively by nurse executives in developing incentives and programs that create an attraction to the nursing field an~ an appealing image of the nurse and her work. Finally, a similar study in other geographical areas with a comparatively larger sample of nurses is suggested.

Maternal-Fetal Bonding and a Previous Spontaneous Abortion. Sharon Sue Elkins. The purpose of this study was to investigate the relationship between the occurrence of a spontaneous abortion in a prior pregnancy and maternal-fetal bonding· in a. current pregnancy. Cranley•s Maternal;;;Fetal Attachment Sca'le and a demographic questionnaire were completed by 236 pregnant women attending either Lamaze classes or a prenatal clinic .. There was no significant difference found in maternal-fetal bonding, measured by the total score on Cranley•s Maternal-Fetal Attachment Sea 1 e, between wome·n who had experienced a spontaneous abortion .in the previous_ pregnancy and women who had not experienced· a spontaneous abortion in the previous pregnancy. However, on ·subscale (2) 11 interaction with the fetus 11 the scores of the spontaneous abortion group. were significantly lower than the scores of the lnonspontaneous abortion group. A1 s o, the spontaneous abortion group had a significantly greater variance than the nonspontaneous abortion group. No relationship was found between the number of weeks pregnant at the time of the spontaneous abortion and maternal~fetal bonding. -. Social class was found to have the greatest effect on maternal-fetal bonding of all the observed variables. Women in higher social classes had significantly higher total scores on the Maternal-Fetal Attachment Scale. Also-, Caucasian women and younger women had significantly \higher total scores on the Maternal-Fetal Attachment Scale. Women who were the greater number of weeks pregnant also had significantly higher scores ·on two of the subscales, 11 i·nteraction with the fetus" and 11 giving of self ...

The purpose of this study was to detennine if there is a relationship between coping behavior used by school-age children during a stressful event in the hospital and subsequent behavior changes after discharge. Seventeen school-age children who were hospitalized for e.lective procedures were observed while receiving pre-operative injections to determine co-ping behaviors used before, during, and immediately after injections. Parents were asked to compl~te the Child ~ehavior Checklist (CBCL 1) questionnaire about their·children's usual behavior prior to hospitalization. Fifteen of seventeen parents r~peated the Checklist (CBCL 2) within one month following their children's discharge. Coping behaviors were initially categorized into nine discreet behaviors. These were later classified into larger groups of positive versus negative and active versus pa~sive behaviors. Analysis of covariance techniques were used to analyze the data. Coping behaviors during the injection were the independent variable and scores on the CBCL 1 were used as the covariate. Posthospitalization behavior scores (CBCL 2) were the dependent variable. Regardless of how coping behaviors were conceptualized (active/passive or positive/negative), there were no significant differences found in children's posthospitalization behavior scores. An analysis of coping patterns before, during, and after injections did, however, reveal some marked trends. Most of the children (65%) were found to behave in positive ways prior to injections. Behaviors were mixed at the time of injections. Immediately after injections, 65% demonstrated negative behaviors, manifested by some. type of withdrawal. Similarly, when behaviors were conceptualized as active and passive, most children were observed to behave actively just prior to injection (77%) and were again mixed during injection itself. Following injections, 82% demon~trated passive patterns. Further study is indicated to determine whether differences in children•s coping behavior during stressful events is related to posthospitalization adjustment~

The purpose of this study .was to systematic·ally examine the needs and emotional distress of family members when an adult relative is hospitalized in an intensive care unit. A modified version of McCubbin and Patterson's (1983) Family Stress Framework provided the theoretical basis for t~e investigation. Using questionnaire/survey· technique~,:data was collected from 32 family members 36 to 96 hours following the admission of an adult relative to an intensive care unit. Two_research questions were po~ed related to need importance as perceiv~d by family members and the perceived degree to which these needs -were met. Using an adapted version of Molter and·Leske's (1983) er~tical Care Family Needs Inventory, family members reported ma:r;1y ·needs·· as very important. These needs. ·appeared to have· constancy in content when visually com~ared to findingi from previous family need-studies.· There were needs which family members perceived as not always met, although, many of the needs perceived as most important were reported by family members as having been met. Employing Pearson's Product Moment Correlation, six research.hypotheses were used to test a theoretical proposition; as the demands of unmet needs .. · increase, distress ·increases in family members within the context of an actual or potential crisis-inducing event. Significant (P_i· os·) pos'itive· correlations· were f·ound between. the demands of unmet needs and emot·ional distress in family . members as mea.sured by Hopkins ··Symptom Checklist ( HSCL) · total-item symptom distress (r=.36) and four HSCL·symptom dimensions to include somatization (r=.33) 1 anxiety (r=.30) 1 depression (r=.40) 1 and interpersonal-sensitivity (r=.37). While there was a positive relationship of c6mparable strength between unmet needs and HSCL symptom dimension· obsessive-compulsive (r=.30) 1 the relationship-was-not statistically sign·ificant.. These findings suggested that family members· of critically .i}l pat·ients were able to ,mobilize resources in meetin'g'·. the needs 'th,ey perceived as ' most important 1 and that' nurses in ·critical care 'settings may be intervening to·· meet ina.riy of .the needs of: family members. Since distres·s was significantly related to unmet -~ ·-· ' ' . ' . . . . . . . . . . . needs I it· may be :,pos.sibl~ .that the :~dapt.iye resources .of .- family members were consumed or depleted in satisfying the needs they perceived as most important. Further, ·the ability .of fa~ily ~embers· to .. mobilize additional resources . ' .. in order to ~eet the ;emaining ·unmet rieed~ was exceeded and distress emerged. Other possib.le explanat·ions may exist since a cause-and-effect relationship bet~een unmet needs and distress cannot be_established based'on the .findings of this descriptive-corr~lational study. It was recommended that nursing interventions in reducing distress and maxi~izing·coping ef:f;ectiveness in· family members when-an adult relative is hospitalized-in an ·intensiva care ·unit~

A ·study of nurses' . attitudes ~award continuing ~ducation w~s ' . conducted to de~ennine .if nurses .t:hink. ~t .participatiOn_ is nece.ssary ' ' - . . . for responsible professio~l practicer. the influence of ~datocy cori-: ·, . ·_ tinuing education requirements on attitUd~s·; the reia~i.onship· b~twe~·" higher acaderriic e~ation · and attitudes; and. to id~ti~ pe~soruil ~d. employrreilt facto~s that influence attitudes toward and __ partic-ipation in- continl,ling education . activities-. 1 · ... - ----~--.-- ----- A descriptive ~ey de~ii?;n usi.Tig a 45·. item -~strurnent sampled · opinions of·registered nurse subjects practicing in 2 selected hos- . ·I· , pitals in 2 southern states; one state . requires mar:tdatory Gohtinuing education for relicensure, one state do~s not. ·A total of .. 200 questionnaires were distributed; 104 completed· questi~r-es, ~er~--.~ eturned by U.S. Mail. Data were analyzed uslnK Sta~istical. ]?ackage for Social Sciences. ·'!he statistical ·tests utilized. were ~lysls· of variance and Pearson Product Moment Correlations. . . Fin~gs indicated that these-registered nurses ·expressed·positive -. . . ~ attitudes toward continuing education· and value participation in order to maintain professional knowledge· and compet~ce. . Negative _attitudes were eXpressed t~ard the ANA. ~f~tion of con~inw_ng· _eduCation, which excludes learning activities for which academic credit is given. No . . ' significant relationship . was found between . attitudes toward _c_?1:1tinulpg · education and mandatory requirements~ Subjects ··frOm. both states eXpressed positive attitudes toward continuing ·education, but negative _at:~ituc1es toward mandatory requirements. . Positive. attitudes were· express~d toward iii. shared responsibility of the nurse and the employer for time and costs of continuing education activities for nurses. Attitude toward continuing education was not shown to be. related to basic educational preparation for nursing . or highest level of educational atta.irnn:mt . . Significant relationships were found between attitude toward continuing education and ·age, position title, and .membership it+ a professional nursing associat~on. .

The purpose 9f this study was to determine the_relationship between self-esteem and l~adership effectiveness among selected nursing leaders. The principal research.question:was:. What is the relationship between self-esteem and 1_ eadershi p effectiveness among· selected nurse administrators? Subjects selected for inclusion in the study were a convenience sampla of 43 administ~ative personnel: Assistant Directors, Supervisors, and H_ead Nurses from three genera-l , acute care hospi ta 1 s in a southeast metropolitan area. This convenience sample was selected because data were available on their leadership effectiveness as perceived by self and one or more· subordinates.· These data were obtained· through the administration of the Leader Effectiveness and Adaptability Description-Self and Other {_LEAD-Self and LEAD-Other} Tool: developed by Hersey and Blanchard. The comBined self and other scores for leadership effectiveness were used as the dependent variable. To obtain self-esteem scores, the Texas Social Behavi9r Inventory (TSBI) developed by Helmreich, Stapp, and Ervin, was administered to the 43 eligible subjects. Thirty-one usable returns were obtained from respondents who thus constituted the sample population. The self-esteem scores obtained from the TSB I were used as the independent var1'ab 1 e. Analy~is of data was conducted. using Pearson product moment coefficients to compute correlations betwe~n self-esteem and leadership v effectiveness. Correlations indicated no systematic relatiqnship between self-esteem and leadership effectiveness as perceived 5y self and others . . in the study sample. Additional findings suggested tflat ther:e was no correlation between self~esteem and self-perceived leadership effect i vene.ss; that nurse 1 eaders' views of their own 1 eadershi p effectiveness did not correlate with·the views of their subordinates; and that there was no relationship between leader self-estee~ and leadership ·effectiveness as perceived by others. These findings suggest that one's rea 1 1 eadershi p effectiveness is somewhere between the 1 eaders •· perceptions of their effectiveness and the followers' perceptions of their leaders' effectiveness.

The purpose of this study was to describe the role of the forensic psychiatric nurse by identifying the job activities performed by the forensic psychiatric nurse, identifying the forensic psychiatric nurse's perceived importance of_each job activity. The· job activities were grouped into three role categories: (1) task role, (2) clinical role, (3) academic role. Using Rheiner's theory, a conceptual model of the role of the forensic psychiatric nurse was constructed and the role performance further delineated in an additional model. The subjects for this study were registered nurses working in forensic psychiatric hospitals in the southeastern United States. The data were collected using a structured questionnaire of job activities of the forensic psychiatric.nurse plus a demographic data sheet. All questionnaires were self-administered. As a result of the analysis of data from those questionnaires returned, 73% of the subjects reported they perform job activities of the task role, 52% perform job activities of the clinical role, and 21% perform the job activities of the academic role. Because of the inconsistency and/or absence of data related to percentage of time invested in each job activity, the percentage of time invested in each role category could not be identified. Respondents indicated that, on :a scale{ of· one to three,-- they perceived the task- role as D most importan:t-:(2 ~-6) ,-.·the cii~icai ·rol~- as mod-erately important (2. 2), a:-nd ·-the- ·ac·ademic ::ron.=! ·as least important (2. 0). iv The findings of this study indicate that the greatest percentage of respondents perform job activities of the task role and perceive this role as most important. A greater percentage of respondents perform job activities in the clinical role than in the academic role. However, they perceive these two roles as moderately important. Since no research has been reported in the area of forensic psychiatric nursing, the implications for future research are vast. The implications for nursing practice are two-fold: (1) awareness of difference in practice, and (2) more emphasis on performance of clinical role.

This study addressed the following research questions: 1). What are the perceived health needs of older warren in the rural environment? 2) Are. there correlations between perceived health needs .and demographic ' ' . . and sociological variables related to. these needs? The descriptive survey utilized a purposive convenience sample of 14 wanen between the I ages of 66 and 79 •. Half were black, half were white. In-hare interviews were c?nducted by the investigator utilizing. a structured . inter...: view questionnaire to collect demographic data and infonnation regarding ·five ·areas of ·health need: . health· condition, functional status,· social interaction, accessibility o~ health care and service· need •. findings revealed that rrore than half the subjects were widowed. Half ·lived alone. ·.The majority ·had inadequate incanes. A relationship between race a.n.d incane, education, self-rated health, life satisfaction, health condition and functional status was noted.. The ma.jority of the health needs. related to physical functioning and chronic' conditions. Blacks and ~ose 75 or over had rrore·chronic conditions, recent illness and physical ·symptoms and used rrore p~escription.drugs than did whites. Blacks and those under 75 reported rrore activity limitations and disability days than whites and those 75 or over. The black ~espo!fdents and. those 75 or over were less healthy than ·the whites and those under 75. The potential for accidental misuse of rredications is increased among this sample as is the possibility of physical· canplications due to inactivity and lack of exercise. A need . for· health educatio:n programs and health prorrotion, maintenance ~d restorative services targeted to this· population ~s noted.