The Mini-Mental State Examination (MMSE), as developed by Folstein, Folstein, and McHugh (1975), is the most widely used of cognitive screening tools. An examination of the psychometric properties of the MMSE seems warranted because the accurate and comprehensive assessment of mental status can yield profound implications for the quality of life of cognitively impaired older adults (Danner, Beck, Heacock, & Modlin, 1993). In clinical practice, nurses must not only use a valid and reliable screening tool for assessing cognitive impairment, but they must also assess the physical disabilities that may affect client performance and, hence, the cognitive impairment score. The purpose of this study is to examine the psychometric properties of the MMSE in comparison to a more standardized tool and to identify implications of the tool for clinical practice.
This study described and compared the childbirth expectations of high-risk and low-risk pregnant women and then examined the influence of anxiety, risk status, and childbirth preparation on these expectations. This descriptive correlational study employed a convenience sample of 75 high-risk nulliparas and 77 low-risk nulliparas. Results indicated that high-risk pregnant women had significantly less positive expectations for their childbirth experience than did low-risk pregnant women. In particular, high-risk pregnant women expected more medical intervention and more difficulty coping with pain during their labor and birth. For both groups of women, anxiety was negatively correlated with childbirth expectations, whereas childbirth preparation was positively correlated with childbirth expectations.
Primary health care (PHC) has been proposed as a key strategy for improving the health of the world community, and nurses are acknowledged as key health-care professionals in meeting this goal. Efforts to have nurses implement PHC policies presuppose that they are knowledgeable about this approach to health care and have positive attitudes. The underlying aim of this study was to develop a measure of knowledge, attitudes, and practices in PHC and to assess the reliability and validity of the measure with a sample of student nurses and faculty in degree and diploma programs. The Primary Health Care Questionnaire (PHCQ) is a three-part self-report measure that provides quantitative data on knowledge and attitudes and qualitative data on practices of PHC. The instrument was developed from a rigorous review of the literature and systematic feedback from two panels (local and national) expert in PHC. Data were collected from 457 students and faculty in one four-year degree program (three sites), one post-diploma degree program, and three diploma programs, in a western Canadian province. Internal consistency reliability estimates using Cronbach's alpha were .76 (knowledge) and .85 (attitudes). Test-retest reliability at two weeks was r = .67 (knowledge) and .76 (attitudes). Content validity was enhanced through a systematic review of the instrument by a two-phase local and a national expert panel. Findings indicated greater knowledge and more positive attitudes among senior compared to junior students, degree compared to diploma students, and faculty compared to students. These findings lend support to the validity of the measure. The qualitative data revealed that learning opportunities related to PHC were built into both the diploma and the degree program through classroom teaching, clinical practice, and written assignments.