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A predictive model of well-being and self-care was tested with 284 women aged 60-88 living in rural communities in Taiwan. The variables studied were age, marital status, social class, social support, perceived health, self-care agency, self-care behavior, and perceived well-being. The model was tested by path analysis. The parameters of the model were estimated with the maximum likelihood method. In the refined model, chi2 (12, N = 284) = 15.18, p =.23), 33% of the total variance in well-being was explained by self-care behavior, social support, and perceived health; 66% of the total variance in self-care behavior was explained by self-care agency and social support; 49% of the total variance in self-care agency was explained by social support, perceived health, social class, and age; 14% of the total variance in social support was explained by marital status, social class, and age; and 8% of the total variance in perceived health was explained by social support. The goodness-of-fit index was.99, indicating that the refined model fit the data well. The findings of this study contribute to a greater understanding of this predictive model for application with older women in rural Taiwan.

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The purpose of this study was to develop a reliable and culturally meaningful exercise self-efficacy questionnaire for older Mexican American women. Items were derived from a 5-item exercise self-efficacy instrument (Laffrey, 2000; Marcus, Selby, Niaura, & Rossi, 1992) and from focus groups with women in the target population. Content validity of the Spanish-language items was supported by three Mexican American professional women and by five Mexican American nurses. A factor analysis of the 11-item questionnaire revealed one major factor. Internal consistency was shown by an alpha reliability coefficient of .86. Item:corrected scale correlation coefficients ranged from .30 to .70. The mean exercise self-efficacy score was significantly higher for 38 regular exercisers than for 37 non-exercisers. The exercise self-efficacy questionnaire can be used in research with older Mexican American women and should be tested with men and with younger men and women to explore its usefulness with these populations.

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Theories of stage of readiness for change and self-efficacy guided this investigation of (a) performance of habitual physical activity (daily activity and leisure/sport activity), (b) preference for leisure Physical activities, and (c) relationships of age, stage of readiness for exercise, and exercise self-efficacy with habitual physical activity. The sample consisted of 71 community-residing Mexican American women aged 60-87 years. Fifty-six women reported performing at least one leisure/sport activity; the most frequent was walking, reported by 47 women. Fifty-three women stated that walking was their preferred leisure activity. Age, self-efficacy, and stage of readiness accounted for 27% of the variance in daily activity and 32% of the variance in leisure/sport activity. These findings suggest that stage of readiness for change and self-efficacy theories are useful for this population.

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The purpose of this study was to adapt and test the reliability and validity of the Personal Resource Questionnaire 85-Part 2 (PRQ85-Part 2) and Exercise of Self-Care Agency Scale (ESCA) for women in Taiwan. Using a 3-phase study, the instruments were first translated into Chinese, back translated into English, and examined for content validity. In the second phase, the Chinese versions of the instruments were administered to 30 women, aged 60 to 75 years, and 34 women, aged 22 to 38 years. Modifications were made in the wording of items to make them more meaningful for the older women. In phase three, the instruments were administered to 284 women, 60 to 88 years of age. Indices of content validity were 1.0 for both the PRQ85-Part 2 and ESCA. Alpha reliability coefficients ranged from .84 to .90 for the PRQ85-Part 2 and from .86 to .92 for the ESCA. A test-retest reliability coefficient after one week was .80 for the PRQ85-Part 2 and .91 for the ESCA. The findings of this study indicate that both instruments are culturally appropriate for use with women in Taiwan.

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Health and nursing are shifting from acute care to community settings, causing confusion for clients and professionals. Although the holistic nursing perspective has improved care to human beings in interaction with their environment and has moved nursing away from pathology-focused care, the community as the focus of care has not been addressed. This article presents an integrated model of community health that expands holistic nursing to the community as client. The model clarifies nursing care for the individual, family, aggregate, and community. One can focus on any one level, with the awareness that each is part of a unified whole. Holistic community nursing completes the circle of care by moving beyond the particular part to focus on the greatest health for the community. The intent is to help nurses describe their unique areas of expertise within the complex community system and to establish a basis for collaboration and partnership.

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The purpose of this study was to identify content areas specific to community health nursing in doctoral programs throughout the United States. The research foci related to community health nursing were compared with previously identified research priorities in the field. Surveys were sent to 52 doctoral program directors; 23 questionnaires were completed. Telephone interviews were conducted with 16 program directors to clarify responses. Newer programs tended to be more generally focussed and without doctoral specialty courses of any kind. The four programs that identified community health nursing as a specialty within their curriculum were some of the oldest and largest programs in the country.

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Illness and health behavior, social support, and health promotion outcomes (time of recovery from an acute illness episode and psychosocial adjustment to illness) were investigated in 44 adults with psoriasis. Illness behavior was significantly associated with shortened recovery time.

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Although the health benefits of illness prevention and health promotion are accepted, little is known about the reasons for which elderly clients attend public health programs or the benefits they perceived from public health nursing care. This study reports the major reasons for which men and women age 60 and over sought care in a public health nursing program and the major benefits they perceived. The sample included 137 new and 360 returning clients. Responses to open-ended questions were content analyzed into categories of like statements, which in turn were placed into overall groups. The results suggest that most clients realized significant benefits from receiving public health care and were able to articulate these benefits. Eliciting client's perceptions can assist public health nurses to implement and market programs in a way that is acceptable and accessible to the recipients.

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The effects of role identity (occupancy and involvement), sex-role orientation, and role integration on perceived health status and psychological symptoms of women in multiple roles were examined. The sample was comprised of 87 female clerical workers who were mothers with one or more children living at home. The mean age was 37; 47% were married; 44% were black, 24% Caucasian, 15% Asian, and 17% Hispanic. Hierarchical multiple regression analyses were used to determine the significant predictors of perceived health status and psychological symptoms. Role involvement and role integration accounted for 24% of the variance in perceived health. Income and role integration accounted for 29% of the variance in psychological symptoms.

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Despite similarities between the goals of primary health care and public health nursing, several obstacles stand in the way of public health nursing's ability to perform its role in achieving an acceptable level of health for all by the year 2000. The purpose of this paper is to describe the essential components of primary health care and public health nursing, discuss obstacles in the way of public health nursing fulfilling its primary health care role, and to pose solutions at the levels of education, practice, and research for overcoming these obstacles.

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A health needs assessment was conducted with Arab-American immigrants in northern California. Data were obtained from community forums, key informants, the U.S. Census, and from a survey of 47 Arab immigrants. In the community forums, parenting difficulties, marital conflicts, and health risks were identified. Key informants (clergy, community leaders, health professionals) identified mental health problems related to child rearing, referrals for appropriate services, education to assist Arab women interface with the health and education systems, and translation and cultural interpretation for Arab patients and health care providers. Arab patients requesting health care identified referrals for appropriate care, advocacy, education about the medical regimen, and technical assistance obtaining care. Social indicators indicated potential needs for health services for those of lower income. A survey of 47 Arab-Americans indicated that predominant illnesses experienced in the past year were upper respiratory infections, cardiovascular and hypertension, diabetes, and family and social stress. Health-related problems reported most frequently were family stress, adjusting to the U.S., managing acute illness, coping with adolescents, and marital stress. For the most part, this group was satisfied with medical care received and stated that their most important health services were health education, availability of Arab speaking health providers, and referrals for appropriate treatment.

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Health conceptions, perceived health status and health behaviors were compared for 58 adults; 29 with cardiovascular disease and 29 who were healthy. Data were collected by interview. Results indicated similarities in health conceptions and behaviors for the two groups. The cardiovascular patients perceived themselves less healthy overall but when health status was subdivided into dimensions, they perceived themselves less healthy on the clinical dimension only. They were equally healthy on the functional, adaptive, and eudaimonistic (self-actualization) dimensions. These findings underscore the necessity of viewing health within a broader context when providing health care to individuals with chronic disease.

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Described in this paper are the development, reliability, and validity of an instrument, the Laffrey Health Conception Scale to measure individual perceptions of the meaning of health. The instrument measures four dimensions of health conception: clinical, functional/role performance, adaptive, and eudaimonistic. A score is obtained for each dimension as well as a total score for the four dimensions. The high levels of reliability and validity in preliminary testing indicate that the instrument warrants further development and use with different populations.

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Perceived weight, perceived health status, health conception, and health behavior choices were studied in 33 normal weight and 26 overweight adults. Data were collected by interview and by weighting the 59 participants (25 men and 34 women). Results indicated that 92% of the overweight and 36% of the normal weight participants perceived themselves to be overweight. The two groups did not differ significantly in perceived health status, health conception, or health behavior choice. Health conception and health behavior choice were significantly related in both groups. Perceived health status was not related to either health conception or health behavior choice in the overweight group but was significantly related to health conception in the normal weight group. Although the overweight participants were aware that they were overweight, they did not perceive themselves to be less healthy than the normal weight group. Further, their health conceptions were as complex and their behavior choices as health promoting as those of the normal weight group.

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