Can easy-to-read immunization information increase knowledge in urban low-income mothers

The research article served four purposes: assessment of self-reported academic attainment and comprehension skills of low-income moms who use public urban clinics for immunization. The second goal of the study was to determine their real reading and comprehension capacity. The third goal of the survey, on the other hand, looked for any weaknesses or disparities between the highest finished grade in school and the actual capacity to read and comprehend. Testing the effectiveness of the nursing intervention effectiveness on the level of immunization awareness through the use of easy to read written reading materials formed the final purpose. In a nut shell, the purpose of the research followed a knowledge, attitude and practice, the KAP model, in assessing the impacts of easy to read immunization materials on health outcome in low income urban mothers.

Research questions

What is the average self-report of the maximum completed grade in school for the participating mothers?

What is the average comprehension and the levels of reading in line with the Rapid estimate of Adult Literacy in Medicine measurement and the respective CLOZE technique?

Does a discrepancy exist between the demonstrated reading skills and a self- report of highest completed grade in school?

Do simplified easy to read materials of immunization enhance the knowledge of immunization over the MMR plus the DTaP among mothers with low income?

Research variables - Immunization knowledge formed the independent variable. Dependent variables include the level of education and income.

Study design - The study adopted experimental study design. Study subjects, totaling thirty seven mothers, were randomly selected to either a control group or experimental group. The experimental group was requested to read the simplified immunization brochures contrary to the control group which read the standard vaccine information pamphlet.

Data collection methods - Administration of revised reading material and the standard vaccine information sheets was used in data collection.

Instrument - The instruments on the other hand included; a demographic questionnaire, CLOZE test, Wilson’s Knowledge About Immunization Test for MMR and DTaP and finally use of the REALM technique.

Study findings - The reading skills of the mothers were found to be four to five grades lower than the self-report school completed higher grade reports. On comprehension test, 46% of the mothers showed mixed reactions. A portion either didn’t comprehend the information they read or were in need of more instructions. In summary, the increase in immunization knowledge for both groups was insignificant thus simplification of information does not necessarily mean an increase in parental knowledge.

Study limitations

Small participant size

High illiteracy levels

Conclusion - The study suggests a more active role taking by parents on the need to effectively assist their children in undertaking immunization. To assist their children, knowledge acquisition is key and should be sought from pediatric nurses in urban set up.

Relevance to nursing - The researchers have a relatively solid case for undertaking the research. This is due to the wider measurement instruments. Such parameters like a demographic questionnaire, CLOZE test, Wilson’s Knowledge About Immunization Test for MMR and DTaP and use of the REALM techniques provide evidence base conclusion. Nursing practitioners are able to utilize the evidence in designing nursing interventions to increase immunization uptake.

Driving factors - Low turn-out in immunization uptake particularly among low income mothers in urban set up necessitated the need to revise the standard immunization education materials.

Component of a research article 2

Greco, K. E., Nail, L. M., Kendall, J., Cartwright, J., & Messecar, D. C. (2010). Mammography decision making in older women with a breast cancer family history. Journal of Nursing Scholarship, 42(3), 348-356.

Purpose - The purpose of the study is to explain and describe how women of over 55 years with a breast cancer family history make decisions on screening mammography.

Research questions - Does having a family history of breast cancer increase risk perception of the disease? Is family history of breast cancer a propagating factor for up taking breast cancer screening?

Research variable - mammography decision is independent variable. Family history of breast cancer case and recall mammography test are dependent variables.

Study design - The research is qualitative in nature applying grounded theory. In addition, purposeful sapling generated 23 women of over 55 years old who has one or more of first degree relatives suffer from breast cancer.

Treatment/ intervention - Generate grounded theory to illustrate participants’ mammography process of decision making

Elaborate actions, circumstances and eventual consequences in relation to the screening mammography decision making.

Data collection methods - Administration of open ended interviews was used in data collection among a total of 23 women of ages 55years and above with one or multiple cases of history of breast cancer.

Instrument - Constant comparative analysis served as analysis instrument to identify actions, associated consequences, conditions that influence mammography screening among participants’ decision making instincts.

Study findings - Breast cancer diagnosis of a family member provoked the need to undertake mammography among relatives of the positively diagnosed individual. The action of women thus takes the form of ‘guarding against cancer’ through undertaking mammography, change of lifestyle, frequent checkups and most of all optimism. Recall for test caused worries propagated by delayed results though.

Study limitations - All the study subjects were of white origin. Majority of the study participants had multiple first and second degree relatives which produces contrasting results in decision making from those with only first degree relatives.

Conclusion - The theory of ‘guarding against cancer’ needs more studies among other vulnerable populations to enhance more literature on mammography decision making and influence positive clinical interventions.

Clinical relevance - From undertaking the study, a stronger case is formulated. Through undertaking the research,

Women of over 55 years old from backgrounds of families with breast cancer history are more susceptible to breast cancer thus need prompt screening, counseling and eventual treatment

Driving force - What is driving the need for the study is the reluctance of the women population in making mammography decisions in prevention and cure of breast cancer in families with disease history.

Component of a research article 3

Thacker, K. S. (2008). Nurses’ advocacy behaviors in end-of-life nursing care. Nursing Ethics, 15(2), 174-185.

Purpose – to describe the advocacy behavior perceptions of nurses in the end of life professional nursing practice across intensive care units

Research questions –

Research variables

Study design – comparative descriptive study design was applied.

Sample population - Three regional hospitals formed the study region with 185 to 800 bed capacity. Differences between the experienced, novice and highly expertise nurses were undertaken.

Data collection methods – a formal interview through administration of 1000 fully packed study packets were equally distributed among the three hospitals.

Data collection instruments – Ethics Advocacy Instrument was used.

Findings – approximately 88.4% of experienced and 88.5% of novice reported a positive attitude of advocacy in end- of –life care. This is to mean there are no significant differences in perception in advocacy behavior.

Study limitations – low instrument reliability measure is one of the study limitations. Secondly, convenience sample from varying geographical regions constitutes another limitation, skewed sample groups and the ultimate variations of data collection timing.

Conclusion – end of life nursing practice and advocacy had a positive influence on the perceived advocacy behaviors when taking care of the patients in end of life as depicted by the ABS and APS cumulative scores. The only reported blockade to practice of advocacy was found to be personal fear, physician and social support from the family units.

Relevance to nursing study – solid research does exist to address negligence occasioned by advocacy during care of patients in end of life. Advised Interventions could be undertaken to mitigate the impacts.

Driving factor – knowledge on how to balance emotions and nursing code of conduct at end-of-life care constitute the missing knowledge.