Single-item indicators that ask respondents for their global rating of a specific concept are congruent with nursing's emphasis on wholism and individualism. They allow the subject to take personally salient features of the situation into account when providing a response. The psychometric performance of single-item indicators in published research and in a sample data set using measures of the mother's choice and satisfaction with her employment decision support the validity and reliability of the measures, suggesting that these indicators deserve more attention in nursing research. Recommendations for the use of single-item indicators are provided.The purpose of this article is to explore the use of single-item indicators in nursing research. Single-item indicators can be classed into two fundamentally different groups. In the first group are single-item instruments that were designed as single-item measures. These measures generally are used to obtain the subject's perception of particular dimensions of multidimensional concepts or of an overall concept. Global single-item measures allow the subject to define the concept in a way that is personally meaningful, providing a measure that can be responsive to individual differences. Global single-item indicators require that subjects consider all aspects of a phenomenon, ignore aspects that are not relevant to their situations, and differentially weight the other aspects according to their values and ideals in order to provide a single rating. They represent a holistic way to measure subjects' perceptions of many concepts that are of interest to nursing and are consistent with nursing's perspective. Whenever nurse researchers are interested in individuals' perceptions of a particular situation, perhaps in order to predict their behavior, a global single-item indicator may be a more valid measure of the concept of interest.The second group consists of single-item indicators that were designed as part of a multiitem scale. These single-item measures often are used in a particular study when the multiitem scale does not perform satisfactorily or as proxy measures for a concept that seems important in understanding the findings but that was not measured in a systematic way. The problem with this practice lies in the way multi-item measures are constructed. Items in a multi-item instrument generally are chosen so that each represents one aspect of the concept, with the goal of adequately sampling from the domain of possible items (Nunnally, 1978). Although this strategy is appropriate and important to the construction of a multi-item scale, it means that a composite of the items is necessary in order to validly measure the concept. Using one item originally designed as part of a multi-item scale may not provide a complete picture of the concept. NIH-PA Author ManuscriptA study of single-versus multi-item measures serves as an example of this problem. Bukowski, Ferber-Goff, and Newcomb (1990) measured antisocial behavior in school children with five items, eac...

Project HealthDesign, a multi-year, multi-site project sponsored by the Robert Wood Johnson Foundation with additional support from the California HealthCare Foundation, is designed to stimulate innovation in personal health records (PHRs). Project HealthDesign teams employed user-centered design processes to create designs and prototypes of computer-based applications to support and enhance human health for a wide range of patients, from children with chronic health conditions to elders transitioning from hospital to home. A program design philosophy encouraged designers to envision PHRs as a suite of personal health information management tools, or applications, separate from, but drawing upon, personal health data from a variety of sources. In addition to information contained in one's medical record, these personal health data included patient-supplied clinical parameters such as blood glucose and daily weights; as well as patient-generated observations of daily living (ODLs) - the unique, idiosyncratic cues, such as sleep adequacy or confidence in self care, that inform patients about their abilities to manage health challenges and take healthy action. A common technical platform provided infrastructure services such as data standards and identity-management protocols, and helped to demonstrate a scalable, efficient approach to user-centered design of personal health information management systems. The program's ethical, legal and social issues consultancy identified challenges to acceleration of action-focused PHRs: personal control of privacy choices, management of privacy in home conditions, and rebalancing power structures in shared decision making.

Objective-This 3-year field experiment engaged 60 nurses and 282 patients in the design and evaluation of an innovative home care nursing model, technology enhanced practice (TEP).Method-Nurses in the TEP conditions augmented usual care with a web-based resource (HeartCareII) that provided patients with self-management information, self-monitoring tools, and messaging services.Results-Patients exposed to TEP demonstrated better quality of life and self-management of chronic heart disease during the first four weeks and were no more likely than patients in usual care to make unplanned visits to a clinician or the hospital. Both groups demonstrated the same long term symptom management and health status achievements.Conclusion-This project provides new evidence that it is possible to purposefully create patient-tailored web resources within a hospital portal; that it is hard for nurses to modify their practice routines even with a highly-tailored web resource, and that the benefits of this intervention are more discernable in the early post-discharge stages of care.

The purpose of this study was to design and test the usability of a computer-mediated smoking cessation program for inner-city women. Design and content were developed consistent with principles of user-centered design. Formative and summative evaluation strategies were utilized in its testing. The summative evaluation was designed to test usability in a naturalistic environment. A sample of 100 women who receive care at an inner-city community health center participated in the study. Average time for completing the computer program was 13.9 minutes. Participants reported a high level of satisfaction with usability of the program. Standardized instruments to measure cognitive processes of change related to smoking were completed at baseline and at 1 week. Participants reported a decrease in favorable attitudes toward smoking (P=0.014) and an increase in cognitive change processes at follow-up (P=0.037). These results indicate that interactive computer technology is acceptable to, and potentially useful for, promoting smoking cessation in low-income women.