betty chang | University of California, Los Angeles (original) (raw)
Papers by betty chang
Journal of Comparative Family Studies
The study compared attitudes toward aging and needs of old people of 200 (100 male, 100 famale) c... more The study compared attitudes toward aging and needs of old people of 200 (100 male, 100 famale) college students from Taiwan and 400 (225 male and 175 female) students of Chinese descent living in the United States. Instruments consisted of Attitude Toward Old People’s Scale (Kogan, 1961), and Needs of Old People (Kitty & Feld, 1976). Results indicated that both groups bad favorable attitudes toward aging and needs of old people. However, differences in the Attitude Toward Old People Scale between the TaiwanChinese and the U.S.-Chinese students were seen with the Taiwan students holding less stereotypical views of the elderly. Differences in the Needs of Old People Scale indicated that the U.S.-Chinese students held a more favorable attitude. Significant differences were noted between U.S.-Chinese subgroups in their Attitude Toward Old People and Needs of Old People. Results are discussed in view of the role of increased urbanization, and educational, societal and family support for...
Health Services Research, Dec 1, 1999
Objective. Through a review of the literature, to identify and describe (1) empirical studies of ... more Objective. Through a review of the literature, to identify and describe (1) empirical studies of inpatient nursing care quality that evaluate links between nursing care processes and health-related patient outcomes, (2) nursing care processes for which process-outcome links have been established, and (3) important nursing care processes that have not yet been evaluated. Data Sources/Study Setting. Published empirical studies of inpatient nursing care quality that evaluated links between processes of nursing care and health-related patient outcomes. Study Design/Data Coilection/Extraction Methods. This literature review used a five-step article search and review method. Principal Findings. Of 257 data-based studies of nursing care quality identified, 135 investigated a process-outcome link but only 17 met study inclusion criteria. The literature provides evidence that the quality of nursing care processes affects healthrelated patient outcomes during and after hospitalization. Gaps in the literature that evaluates nursing quality are identified. Conclusions. Although some nursing care processes affect health-related patient outcomes, the full extent of nursing process-outcome links is relatively understudied. Further evaluation of the interrelationships between nursing care processes and outcomes is critical.
Proceedings of the Annual Symposium on Computer Application in Medical Care, Oct 26, 1983
the use of computers as any other innovation, may be conceptualized according to the This pilot s... more the use of computers as any other innovation, may be conceptualized according to the This pilot study investigated typology developed by Houle. In describing differences in nursing expectations regarding adoption of change, Houle indicated that the use of computers between two groups the rate of adoption is correlated with of nurses. Twenty-six volunteers from two favorable exposure. Within any large group, groups identified as pace-setters (Group A) there will be four categories of adopters. and middle-majority (Group B) completed First, there are the innovators who are investigator-constructed questionnaires. usually loners, and the first to explore new ways of approaching a specific problem Results indicated that Group A in or set of problems. Second, there will be general had more positive responses than be pace-setters who are progressive, but Group B. Differences were seen between the who derive much of their stimulation and two groups with respect to their willingness gratification from social interactions and to interact with computers in order to from being among the first to adopt innovaaccomplish 9 common nursing activities. tions. The largest group, the third group, The nature of activities that either group are the middle-majors who follow the pacewas willing to accomplish by computers setters in accepting new innovations. suggests needs in nursing education and Finally, there are the laggards who are the practice. last to adopt, if at all. They may be the "die hards" and "resisters" in a group when Reports of results of computer use in hospitals have included factors such as job 519
Nurses' independent decisions about assessment, treatment, and nursing interventions for ... more Nurses' independent decisions about assessment, treatment, and nursing interventions for hospitalized patients are important determinants of quality of care. Physician peer implicit review of medical records has been central to Medicare quality management and is considered the gold standard for reviewing physician care, but peer implicit review of nursing processes of care has not received similar attention. The objective of this study was to develop and evaluate nurse structured implicit review (SIR) methods. We developed SIR instruments for rating the quality of inpatient nursing care for congestive heart failure (CHF) and cerebrovascular accident (CVA). Nurse reviewers used the SIR form to rate a nationally representative sample of randomly selected medical records for each disease from 297 acute care hospitals in 5 states (collected by the RAND-HCFA Prospective Payment System study). The study subjects were elderly Medicare inpatients with CHF (n = 291) or CVA (n = 283). We developed and tested scales reflecting domains of nursing process, evaluated interrater and interitem reliability, and assessed the extent to which items and scales predicted overall ratings of the quality of nursing care. Interrater reliability for 14 of 16 scales (CHF) or 10 of 16 scales (CVA) was > or = 0.40. Interitem reliability was > 0.80 for all but 1 scale (both diseases). Functional Assessment, Physical Assessment, and Medication Tracking ratings were the strongest predictors of overall nursing quality ratings (P < 0.001 for each). Nurse peer review with SIR has adequate interrater and excellent scale reliabilities and can be a valuable tool for assessing nurse performance.
Proceedings Amia Annual Symposium Amia Symposium, Feb 1, 1999
The movement of health care from hospitals to the community has demanded a major shift in the way... more The movement of health care from hospitals to the community has demanded a major shift in the way in which health care professionals are being taught. This paper describes the collaboration of the Schools of Nursing and Medicine in the use of telehealth technology for the education of health care professionals. The specific aims of the project were to use the technology for the verification of the students' assessment and physical examinations, for the conduct of multi-professional patient rounds, and provision of consultations to professionals at remote sites. Capitalizing on the Schools' previous experience for observing students via computer technology at remote sites, we employed PC-based workstations, specialized peripherals, and Internet connecting protocols to implement a telehealth project for professional clinical education. Initial student, faculty and staff reactions were generally positive. The formal evaluation plan focuses on students, faculty, and staff. Structured questionnaires are used and a comparison of learning by telehealth technology will be made with alternative (more conventional) methods in evaluating knowledge and quality of verification of physical examination findings, and satisfaction with the learning process.
Journal of Gerontological Nursing, Sep 1, 2004
The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 car... more The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 caregivers of family members with dementia. Study participants were assigned by groups to experimental (n = 41) or attention-only control (n = 42) conditions. Initial baseline interview data and narrative transcripts of telephone calls were used in this study. Major perceived reasons for helpfulness were that participants were assisted in sharing thoughts and feelings, expressing feelings of being overwhelmed, discussing physical and psychosocial problems, forgetting the situation, seeking reassurance, and asking for information; several participants perceived the telephone calls to be lacking in helpfulness. Results from this study suggest family caregivers can be helped through a variety of social support mechanisms.
... Katherine L. Kahn, MD, Senior Natural Scientist at RAND and practicing internist and Professo... more ... Katherine L. Kahn, MD, Senior Natural Scientist at RAND and practicing internist and Professor of Medicine at the UCLA School of ... at RAND and practicing internist and Associate Clinical Professor of Medicine at the UCLA School of Medicine and Sepulveda VA Medical Center ...
Cancer is the second leading cause of death among American Indians over the age of 45 years 1, 2 ... more Cancer is the second leading cause of death among American Indians over the age of 45 years 1, 2 . Cancer rates which were previously reported to be lower in Indian populations, have been shown to be increasing in the past twenty years 1, 2 . Reported mortality rates are also ...
The Seventh Annual Symposium on Computer Applications in Medical Care, 1983. Proceedings., 1983
The Nursing clinics of North America, 1999
Older Americans are a rapidly growing segment of our population and present unique health problem... more Older Americans are a rapidly growing segment of our population and present unique health problems. Although life expectancy is increasing and disability is currently decreasing in the elder population as a whole, socioeconomic and environmental resources are lacking for many elders. This lack of resources added to physiologic decline places elders at increased risk for health problems. Nurses need to expand their traditional, individualistic view of health care and incorporate a broader, social perspective in order to provide adequate health care for the vulnerable population.
Nursing diagnosis : ND : the official journal of the North American Nursing Diagnosis Association
To describe the predictive power of a set of the best clinical indicators for the nursing diagnos... more To describe the predictive power of a set of the best clinical indicators for the nursing diagnostic labels self-care deficit (SCD) and impaired physical mobility. Patient assessment data (physical examination and interview) were obtained from 414 hospitalized patients. Patients with the diagnostic label of self-care deficit were significantly older in age, had a greater number of nursing diagnoses, required greater assistance in activities of daily living, and were less mobile than those without the diagnostic label. While 18 of 32 clinical indicators were positively related to self-care deficit, five clinical indicators were sufficient to diagnose SCD. Further development of the method may be useful in improving diagnostic accuracy and efficiency of nursing diagnoses.
Western journal of nursing research, 1998
American journal of critical care : an official publication, American Association of Critical-Care Nurses, 1996
This study examined the validity of medical-record-based nursing assessment and monitoring of sig... more This study examined the validity of medical-record-based nursing assessment and monitoring of signs and symptoms (nursing surveillance) in predicting patients who were admitted to ICUs and those admitted to non-ICUs. The association of this assessment and monitoring with differences in an intermediate patient outcome, instability at discharge, was also explored. Patients admitted to either setting with a diagnosis of acute myocardial infarction, cerebrovascular accident, congestive heart failure, or pneumonia, were included in the study. A secondary analysis was carried out using a subset of data originally collected for a quality-of-care study. Data from the medical records of 11,246 patients (52% female, 48% male) with a mean age of 76.4 years were used in the present study. ICU patients (n = 3969) were found to have a longer length of stay and to be sicker on admission than non-ICU patients (n = 7277). Overall, patients in the ICU received significantly higher nursing assessment ...
Western journal of nursing research, 2004
The aim of this report is to describe the process and feasibility of having elders respond to sta... more The aim of this report is to describe the process and feasibility of having elders respond to standardized questionnaires in an Internet intervention program for caregivers of persons with dementia. Twenty-one persons with dementia (mean 75 years), and their spouse caregivers (mean age of 65 years) used the intervention program and responded to the questionnaires. Results indicated that with adequate support, elderly caregiver participants were able to provide responses to standardized questionnaires comparable to scores found in other caregiver studies using traditional methods. Suggestions are provided for further testing.
Journal of gerontological nursing, 2004
The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 car... more The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 caregivers of family members with dementia. Study participants were assigned by groups to experimental (n = 41) or attention-only control (n = 42) conditions. Initial baseline interview data and narrative transcripts of telephone calls were used in this study. Major perceived reasons for helpfulness were that participants were assisted in sharing thoughts and feelings, expressing feelings of being overwhelmed, discussing physical and psychosocial problems, forgetting the situation, seeking reassurance, and asking for information; several participants perceived the telephone calls to be lacking in helpfulness. Results from this study suggest family caregivers can be helped through a variety of social support mechanisms.
International Journal of Nursing Terminologies and Classifications, 1990
Angeles, School of Nursing. She is the principal investigator of a project entitled, Computer-Aid... more Angeles, School of Nursing. She is the principal investigator of a project entitled, Computer-Aided Nursing Diagnosis. She authored a chapter for the current NANDA proceedings and is an active member of NANDA and SCANDA.
International Journal of Nursing Terminologies and Classifications, 1994
11 customized computer program for the CARIN project, providing a system capable of analyzing pat... more 11 customized computer program for the CARIN project, providing a system capable of analyzing patient problems j+om several perspectives. The system provides an accurate assessment and siibseqiient analysis of patient problems, as well as large data sets. Implications for thefuture of niirsing diagnosis research are discussed.
Healthcare Information Management Systems, 2004
Journal of Comparative Family Studies
The study compared attitudes toward aging and needs of old people of 200 (100 male, 100 famale) c... more The study compared attitudes toward aging and needs of old people of 200 (100 male, 100 famale) college students from Taiwan and 400 (225 male and 175 female) students of Chinese descent living in the United States. Instruments consisted of Attitude Toward Old People’s Scale (Kogan, 1961), and Needs of Old People (Kitty & Feld, 1976). Results indicated that both groups bad favorable attitudes toward aging and needs of old people. However, differences in the Attitude Toward Old People Scale between the TaiwanChinese and the U.S.-Chinese students were seen with the Taiwan students holding less stereotypical views of the elderly. Differences in the Needs of Old People Scale indicated that the U.S.-Chinese students held a more favorable attitude. Significant differences were noted between U.S.-Chinese subgroups in their Attitude Toward Old People and Needs of Old People. Results are discussed in view of the role of increased urbanization, and educational, societal and family support for...
Health Services Research, Dec 1, 1999
Objective. Through a review of the literature, to identify and describe (1) empirical studies of ... more Objective. Through a review of the literature, to identify and describe (1) empirical studies of inpatient nursing care quality that evaluate links between nursing care processes and health-related patient outcomes, (2) nursing care processes for which process-outcome links have been established, and (3) important nursing care processes that have not yet been evaluated. Data Sources/Study Setting. Published empirical studies of inpatient nursing care quality that evaluated links between processes of nursing care and health-related patient outcomes. Study Design/Data Coilection/Extraction Methods. This literature review used a five-step article search and review method. Principal Findings. Of 257 data-based studies of nursing care quality identified, 135 investigated a process-outcome link but only 17 met study inclusion criteria. The literature provides evidence that the quality of nursing care processes affects healthrelated patient outcomes during and after hospitalization. Gaps in the literature that evaluates nursing quality are identified. Conclusions. Although some nursing care processes affect health-related patient outcomes, the full extent of nursing process-outcome links is relatively understudied. Further evaluation of the interrelationships between nursing care processes and outcomes is critical.
Proceedings of the Annual Symposium on Computer Application in Medical Care, Oct 26, 1983
the use of computers as any other innovation, may be conceptualized according to the This pilot s... more the use of computers as any other innovation, may be conceptualized according to the This pilot study investigated typology developed by Houle. In describing differences in nursing expectations regarding adoption of change, Houle indicated that the use of computers between two groups the rate of adoption is correlated with of nurses. Twenty-six volunteers from two favorable exposure. Within any large group, groups identified as pace-setters (Group A) there will be four categories of adopters. and middle-majority (Group B) completed First, there are the innovators who are investigator-constructed questionnaires. usually loners, and the first to explore new ways of approaching a specific problem Results indicated that Group A in or set of problems. Second, there will be general had more positive responses than be pace-setters who are progressive, but Group B. Differences were seen between the who derive much of their stimulation and two groups with respect to their willingness gratification from social interactions and to interact with computers in order to from being among the first to adopt innovaaccomplish 9 common nursing activities. tions. The largest group, the third group, The nature of activities that either group are the middle-majors who follow the pacewas willing to accomplish by computers setters in accepting new innovations. suggests needs in nursing education and Finally, there are the laggards who are the practice. last to adopt, if at all. They may be the "die hards" and "resisters" in a group when Reports of results of computer use in hospitals have included factors such as job 519
Nurses' independent decisions about assessment, treatment, and nursing interventions for ... more Nurses' independent decisions about assessment, treatment, and nursing interventions for hospitalized patients are important determinants of quality of care. Physician peer implicit review of medical records has been central to Medicare quality management and is considered the gold standard for reviewing physician care, but peer implicit review of nursing processes of care has not received similar attention. The objective of this study was to develop and evaluate nurse structured implicit review (SIR) methods. We developed SIR instruments for rating the quality of inpatient nursing care for congestive heart failure (CHF) and cerebrovascular accident (CVA). Nurse reviewers used the SIR form to rate a nationally representative sample of randomly selected medical records for each disease from 297 acute care hospitals in 5 states (collected by the RAND-HCFA Prospective Payment System study). The study subjects were elderly Medicare inpatients with CHF (n = 291) or CVA (n = 283). We developed and tested scales reflecting domains of nursing process, evaluated interrater and interitem reliability, and assessed the extent to which items and scales predicted overall ratings of the quality of nursing care. Interrater reliability for 14 of 16 scales (CHF) or 10 of 16 scales (CVA) was > or = 0.40. Interitem reliability was > 0.80 for all but 1 scale (both diseases). Functional Assessment, Physical Assessment, and Medication Tracking ratings were the strongest predictors of overall nursing quality ratings (P < 0.001 for each). Nurse peer review with SIR has adequate interrater and excellent scale reliabilities and can be a valuable tool for assessing nurse performance.
Proceedings Amia Annual Symposium Amia Symposium, Feb 1, 1999
The movement of health care from hospitals to the community has demanded a major shift in the way... more The movement of health care from hospitals to the community has demanded a major shift in the way in which health care professionals are being taught. This paper describes the collaboration of the Schools of Nursing and Medicine in the use of telehealth technology for the education of health care professionals. The specific aims of the project were to use the technology for the verification of the students' assessment and physical examinations, for the conduct of multi-professional patient rounds, and provision of consultations to professionals at remote sites. Capitalizing on the Schools' previous experience for observing students via computer technology at remote sites, we employed PC-based workstations, specialized peripherals, and Internet connecting protocols to implement a telehealth project for professional clinical education. Initial student, faculty and staff reactions were generally positive. The formal evaluation plan focuses on students, faculty, and staff. Structured questionnaires are used and a comparison of learning by telehealth technology will be made with alternative (more conventional) methods in evaluating knowledge and quality of verification of physical examination findings, and satisfaction with the learning process.
Journal of Gerontological Nursing, Sep 1, 2004
The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 car... more The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 caregivers of family members with dementia. Study participants were assigned by groups to experimental (n = 41) or attention-only control (n = 42) conditions. Initial baseline interview data and narrative transcripts of telephone calls were used in this study. Major perceived reasons for helpfulness were that participants were assisted in sharing thoughts and feelings, expressing feelings of being overwhelmed, discussing physical and psychosocial problems, forgetting the situation, seeking reassurance, and asking for information; several participants perceived the telephone calls to be lacking in helpfulness. Results from this study suggest family caregivers can be helped through a variety of social support mechanisms.
... Katherine L. Kahn, MD, Senior Natural Scientist at RAND and practicing internist and Professo... more ... Katherine L. Kahn, MD, Senior Natural Scientist at RAND and practicing internist and Professor of Medicine at the UCLA School of ... at RAND and practicing internist and Associate Clinical Professor of Medicine at the UCLA School of Medicine and Sepulveda VA Medical Center ...
Cancer is the second leading cause of death among American Indians over the age of 45 years 1, 2 ... more Cancer is the second leading cause of death among American Indians over the age of 45 years 1, 2 . Cancer rates which were previously reported to be lower in Indian populations, have been shown to be increasing in the past twenty years 1, 2 . Reported mortality rates are also ...
The Seventh Annual Symposium on Computer Applications in Medical Care, 1983. Proceedings., 1983
The Nursing clinics of North America, 1999
Older Americans are a rapidly growing segment of our population and present unique health problem... more Older Americans are a rapidly growing segment of our population and present unique health problems. Although life expectancy is increasing and disability is currently decreasing in the elder population as a whole, socioeconomic and environmental resources are lacking for many elders. This lack of resources added to physiologic decline places elders at increased risk for health problems. Nurses need to expand their traditional, individualistic view of health care and incorporate a broader, social perspective in order to provide adequate health care for the vulnerable population.
Nursing diagnosis : ND : the official journal of the North American Nursing Diagnosis Association
To describe the predictive power of a set of the best clinical indicators for the nursing diagnos... more To describe the predictive power of a set of the best clinical indicators for the nursing diagnostic labels self-care deficit (SCD) and impaired physical mobility. Patient assessment data (physical examination and interview) were obtained from 414 hospitalized patients. Patients with the diagnostic label of self-care deficit were significantly older in age, had a greater number of nursing diagnoses, required greater assistance in activities of daily living, and were less mobile than those without the diagnostic label. While 18 of 32 clinical indicators were positively related to self-care deficit, five clinical indicators were sufficient to diagnose SCD. Further development of the method may be useful in improving diagnostic accuracy and efficiency of nursing diagnoses.
Western journal of nursing research, 1998
American journal of critical care : an official publication, American Association of Critical-Care Nurses, 1996
This study examined the validity of medical-record-based nursing assessment and monitoring of sig... more This study examined the validity of medical-record-based nursing assessment and monitoring of signs and symptoms (nursing surveillance) in predicting patients who were admitted to ICUs and those admitted to non-ICUs. The association of this assessment and monitoring with differences in an intermediate patient outcome, instability at discharge, was also explored. Patients admitted to either setting with a diagnosis of acute myocardial infarction, cerebrovascular accident, congestive heart failure, or pneumonia, were included in the study. A secondary analysis was carried out using a subset of data originally collected for a quality-of-care study. Data from the medical records of 11,246 patients (52% female, 48% male) with a mean age of 76.4 years were used in the present study. ICU patients (n = 3969) were found to have a longer length of stay and to be sicker on admission than non-ICU patients (n = 7277). Overall, patients in the ICU received significantly higher nursing assessment ...
Western journal of nursing research, 2004
The aim of this report is to describe the process and feasibility of having elders respond to sta... more The aim of this report is to describe the process and feasibility of having elders respond to standardized questionnaires in an Internet intervention program for caregivers of persons with dementia. Twenty-one persons with dementia (mean 75 years), and their spouse caregivers (mean age of 65 years) used the intervention program and responded to the questionnaires. Results indicated that with adequate support, elderly caregiver participants were able to provide responses to standardized questionnaires comparable to scores found in other caregiver studies using traditional methods. Suggestions are provided for further testing.
Journal of gerontological nursing, 2004
The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 car... more The purpose of this study was to determine the perceived helpfulness of telephone calls to 83 caregivers of family members with dementia. Study participants were assigned by groups to experimental (n = 41) or attention-only control (n = 42) conditions. Initial baseline interview data and narrative transcripts of telephone calls were used in this study. Major perceived reasons for helpfulness were that participants were assisted in sharing thoughts and feelings, expressing feelings of being overwhelmed, discussing physical and psychosocial problems, forgetting the situation, seeking reassurance, and asking for information; several participants perceived the telephone calls to be lacking in helpfulness. Results from this study suggest family caregivers can be helped through a variety of social support mechanisms.
International Journal of Nursing Terminologies and Classifications, 1990
Angeles, School of Nursing. She is the principal investigator of a project entitled, Computer-Aid... more Angeles, School of Nursing. She is the principal investigator of a project entitled, Computer-Aided Nursing Diagnosis. She authored a chapter for the current NANDA proceedings and is an active member of NANDA and SCANDA.
International Journal of Nursing Terminologies and Classifications, 1994
11 customized computer program for the CARIN project, providing a system capable of analyzing pat... more 11 customized computer program for the CARIN project, providing a system capable of analyzing patient problems j+om several perspectives. The system provides an accurate assessment and siibseqiient analysis of patient problems, as well as large data sets. Implications for thefuture of niirsing diagnosis research are discussed.
Healthcare Information Management Systems, 2004