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Showing papers in "Journal of Nursing Education and Practice in 2016"


Journal ArticleDOI
TL;DR: In this article, the authors describe the meaning of theme and offer a method on theme construction that can be used by qualitative content analysis and thematic analysis researchers in line with the underpinning specific approach to data analysis.
Abstract: Sufficient knowledge is available about the definition, details and differences of qualitative content and thematic analysis as two approaches of qualitative descriptive research. However, identifying the main features of theme as the data analysis product and the method of its development remain unclear. The purpose of this study was to describe the meaning of theme and offer a method on theme construction that can be used by qualitative content analysis and thematic analysis researchers in line with the underpinning specific approach to data analysis. This methodological paper comprises an analytical overview of qualitative descriptive research products and the meaning of theme. Also, our practical experiences of qualitative analysis supported by relevant published literature informed the generation of a stage like model of theme construction for qualitative content analysis and thematic analysis. This paper comprises: (i) analytical importance of theme, (ii) meaning of theme, (iii) meaning of category, (iv) theme and category in terms of level of content, and (v) theme development. This paper offers a conceptual clarification and a pragmatic step by step method of theme development that has the capacity of assisting nurse researchers understand how theme is developed. As nursing is a pragmatic discipline, nurse researchers have tried to develop practical findings and devise some way to “do something” with findings to enhance the action and impact of nursing. The application of a precise method of theme development for qualitative descriptive data analysis suggested in this paper helps yield meaningful, credible and practical results for nursing.

1,164 citations


Journal ArticleDOI
TL;DR: Information is presented about the characteristics of Generation Z students, their views about education and work, information faculty need to understand about this group of students, and implications for nursing educators who are working with Generation ZStudents.
Abstract: The purpose of this paper will be to focus on characteristics of Generation Z students and to provide suggestions for how to create a meaningful learning environment for them. Students who are age 21 or younger, who were born in 1995 or after, are the new Generation Z students. As with any other generational cohort, Generation Z students have their own unique characteristics that influence their approach to education and work. This article presents information about the characteristics of Generation Z students, their views about education and work, information faculty need to understand about this group of students, and implications for nursing educators who are working with Generation Z students.

46 citations


Journal ArticleDOI
TL;DR: The meaning of knowledge in general and nursing knowledge in particular is discussed and the role of nurse educators in delineating the impact of knowledge on nurses’ practice and patients’ outcomes is discussed.
Abstract: The theory-practice gap is a quandary that many researchers have been trying to resolve for several decades in many practice disciplines. Nursing as a practice discipline encounters this predicament due to the fact that nursing knowledge is not yet well-defined. In this paper, we discuss the meaning of knowledge in general and nursing knowledge in particular. We also discuss the role of nurse educators in delineating the impact of knowledge on nurses’ practice and patients’ outcomes. Finally we suggest approaches for nursing faculty to bridge the theory-practice gap to assist students to apply theory to their clinical practice.

36 citations


Journal ArticleDOI
TL;DR: The students perceive structured debriefing as an interactive method which allows the consolidation and systematisation of knowledge, the individual and collective reflection and the structured thought.
Abstract: Background and Objective: Debriefing is the strategy which allows a review of a simulated experience or activities in which the participants explore, analyse and summarise their own action and thinking processes, their emotional state and other information which can enhance their performance in real-life situations. The aim of this study was to analyse the students’ perception of the structured debriefing. Methods: Qualitative research developed with 22 students in their fourth year of the nursing degree course. A voluntary, anonymous and confidential questionnaire was applied. The content analysis was based on Bardin. Results: Five categories resulted from the content analysis: the concept; the attributes; the cognitive impact; the psychosocial and the affective impact. They were all grouped into two dimensions: ‘The perception of Structured Debriefing’ and ‘The impact of Structured Debriefing on Students’. Several suggestions emerged such as the continuity of its use and its application to other contexts. Conclusions: The students perceive structured debriefing as an interactive method which allows the consolidation and systematisation of knowledge, the individual and collective reflection and the structured thought. On the other hand, the students mention that structured debriefing enables them to ask questions more ‘openly’ and to have greater proximity among colleagues, making the communication between all participants easier, inter alia, allowing us to mention the positive impact that it has on building skills.

29 citations


Journal ArticleDOI
TL;DR: The findings are significant as the United States addresses the shortage of primary care providers and models for postgraduate residencies and fellowships for nurse practitioners and other advanced practice registerered nurses emerge.
Abstract: Background/Objective : Although the literature supports that nurse practitioners provide quality primary care resulting in excellent outcomes, the transition from nurse pracitioner education to practice is often difficult. Postgraduate residency programs have been suggested to help new nurse practitioners successfully transition, and studies indicate that most new nurse practitioners are interested in postgraduate residencies; however, little is known about how residencies facilitate transitioning. We sought to understand the experience of nurse practitioners in a residency program in the United States and how the program facilitated their transition to the role of primary care provider. Methods : Reflective journals of 24 Residents who completed the first primary care nurse practitioner residency in the United States were analyzed using Content Analysis. Results : Four to nine themes for each month and one theme for each yearly quarter were identified. Residents went from feeling shocked and overwhelmed to becoming confident, competent primary care providers, committed to underserved populations. Transitioning conditions ( e.g. , on-call experience) and specific facilitators ( e.g. , engaged preceptors) and stressors ( e.g ., managing chronic pain and reqests for opioids) that impacted their transition were also identified. Conclusions : The findings are significant as the United States addresses the shortage of primary care providers and models for postgraduate residencies and fellowships for nurse practitioners and other advanced practice registerered nurses emerge. The findings also represent the first qualitative data that reflect the experience of nurse practitioner Residents and provide rich insight into the overall experience of a one year residency, as well as facilitating and stressful factors. Organizations that are developing or refining nurse practitioner residencies or fellowships should consider these findings and discuss ways to address them with both nurse practitioner Residents and preceptors, as well as program and organizational leadership.

29 citations


Journal ArticleDOI
TL;DR: This 2013 study examined the type of anxiety that is experienced by baccalaureate nursing students, the timing, and severity of anxiety within the program of study, and the results showed that a significant number of nursing students experienced state and trait anxiety at alarmingly high levels compared to the overall norm for college students.
Abstract: Nursing students report higher levels of anxiety than the overall population of college students, in part due to competition for entrance into programs, course structure, long hours of clinical experiences, and working with very sick persons Excessive anxiety in nursing students can have negative health, academic, economic, and patient care outcomes, as well as impact future role transition into professional practice; including burnout and poor job performance This 2013 study examined the type of anxiety that is experienced by baccalaureate nursing students, the timing, and severity of anxiety within the program of study The results showed that a significant number of nursing students experienced state and trait anxiety at alarmingly high levels compared to the overall norm for college students Contrary to the literature, anxiety did not increase in the study population over time spent in the program, rather students beginning clinical nursing courses (midway through the program of study) experienced the most alarming levels of state and trait anxiety In order to recruit and retain healthy nurses essential to the future of the profession; nurse educators, administrators, and policy makers must become aware of the factors contributing to and the implications of anxiety in student and novice nurses Anxiety reduction strategies should be implemented at every level to maintain positive learning and working environments

26 citations


Journal ArticleDOI
TL;DR: AAT increased positive social behaviors resulting in fewer incidents requiring staff intervention among elderly patients with dementia in long-term care facility as well as improving and enhancing socialization behaviors among older adults with dementia.
Abstract: There is a growing population of those with dementia and other cognitive impairments that affect the quality of life. This is attributed to advances in science, technology and medicine leading to reductions in maternal mortality, infectious and parasitic diseases, occupational safety measures, and improvements in nutrition and education of the global population. According to the Administration on Aging (AoA), an agency of the U.S. Department of Health and Human Services in 2000, approximately 605 million people were 60 years or older. By 2050, that number is expected to be close to 2 billion. Animal assisted therapy (AAT) has been used as a therapeutic activity among the elderly to help improve well being and quality of life, but there has been limited research to demonstrate its effectiveness among those with dementia. The purpose of this study was to compare the effectiveness of AAT versus human interaction only on social behaviors and engagement among elderly patients with dementia in long-term care facility. Following random assignment to groups, the participants experienced two visits per week over a two-week time period of either animal therapy visits or human interaction visits. One week with no activities then followed then with alternate animal therapy and human interaction visits. The human interaction visits consisted of conversation and reading from and looking at pictures in a newspaper. During animal visits, participants were encouraged to touch, pet, brush, and talk to the dogs. In this study, AAT increased positive social behaviors resulting in fewer incidents requiring staff intervention. AAT coincides with current goals in long-term care settings - improving and enhancing socialization behaviors among older adults with dementia.

23 citations


Journal ArticleDOI
TL;DR: Short-term health-related study abroad seminars may help students develop self-awareness and cultural openness by providing theoretically based curriculum before departure and while in the host country, including structured reflections and cultural mentoring, engagement with locals, and a balance of challenge with support.
Abstract: Objective : Short-term international health-related study abroad seminars for health-professions students are increasingly popular because of a focus in higher education on global awareness and intercultural competency. This study describes a study abroad strategy to teach students intercultural communication skills and knowledge, and evaluated the effectiveness of a 3-week health-related study abroad program and intercultural competency curriculum in increasing skills and knowledge of health-profession students. Methods : This was a mixed methods study, with a pretest-posttest, within-subjects design, and content analysis of student reflection journals. The curriculum was designed to increase students’ sensitivity to different cultural worldviews and support attitudes such as curiosity and openness that lead to relational abilities such as flexibility and adaptability. Students completed the Intercultural Sensitivity Scale (ISS) and Intercultural Effectiveness Scale (IES) both 3 months prior to and immediately following the trip. Means and standard deviations were calculated and a paired t -test was performed. Results : Qualitative analysis of students’ reflections presented evidence of developing awareness of their own cultural worldview, openness to Indian culture, and the use of skills to develop intercultural competence. There was a non-statistically significant improvement in ISS and IES scores. Conclusions : Students’ reflections demonstrated personal growth through the acquisition of knowledge and skills needed for further intercultural competence development. Students indicated that the curriculum helped them make meaning out of their experiences. Short-term health-related study abroad seminars may help students develop self-awareness and cultural openness by providing theoretically based curriculum before departure and while in the host country, including structured reflections and cultural mentoring, engagement with locals, and a balance of challenge with support.

23 citations


Journal ArticleDOI
TL;DR: HRM systems comprising employee-friendly employment practices and nursing high-involvement work practices may play a significant (yet modest) role in reducing RN turnover.
Abstract: Background: The objective of this study is to explore the nature of the association of discrete systems of human resource management practices and the rate of voluntary turnover of registered nurses (RNs) in a large sample of Canadian acute care hospitals and nursing homes. Turnover of nursing staff is a significant issue affecting healthcare cost, quality and access. The rate of annual turnover for registered nurses has been estimated to be about 20 percent in Canada, with a total cost of almost US$27,000 for each RN. Healthcare organizations that employ large numbers of registered nurses are keen to learn more about the role that organizational policies and practices play in reducing voluntary turnover, including the role of management and its deployment of human resources. The relationship of human resource management (HRM) practices and employee turnover has generally been under-investigated. Three HRM systems, composed of bundles of discrete workplace and employment practices, were assembled in order to assess the relationship of HRM practice systems with the rate of voluntary RN turnover, at the establishment level. The three HRM practice systems constructed are: a technical HRM system that focuses on policies and practices that regulate the employee-employer relationship; a quality-of-worklife HRM system that includes a variety of employee- and family-friendly employment practices; a high-involvement HRM system that involve workplace arrangements that increase commitment, engagement and participation of employees. Method and analysis: A questionnaire was sent to the chief nursing officers of 2,208 hospitals and long-term care facilities in every province and territory of Canada, yielding valid responses from 705 establishments. Each of the three HRM practice systems is estimated at each facility and comprises eight (8) discrete employment and workplace practices. Using estimates of voluntary RN turnover as the dependent variable, the analysis featured a step-wise ordinary least squares (OLS) regression model for each practice system. Results: After controlinf for facility characteristics and local labour market conditions, the quality-of-worklife HRM employment system ( p <.05) and high-involvement HRM works system ( p <.05) are found to be associated with lower voluntary turnover, yet their overall relationship with facility turnover appears to be quite modest. Our technical HRM system is not found to be associated with facility RN turnover. Conclusion: HRM systems comprising employee-friendly employment practices and nursing high-involvement work practices may play a significant (yet modest) role in reducing RN turnover.

21 citations


Journal ArticleDOI
TL;DR: Overall significant improvement in students’ self-assessed confidence from program mid-point to end-point lends support to the efficacy of a clinical teaching model that uses a high dose of simulation to substitute for traditional clinical hours.
Abstract: Objective: This paper describes undergraduate nursing students’ assessment of confidence in clinical practice within a modelthat uses a “high-dose” of clinical simulation to replace 50% of the traditional clinical experience hours in an upper division bachelor’s degree program. We assessed changes in self-reported confidence between the middle and end of a two-year nursingcurriculum. Design: Longitudinal design. We surveyed undergraduate nursing students to assess their perceived self-confidence in carryingout eight core competencies associated with generalist nursing practice with the Assessment of Nursing Education Scale (Robert Wood Johnson Foundation, 2009) at the mid-point (semester 2) and end of program (semester 4). Methods: Data were analyzed Generalized Linear models. To account for changes over time, we included program track(traditional BSN or 15-month accelerated second degree program) and gender (male/female) as co-variates in the models. Results: One hundred and twenty-two students completed the ANE at the two time points. Results for analysis of student confidence over time showed significant improvement on each of the eight domains of generalist nursing practice. There was nosignificant effect of gender or program type on student’s perceived self-confidence. Conclusions: Overall significant improvement in students’ self-assessed confidence from program mid-point to end-point lends support to the efficacy of a clinical teaching model that uses a high dose of simulation to substitute for traditional clinical hours.

21 citations


Journal ArticleDOI
TL;DR: In Sweden, universities are free to design their educational programs since there is no universal curriculum that applies to all the universities; nonetheless, the relatively high level of cultural awareness remained the same for the universities under investigation.
Abstract: Background/Objective: Cultural awareness refers to when someone is aware of his/her own and other people’s cultural values. Academic nursing education should promote students’ ability to analyze, understand, and respect people’s cultural backgrounds and their values to be able provide equitable care in a multicultural society. This essential competence for nursing students can be obtained through learning and practicing to prioritize people’s greatest needs. The aim of this study was to explore students’ cultural awareness related to their nursing education by considering their socio-demographic background. Methods: This quantitative study was conducted by means of a pre-designed Cultural Awareness Scale. In total, 215 students participated in this study. Descriptive statistics were used to report the distribution of the data, and regression analysis was carried out to assess the statistical significance of the association between the variables. Results: The results indicated moderately high cultural awareness among nursing students related to their general education, cognitive awareness, comfort with interaction, and clinical practice/patient care. Nevertheless, no statistically significant correlation was identified between the socio-demographic factors (sex, age, and experience of living abroad). However, being a first generation immigrant was significantly associated with better cultural awareness in terms of Patient Care/Clinical Issue. Conclusions: In Sweden, universities are free to design their educational programs since there is no universal curriculum that applies to all the universities; nonetheless, the relatively high level of cultural awareness remained the same for the universities under investigation. This finding suggests that the importance of cultural awareness in nursing education is recognized in this context.

Journal ArticleDOI
TL;DR: The importance of identifying the conflict resolution strategies being utilized by nurses when they deal with their patients and doctors is determined and it is revealed that the overall use of conflict Resolution strategies is significantly related to both patients andDoctors.
Abstract: Background: Conflict is inevitable and can be found in all settings. It can co-exist between and among health care professionals such as doctors and nurses and their patients. The roles of the nurses in each scenario and the kind of strategies they utilized also vary. This study aimed to determine the conflict resolution strategies of nurses in a selected government tertiary hospital in the Kingdom of Saudi Arabia. Methods: Utilizing a Descriptive Correlational Research Design, 78 nurses were asked to identify their conflict resolution strategies during their day to day interaction with the patients and doctors through a 20-item questionnaire. This study was conducted in a government tertiary hospital specializing in maternity and pediatric care with 310 beds in the East of Riyadh. Results: Findings yielded a high utilization of conflict resolution strategies by nurses with patients. Accommodating (61.5%; n = 48) was ranked number one as nurses used this strategy in dealing with patients. Secondly, collaborative (60.3%; n = 47), the third is both compromising and avoiding at (57.7%; n = 45); and the least in rank is competing (56.4%; n = 44). Nurses utilized the following conflict resolution strategies with doctors such as: (1) competing (43.6%; n = 34), (2) both compromising and avoiding (42.3%; n = 33), (3) collaborative (39.7%; n = 31), and (4) accommodating (38.5%; n = 3). It shows that the number 1 priority for conflict resolution strategies is “accommodating” for patients which was regarded the least for the doctors. On the other hand, the least strategy “competing” with patients is the number 1 strategy of nurses with doctors. There is a significant relationship between nurses’ use of conflict resolution strategies consistent at collaborative with patients and doctors and their age. Findings further reveal that the overall use of conflict resolution strategies is significantly related to both patients and doctors. There is a significant relationship between nurses’ use of conflict resolution strategies at compromising with doctors and their nursing qualification. There is a significant relationship between nurses’ use of conflict resolution strategies (collaborative) with patients and their current nursing experience. The overall use of compromising as a strategy is significantly related to doctors. There is a significant positive correlation between the nurses’ scores of conflict resolution strategies for both patients and doctors. On the one hand, there is no significant difference relation between nurses’ use of conflict resolution strategies with patients and doctors and their socio-demographic variables (age, years of nursing experience) except nursing qualification. There is a significant difference between nurses’ use of conflict resolution strategies (avoiding) with patients and doctors and their qualifications. Conclusions: Consequently, conflict is inevitable and is still growing in healthcare. We have determined the importance of identifying the conflict resolution strategies being utilized by nurses when they deal with their patients and doctors. Nurses can safely identify conflict and implement systems for its management. Nurses and doctors must establish positive collegial relationships. The active management of conflict is an important aspect towards a positive collegial relationship. Doctors and nurses can effectively manage conflict to produce positive outcomes for patients.

Journal ArticleDOI
TL;DR: In order to reduce the prevalence of workplace bullying among nurses working in tertiary hospitals in Enugu, the nurses do not only require education on what constitutes workplace bullying, they also need adequate information about how to communicate respectfully with each other in the workplace.
Abstract: Background : Workplace bullying among nurses has been identified as a major contributor to poor attitude towards duties, and reduction in overall productivity. This study examined the occurrence and effects of behaviors that constitute workplace bullying among nurses in tertiary hospitals in Enugu, Southeast Nigeria. Methods : Data were collected from 286 nurses working in 4 tertiary hospitals in Enugu State, Southeast, Nigeria, using a modified 22-item Negative Acts Questionnaire (NAQ) for measuring bullying behaviors in the workplace, and a 26-item General Health Questionnaire (GHQ) for measuring the impact of bullying. Results : The prevalence of workplace bullying among nurses working in tertiary hospitals in Enugu is reported to be high. Data provided by the respondents in relation to prevalence was greatly affected by poor knowledge of what constitutes workplace bullying among nurses. A total of 82.6% of the respondents reported that they have been victims of workplace bullying. Behaviors observed most (on daily basis) over the 6-month period preceding the study include gossiping (22.0%), backbiting (18.7%), excessive workload without supervision (17.3%), failure to respect privacy (13.1%), intimidation (12.6%), humiliating someone in front of others including patients (12.1%) and unfair allocation of job and postings (8.4%). The main perpetrators of workplace bullying were identified by 76% of the respondents as senior nurses overseeing hospital wards/units, 84.1% of the respondents also indicated that nurses in junior cadre were the main targets. Female nurses were identified as the main perpetrators and targets of workplace bullying among nurses by 93.9% and 92.1% of the respondents respectively. The reported impact of workplace bullying among nurses include anger (50.5%), an intention to travel abroad because of the feeling that the prevalence is less there (33.6%), anxiety (21.5%), frustration (16.8%) and strained social relationships amongst colleagues (11.2%). Conclusions : Workplace bullying (mainly from senior nurses to junior ones) is highly prevalent and has significant impact on the health, job performance and retention rate of nurses working in tertiary hospitals in Enugu. Poor knowledge of what constitutes workplace bullying among nurses, relational aggression and female oppression have great implication in the prevalence, nature of bullying behaviors exhibited, characteristics of the perpetrators and the outcome of workplace bullying among the nurses. In order to reduce the prevalence of workplace bullying among nurses working in tertiary hospitals in Enugu, the nurses do not only require education on what constitutes workplace bullying, they also need adequate information about how to communicate respectfully with each other in the workplace. Nurse leaders and hospital administrators should also constitute disciplinary committees, encourage nurses to report the incidence of workplace bullying, punish perpetrators as well as protect those who report the cases from further attacks of bullying through establishment of policies to regulate interpersonal relationships among nurses.

Journal ArticleDOI
TL;DR: Positive impacts of workplace incivility on patient care included breakdown in communication, often involving nursing staff avoiding uncivil coworkers, and the importance of implementing interventions designed to reduce incivilities in military healthcare settings.
Abstract: Incivility in the workplace is associated with decreased quality of performance In a healthcare setting, decreased performance diminishes the opportunity for excellence in patient care and introduces potential threats to patient safety and wellbeing Affected individuals and those who witness the most severe form of workplace incivility, including bullying, are likely to experience negative psychosocial consequences such as depression, substance abuse, and suicide The degree to which different forms of incivility persist in healthcare settings is unclear and as a result, the sources of workplace incivility and its effects on nursing staff and their patients are also not well established This study explored the prevalence of eight different forms of incivility toward nursing staff, profiles of the main offenders of incivility, and the impact of each behavior on patient care from the perspective of a sample of nursing staff affiliated with one Military Health System (MHS) hospital Condescending language (56%) and impatience with questions (58%) were most commonly reported as occurring sometimes or often in the workplace Nursing peers were cited as the most common source of incivility (33%) Negative impacts of workplace incivility on patient care included breakdown in communication, often involving nursing staff avoiding uncivil coworkers Findings suggest the importance of implementing interventions designed to reduce incivility in military healthcare settings

Journal ArticleDOI
TL;DR: It can be concluded that adjustment to retirement was affected by the retirees’ gender, marital status, level of education, type of job before retirement, job condition, and place of work.
Abstract: Background and aim : The loss of work through retirement is one of the major adjustments for individual ages. For many, this is the first indicator of the impact of aging. Aim of the study was to identify factors affecting adjustment to retirement among retirees' elderly persons. Method : Cross-sectional descriptive design was adopted. This study was conducted at Waiting Lounge of El Ahly Bank, Nasser Bank, and Faculties of Commerce, Medicine, Science and Veterinary affiliated to Mansoura University, Dakahlia Governorate, Egypt. 210 retirees' elderly person who represented the participants of the current study retired since one year and more. Data was collected using Self-Administered Questionnaire, Retirement Adjustment Scale, and Retirement Resources Inventory. Results: None of the retirees' elderly (100.0%) attended a preparation program for retirement. The total mean score of retirement adjustment scale correlated significantly and positively to the total mean score of the physical, financial, social, and mental resources. Additionally, there is a significant relation between preparation for retirement and the total mean score of retirement adjustment scale. Conclusion: It can be concluded that adjustment to retirement was affected by the retirees’ gender, marital status, level of education, type of job before retirement, job condition, and place of work. In addition, adequate resources as physical, financial, social support and mental capacity are associated with better adjustment to retirement.

Journal ArticleDOI
TL;DR: Empowerment of hemodialysis patients and their caregivers can assist them with the management of health-related problems and improve their self efficacy and decrease the burden level of the caregivers so the study recommended that before the beginning of dialysis therapy, health professionals should identify and explore patient needs and potential caregiver in the family of patient.
Abstract: Background : Hemodialysis is a prolonged process that affects all life aspects of the patient and his family including the physiological, psychological, functional ability, and lifestyle changes. The aim of this study was as to evaluate the effect of family centered empowerment model on hemodialysis patients and their caregivers. Methods : Quasi experimental design was used in this study. This study was conducted in dialysis unit in Tanta University Hospital. Fifty hemodialysis patients and fifty caregivers attending the previous setting were included in the study. Tools of the study: Five tools were used in this study; Pre-test data were obtained by using two socio-demographic data form for patients and caregivers and three questionnaires tools for self-efficacy and burden level. Empowerment intervention was given to the studied subjects then post test data was collected. Results : The majority of the studied subjects obtained low score level of self-efficacy in relation to (autonomy, self - integration, problem solving ability and seeking social support category) pre-empowerment intervention, while post empowerment, none of them fall in the same category and more than two thirds of them had high score regarding level of autonomy, level of self integration and problem solving ability. Most caregivers have low self efficacy pre empowerment. While post empowerment, more than two thirds and nearly one third of them fall in moderate and high level respectively. All caregivers obtained severe burden level pre empowerment while post empowerment 66% falls in mild to moderate level. Conclusions and recommendation : Empowerment of hemodialysis patients and their caregivers can assist them with the management of health-related problems and improve their self efficacy and decrease the burden level of the caregivers so the study recommended that before the beginning of dialysis therapy, health professionals should identify and explore patient needs and potential caregiver in the family of patient and established empowerment programs to prepare them for the task to be carried out, mainly in the initial phase of their activities.

Journal ArticleDOI
TL;DR: Staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students with emphasis on the RN’s perceptions of the role are explored, specifically the preparation for, support in, and understanding of what the role entails.
Abstract: Preceptorships are an indispensable part of undergraduate clinical education and are prevalent among schools of nursing. However, there is wide interpretation and implementation of preceptorships which leaves many facets of the preceptor role poorly understood. Research has suggested preceptors experience several benefits from serving; however, the role has also been described as one leading to overload, conflict, and burnout. There is a lack of studies exploring preceptor role functions from the perspective of those who serve in it. The purpose of this qualitative study was to explore staff nurse experiences as preceptors to undergraduate, pre-licensure nursing students with emphasis on the RN’s perceptions of the role, specifically the preparation for, support in, and understanding of what the role entails. Focus groups were used to collect data. Transcripts were analyzed using conventional content analysis. Findings suggest that the primary role function is Protector, with Socializer and Teacher as secondary role functions. Preceptors in this study described a strong empathetic drive to protect students from negative experiences, to protect patients from harm, to protect their own professional identities, and to protect the nature of the nursing profession. Within each role function, there are specific behaviors in which the preceptor engages to varying degrees depending on the needs of the individual student. Findings have implications for continued development of the preceptor role.

Journal ArticleDOI
TL;DR: The study demonstrates the effectiveness of health educational intervention guidelines in improving T2DM patients’ knowledge, self-management behaviors and self-care practices through provision of sound information and fostering their self-efficacy.
Abstract: Background: Diabetes is a common costly condition associated with significant morbidity and mortality. The process of teaching individuals to manage their diabetes had been considered an important part of the clinical management. The goals of self-management education are to optimize metabolic control, prevent acute and chronic complications, and optimize quality of life; Aim: To evaluate the impact of a health education intervention guidelines for T2DM on Patients’ knowledge, self-efficacy, and self-management practices. Methods: Design: quasi-experimental uncontrolled design on 50 patients evaluated at pre-intervention, post-intervention, and 6-month follow-up. Setting: The study was carried out in the outpatient clinics of Endocrinology and Metabolism at Zagazig University Hospital. Tools: three tools were used, 1st tool was an interview questionnaire to assess socio-demographic data and patients’ knowledge, self-efficacy scale and patients’ self-reported self-management behaviors concerning self-care practices. Results: There were statistically significant improvements in patients’ knowledge ( p < .001), self-efficacy ( p < .001), and selfmanagement ( p < .001), which continued through follow-up. Multivariate analysis showed that the knowledge and self-efficacyscores positively predicted the scores of self-management. Conclusions: The study demonstrates the effectiveness of health educational intervention guidelines in improving T2DM patients’self-management behaviors and self-care practices through provision of sound information and fostering their self-efficacy. The slight decline at the follow-up phase indicates the need for periodic booster doses of the intervention. Therefore, the study recommends generalization of such educational guidelines in all health care settings providing services to T2DM patients. Such guidelines should particularly address the patients with low educational attainments, long history of T2DM, and those residing in rural areas. More research is needed to investigate the long-term effect of such educational interventions.

Journal ArticleDOI
TL;DR: A validated survey tool that concisely measures nurses’ values, knowledge and implementation of evidence-based practice (EBP) is needed to develop needs-based curricula for continuing nurse education.
Abstract: Objective: A validated survey tool that concisely measures nurses’ values, knowledge and implementation of evidence-based practice (EBP) is needed to develop needs-based curricula for continuing nurse education. Purpose: Develop a succinct measurement instrument, the Quick-EBP-VIK, assessing nurses’ values, implementation and knowledge of EBP, to establish face and content validity. Methods: In Phase I-Review of the existing literature to establish topic domains, developed and refined questions. Phase II established face validity, and Phase III content validity using EBP experts as raters. Results and conclusions: Twenty-five questions met the clarity and relevance criteria with content validity indices of > .80. Questions were critically evaluated by EBP experts from both academic and clinical settings across the country for relevance and clarity and revised when indicated. The use of EBP experts and content validity indices resulted in a final survey instrument, measuring nurses’ values, knowledge and implementation of EBP.

Journal ArticleDOI
TL;DR: Investigating factors associated with fear of childbirth (FOC), and its effect on women’s preference for elective cesarean section (CS), revealed that 47.8% of pregnant women preferred elective CS, and childbirth factor was the highest factor associated with FOC.
Abstract: Background and objective : Childbirth fear is a major problem for women, as it results in avoidance of maternity, women & fetal stress and raise in women requests for cesarean delivery. The aim of this study is to investigate factors associated with fear of childbirth (FOC), and its effect on women’s preference for elective cesarean section (CS). Methods : Design: Cross sectional descriptive design. Setting: Study conducted at five obstetrical and gynecological private clinics in El-Mahalla El-Kobra city. Subjects: A purposive sample consisted of 205 pregnant women selected according to the inclusion and exclusion criteria. Tools: Three tools were used for data collection (Structured Interview Questionnaire, Melender (2002) Questionnaire to measure childbirth fear associated factors and Childbirth Attitudes Questionnaire). Results : Revealed that 47.8% of pregnant women preferred elective CS. Fear of vaginal birth, safer mode for the baby, no influence on postpartum sexual life and pain associated with delivery were the most reasons for CS preference. Childbirth factor was the highest factor associated with FOC with mean ± SD 12.439 ± 3.949. Fear of pain, episiotomy and lacerations were the highest sub factors representative for childbirth factor (89.3%, 83.9%, and 82.4% respectively). The highest cause of FOC was negative mood with mean ± SD 13.302 ± 3.500. 50.0% of pregnant women with high FOC preferred CS. Conclusions and recommendations : Childbirth factor was the highest factor associated with FOC. Fear of pain, episiotomy and lacerations were the highest sub factors representative for childbirth factor associated with FOC. Pregnant women with high fear of childbirth preferred cesarean section. Recommendations: Undertaking information, education and communication programs to increase awareness of the women, husbands, health providers and society about childbirth fear and its effect on cesarean section preference in order to decrease elective cesarean section rate.

Journal ArticleDOI
TL;DR: The investigators sought to assess the perceptions of nurses with regard to using the SBAR tool for hand-off communication at a cancer hospital in Qatar and found that SBAR is safe and efficient, and it can be recommended for all healthcare settings.
Abstract: Background : Communication failure has been reported in the literature as the primary source of medical errors and patient harm. Among various methods of handoff communication, Situation, Background, Assessment, and Recommendation (SBAR) is a reliable and efficient framework that nurses worldwide use. The investigators sought to assess the perceptions of nurses with regard to using the SBAR tool for hand-off communication at a cancer hospital in Qatar. Methods : A cross-sectional descriptive study was carried out to assess perceptions regarding the use of SBAR among 117 staff nurses working in inpatient units of National Center for Cancer Care and Research (NCCCR). A handover evaluation tool was used, enabling nurses to self-report their perceptions. Results : The majority of staff nurses opined that SBAR followed a logical sequence, with a reduction in communication errors after its use. Also, 53.9% of the nurses reported that they would always recommend the SBAR framework in other areas. The majority (87.3%) of the nurses had good perceptions regarding the use of the SBAR framework, and none of them had poor perceptions regarding the same. The mean duration of handovers reduced after their use of SBAR. There was no association between perceptions and demographic variables. Conclusions : SBAR is safe and efficient, and it can be recommended for all healthcare settings. The SBAR communication technique provides an organized logical sequence and improved communication that has been proved to ensure patient safety.

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TL;DR: The study found that respondents had minimal and limited disaster experience, as reflected in their low levels of confidence after being involved in real disaster events.
Abstract: Background and objective : The Kingdom of Saudi Arabia has recently faced many man-made and natural disasters. Since disaster victims are transferred to hospitals, nurses are among the first health care providers to respond to an emergency. Therefore, to improve disaster management it is essential to examine the current state of nurses’ preparedness. The aim of the study was attempts to determine the disaster preparedness of emergency nurses in Saudi Arabia. Methods : The study data were collected using two survey tools from the research literature, and 72 participants were recruited from two government hospitals in Riyadh. The response rate was 31.7%. Results : The study revealed that most nurses understood their roles after reading the disaster plan. Although half of the respondents had completed training in the previous 12 months, only 60% answered the item related to confidence after training. There was a significant difference between the confidence of those who had participated in a disaster or mass casualties training program and that of those who had not. Only 26% answered the item related to confidence after being involved in a real disaster, and no significant difference was found between the confidence of those who had attended a real disaster or mass casualties event and that of those who had not. Conclusions : The study found that respondents had minimal and limited disaster experience, as reflected in their low levels of confidence after being involved in real disaster events. This highlights the need for continued efforts to expand disaster training and ensure that nurses are appropriately prepared.

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TL;DR: Tailored assignments from midwives enhanced students’ learning and apprehensive relationships with midwives inhibited learning, and classical grounded theory was used to analyze longitudinal data from 15 individual and three focus group interviews of 10 postgraduate midwifery students in Norway.
Abstract: Midwives are responsible for the well-being of women and babies during labor and birth. Learning midwifery is complex and challenging, and how students are welcomed into the labor wards affects learning. This study aimed to identify and explain the conditions that affected midwifery students’ learning in labor wards and their consequences. We used classical grounded theory to analyze longitudinal data from 15 individual and three focus group interviews of 10 postgraduate midwifery students in Norway.The key conditions identified that affect the learning outcomes of midwifery students were related to the students’ relationships with midwives, the students themselves and the learning arena. Tailored assignments from midwives enhanced students’ learning and apprehensive relationships with midwives inhibited learning. Midwives played a key role in facilitating students’ learning by tailoring their learning opportunities and debriefing after challenging incidents and thus smoothed how students’ emotions affect their self-esteem and learning process.

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TL;DR: Future research will need to focus on addressing the challenges acute care nurses face when practicing in high acuity areas heavily influenced by a biomedical approach to care, so that nurses may liberally engage in caring science inclusive of a philosophical worldview.
Abstract: Nursing in the 21st century continues to challenge point of care nurses working in high acuity areas. The complexities of patient care are multifaceted, advances in technology, environmental and sociopolitical influences often impede nurse presence at the bedside. Ideally, the intention for these nurses is to broaden their knowledge and ways of knowing beyond the physiological needs of the client, therefore, circumventing biomedical control over their work towards that of a caring science approach. Using Arksey, and O’Malley’s five-stage framework, 1) identify the research question, 2) identify relevant studies, 3) study selection, 4) charting the data and 5) collating, summarizing and reporting the results. Eleven papers written in English were selected to examine the research question, “How does the dominance of biomedical approaches to care influence point of care nurses’ presence in high acuity areas?” Qualitative software-ATLAS.ti version 7 was used for data collection and analysis; two main themes emerged from the literature: 1) empowered caring, and 2) incommensurable closeness-distance. Future research will need to focus on addressing the challenges acute care nurses face when practicing in high acuity areas heavily influenced by a biomedical approach to care, so that nurses may liberally engage in caring science inclusive of a philosophical worldview and nurse presence regardless of their practice environment.

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TL;DR: The interrelatedness of the systemic transfer of training model is confirmed and the importance of considering all elements that influence learning transfer when planning clinical placements of students is emphasised.
Abstract: Supportive work environments promote professional socialisation and integration of theory in practice. Qualitative data generated through four nominal groups were deductively analysed using the components of the systemic model of training transfer. This article reports on the perspectives of nurse clinicians, clinical facilitators, and students from the training institution regarding aspects of student characteristics, educational design, transfer climate and work environment that influence nursing students’ transfer of learning in primary healthcare (PHC) facilities. A perception exists that students lack the desire to use knowledge and skills mastered in the training programme in clinical practice. Although the educational design strives to promote transfer of classroom learning, students may not be motivated to transfer classroom learning. The learning climate hampers transfer of learning because the students’ perceptions are that they are unwelcome, not taken into consideration and not respected. The lack of essential equipment demotivates students. This study confirms the interrelatedness of the systemic transfer of training model and emphasises the importance of considering all elements that influence learning transfer when planning clinical placements of students.

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TL;DR: Educational program is effective in improving the knowledge of adolescent girls regarding polycystic ovarian syndrome and Nursing curriculum should be updated to include comprehensive information about PCOS to improve the awareness of other women once in practice.
Abstract: Background : Polycystic Ovarian Syndrome (PCOS) is one of the common health problem which increase in adolescent’s girls in addition young women during their reproductive years. It is one of the most endocrine disorders with prevalence of 5%–10% in different ethnic populations and as much as 22% of women in general population. PCOS is a heterogeneous endocrine disorder which affects one in 15 women worldwide . The aim of the study was to evaluate the effect of educational program on the level of knowledge regarding PCOS among adolescent girls. Subject and methods : This study was conducted at the Faculty of Nursing at Minia university using quasi experimental research design on ninety six female students. Interviewing questionnaire and knowledge assessment tool (pre/post educational program) used for data collection. Results: After the educational program, majority (94.69%, 95.85%, 94.79%, 97.31, 95.42%) of the students' have correct knowledge regarding to diagnosis, causes, risk factors, complications and management respectively after education program. Majority (92.7%) of the students had good knowledge, average knowledge observed on the (6.25%) from student , and only (1.04%) had poor knowledge after educational program. Mean scores of posttest were significantly higher after educational program compared to their values at pretest ( p < .0001). Statistically significant difference was found between demographic characteristics such as age of the students and family history with students' knowledge at pre-test (p<0.02 and p < .05) respectively. Conclusion and recommendations : based on the results of the present study it can be concluded that, before utilization of educational sessions, most of the students (84.4%) had poor knowledge regard polycystic ovarian syndrome. After the educational sessions there was enhancement of knowledge score on polycystic ovarian syndrome. It found that the mean scores of posttest were significantly higher after educational program compared to their values at pretest in all variable. Also the overall score posttest mean value (54.66) was higher than the overall score pretest mean value (25.5). So it can be concluded that, educational program is effective in improving the knowledge of adolescent girls. Based on the results, the current study recommended that: Application of educational program for adolescent girls in different setting should be conducted in order to increase level of knowledge regarding PCOS, Nursing curriculum should be updated to include comprehensive information about PCOS to improve the awareness of other women once in practice. Study can be replicated on a larger sample for generalizing the findings.

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TL;DR: From the evidence it was found that problem-based learning (PBL) had positive effects on nurse competence and is instrumental in equipping nurses with leadership skills and the ability to provide high level, quality patient care.
Abstract: Objective : The aim of this review was to examine studies for evidence of the effects of problem-based learning on the competence of nurses in clinical practice. Methods : A 5-step systematic review was undertaken as follows: defining the review question, setting the review objectives, searching databases to identify relevant studies between 1999-2009, selecting studies according to set criteria, and extracting and analysing the data. A primary review of 2,815 abstracts led to the selection of 11 studies, identified from a search of eight databases. By consensus review these were narrowed down to five studies: one quantitative and four qualitative. Using the Joanna Briggs SUMARI (System for the Unified Management, Assessment and Review of Information) programme, data were analyzed by meta-synthesis of the qualitative studies and a narrative summary of the quantitative study. Results : Five studies (two from the USA; two from South Africa; one from Canada) met the inclusion criteria. From the evidence it was found that problem-based learning (PBL) had positive effects on nurse competence. The most commonly identified competencies include problem-solving, critical thinking, self-directedness and independent practice. PBL is instrumental in equipping nurses with leadership skills and the ability to provide high level, quality patient care. Conclusions : Problem-based learning has positive effects on the development of nurse competence. Supervisors in clinical practice are generally positive about graduates’ competence and are inclined to place them in a leadership position in clinical areas.

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TL;DR: While patient education is frequently informal, it can be supported and enhanced to help overcome challenges brought about by this type of delivery, and nurses can work towards enhancing and improving instances of informal instruction to make it more effective and productive.
Abstract: Objective : Informal patient education is a common practice used by nurses in the healthcare setting. Informal methods use quick delivery instruction, and often promote self-directed learning and focus on specific tasks, based on the needs of the patient. While there are effective models for more structured patient education programs, they are not typically applicable to informal instructional situations, such as at a patient’s bedside, or upon discharge. The purpose of this paper is to: a) define how informal patient education manifests itself in healthcare settings, b) identify, through a review of literature, potential issues arising from informal patient education practices, and c) suggest ways nurses can further support and enhance informal patient education to help overcome these issues. Methods : This review of literature explores research and findings relevant to informal patient education in healthcare settings, including an examination of potential issues related to this often spontaneous, less-structured approach. Also, this review reveals findings that inform practitioners and researchers in this field with further ways to improve informal patient education practices. Results : While informal patient education holds a valuable place in healthcare settings, it also presents issues related to areas such as quality control, assessment, and curriculum. Without addressing these issues, research shows that healthcare providers, including nurses, risk a myriad of negative outcomes affecting both the patient and the organization. An analysis of the literature informed recommendations of strategies to support and enhance informal patient education, guided by four areas: desire to learn, learning by doing, feedback, and reflection. Discussion: While patient education is frequently informal, it can be supported and enhanced to help overcome challenges brought about by this type of delivery. The discussion provides specific ways nurses can help enhance informal instruction in practice. Conclusions : Informal patient education remains prevalent in patient care, but it has drawbacks. By incorporating new strategies in practice, nurses can work towards enhancing and improving instances of informal instruction to make it more effective and productive.

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TL;DR: Application of care protocol for patients with COPD has positive effect on improving knowledge, practice and clinical outcomes regarding dyspnea, fatigue, sleep quality, mood.
Abstract: Background : Care protocol for patients with chronic obstructive pulmonary disease is considered as a strategy for promoting their knowledge, practice and clinical outcomes. Aim: This study aimed to evaluate the effect of care protocol on knowledge, practice and clinical outcomes of patients with COPD through the following: A. Assessment of knowledge, practice and clinical outcomes of patients with chronic obstructive pulmonary disease (COPD). B. Developing and implementing care protocol for patients with COPD. C. Evaluating the effect of care protocol on knowledge, practice and clinical outcomes of patients with COPD. Methods : Study design: A quasi-experimental design was utilized to conduct this study. Setting: The study was conducted at chest department and outpatient clinic at Ain Shams University Hospitals. Subjects: A purposive sample of 50 patients with chronic obstructive pulmonary disease was included in the study. Data collection tools: (1) Patients’ assessment sheet. (2) Patients’ observational checklists. (3) Clinical outcomes assessment sheet. Results : There were statistically significant differences between mean scores of the pre and post test regarding patients’ knowledge, practice and clinical outcomes except for respiratory muscle training. Conclusions : Application of care protocol for patients with COPD has positive effect on improving knowledge, practice and clinical outcomes regarding dyspnea, fatigue, sleep quality, mood. Recommendations: Applying care protocol for all patients with chronic obstructive pulmonary disease in the chest units and up-dating its content periodically in order to improve knowledge, practice and clinical outcomes for those patients.

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TL;DR: The study identified no statistically significant difference in the prevalence of falls or self-harm events when video monitoring was used to provide constant observation and there was statistically significant lower cost per patient day with video monitoring.
Abstract: Background/Objective : Use of in-room sitters to prevent patient’s fall or injury is widespread in hospitals. This practice, however, is expensive, seldom reimbursed, controversial in the literature, and not supported by a strong body of evidence. The objective of this study was to determine the prevalence of patient falls and self-harm using in-room sitters and video monitoring and associated costs. Methods : In-room sitters and video monitoring was studied in two adult, medical surgical units, using an evaluative research design, with quasi-experimental approach. Descriptive statistics and independent samples t tests were performed for analysis. Results : The study identified no statistically significant difference in the prevalence of falls or self-harm events when video monitoring was used to provide constant observation. There was statistically significant lower cost per patient day with video monitoring. Conclusions : Video monitoring is less expensive than sitters and does not impose a patient safety risk for falls or self-harm.