Effectiveness of stress management interventions for nursing students: A systematic review and meta-analysis

Elevated stress levels are related to diminished mental health, potentially leading to decreased well-being and performance of nursing students. While researchers have focused on developing stress management interventions, there is a need to synthesize the evidence. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of stress management interventions in nursing students. A systematic literature search identified controlled stress management interventions employing a validated psychological or physiological stress measure. Forty-one studies were included, with 36 forming a pool of 2715 participants in the meta-analysis. The overall effect on psychological stress was positive. Intervention type, delivery modality, intervention duration in weeks, and number of sessions were moderators of intervention effectiveness, with more significant effects for mind-body programs, on-site delivery methods, durations of 9-12 weeks, and 15-30 sessions. For physiological stress, the biomarkers of blood pressure, heart rate, and cortisol levels decreased significantly. Future research is necessary for promising outcomes related to currently underrepresented indicators and to investigate the long-term effects of interventions.

Exploring the Barriers and Coping Strategies Faced by Male Nursing Students in Japanese Nursing Education

PURPOSE

Nursing is traditionally considered a female profession, and male nursing students face gender stereotype barriers. Most studies of male nursing students in Japan focus on their learning experiences in maternal nursing, and little is known about the experiences of male nursing students in their usual learning environment. Therefore, the purpose of this study is to explore the barriers and coping strategies of Japanese male nursing students in nursing education, including classroom and practical training.

METHODS

A qualitative descriptive design was used to study 20 male nursing students from eight Japanese universities. Purposive sampling using the snowball method was used to recruit participants. Semistructured interviews were used to gather data about the participants' thoughts and experiences in nursing education. All interview data were analyzed using thematic analysis.

RESULTS

Four themes emerged from the data: (1) nursing choices of own volition; (2) loneliness due to the female-dominated environment and marginalization; (3) dealing with barriers and seeking support; and (4) positive experiences in nursing education. Male nursing students face barriers such as loneliness and feelings of alienation. Family support, mutual support among male nursing students, and the presence of role models were factors that addressed these barriers and positively influenced career choice.

CONCLUSIONS

This research suggests that nursing educators need to understand the barriers faced by male nursing students and provide a gender-neutral learning environment for all students.

Effectiveness of telesimulation on cardiorespiratory arrest for nursing students

Objective

To evaluate the effectiveness of telesimulation on cardiorespiratory arrest to improve the performance of nursing students.

Methods

This was an experimental study, whose sample consisted of 30 undergraduate nursing students from a Brazilian university. It was structured from two groups: an experimental (n=15) and a control (n=15). For both groups, expository classes and skills training were held. For the experimental group, a virtual clinical simulation scenario was implemented. Before the beginning of the interventions, a pre-test was applied and, after the end of this, a post-test was applied to evaluate the students' gain of knowledge and skills.

Results

From the analysis of the total correct answers and the scores obtained in the pre-test and post-test, it was found that there was an improvement in the performance of both study groups. Regarding the averages of the points obtained, there was a statistically significant difference between the groups (p=0.001). The post-test score was significantly higher than the pre-test score in the intervention group (p=0.001).

Conclusion

The virtual scenario developed proved to be superior in improving the performance of nursing students in managing cardiorespiratory arrest when compared to traditional teaching methods.

Stress levels and coping strategy of nursing students in online learning during COVID-19 Pandemic. A mixed-methods study

Objective

To explain the stress level and coping strategies of nursing students in online learning during Covid-19 pandemic.

Methods

. Explanatory sequential mixed method QUAN-QUAL study conducted at a private university in Bandung, Indonesia. Of the 260 nursing students, 157 consented to participate and answered a Depression Anxiety Scale-42 (DDAS-42) and The Ways of Coping in the Indonesian version. The participants of the quantitative phase with the indicative of stress were interviewed individually (n=17) to provide an in-depth understanding of the students' experiences of stress and coping strategy in online learning.

Results

Almost one out of two students (47.1%) had some level of stress (16% between severe and extremely severe). Most nursing students (45.9%) used emotion focused coping strategies. Stress level was significantly higher among female students and internship academic level (p < 0.05). Nursing students' sources of stress were new experiences and hindrances to online learning. Coping strategies included seeking support and positive acceptance.

Conclusion

A high proportion of nursing students experienced stress during their education process in COVID-19 times; they used specially emotion-focused coping strategies to reduce barriers to online learning.

Smartphone addiction and its impact on quality of sleep and academic performance among nursing students. Institutional based cross-sectional study in Western Rajasthan (India)

Objective

To explore the smartphone addiction and its impact on quality of sleep and academic performance among the nursing students.

Methods

. A descriptive cross-sectional study was conducted among the nursing students (n=160) in tertiary care teaching hospital in western Rajasthan (India) by using standardized Smartphone Addiction Scale Short Version (SAS-SV), the quality of sleep was assessed by standardized Pittsburg's Sleep Quality Index scale (PSQI) and academic performance was assessed by self -made Academic Performance Scale.

Results

In this study 38.1 % students were having moderate smartphone addiction. The smartphone addiction is directly associated with hours daily spend on smartphone (p < 0.001), time check smartphone after wake up in the morning (p < 0.001), and frequency of smartphone pickups in a day (p=0.003) of students. The quality of sleep is inversely associated with duration of smartphone use (p=0.004), hours daily spend on smartphone (p=0.002), time check smartphone after wake up in morning (p=0.010), of students The academic performance is significantly associated with hours daily spend on smartphone (p=0.003), time check smartphone after wake up in morning (p=0.001), and frequency of smartphone pickups in a day (p=0.015) of students.

Conclusion

A high proportion of nursing students have moderate smartphone addiction. This addiction was associated with an increased risk of poor sleep quality and poor academic performance. Educational activities on the healthy use of smartphones are needed in the studied group.

Socio-family Factors Predictive of Adaptative Coping Post COVID-19 Pandemic in Nursing Students from a Private University

Objective

To identify socio-academic and family functionality factors - communication, cohesion, and flexibility - as predictive stimuli of adaptive coping of nursing university students in the post-COVID-19 pandemic.

Methods

A cross-sectional descriptive study with stratified random sampling, with participation by 416 Nursing students from a private university in Pereira (Colombia), who answered a self-completed sociodemographic characterization survey, the Olson et al., communication scale, FACES III scale to assess family cohesion and flexibility, and the Calixta Roy CAPS scale to assess coping and adaptation capacity. Binary logistic regression and Hosmer-Lemeshow goodness-of-fit were performed to determine predictors of success, using SPSS v.26.

Results

The profiles of the participants showed a higher proportion of women (78.4%), ages between 21 and 30 years (57.5%), young people who study and work (60.1%), and those who have an academic session on Friday and Saturday (67.5%). Nursing students perceive that their families communicate efficiently and satisfactorily (85.8%), have strong cohesion with a tendency towards attachment (73.6%) and flexibility, show a tendency towards chaos (70.7%) and have adaptive coping (48.5%). The success predictors for adaptive coping were female sex (p=0.007), academic session Friday and Saturday (p=0.042), occupation, study, and work (p=0.026), socioeconomic strata 4.5 and 6 (p=0.041), good or very good communication (p=0.001), balanced family cohesion (p = 0.048), and balanced family flexibility (p=0.039).

Conclusion

This study found that good family functionality and having adequate socioeconomic conditions were predictors of higher coping and adaptation capacity during the COVID-19 pandemic in the nursing students who participated in the study.

Psychometric properties of the Latino Students Patient Safety Questionnaire, Brazilian version

OBJECTIVES

to assess the psychometric properties of the Latino Students Patient Safety Questionnaire, Brazilian version.

METHODS

a methodological study, carried out between April 2020 and January 2021, with 218 nursing and medicine students. Structural and discriminant construct validity were assessed by confirmatory factor analysis and cross factor loadings. Reliability was verified by McDonald's omega, average variance extracted, composite reliability, and item-total correlation.

RESULTS

the final model reproduced the original structure of 21 items, distributed in five dimensions, requiring the exclusion of one item. Acceptable fit indexes were obtained (x2/gl=2.325; CFI=0.99; TLI=0.98; RMSEA=0.054). Discriminant validity was confirmed. Reliability indicators were adequate, except McDonald's omega, in one factor (0.68), and average variance extracted, in two factors (0.41; 0.47).

CONCLUSIONS

the instrument demonstrated evidence of internal validity and satisfactory reliability among nursing and medical students.

Teaching entrepreneurship in undergraduate Nursing course: evaluation of an educational proposal

OBJECTIVE

To evaluate a proposal for teaching entrepreneurship in an undergraduate Nursing course that uses active methodologies and activities based on the theory of meaningful learning.

METHODS

Interventional, prospective study, with a quantitative perspective, with a total of 102 participating students, carried out from July 2017 to December 2019 at a public university in the state of Sao Paulo. Statistical analysis were performed by non-parametric Chi-square or Fisher's exact tests, with differences considered statistically significant if p < 0.05.

RESULTS

Improvements were observed in almost all items evaluated, revealing that meaningful learning became more effective with the use of active teaching methodologies. Most students need adaptation and effort to be put into these methods.

CONCLUSIONS

The proposal offers pedagogical content adaptation, specifically for nursing students. New research should expand teaching-learning techniques for the development of future nurses, preparing them adequately for the job market.

News reporting of suicide in nurses: A content analysis study

Media impact on suicide is well-established. Groups at heightened risk of suicide, such as nurses, may be particularly influenced by poor news reporting. This study aimed to examine UK newspaper reporting of suicide of nurses and student nurses, including during the COVID-19 pandemic. Print and online newspaper reports about suicide in nurses (including students) published in the UK between January 2018 and August 2021 were obtained and data extracted for analysis in collaboration with Samaritans' media advisory team. Content and quality of newspaper reports were examined using a content analysis approach. The study was compliant with the STROBE checklist. Nurse or student nurse suicides were reported in 134 articles, including 50 individual suicides. Most articles were acceptable against Samaritans' media guidelines. However, common problems included absence of signposting to support organizations and lack of suicide prevention messages. A minority of articles included methods of suicide within article headlines (18, 13.4%) and sensationalist or romanticizing language (14, 10.7%). Most contained occupation-related content. Many named the individual's specific hospital or university and a substantial proportion included occupation-related images. Working on the frontline was the most reported link between COVID-19 and nurse suicide. While reporting on suicide among nurses and students was largely acceptable, quality of reporting was variable. Occupation was often discussed, and most articles published during COVID-19 linked suicide to the pandemic. The research findings can help shape guidance on reporting of suicide in specific professions and occupations, including nursing, to encourage responsible reporting and reduce inadvertent promotion of suicide.

A National Survey of the Prevalence of Chronic Pain in Nursing Students and the Associated Factors

OBJECTIVES

To examine the prevalence of chronic pain and the associated factors among nursing students.

METHODS

This study is a descriptive, cross-sectional. The subjects were 1684 nursing students who were selected from the universities of medical sciences in Iran via cluster sampling in 2019. Data were collected using a three-part questionnaire: a demographic characteristics survey, characteristics of chronic pain, and a pain scale.

RESULTS

The majority of the students were female (62.1%) and single (87%).The mean age of the participants was 22.4±2.96 years. The results of data analysis showed that 30.2% of the students suffered from chronic pain. The areas which were most affected by pain were: head (31.24%), abdomen (11.98%), and the back (9.23%). 56.4% of the nursing students declared the origin of their pain to be unknown, 22.7% attributed their pain to migraine, and 6.48% reported spinal disorders to be the cause of their pain. There was a significant relationship between the students' chronic pain and the variables of age (higher in the 29-and-above age group), marital status (higher in married subjects), and education (higher in postgraduates).

CONCLUSIONS

A relatively large number of nursing students suffer from chronic pains. Nursing schools should contribute to improving students' knowledge of chronic pain prevention and management.

Male Nursing Students' Perception of Gender Barriers in Nursing Curricula in an Iranian University of Medical Sciences

OBJECTIVES

The present study aimed to determine male nursing students' perception of gender barriers in nursing curricula.

METHODS

This descriptive study was conducted on 150 B.Sc. and M.Sc. nursing students at Tabriz School of Nursing and Midwifery, Tabriz university of medical sciences, Tabriz, Iran that were selected through convenience sampling. The study data were collected using Inventory of Male Friendliness in Nursing Programs-Short (IMFNP-S). This scale has 17 items for investigating male nursing students' perception of gender barriers in nursing curricula. Each item is a 5-point Likert-type scale scored from 0 to 4; total scale score could range from 0 to 68, higher scores representing male nursing students' perception of less gender barriers in nursing curricula.

RESULTS

The total mean score of gender barriers was 35.11+6.15. The most important barriers included different requirements/limitations in obstetrics apprenticeship (Median=1), and need for proving oneself because of people's expectation of nurses to be female (Median=2). On the other hand, the least important barriers were lack of important people's support on one's career decisions (Median=3), and lack of opportunity to work with other male nurses (Median=3). The scale score was not associated with the socio-demographic characteristics studied.

CONCLUSIONS

The most male nursing students feel various gender issues in the nursing curriculum in a medium level that may negatively impact on their learning, professional performance and motivation and tendency to nursing. Furthermore, this vicious cycle can lead to lack of professional development, leaving the job and burnout. Thus, creating a gender-neutral environment can make nursing programs more male friendly.

Patient Safety Incidents and the second victim phenomenon among nursing students

OBJECTIVE

To map the factors involved in incidents that harm patient safety and contribute to the second victim phenomenon among nursing students.

METHOD

Qualitative, exploratory-descriptive study addressing 23 nursing students attending a Federal University in the South of Brazil. The interviews were analyzed using text and discoursive analysis. The Iramuteq software supported the processing of texts.

RESULTS

Communication failures within the health staff, a lack of protocols and equipment that prioritize patient safety, and factors related to the teaching-learning process favor the occurrence of patient safety incidents and the second victim phenomenon among nursing students.

CONCLUSION

Addressing the topic concerning patient safety in nursing programs can promote the patient safety culture by encouraging reporting and admitting the possibility of errors and learning from them, strategies that can mitigate second victim effects.

New nurses apply only basic source evaluation criteria but realize their skills are lacking: More sophisticated approaches to teaching evaluation skills are required

BACKGROUND

While information evaluation is an essential component of evidence based practice, it remains unclear how nurses perceive their own source evaluation skills and what evaluation criteria they typically apply.

OBJECTIVES

This study aims to determine nurses' self-reported confidence in their evaluation skills and their actual source evaluation ability. The findings will guide information literacy instruction.

METHODS

A questionnaire asked recently graduated nurses from four institutions in the Intermountain West (USA) to rate their confidence in evaluating information and to provide examples of evaluation criteria they typically applied. The quality of these criteria was rated by nursing librarians, then compared with reported confidence in evaluation, years employed as a nurse and highest degree level.

RESULTS

While nurses' self-reported confidence levels about source evaluation largely matched their ability, their evaluation criteria showed a low level of sophistication and did not match the recommended criteria by professional organizations. Graduate education, not years of work experience, was predictive of the quality of criteria used by nurses, suggesting the importance of more instruction on source evaluation for nursing students.

CONCLUSIONS

Nursing educators, including librarians, need to teach evaluation skills at the undergraduate level. Further investigation into building evaluation skills in nurses is warranted.

Implementing Peer Tutoring for the Development of Empathy in Nursing Education

OBJECTIVES

This research sets out the effects of a training method based on peer tutoring, aimed at developing empathy among nursing students at the University of Barcelona (Spain).

METHODS

After initial training, students are matched in pairs with similar level of empathy, exchanging the role of tutor and tutee in every session, during 12 sessions. Before the session, the tutor prepares the activities to work with his or her tutee, following this structure: exploration of prior knowledge, explanation, practical activities, feedback, and reflection. Jefferson Scale of Empathy was administered as pre-test and post-test to 76 nursing students, 40 in the intervention group, and 36 in the comparison group. Following a mixed-methods sequential explanatory design, a quantitative study (a quasi-experimental design with a comparison group) was combined with a qualitative study (interaction analysis of the 12 videotaped sessions).

RESULTS

The results revealed statistically significant improvements in empathy in the intervention group. Subsequent analysis of the peer tutoring interaction highlighted the specific actions that had resulted in these improvements and generated a context in which the tutee was able to understand complex concepts, while enabling both students to participate, reflect and discuss.

CONCLUSIONS

Peer tutoring is an effective method for the development of empathy in nursing students.

Moral courage in nursing - An integrative literature review

Moral courage and understanding of its meaning are essential when nurses face ethical conflicts in their practice. This integrative review aimed to explore moral courage in nursing and possible associated individual and organizational factors. A database search in January 2020 identified 1308 scientific articles of which 25 were selected for the review. Inductive analysis with clear steps for defining and synthesizing themes in research reviews revealed three categories concerning moral courage in nursing: definition and descriptions of moral courage, characteristics of the morally courageous nurse, and skills and acts of the morally courageous nurse. Individual and organizational factors, such as positive personal experiences, commitment to ethical principles, supportive work environment and teamwork, were associated with moral courage in nursing, contributing to a more comprehensive description of nurses' moral courage. Findings indicate that in nursing practice, there is a need for promoting multi-professional collaboration and discussion of ethical dilemmas to provide opportunities to enhance moral courage. Developing care environments in which hierarchy does not inhibit nurses' moral courage seems justified. Further research on moral courage with varying methodologies and multi-disciplinary and international approaches is needed.

Fear, Stress, and Knowledge regarding COVID-19 in Nursing Students and Recent Graduates in Mexico

OBJECTIVES

The study sought to correlate fear, stress, knowledge regarding COVID-19 in Nursing students and recent graduates in Mexico.

METHODS

Correlational design, sample comprising 912 nursing students and graduates during the last 18 months from public and private universities of Mexico. To measure the variables, the study applied the instrument Fear of COVID-19 Scale, knowledge subscale of the scale Knowledge, attitudes, and practices towards COVID-19, and the instrument COVID Stress Scale.

RESULTS

Relationship was found of the age variable with fear, danger of contamination, traumatic stress, knowledge and minor socioeconomic consequences (p<0.05). Likewise, relationship was observed of fear with stress regarding COVID-19, danger of contamination, socioeconomic consequences, xenophobia, traumatic stress, and compulsive checking (p<0.05). Stress and knowledge explain the presence of fear regarding COVID-19 in 50.3%, and fear and knowledge explain stress regarding COVID-19 in 50.4%.

CONCLUSIONS

Nursing students and recent graduates have high levels of stress and fear, besides low level of knowledge. The presence of high stress and low knowledge predict fear regarding COVID-19. Interventions are required on knowledge, stress, and fear regarding COVID-19 in the population studied.

Configuration of Mobile Learning Tools to Support Basic Physical Assessment in Nursing Education: Longitudinal Participatory Design Approach

Background

As many students in higher education are skilled users of mobile technology, mobile learning (mLearning) can be a promising educational strategy to enhance their learning experience. mLearning might also be well suited for nursing students as they navigate between multiple learning contexts in their educational curriculum. As an educational strategy, mLearning may also reduce challenges caused by the theory-practice gap in nursing by supporting skills and knowledge transfer between the university and clinical settings. As the introduction of basic physical assessment skills (B-PASs) into Norwegian bachelor’s degree education in nursing occurred quite recently, there is a lack of competence in supervision and teaching in both university and clinical settings. As such, mLearning appears to be a good strategy to support student B-PAS learning and knowledge transfer across learning contexts.

Objective

This study aims to explore and elicit the perspectives of students regarding the way in which a selection of digital learning resources supports B-PAS learning and application in clinical rotation, which of the selected digital learning resources are beneficial to include in a suite of mLearning tools, and how the selected digital learning resources could support the transfer of skills and knowledge from the academic to clinical context.

Methods

We used a longitudinal participatory design approach to co-design a suite of mLearning tools. The co-design processes took place in several workshops (WSs) over a period of 3 months: 2 WSs with first-year students (n=6), 3 WSs with second-year students (n=6), and 3 WSs with third-year students (n=8). The students evaluated several digital learning resources in both academic and clinical contexts. The digital learning resources included digital simulation with virtual patients, massive open online courses, and multimedia learning material. In the co-design WS, the potential and benefits of these digital learning resources for the learning and application of B-PASs were explored.

Results

The students reported that the digital learning resources stimulated learning in 7 different ways. They also emphasized the importance of including all selected and tested digital learning resources. Moreover, students supported the inclusion of additional learning material, such as multiple-choice tests and written assignments, aimed at providing feedback and contributing to knowledge development.

Conclusions

The co-design processes and collaboration with the nursing students provided insight into how a suite of mLearning tools may support the learning and application of B-PASs and human bioscience knowledge in clinical rotation. From the students’ perspective, one of the strengths of the suite of mLearning tools was the range of content, as this met a broader range of student learning preferences regarding learning B-PASs. The suite of mLearning tools contributes to and supports skills training and knowledge transfer between multiple learning contexts.

Formation of Nurses at Universidad de Antioquia: A Reality embodied in its Study Plans

The article presents the trajectory of the study plans that have guided the formation of nursing professionals at Universidad de Antioquia in Medellín (Colombia). It presents the principal milestones or events that at a given moment determined significant ruptures in the formation processes and which show how this Faculty of Nursing, in its 70 years of existence, has always articulated the health needs of the context with the formulation of its study plans, with the sole purpose of forming critical and innovative nursing professionals capable of responding assertively to care needs, according with the principal challenges or trends that condition the health environment.

Presence of the Reflective and Critical Thinking Capacity in Nursing Curricula in Iberian America

OBJECTIVES

The objective was to identify the presence of the capacity for reflexive-critical thinking or similar, in Nursing Curricula in Iberian America.

METHODS

The article gathers the results of one of the objectives of the macro-project developed by the Iberian American Network on Nursing Education Research, titled Strategies to develop reflective and critical thinking in nursing students: Iberian America situation. To achieve this, a descriptive and exploratory research was conducted with qualitative approach. An instrument created for this project was used, along with some guiding questions to focus the information.

RESULTS

Eight countries participated (Bolivia, Brazil, Colombia, Ecuador, Spain, Mexico, Peru, and Venezuela), which contributed information from 189 curricular plans. The R&CT was found in the majority of the curricula, although with diverse denominations. The principal learning strategies used were problem-based learning, group dynamics, reflective reading, clinical practice, and simulation laboratories. The evaluation methods used are the knowledge test, case analysis, and practical exam.

CONCLUSIONS

Significant stress exists in the discourse and curricular organization. Incongruences were found and a clear inclination toward the formation of professionals with broad technical skills under a traditional, memory, banking and knowledge accumulation education.

Formation in Interprofessional Education in Nursing and Medical Students Globally. Scoping review

OBJECTIVES

This work sought to know the state of the art related to the theme of Interprofessional Education (IPE) in the training of Nursing and Medical students and the level of evidence developed thus far.

METHODS

This was an exploratory systematic review, declared as scoping review by the Joanna Briggs Institute, JBI, in which a search was performed in Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus and ERIC databases, limiting between 2009 - 2019 by using the DeCS and MeSH terms of Interprofessional education, education research, healthcare professionals, nursing and medicine, selecting 39 original articles after carrying out the review process with the criteria by the JBI.

RESULTS

Four thematic nuclei emerged: Experiences and perceptions of interprofessional learning, Didactics related with IPE, Empirical indicators related with IPE, and Development of professional skills. The highest level of evidence is presented by the articles dealing with didactics; on the contrary, no articles were found that dealt with topics related with early inclusion of IPE in the medical and nursing curricula, which are currently necessary to complement the focus of patient-centered care.

CONCLUSIONS

The thematic nuclei show that the level of evidence in the literature is varied, although mostly descriptive in scope, highlighting the development of professional skills as a result of interprofessional education.

Stress level among undergraduate nursing students related to the training phase and sociodemographic factors

OBJECTIVE

identify the stress level among nursing undergraduates and the associated sociodemographic and academic factors; to compare stress level among college students according to the training phase in the course.

METHOD

cross-sectional study with 286 university students. The instrument of sociodemographic and academic characterization and the stress scale were applied. The overall stress level was assessed by standardized score. In the bivariate analysis, Pearson's chi-square or Fisher's exact test was used, and multiple logistic regression analysis was performed using the Poisson model. Statistical significance of 5% was adopted.

RESULTS

higher proportion of college students presented medium/high level of global stress. Students from 6th to 10th semesters presented higher levels of stress compared to those from 1st to 5th, in the Realization of practical activities, Professional Communication (p = 0.014), Environment (p = 0.053) and Vocational Training (p = 0.000) domains). In the multivariate analysis, they contributed to the highest level of stress the variables attending the 6th to 10th semesters, female gender, monthly income ≤ one minimum wage and income considered insufficient.

CONCLUSION

women in a more advanced stage of education and with low economic condition present a higher level of stress in their academic education.

Burnout among nursing students: a mixed method study

OBJECTIVES

Investigate the burnout syndrome among undergraduate students in nursing.

METHODS

Explanatory sequential mixed method study conducted at a public university in Brazil. Of the 119 nursing students, 114 consented to participate and answered a questionnaire composed of sociodemographic, academic variables, and the Maslach Burnout Inventory - Student Survey, which were analyzed by multiple linear regression. The participants of the quantitative phase with the indicative / risk of burnout were interviewed individually (n=21) to provide an in-depth understanding of the students' experiences regarding the dimensions of the syndrome, whose statements were analyzed by the Collective Subject Discourse.

RESULTS

The prevalence of burnout syndrome was 10.5% among the surveyed. The more advanced the school year, the higher were the exhaustion (p=0.003), depersonalization (p < 0.001) and low academic effectiveness (p=0.012) scores. Students with a higher workload of assignments also had higher scores of exhaustion (p=0.001), depersonalization (p < 0.001) and academic (in)effectiveness (p=0.042). Dissatisfaction with the course was related to higher exhaustion (p=0.049) and depersonalization (p=0.001). The collective speeches showed the daily demands of the course, considered as intense, producing overload and exhaustion, which produced symptoms of physical and mental illness. Thus, there was the student's distancing from the course activities, as a defensive attitude, which culminated in feelings of incompetence and frustration.

CONCLUSIONS

The occurrence of burnout syndrome dimensions among nursing students was related to the activities of academic daily life. It is urgent to invest in health promotion and prevention actions of these individuals in the university context.

Social representations of nurses. Differences between incoming and outgoing Nursing students

OBJECTIVES

This article explored and compared social representations of nurses held by incoming and outgoing Nursing students in the Technical Nursing Program in San Juan, Argentina.

METHODS

Our research was descriptive and utilized the prototypicality method of analysis for social representations, from a structural approach. The sample was made up of 194 students (104 incoming and 90 outgoing), to whom we applied the word association technique for the term "nurse".

RESULTS

Differences were found in the representations that incoming and outgoing students had. i) For incoming students: we observe a wide and general concept of a nurse, expressed in non-specific terms such as "health" in the central core, while for outgoing students the term "care" emerged; ii) We infer distancing from the hegemonic medical model on the part of outgoing students, as well as an emphasis on the relational, as terms such as "vocation", "humanization", "love" and "empathy" are evoked, while the term "illness" decreases; iii) We understand that outgoing students highlight their autonomy with respect to doctors and nursing as a profession with the term "professional" with no mention of "assistance", "help" and "assistant", terms which did appear with incoming students; iv) Outgoing students convey a sense of a nurse's diverse roles that go beyond the hospital setting, as instead of mentioning "hospital" and "injection" like incoming students, they mention "prevention" and "research".

CONCLUSIONS

The comparison of representative structures held by incoming and outgoing students suggests a transformation of self-image through a process of academic education.

Nursing Student Experiences of Caring for Burned Patient: From Fearfulness to Normalization

OBJECTIVES

To describe the care experiences of students in burn units.

METHODS

Qualitative research of the phenomenological descriptive type which was conducted with the participation of eight senior nursing students in Shiraz College of Nursing and Midwifery, Iran. The method used for gathering data about Student experiences in Care Services for Burn Cases was the individual semi-structured interview. The Colaizzi method was used for analysing and interpreting the data.

RESULTS

Three main themes emerged: the attractive but stressful experience, trying to adjust and metamorphosis in attitude. Taking care of burned patients led to metamorphosis and adaptation to the requirements of burn care due to the students' improved attitudes, awareness and potentials. This finally turned the stressful nature of taking care of a burn patient into an attractive experience for them.

CONCLUSIONS

Students with little clinical experience of stressful working situations in burn units faced different challenges. Due to the specific nature of taking care of burned patients, the clinical experiences of nursing students who offer these services are unique.

Newly Qualified Nurses' Perception of Their Competency Achievement on Leaving University: A Qualitative Study

Background: After implementing the Tuning Educational Structures in Europe Project, numerous efforts have been made to define, establish, and evaluate nursing competences. The European Federation of Nurses Association played a key role in enacting the nursing competences included in Directive 2013/55/EU. Nevertheless, assessing competences remains elusive, and there is little research into nurses’ perceptions of the competency training provided by their universities. The purpose of the study was to explore the perceptions and experiences of newly qualified nurses about the competences they acquired during their university education. Methods: A qualitative research study was developed in a Spanish university. Twelve semi-structured interviews with newly qualified nurses were conducted, and two focus groups made up of twelve students were carried out in order to triangulate the results. Participants were recruited through email contact. Interviews focused on clinical training, theoretical content, and the reality of healthcare. Data was analyzed thematically. Results: Two main themes emerged: (1) improving theoretical content and (2) rethinking practical lessons and clinical training. A lack of knowledge about mental health, pharmacology, or critical care has been found; in addition, it was highlighted, among others, the need to improve communication skills in difficult and conflictive situations. Conclusions: Considering the participants’ perception of deficiency in some aspects of most of the competences established by the European Federation of Nurses Association, further research has been suggested to include other stakeholders’ views.

Stress and overweight/obesity among nursing students

OBJECTIVE

analyze associations between demographic, academic, health, stress, overweight and obesity characteristics among nursing students.

METHOD

this is a cross-sectional study with 95 students from a private university in Rio Grande do Sul, Brazil. A demographic, academic and health characterization questionnaire and the Assessment of Stress in Nursing Students (ASNS) scale were applied. Anthropometric measures were taken and descriptive and bivariate analyses were performed.

RESULTS

female students predominated in this study, mean age: 25.6±5.87 years. Weight gain was observed in 52.6% of the students, with the 'Professional training' session reporting high (29.5%) and very high (36.8%) levels of stress. None of the stress scale sessions was associated with overweight and obesity.

CONCLUSION

overweight and obesity were associated with male participants, high blood pressure, weight gain since the beginning of the course, altered waist circumference, no physical activity, eating more in stressful situations, and consumption of unhealthy foods.

State of Mental Health and Associated Factors in Nursing Students from Southeastern Iran

OBJECTIVES

To evaluate the state of mental health and its relation with associated factors among nursing students.

METHODS

A cross-sectional study was conducted with 130 students from the Nursing and Midwifery College affiliated to the University of Medical Sciences of Shiraz (Iran). Data was collected through a document that included information on the demographic characteristics, the mean grades of the practical assignments and of the total (practical and theoretical assignments), and the Goldberg Health Questionnaire (GHQ-28) that measures symptoms grouped into four dimensions (somatic symptoms, anxiety and insomnia, social dysfunction, and depression).

RESULTS

Most of the participants (65.1%) were women; 5.3% were between 21 and 22 years of age, 84.5% were single, and 33.3% were in the sixth semester; 68.5% of the students had problems with mental health. By dimensions of the GHQ-28, it was found that 7.7% had somatic symptoms, 13.8% symptoms of anxiety and sleep disorders, 52.3% social dysfunction, and 6.2% depression. Males had a higher score of depression than females, and being single was related with higher scores of physical symptoms, anxiety and insomnia, and depression, compared with those who were married. An inverse relationship was found between the GHQ-28 average score and the semester, the grade in practical assignments, and the total grade for physical symptoms and anxiety and insomnia.

CONCLUSIONS

There is a high proportion of nursing students with suspected mental health disorder. Some demographic and academic factors are related with the mental health of students and must be kept in mind by the institutions training future nurses.

Perceived stress and resilience and their relationship with the use of mobile phone among nursing students

OBJECTIVES

The study sought to explore the relationship between levels of stress and resilience with the use of the mobile phone in nursing students.

METHODS

Cross-sectional study conducted with 102 nursing students from several Nursing schools in India who were invited to participate in the research. The data were gathered by using the following instruments: Perceived Stress Scale (PSS) by Cohen, The Connor-Davidson Resilience scale (CD-RISC), and Mobile Phone Involvement Questionnaire (MPIQ) by Walsh.

RESULTS

Most of the participants were women (94.1%), studying in the undergraduate (70.6%), with a mean age of 25.2 years. In all, 77.5% of the students had stress perception between moderate and high, 20.6% had high resilience capacity, and 25.5% were frequent mobile phone users. Perceived stress was correlated significantly and negatively with age and resilience capacity. Graduate students had greater capacity to recover than undergraduate students.

CONCLUSIONS

This study indicates the negative relation of resilience capacity with stress and the use of mobile phones among nursing students. Hence, it is necessary for institutions preparing nurses to develop intervention strategies to enhance the resilience capacity, improve skills to manage stress, and healthy use of the mobile phone.

Pattern of Internet Use by Iranian Nursing Students. Facilitators and Barriers

OBJECTIVES

To evaluate the pattern of internet use and factors that facilitate or dissuade its use among nursing students from a university in Urmia, Iran.

METHODS

A cross-sectional, descriptive study was conducted with 162 nursing students selected through simple random sampling.

RESULTS

The findings indicated that 49.1% of the students used the internet from 15 to 60 min per day. The principal use of the internet was to search for scientific content in the Web. Factors that facilitated internet use were "ease of use" and "Access to experts to solve problems and answer questions", while the dissuasive factors were "lack of concentration", "cost of internet services", and preference for information provided by professors or available directly in textbooks. Internet use by the students was related with the use of this tool in classroom activities and with English fluency.

CONCLUSIONS

Students have an internet use pattern aimed at self-study that should be strengthened with knowledge of English, assignments online, familiarization with the use of electronic databases, and other strategies to motivate them to use this technology with greater frequency.

The Effect of Group Reflection on Nursing Students' Spiritual Well-being and Attitude Toward Spiritual Care: a randomized controlled trial

OBJECTIVES

To investigate how group reflection about spiritual care affects nursing students' spiritual well-being and attitude toward spirituality and spiritual care.

METHODS

This was a randomized controlled trial conducted on 63 second-year nursing students who were studying at Nursing and Midwifery Colleges in Shiraz and Jahrom, both located in south of Iran. The students were randomly divided into an intervention (n=30) and a control (n=33) group. The study data were collected using the Spiritual Well-Being Scale and Spirituality and Spiritual Care Rating Scale before and after the intervention. The intervention consisted in four sessions of group reflection based on the scenarios related to spiritual care. The control group was given a related lecture in one session.

RESULTS

A significant difference was found between the two groups' means in spiritual well-being scores after the intervention compared to before that. Likewise, a significant difference was observed in the intervention group students' total scores of attitude before and after the intervention.

CONCLUSIONS

Group reflection improved the nursing students' spiritual well-being and their attitude toward spirituality and spiritual care compared with control group.

The relationship between knowledge management and creativity in bachelor degree compared to master degree nursing students

OBJECTIVES

To investigate the relationship between knowledge management and creativity in undergraduate compared with master degree nursing students.

METHODS

This cross-sectional study was conducted with nursing students of the faculty of nursing and midwifery in an urban area in the southeast of Iran from August 2017 to January 2018. In this study, 180 students were selected using a simple random sampling method (Bachelor degree=120 and Master degree=60). Data was collected using the Nonaka and Takeuchi̛s knowledge management and Randsip's Creativity questionnaires.

RESULTS

There was a direct and significant relationship between knowledge management and creativity in the students (r=0.47 in Bachelor degree and r=0.36 in Master degree). The mean scores of knowledge management dimensions and creativity were higher in the master degree students.

CONCLUSIONS

There was a relationship between knowledge management and creativity in the bachelor and master degree students. It is necessary to corroborate the Efforts for the implementation of strategies for the knowledge management in all its dimensions. Therefore, the education environment can help with the development of students' knowledge and skills.

Pedagogic Aspects in Nursing Education: Integrative Review

OBJECTIVES

Objective To know the current state of development of the thematic area of nursing education related with professional training and to determine the research trends.

METHODS

Descriptive integrative review, which conducted a search in databases limited from 2005 to 2016, using MeSH and DeCS terms, like Nursing, education, Nursing education research, Nursing students, health knowledge practice, and professional competence, which analyzed 50 original articles.

RESULTS

The concepts that emerged were: successful didactics, caring learning process, professional skills, professor role, and pedagogic relationships. The highest levels of evidence were found in studies on didactics; however, the trends and challenges of this review are aimed at the professional skill because it becomes the transversal concept in the formation of nurses.

Experiences of Iranian Nursing Students Regarding Their Clinical Learning Environment

PURPOSE

The aim of this study was to explain the experiences of Iranian nursing students regarding their clinical learning environment (CLE).

METHODS

Twenty-one nursing students participated in this qualitative study. Data were collected using semistructured interviews and analyzed using conventional content analysis.

RESULTS

Analysis of interviews identified six categories: educational confusion, absence of evaluation procedures, limited educational opportunities, inappropriate interactions with nursing staff, bullying culture, and discrimination. Systematic and consistent methods were not used in clinical education and evaluation of nursing students. In addition, there were inadequate interactions between nursing students and health-care staff, and most students experienced discrimination and bullying in clinical settings.

CONCLUSION

Findings showed that the CLE of Iranian nursing students may be inadequate for high-level learning and safe and effective teaching. Addressing these challenges will require academic and practice partnerships to examine the systems affecting the CLE, and areas to be addressed are described in the six themes identified.

The Mediating Effects of Social Support and a Grateful Disposition on the Relationship between Life Stress and Anger in Korean Nursing Students

PURPOSE

Anger management is a very important issue for nursing education. However, there is a lack of research identifying related factors. This study examined the mediating effects of social support and a grateful disposition on the relationship between life stress and anger in nursing students.

METHODS

The participants were 172 nursing students recruited from two universities in cities in South Korea. Baron and Kenny's regression method and the Sobel test were used to analyze the mediating effects of social support and a grateful disposition on the association between life stress and anger.

RESULTS

There were significant correlations between life stress, social support, a grateful disposition, and anger. In addition, social support and a grateful disposition exerted full mediating effects on the relationship between life stress and anger.

CONCLUSION

Based on this study's results, enhancing social support and grateful disposition could help nursing students who experience anger resulting from life stress to manage their anger effectively. This finding suggests that, as specific strategies for anger management, nursing educators should encourage nursing students to use sources of social support and to engage in various gratitude activities.

Cooperative Learning and Hand Disinfection in Nursing Students

OBJECTIVES

The study sought to evaluate the effectiveness of an educational intervention based on cooperative learning on the acquisition of knowledge and skills on hand washing. In addition, the interest and self-perception was studied of the participants on the acquisition of knowledge and skills.

METHODS

This was a pre-post intervention study with 49 students from the second course of the Nursing degree, evaluating: i) acquisition of knowledge with an ad hoc questionnaire; ii) skills on hand washing by conducting the technique with reagent solution and verification with fluorescent lamp; and iii) interest and self-perception of the importance of acquiring knowledge and skills with specific questions.

RESULTS

The mean age was 21.8 years, 83.7% were women, and 32.6% had prior studies related with health. Significant post-intervention improvement was evident in the level of knowledge (p< 0.001) and skills (p<0.001). Interest for the intervention (m=4.1±0.6) and perception on the acquisition of knowledge (m=4.4±0.6) and skills (m=4.3±0.5) were scored high (scale from 1 to 5).

CONCLUSIONS

The cooperative learning intervention improved knowledge and skills on hand washing in nursing students and awakened their interest.

Gender Differences in Body Mass Index, Body Weight Perception, weight satisfaction, disordered eating and Weight control strategies among Indian Medical and Nursing Undergraduates

OBJECTIVES

To assess gender disparity in body weight perception, Body Mass Index (BMI), weight satisfaction and role of depression among undergraduate Medical and Nursing students.

METHODS

A descriptive cross sectional descriptive study was conducted in conveniently selected medical (n=241) and nursing (n=213) students of Bangalore, South India. Data was collected using self-administered SCOFF questionnaires.

RESULTS

Our findings revealed that men had a significantly higher BMI than women (t=5.403, p<0.001). More number of women compared to men, perceived themselves as over weight (74.8%) and not satisfied with their weight status (81.6%). More men than women scored positively for disordered eating behaviors on SCOFF (45.4% vs. 31.1%) and EAT scale (16.5% vs. 8.7%). While, 48.2% of the women practice binge eating, 41.2% of the men practice it (p<0.004); more men (47.4%) than women (25.4%) exercised for more than sixty minutes (p<0.001) to control their weight.

CONCLUSIONS

Findings indicate small differences between the genders that have to be taken in consideration in planning interventional programs to prevent eating disorders in this population.

The teacher's body elements that influence the teaching-learning process of university nursing students

OBJECTIVES

To identify the body elements of the teacher that influence the teaching-learning process and to analyze their effects on university nursing students.

METHODS

Qualitative research with descriptive approach implemented through a dramatic play dynamics. In the second half of 2015, sixteen students from a private university center located in Rio de Janeiro (Brazil) participated in the study. The data processing was carried out by using Bardin's theoretical and analytical framework.

RESULTS

Four decoding units were created. They verse about the teacher's positioning, body movements, eyes, facial expressions as well as the clothes used to teach nursing.

CONCLUSIONS

The teacher's elements are capable of generating effects that influence the process of learning nursing. This leads us to believe that the body should continue to be an object of study and discussion in the higher education of nurses.

Impact of Applying a Learning Strategy to Improve the Sample Quality in Cervical Screening in Nursing Staff in Social Service

OBJECTIVES

The study sought to assess the impact of applying a learning strategy to improve the quality of sample collection during cervical screening by students from the Nursing Degree Program doing social service.

METHODS

This was a longitudinal, quasi-experimental study with the participation of 23 interns from the Nursing Degree Program at a public university from San Luis Potosí, Mexico. The work assessed knowledge of practical skills in taking cervical cytology tests and the quality of samples before and after applying a learning strategy that included 10 h of theoretical training and 22 h of practices on themes related to sample collection in cervical screening.

RESULTS

A statistically significant difference was obtained in improved knowledge (t = -12.8 p<0.001) and practical skills (t = -8.86 p<0.001) after the intervention. The increased percentage of suitable samples from 30.43% to 82.60% was attributed to the application of the learning strategy in the pre- and post-intervention phases (p<0.001).

CONCLUSIONS

Training is effective to improve knowledge and practical skills to collect samples in cervical screening, as well as the quality of the samples for their interpretation.

In-depth Knowledge of the Role of the Clinical Mentor

OBJECTIVES

This work sought to unveil the meaning expressed by clinical nurses by being mentors for students from the nursing internship level.

METHODS

Phenomenological research. In-depth interviews were conducted with nine clinical nurses from a hospital in Santiago de Chile, who participate as mentors of nursing students in their last stage of university formation.

RESULTS

Four comprehensive categories were obtained with their respective units of meaning by nursing: 1) vocation and gratification, 2) personal and professional challenge, 3) big responsibility, and 4) transmission of experience.

CONCLUSIONS

Clinical mentorship is a relevant experience in the professional lives of nurses, which implies overcoming challenges, self-training, and delivering the best of oneself, for the purpose of training future professionals prepared to practice nursing integrally.

Biosocial-academic profile and stress in first- and fourth-year nursing students

OBJECTIVES

To compare the biosocial and academic profile and stress levels between first- and last-year nursing students from a public university in Sao Paulo.

METHODS

This is an analytic and quantitative study. A biosocial and academic form and the instrument for Assessment of Stress in Nursing Students by Costa and Polak were applied to 83 students between February and March 2016.

RESULTS

Insufficient income and extracurricular activities contribute to higher levels of stress in both groups of students assessed. Fourth-year students showed higher levels of general stress, particularly generated by the factors: performance of practical activities, professional communication, environment and professional training. Time management produces higher stress in first-year students.

CONCLUSIONS

Fewbiosocial and academic features equally contribute for the stress levels in first- and last-year nursing students, but those in last-year present higher stress than students who are starting the course.

Medical and nursing students' attitudes toward mental illness: An Indian perspective

OBJECTIVES

Compare the attitudes toward mental illness between medical and nursing undergraduate students from a university in India.

METHODS

A cross sectional descriptive study was carried out among medical (n=154) and nursing undergraduate students (n=168) using Attitude Scale for Mental Illness (ASMI) questionnaire with six sub scales namely; Separatism, Stereotyping, Restrictiveness, Benevolence, Pessimistic prediction and Stigmatization. This was a 5-point Likert scale with 34 items to rate participants responses from totally disagree (1) to totally agree (5). The lower scores indicate positive attitudes toward persons with mental illness.

RESULTS

Our findings revealed that 54.5% of medical students versus 64.8% of nursing students have positive attitudes toward mental illness. While medical students have better attitudes against separatism and stigmatization, nursing students have more positive attitudes in benevolence and against pessimism.

CONCLUSIONS

An important proportion of medical and nursing students have negative attitudes toward mental illness. It is necessary to review and adapt the current curriculum to favor the positive attitude of future professionals toward people with these types of diseases.