Effects of mobile text messaging on breast cancer and breast self-examination (BSE) knowledge, BSE self-efficacy, and BSE frequency: a randomised controlled trial

AIMS

Educating women regarding breast cancer and increasing breast self-examination uptake continues to remain a major challenge despite the intensive campaigns. An innovative, cost-effective and easily customised intervention is needed especially in under-resourced and hard to reach communities. This paper is a report examining the effects of mobile text messaging on women's knowledge of breast cancer and BSE, BSE self-efficacy and frequency of BSE.

METHODS

A randomised controlled trial design was used. The study sample consisted of 128 women of reproductive age (WRA) (64 in the experimental group and 64 in the control group) from two communities in the Philippines during the months of August to October 2018. Three to five short messages were sent to the participants in the experimental group daily for one month while the control group did not receive the messages.

RESULTS

Women who received mobile text messages had higher knowledge of breast cancer (F = 21.756, p = 0.001) and breast self-examination (F = 6.776, p = 0.010) than the control group. However, no significant improvements were seen in the BSE self-efficacy (F = 1.446, p = 0.232) and frequency of BSE (F = 3.374, p = 0.69).

CONCLUSION

Mobile text messaging significantly improved the knowledge on breast cancer and breast self-examination among women; however, it did not affect their breast self-examination self-efficacy and frequency. Mobile text messaging can be a viable tool that can be used by healthcare workers in order to educate women regarding breast cancer and breast self-examination.

High-fidelity simulation and nursing students' anxiety and self-confidence: A systematic review

BACKGROUND

As a complementary teaching pedagogy, high-fidelity simulation remains as an effective form of simulation modality. Empirical evidence has additionally shown high-fidelity simulation (HFS) to be an effective contributor to students' learning outcomes.

PURPOSE

This paper critically appraised existing scientific articles that covered the influence of utilizing HFS on the effects of nursing students' anxiety and self-confidence during undergraduate nursing education.

METHODS

This was a systematic review of scientific articles conducted from 2007 to 2017 on the topic of the influence of using HFS on students' self-confidence and anxiety. The literature of six electronic databases (Proquest, SCOPUS, MEDLINE, PubMed Central, CINAHL, and PsychINFO) was reviewed.

RESULTS

Following the literature search, 35 articles were selected. This review provides updated evidence on the efficacy of HFS in reducing anxiety and enhancing self-confidence among nursing students when performing nursing duties or managing patients. Moreover, this review highlights the need for more research that examines the impact of HFS on students' anxiety.

CONCLUSION

As this form of simulation is found to be effective in the enhancement of nursing student self-confidence and the reduction of their anxiety when caring for patients and/or employing nursing skills, the inclusion of simulation-based activities in all clinical nursing courses is vital.

Predictors and outcomes of nurse professional autonomy: A cross-sectional study

AIMS

This paper is a report examining the level of professional autonomy as well as its predictors and outcomes among practicing nurses in the Philippines.

METHODS

This study adopted a descriptive, cross-sectional research design. One hundred sixty-six (n = 166) nurses participated in the study or a response rate of 83% during the months of January 2017 to May 2017. Seven self-reported scales were used for this study: the Nurse Autonomy Scale, Job Stress Scale, Burnout Measure Scale, Job Satisfaction Index, Organizational Commitment Questionnaire, Turnover Intention Inventory Scale, and the Six Dimension Scale of Nursing Performance. Inferential and descriptive statistics were used to analyse the collected data.

RESULTS

Nurses demonstrated moderate levels of professional autonomy with education and hospital bed capacity as strong predictors. Regression analysis showed positive effects of professional autonomy on nurses' job outcomes such as organizational commitment, job satisfaction, and work performance.

CONCLUSION

Consistent to international studies, nurses in the Philippines demonstrated moderate levels of professional autonomy. Nurses who had higher levels of autonomy tended to be high performing, satisfied, and committed in their jobs. Organizational efforts are critically important to foster autonomy in practicing nurses through adequate support, education, training, and developed policies.

A cross-country comparative study on stress and quality of life in nursing students

PURPOSE

This study was conducted to compare perceptions of stress and quality of life (QoL) among nursing students from three countries (the Philippines, Greece, and Nigeria) and to examine the impact of stress on their QoL.

DESIGN AND METHODS

A comparative, cross-sectional research design was used in this study. Data were collected from 547 nursing students from three countries using the perceived stress scale (PSS) and the quality of life evaluation skill (QOLES).

FINDINGS

Students' perceptions of stress and QoL were different across the three countries. Furthermore, higher stress perceptions were identified from taking care of patients, the clinical environment, and faculty, peer, and staff encounters, which predicted a negative QoL.

PRACTICE IMPLICATIONS

The findings emphasized the need for empirically tested and culturally tailored interventions to effectively reduce stress and enhance the QoL in nursing students.

An integrative review on conflict management styles among nursing professionals: implications for nursing management

AIM

To critically appraise and synthesize empirical studies that examined conflict-management styles used by nursing professionals when dealing with conflict.

BACKGROUND

Conflict is an organisational issue not new to the nursing profession. Despite the increasing research interest on this topic, no studies had been conducted to appraise and summarize evidence that examined conflict-management styles in nursing professionals.

METHOD

An integrative review method was used to analyse the findings. The primary databases used to access articles published from 2000 onwards were CINAHL, Medline, Psych Info, ERIC, Embase and SCOPUS. The search words and MeSH terms included: conflict, management, nursing, nurse manager, nurse, style, and strategy.

RESULTS

Twenty-five studies met the inclusion criteria. Integration was the most frequent style employed by nursing professionals when dealing and managing conflict, followed by accommodation. Avoiding and competing were found to be the least frequently used styles. Mixed and conflicting results were obtained when nurses' demographic variables were considered. Studies are needed to examine how organisational and interpersonal factors influence nurses' choice of style for handling conflicts.

CONCLUSION

Findings demonstrated that nursing professionals used constructive/positive conflict management approaches rather than destructive/negative conflict management approaches.

IMPLICATIONS FOR NURSING MANAGEMENT

This integrative review provided up-to-date evidence that is useful when formulating interventions to equip nurses with positive conflict-management styles necessary to mitigate and manage conflict. Such interventions may include: structured training on conflict management, team building, and conflict coaching activities, continuing professional development, reflective exercises, simulation, and role playing.

Interprofessional simulation in undergraduate nursing program: An integrative review

OBJECTIVES

Interprofessional (IP) competencies are critical for successful collaborative practice. Nurse education, through interprofessional simulation, plays a critical role in preparing nursing students achieve these competencies. Although considerable research has been conducted on this topic, a broader perspective is lacking. This review systematically appraised and synthesized evidence examining the effects of interprofessional simulation on nursing students' outcomes.

DESIGN

An integrative review method guided this review.

DATA SOURCES

Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO, and MEDLINE) were searched to locate articles published from 2010 onwards. Search and MeSH terms included: interprofessional, interdisciplinary, simulation, nurse education, nursing, and student. Thirty (30) articles were included in this review.

RESULTS

Findings of content analysis revealed five essential themes: interprofessional communication, appreciation of interprofessional team roles, interprofessional teamwork or collaboration, self-confidence or self-efficacy, and positive attitudes or readiness toward interprofessional learning.

CONCLUSIONS

This review provides a current state of knowledge on the efficacy of interprofessional simulation in enhancing interprofessional learning and competencies in nursing students. However, more research should be done utilizing a more robust method of research and reliable assessment methods. Through interprofessional simulation experiences, nurse academe can adequately prepare nursing students for future collaborative practice. Inclusions of interprofessional simulation activities in all clinical nursing courses can help prepare nursing students achieve inter-professional learning.

Examining stress perceptions and coping strategies among Saudi nursing students: A systematic review

OBJECTIVES

Stress is a perennial problem in nursing education and Saudi student nurses are not immune. Despite the growing literature examining stress in Saudi student nurses, a broader perspective on this concept has not been explored. This paper is a report of a review systematically appraising and synthesizing existing scientific articles reporting stress perceptions and coping styles in Saudi student nurses.

DESIGN

A systematic review method guided this review.

DATA SOURCES

Four (SCOPUS, CINAHL, PubMed, Ovid) bibliographic databases were searched to locate relevant articles.

REVIEW METHODS

An electronic database search was performed in August 2017 to locate studies published from 2010 onwards. The search words included: "stress" OR "psychological stress", "coping" OR "psychological adaptation", "Saudi Arabia", "student", and "nurse". Eleven (11) articles met the inclusion criteria.

RESULTS

Review of the findings showed moderate to high stress levels in Saudi student nurses that originated mainly from heavy workloads and taking care of patients. However, when the students' demographic characteristics were taken into account, inconclusive results were found, although some evidence showed higher stress levels in higher level students. Both active and passive coping styles were used by nursing students when dealing with stress.

CONCLUSIONS

Consistent with international studies, Saudi student nurses experience a considerable levels of stress from various sources. Findings may provide a direction for nursing faculty in formulating stress interventions that are empirically tested and culturally appropriate.

Stress and ways of coping among nurse managers: An integrative review

AIMS AND OBJECTIVES

To appraise and synthesise empirical studies examining sources of occupational stress and ways of coping utilised by nurse managers when dealing with stress.

BACKGROUND

The Nurse Manager's role is challenging yet draining and stressful and has adverse consequences on an individual's overall health and well-being, patients' outcomes and organisational productivity. Considerable research has been carried out; however, an updated and broader perspective on this critical organisational issue has not been performed.

DESIGN

An integrative review.

METHODS

Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO and MEDLINE) were searched to identify relevant articles. Search terms and MeSH terms included: "charge nurse," "coping," "coping strategy," "coping style," "psychological adaptation," "psychological stress," "stressors," "nurse manager" and "unit manager." Twenty-two articles were included in this review. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines.

RESULTS

Four themes were identified: moderate stress levels, common sources of stress, ways of coping and the impact of nurses' characteristics on stress.

CONCLUSIONS

Nurse managers experienced moderate levels of stress mainly from heavy workloads, lack of resources and financial responsibilities. Enhancing social support and promoting job control were seen as important in reducing work stress and its related consequences. Additional studies using a more rigorous method and a larger sample size preferably in multicultural settings would shed more light on this topic.

RELEVANCE TO CLINICAL PRACTICE

Hospital and nurse administrators play an important role in promoting supportive structures for daily professional practice for nurse managers through staffing, organisational resources, support services, leadership and stress management training.

Stress and coping strategies among nursing students: an international study

BACKGROUND

Mounting literature on stress and coping in nursing students are available; however, most of the findings are confined to a single cultural group.

AIMS

This study was conducted to determine the level of stress, its sources and coping strategies among nursing students from three countries: Greece, the Philippines and Nigeria.

METHODS

Using a descriptive, comparative research design, 547 nursing students (161 Greek nursing students, 153 Filipino nursing students, 233 Nigerian nursing students) participated in the study from August 2015 to April 2016. Two standardized instruments were used, the Perceived Stress Scale (PSS) and the Coping Behavior Inventory (CBI).

RESULTS

Findings revealed that the degree of stress and the type of stressors and coping styles utilized by nursing students differ according to the country of origin. The year of study predicted overall stress (β = -0.149, p < 0.001) while advanced age predicted overall coping (β = 0.008, p = 0.037) in the nursing students.

CONCLUSIONS

Strengthening nursing students' positive coping skills may be helpful for them to effectively deal with various stressors during their educational experiences while maximizing learning. Implementing empirically tested approaches maybe useful to prevent the recurrence of stress and lessen its impact such as stress management counseling, counseling programs, establishing peer and family support systems, and formulating hospital policies that will support nursing students.

Job stress in new nurses during the transition period: an integrative review

AIM

This review appraised and synthesized evidence relating to new nurses' stress experiences during the transition period.

BACKGROUND

Although stress among nursing professionals has been a subject of several systematic reviews in the recent years, there is still scarcity of systematic evidence examining job stress in new nurses.

METHODS

This is an integrative review of original studies conducted from 2002 onwards examining new nurses' stress experiences. Five databases were used to retrieve relevant articles such as CINAHL, SCOPUS, PubMed, PsycINFO and MEDLINE. Twenty-one articles were included in this review.

FINDINGS

New nurses perceived low to moderate levels of stress mainly from heavy workloads and lack of professional nursing competence. Individual and organizational factors that might contribute to their stress experiences were rarely explored.

CONCLUSION

This integrative review evaluated and synthesized available evidence examining stress in new nurses and contributed to the literature regarding stress in nursing professionals. The findings of this review may offer specific information to nurse administrators that can relate to the stress encountered by new nurses who enter into healthcare facilities.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Findings of this review may provide valuable input to assist nurse administrators in developing and implementing organizational measures to reduce stress in new nurses while maximizing and facilitating their integration into the nursing workforce. Such measures may include the following: establishment of a well-structured transition programme, provision of an adequate orientation and senior staff mentorship, stress management programmes, in-service educational programmes and exposure to clinical simulation scenarios.

An integrative review on conflict management styles among nursing students: Implications for nurse education

OBJECTIVES

Nurse education plays a critical role in the achievement of conflict management skills in nursing students. However, a wider perspective on this concept has not been explored. This paper is a report of a review appraising and synthesizing existing empirical studies describing conflict management styles among nursing students.

DESIGN

An integrative review method guided this review.

DATA SOURCES

Five (5) bibliographic databases (CINAHL, Medline, Psych Info, Embase and SCOPUS) were searched to locate relevant articles.

REVIEW METHODS

An electronic database search was performed in December 2016 to locate studies published from 2007 onwards. The search words included: 'conflict', 'management resolution', 'management style', 'management strategy', 'nursing', 'student'. Thirteen (13) articles met the inclusion criteria.

RESULTS

Nursing students preferred 'constructive/positive conflict management styles' when handling conflicts. However, more studies are needed to identify factors that may affect their choice of styles. Further, this review emphasizes the need for empirical studies to identify appropriate interventions that would effectively enhance nursing students' skills in managing conflicts using rigorous methods.

CONCLUSIONS

Nursing faculty play a critical role in teaching, training, and modeling constructive conflict resolution styles in nursing students. Simulation scenarios, reflective exercises, and role playing may be useful to facilitate such learning in choosing constructive conflict management styles. Structured training programme on conflict management will assist nursing students develop positive conflict management styles.

A systematic review on hand hygiene knowledge and compliance in student nurses

BACKGROUND

Hand hygiene competence is one of the critical outcomes in nursing education. Ensuring nursing students recognize the what, when and how of hand hygiene is critical in the light of the increasing rates of healthcare-associated infections.

AIM

To systematically appraise and synthesize articles on hand hygiene knowledge and compliance among nursing students.

METHODS

This is a systematic review of scientific articles published from 2006 to 2016. The primary databases used were as follows: PubMed, Embase, Cumulative Index to Nursing & Allied Health Literature, Proquest and PsychINFO. Key search terms utilized were as follows: 'handwashing', 'hand hygiene', 'compliance', 'knowledge', 'practice' and 'nursing students'.

FINDINGS

Nineteen studies met the review criteria. The findings revealed a low-to-moderate knowledge of and compliance with hand hygiene among nursing students. In addition, there were significantly higher rates of hand hygiene compliance in nursing students when compared to medical students. Relatively few studies attempted to identify predictors of hand hygiene knowledge and compliance.

CONCLUSION

This review demonstrated suboptimal knowledge and compliance to hand hygiene among student nurses. In addition, this review also highlighted the paucity of studies that examined individual and organizational factors, which influence nursing students hand hygiene knowledge and compliance.

IMPLICATIONS FOR NURSING AND POLICY

The findings of this review emphasized the role of nurse educators in enhancing hand hygiene competence in nursing students. Implementation of empirically tested strategies such as utilizing multidimensional interventions, scenario-based hand hygiene simulation activities and hand hygiene education programmes that would enhance nursing students' hand hygiene knowledge and compliance is an asset. Hospital and nursing administrators should ensure continuous support and monitoring to guarantee that hand hygiene programmes are institutionalized in every healthcare setting by every healthcare worker.

Disaster preparedness among nurses: a systematic review of literature

AIM

This review explored peer-reviewed publications that measure nurses' preparedness for disaster response.

BACKGROUND

The increasing frequency of disasters worldwide necessitates nurses to adequately prepare to respond to disasters to mitigate the negative consequences of the event on the affected population. Despite growing initiatives to prepare nurses for any disasters, evidence suggests they are under prepared for disaster response.

METHODS

This is a systematic review of scientific articles conducted from 2006 to 2016 on nurses' preparedness for disasters. SCOPUS, MEDLINE, PubMed, CINAHL and PsychINFO were the primary databases utilized for search of literature. Keywords used in this review were as follows: 'emergency', 'disaster', 'disaster preparedness', 'disaster competencies', 'disaster nursing', 'disaster role' and 'nurse'. Seventeen (17) articles were selected for this review.

FINDINGS

Factors that increase preparedness for disaster response include previous disaster response experience and disaster-related training. However, it is widely reported that nurses are insufficiently prepared and do not feel confident responding effectively to disasters.

CONCLUSION

The findings of this review contribute to a growing body of knowledge regarding disaster preparedness in nurses and have implications for academia, hospital administration and nursing educators. The findings of this review provide evidence that could be used by nurse educators and nurse administrators to better prepare nurses for disaster response.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

The findings from this review place an emphasis on hospitals to implement policies to address lack of preparedness among their employees. Furthermore, this review highlights the benefit of further research and provision of well-grounded disaster exercises that mimic actual events to enhance the preparedness of the nursing workforce.

Organizational politics, nurses' stress, burnout levels, turnover intention and job satisfaction

AIM

This is a research report examining the influence of organizational politics perceptions on nurses' work outcomes (job satisfaction, work stress, job burnout and turnover intention).

BACKGROUND

Organizational politics is a phenomenon common in almost all institutions and is linked with undesirable consequences in employees.

INTRODUCTION

Despite the plethora of research around the world on this topic, studies describing organizational politics in nursing remain underexplored.

METHODS

A cross-sectional research design was utilized in this study. One hundred sixty-six (166) nurses participated. Five standardized tools were used: the Job Satisfaction Index, the Job Stress Scale, the Burnout Measure Scale, the Turnover Intention Inventory Scale and the Perception of Organizational Politics Scale.

RESULTS

Nurses employed both in private and government-owned hospitals perceived moderate levels of organizational politics. Positive correlations were identified between perceived organizational politics and job stress, turnover intention and job burnout. Negative correlations were found between perceived organizational politics and job satisfaction.

DISCUSSION

Perceptions of workplace politics in Filipino nurses were lower when compared to findings in other international studies. A strong link was found between organizational politics perceptions and the four job outcomes (stress and burnout levels, turnover intention and job satisfaction).

LIMITATIONS

Use of a self-reporting questionnaire and exclusion of nurses from other provinces.

CONCLUSION

Perceived organizational politics predicted nurses' stress and burnout levels, turnover intention and job satisfaction.

IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

The findings of this study may provide a valuable perspective of this organizational issue and could assist policymakers and nurse administrators in formulating interventions that could minimize the effect of workplace politics.

Filipino Nurses’ Spirituality and Provision of Spiritual Nursing Care

This study was to explore the perceptions of Filipino nurses’ spirituality and the provision of spiritual nursing care. A descriptive, cross-sectional, and quantitative study was adopted for this study. The study was conducted in the Philippines utilizing a convenience sample of 245 nurses. Nurses’ Spirituality and Delivery of Spiritual Care (NSDSC) was used as the main instrument. The items on NSDSC with higher mean scores related to nurses’ perception of spirituality were Item 7, “I believe that God loves me and cares for me,” and Item 8, “Prayer is an important part of my life,” with mean scores of 4.87 ( SD = 1.36) and 4.88 ( SD = 1.34), respectively. Items on NSDSC with higher mean scores related to the practice of spiritual care were Item 26, “I usually comfort clients spiritually (e.g., reading books, prayers, music, etc.),” and Item 25, “I refer the client to his/her spiritual counselor (e.g., hospital chaplain) if needed,” with mean scores of 3.16 ( SD = 1.54) and 2.92 ( SD = 1.59). Nurse’s spirituality correlated significantly with their understanding of spiritual nursing care ( r = .3376, p ≤ .05) and delivery of spiritual nursing care ( r = .3980, p ≤ .05). Positive significant correlations were found between understanding of spiritual nursing care and delivery of spiritual nursing care ( r = .3289, p ≤ .05). For nurses to better provide spiritual nursing care, they must care for themselves through self-awareness, self-reflection, and developing a sense of satisfaction and contentment.

Nursing students' perceptions of their instructors' caring behaviors: A four-country study

BACKGROUND

Caring is the core and essence of the nursing profession. Nurse educators, are in a key position to role model for perspective nurses the role of caring while including caring as a vital component in a nursing curriculum.

OBJECTIVES

This paper is a report on students' perceptions of instructors' caring behavior in four countries: India, Greece, Nigeria, and the Philippines.

METHODS

This study utilized a quantitative, cross-sectional, comparative approach. A total of 450 nursing students participated with an almost equal nursing student frequency distribution. The main instrument used in this study was the Nursing Students' Perceptions of Instructor Caring (NSPIC). The study was conducted during the months of September 2013 to January 2014. Descriptive statistics, correlations analysis, linear regression model and one-way analysis of variance (ANOVA) were used to analyze the data collected.

FINDINGS

The highest rated subscale in the NSPIC was "instills confidence through caring" (M=4.268, SD=0.964), while the lowest ranked subscale was for the subscale "Control versus flexibility" (M=3.609, SD=1.076). No significant correlations were found between the NSPIC scale and gender (F=0.060, p=0.807), age (F=3.220, p=0.073), educational level (F=0.100, p=0.752) and family status of students (F=1.417, p=0.235), except the country of origin (F=3.703, p=0.012, η(2)=0.024).

CONCLUSION

With this study as an initial investigation into ascertaining nursing instructors caring focused on a cross-country approach, nurse educators can utilize this information to better portray their role as a nurse educator when being perceived by their nursing students.

Disaster Preparedness in Philippine Nurses

PURPOSE

This study examined the perceived level of disaster preparedness in Philippine nurses.

DESIGN

A descriptive, cross-sectional research design was used in this study.

METHODS

Two hundred nurses were invited to participate in the study, with 170 responses (105 hospital nurses and 65 community nurses) or an 85% response rate, during the months of April 2014 through July 2014. Data collection was based on interviews using a standardized instrument, the Disaster Preparedness Questionnaire. Descriptive statistics such as frequencies, means, percentages, and standard deviations were utilized to quantify the responses.

RESULTS

Three fourths of the respondents (n = 136, 80%) indicated that they were not fully prepared to respond to disasters, while only 20% (n = 34) acknowledged that they felt they were adequately prepared. Respondents believed that they could function in the primary roles of educator (n = 107, 62.94%), caregiver (n = 104, 61.17%), and counselor (n = 82, 48.24%). More than half of the respondents (n = 98, 57.7%) were not aware of existing protocols of disaster management in the workplace. Courses taken in such areas as first aid (n = 79, 46.4%), field triage (n = 43, 25.29%), and basic cardiac life support (n = 57, 33.53%) were cited as important in preparing for disasters.

CONCLUSIONS

Nurses in the study revealed that they were not sufficiently prepared for disasters nor were they aware of disaster management protocols in the workplace.

CLINICAL RELEVANCE

Hospital administrators should consider the development and formulation of disaster management protocols and provide appropriate disaster nursing education and training. Nursing curricula should incorporate basic principles of disaster management into nursing courses as a framework for addressing this critical deficit.

Impact of Instructors' Caring on Students' Perceptions of Their Own Caring Behaviors

PURPOSE

The aim of this study was to identify the correlation between instructors' and students' caring behaviors and to explore the impact of instructors' caring on students' perceptions of their own caring behaviors.

DESIGN

A descriptive, nonexperimental design was used in this study.

METHODS

A total of 586 student nurses from four countries (Greece, the Philippines, India, and Nigeria) were recruited to participate in this study during the months of September 2013 to January 2014. Data collection was based on interviews using two standardized questionnaires: the Nursing Students' Perception of Instructor Caring (NSPIC) and the Caring Behavior Inventory (CBI). Inferential statistics such as the Pearson r correlation and regression analysis were used to determine correlations between relevant variables.

FINDINGS

Student nurses perceived "instills confidence through caring" (mean = 4.275, SD = 0.755) as the most frequently demonstrated subscale, while "control vs. flexibility" (mean = 3.469, SD = 0.701) was the least demonstrated subscale. The highest self-reported subscale in the CBI was "assurance" (mean = 4.796, SD = 0.949), while "connectedness" (mean = 4.541, SD = 0.985) was the lowest self-rated subscale. The NSPIC correlated significantly with the CBI (r = .587, p < .001). Four of the five subscales in the NSPIC correlated significantly with the CBI when considered individually; the exception was the "Supportive learning climate" subscale (r = .009, p < .40). Among the NSPIC subscales, "instills confidence through caring" explained 32% in the CBI and "appreciation of life's meaning" explained 3% in the CBI.

CONCLUSIONS

Instructors' caring behaviors influenced nursing students' caring behaviors positively. Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competence of caring.

CLINICAL RELEVANCE

The knowledge generated from this study provides direction in developing useful and effective caring strategies and curricular programs for nursing students. Understanding this concept in a cross-cultural context is necessary in order to develop an international perspective about caring, which is necessary in developing and formulating effective teaching and clinical strategies.

Use of Music Intervention for Reducing Anxiety and Promoting Satisfaction in First-Time Filipino Fathers

Childbirth is an anxiety-provoking event in a man's life. Therefore, strategies to decrease paternal anxiety during childbirth are necessary. This study determined the effects of music and satisfaction of first-time Filipino fathers during childbirth. In the study, a prospective quasi-experimental design was utilized. Ninety-eight purposive samples of first-time fathers were included in the study, 50 were allocated in the experimental group (music group) and 48 in the control group (nonmusic group) during the months of August to October 2013. Paternal anxiety and satisfaction were measured using the State Trait Anxiety Inventory and the Visual Analogue Scale for Satisfaction, respectively. Results revealed that the first-time fathers in the experimental group had lower State Trait Anxiety Inventory scores (p < .05) and higher Visual Analogue Scale for Satisfaction scores (p < .05) than those in the control group. Findings of the study provide substantial evidence to support the use of music in reducing anxiety and promoting satisfaction among first-time fathers during childbirth.

Influence of Music on Preoperative Anxiety and Physiologic Parameters in Women Undergoing Gynecologic Surgery

The aim of this study was to determine the influence of music on anxiety levels and physiologic parameters in women undergoing gynecologic surgery. This study employed a pre- and posttest experimental design with nonrandom assignment. Ninety-seven women undergoing gynecologic surgery were included in the study, where 49 were allocated to the control group (nonmusic group) and 48 were assigned to the experimental group (music group). Preoperative anxiety was measured using the State Trait Anxiety Inventory (STAI) while noninvasive instruments were used in measuring the patients’ physiologic parameters (blood pressure [BP], pulse [P], and respiration [R]) at two time periods. Women allocated in the experimental group had lower STAI scores ( t = 17.41, p < .05), systolic ( t = 6.45, p < .05) and diastolic ( t = 2.80, p < .006) BP, and P rate (PR; t = 7.32, p < .05) than in the control group. This study provides empirical evidence to support the use of music during the preoperative period in reducing anxiety and unpleasant symptoms in women undergoing gynecologic surgery.