Reciprocity of service learning among students and paired residents in long-term care facilities

Intergenerational engagement with Asian residents in long-term care facilities: a mixed method systematic review

Introduction

Asian countries are experiencing a rapid rise in their aging populations. Cognitive and physical decline associated with aging can limit social interaction. This particularly impacts on those residing in long-term care facilities and engagement with children and young people. Intergenerational engagement has known benefits on the health and wellbeing of older people, it is unclear what the impact of intergeneration engagement interventions might have on older people in Asian long-term care settings. This review aims to evaluate the effectiveness and experiences of intergenerational engagement with older people in long-term care facilities in Asia.

Methods

Ten databases were searched to locate empirical studies of any design published in English or Chinese from January 2000 to June 2023. The search was limited to papers reporting effectiveness and/or experiences of intergenerational engagement on older people residing in Asian long-term care settings. The protocol was registered with PROSPERO (CRD42023413935) and followed PRISMA guidelines for reporting. A convergent design employing narrative synthesis was used to synthesize and integrate findings.

Results

From initial searches, 1,092 records were identified, of which 13 studies were retained for the review: 7 quantitative (including 1 randomized controlled trial, 1 cross-sectional observational design, and 5 quasi-experimental designs), 3 qualitative, and 3 mixed methods. Included studies were of variable quality. Quantitative evidence revealed that intergenerational engagement reduced depression (4.47 vs. 8.67, p = 0.005), negative emotions (14.11 vs. 16.56, p = 0.030), and feelings of loneliness (p < 0.01) among older people; and increased quality of life (mean change = -1.91; 95% CI = -3.18, -0.64) and strengthens interpersonal interactions (p = 0.025). Qualitative insights suggested that intergenerational engagement could foster emotional bonds, enhance intergenerational relationships, promote lifelong learning, satisfy social needs and improve older peoples' overall quality of life. However, some challenges such as language differences and noise levels can hinder successful implementation of intergenerational engagement.

Conclusion

This review indicates that intergenerational engagement can reduce depression and loneliness, improve quality of life, and strengthen social bonds for older individuals in Asian long-term care facilities. Despite some challenges, the evidence underlines its potential to meet the emotional and social needs of older people. Recognizing and addressing delivery challenges is essential for effective implementation.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023413935, identifier: CRD42023413935.

The effect of service-based learning on health education competencies of students in community health nursing internships

AIM

This study investigated the impact of service-based learning on the health education competencies of students in community health nursing internships. community health nursing internship is one of the areas where students acquire health education competencies. Studies have shown that some students have poor health education competencies, and new educational interventions, such as service-based learning, can help improve their competencies.

METHOD

This quasi-experimental study was conducted in 2021-2022. The participants were final-year nursing students affiliated to Kerman University of Medical Sciences. All participants (n = 72) were selected via the census method and randomly divided into intervention and control groups (36 participants in each group). The students in the intervention group attended a service-based learning program for 20 days. The data were collected before and one month after intervention using a 48-item health education qualification questionnaire. The collected data were analyzed using SPSS22 software.

RESULTS

The results showed that the mean health education competencies scores were lower before intervention in the intervention and control group (165.75 ± 23.09) (170.16 ± 28.58)(p > 0.05). There was no significant difference between the two groups in terms of their mean scores on health education competencies(p > 0.05). The health education competencies score increased significantly for the participants in the intervention group (191.58 ± 28.35) compared to the control group (165.97 ± 28.11) after intervention.

CONCLUSION

Nursing administrators and professors need to take effective steps to empower nursing students as much as possible and incorporate service-based learning techniques in clinical education programs for nursing students.

Student nurses' views of participating in an intergenerational café with older people

BACKGROUND

Within the context of global ageing, older people will require health care during times in their later lives. As most nurses will care for older people across a variety of care settings, it is crucial that older people and nurses can work together in partnership. In preparation for this, it is important to develop intergenerational learning innovations for student nurses and older people. An online intergenerational discussion café was developed to provide an opportunity for older people and student nurses to meet and get to know each other.

OBJECTIVES

1) Evaluate the effectiveness of an intergenerational discussion café as a way of facilitating intergenerational learning, 2) Elicit participants' views on whether intergenerational learning had occurred.

DESIGN

Ethically approved survey research.

SETTINGS

Tertiary education institution.

PARTICIPANTS

Third year student nurses (n = 50) across three BSc Nursing pre-registration degree programmes enrolled on a shared community care module.

METHODS

Post-café, student nurses were invited via email to voluntarily participate in the research and to complete an anonymous online survey. Questionnaire return implied consent. Fifty student nurses (n = 50) participated in the post café survey. Descriptive statistical analysis of Likert scale quantitative data and thematic analysis of open-ended questions was undertaken.

RESULTS

Participants reported that the intergenerational cafés were well organised, worked well and strongly agreed that the cafés were helpful in facilitating student nurses and older people to connect socially and share views. Results also showed that participants felt they got to know a lot about older people and that they were in many ways quite similar to older people.

CONCLUSIONS

This study provides valuable information on the use of intergenerational cafés as a means of facilitating intergenerational learning. Findings indicate that it was a positive learning experience for participants.

Facilitating intergenerational learning between older people and student nurses: An integrative review

AIM

To examine the literature on intergenerational learning between older people and student nurses.

BACKGROUND

Intergenerational activities offer opportunities for intergenerational learning and help reduce ageism. There are several older person/school children intergenerational learning initiatives. However, there is less known about how intergenerational learning occurs in nurse education programmes outside of service provision.

METHODS

Whittemore and Knafl's (2005) integrative review framework was used to guide the review process. Population, intervention, context and outcome (PICO) was used to develop the review question, search strategy and inclusion/exclusion criteria. Database (CINAHL, Cochrane library, Medline, PubMed, Scopus and PsychInfo) searches and hand searching occurred from 2012 to 2023. Screening, appraisal and data extraction was undertaken according to Prisma guidelines.

RESULTS

Nine papers were included (North American (n = 5), Canadian (n = 1) Chinese (n = 2), Taiwanese (n = 1)). Mixed methods designs were included. Four themes were identified: 1) Seeing beyond first glance; 2) Connecting and getting to know each other; 3) Learning together; and 4) Challenges for intergenerational learning.

CONCLUSION

This review demonstrates the relevance of intergenerational learning in nurse education and highlights the importance of embedding initiatives which will promote and support mutual learning. Innovative intergenerational initiatives enable students to explore their underlying attitudes and views in a way that they may not be able to in the more traditional service and care giving learning situations.

Comparison of attitudes toward the medical student-led community health education service to support chronic disease self-management among students, faculty and patients

BACKGROUND

Shortage of health professionals is one of the most important barriers for community health centers to provide quality primary care for chronic disease patients especially after the outbreak of COVID-19. Under such condition, medical students have been well-accepted as a force multiplier for community-based health service. Community service learning (CSL) based on medical student-led community health education service to support chronic disease self-management might be a valuable interactive learning tool in medical education. This study compared the attitudes toward medical student-led community health education service to support chronic disease self-management among three stakeholder roles in CSL, including medical students, faculty and patients.

METHODS

This cross-sectional comparative survey was conducted using a self-developed questionnaire among the convenience samples of undergraduate students and faculty members from the Medical College, Wuhan University of Science and Technology, as well as patient volunteers with chronic diseases recruited from a free on-site clinic offered by a community health center. Attitudes toward medical student-led community health education service to support chronic disease self-management were compared among students, faculty and patients.

RESULTS

A total of 515 valid questionnaires were obtained (342 were collected from medical students, 54 from faculty respondents, and 119 from patients). Overall positive attitudes toward medical student-led community health education service to support chronic disease self-management were positive. Among the three stakeholder roles, faculty and patients were more supportive of the current inadequate level of primary care provision within the community. However, patient respondents showed more negative attitudes towards using resources in higher medical education system to provide support for primary care practice, and participating in the medical student-led community health education service to support chronic disease self-management, and were most skeptical about the medical students' competency in supporting chronic disease self-management with their professional knowledge and skills. The educational value of CSL for medical undergraduates and the role of faculty instructors were most appreciated by faculty respondents. Additionally, > 62 years old and > 2 kinds of chronic diseases per patient exhibited significant correlations with positive patients' attitudes.

CONCLUSIONS

Medical students, faculty and patients had overall positive attitudes towards CSL based on medical student-led community health education service to support chronic disease self-management. However, more should be done to create higher expectations and enthusiasm of patients about CSL.

Educational effects of community service-learning involving older adults in nursing education: An integrative review

BACKGROUND

Community service-learning is a structured experiential learning approach in which students engage in service activities in response to identified community need(s). Service-learning programmes are developed to promote understanding of societal issues and facilitates critical learning for the learners, with emphasis on learning through reflection.

OBJECTIVES

To synthesize findings from published and grey literature related to the educational effects of community service-learning involving older adults in nursing education and evaluate the quality of existing service-learning programmes.

DESIGN

Integrative review following Whittemore and Knafl's framework to analyse and synthesize a broader range of evidence.

DATA SOURCES

Six databases (PubMed, ScienceDirect, CINAHL, PsycINFO, ERIC and ProQuest) were systematically searched from inception until 30 July 2021. Reference lists of relevant studies and reviews were also assessed for eligible studies. We also searched for grey literature and dissertations in ProQuest and Google Scholar.

REVIEW METHODS

The 5-step method was used: problem identification, literature search, data evaluation, analysis, and presentation. Included studies were appraised using the Mixed Methods Appraisal Tool checklist. Service-learning programmes were evaluated using the Service-Learning Quality Assessment Tool.

RESULTS

A total of 21 studies were included. Educational benefits of service-learning in the three domains of learning (cognitive, affective and psychomotor) were identified. Nine service-learning programmes achieved adequate quality and implementation of service-learning principles, while 12 exhibited emergent quality and implementation.

CONCLUSIONS

Service-learning provides various benefits in nursing education. Existing empirical studies do not always follow established service-learning principles, and the quality of evidence is considered low. Future studies should use more rigorous methodologies and improve the reporting of research.

Nursing students' experiences with service learning: A qualitative systematic review and meta-synthesis

OBJECTIVE

The aim of this review was to synthesize qualitative evidence on nursing students' experiences with service learning (SL).

DESIGN

A systematic review.

DATA SOURCES

Comprehensive searches were performed using databases including PubMed, MEDLINE (Ovid), Embase (Ovid), CINHAL (EBSCO), ProQuest Dissertations and Theses, Web of Science, Wangfang (Chinese), CNKI (Chinese), Google Scholar, and Baidu Scholar (Chinese).

REVIEW METHODS

The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the methodological quality of the included studies. We conducted a meta-aggregation to synthesize the findings of the included studies. The Confidence in the Output of Qualitative Research Synthesis (ConQual) approach was used to assess confidence in the synthesized findings.

RESULTS

Forty-two studies were identified, and 39 studies were included in the meta-aggregation. One hundred and sixty-seven findings, 16 categories, and 6 synthesized findings were identified. The six synthesized findings identified from the 39 studies concerned the following topics: adaption and emotion shifting, knowledge translation and skills development, leadership and collaboration in multidisciplinary teams, cultural sensitivity, discovery of nursing roles and professional growth, and overall appraisal and suggestions.

CONCLUSIONS

We recommend empowering nursing students by developing their self-confidence in their leadership abilities and their identities before they participate in SL programs. During SL, educators should provide sufficient space for students and should not become involved in students' teams to avoid decreasing their self-confidence in their leadership abilities. After SL programs, maintaining long-term relationships between the university and the community is a prerequisite for students working smoothly in the community and is a key factor for program sustainability.

Facilitating students' interest in older people nursing: Gerontological nurse teachers under scrutiny

Having teachers who are knowledgeable and passionate about issues related to older people is crucial in enhancing nursing students' interest in older people nursing. However, whether such commitments and abilities are present among gerontological nurse teachers is unknown. This study therefore describes how undergraduate nursing students perceive their gerontological nurse teachers' abilities to facilitate students' interest in older people nursing. This is a descriptive cross-sectional study of undergraduate nursing students (N = 331) in Finland. The data were collected electronically using the Gerontological Nurse Teacher Scale (GeNTS). Descriptive statistics were used to analyze the data. The students agreed that their teachers are knowledgeable and interested in gerontological nursing (M = 3.62, SD = 0.92) and demonstrate leadership in gerontology (M = 3.50, SD = 1.04). However, they were uncertain about how their teachers address students concerns about aging, promote gerontology careers, and the teachers' abilities in developing gerontological nursing practical training. Gerontological nursing teachers should make deliberate effort to promote gerontology careers by highlighting the incentives and possibilities for career advancement in older people nursing. Further studies are needed to find out if nursing students' perception of their gerontological nurse teachers is a predictor of students' interest in older people nursing.

Gerontological nurse teachers' abilities and influence on students' willingness in older people nursing: A cross-sectional, correlational survey

BACKGROUND

Previous studies have focused on identifying the factors hindering nursing students' interest in gerontology careers, whereas others have suggested interventions to promote students' interest in older people nursing. However, the role of a teacher is equally vital in shaping students' career preference.

OBJECTIVE

This study therefore explored students' perspectives of their gerontological nurse teachers' abilities and its association with students' willingness to work in older people nursing.

DESIGN

A cross-sectional correlation study.

SETTING

Five Universities of Applied Sciences in Finland.

PARTICIPANTS

Undergraduate nursing students (N = 243).

METHOD

A self-administered survey using the Gerontological Nurse Teacher Scale (GeNTS) and the subscale (Willingness) of the Students' Interest in Nursing Older People Scale (SINOPS). Descriptive and inferential analysis were conducted using SPSS.

RESULTS

There was a moderate positive association (R = 0.25, N = 243, p = 0.000) between students' perspectives of their gerontological nurse teachers' abilities and students' willingness to work in older people nursing. The teachers' abilities to develop gerontological nursing course most influence students' willingness in older people nursing (r = 0.26, p = 0.001), whereas their knowledge and interest in gerontology, least influenced students' willingness in older people nursing (r = 0.14, p = 0.025). Also, the teachers abilities to address students' concerns about aging, promote gerontology careers, and demonstrate leadership skills in gerontology all had a similar statistically significant moderate positive association (r = 0.23, p = 0.001) with students' willingness to work in older people nursing.

CONCLUSION

Faculty need to ensure that there is adequate personal with expertise in gerontological nursing to advocate for resources to establish a reputable gerontological nursing profile in nursing curriculum and to develop and sustain a positive attitude towards older people nursing among students and staff. A qualitative study is needed to understand the reasons behind students' ratings.

Communicative Accessibility in Aphasia: An Investigation of the Interactional Context of Long-Term Care Facilities

PURPOSE

The purpose of this study was to examine the ability of persons with aphasia to access interaction and be included in social encounters in long-term care facilities (LTCFs).

METHOD

Four persons with aphasia were the focus of this investigation. A qualitative research approach using ethnographic methods was used to conduct participant observation, semistructured interviews, and artifact analysis. Expanded field notes from observations, transcribed interviews, and artifacts were then coded to identify patterns in the data.

RESULTS

The interactional context of LTCFs negatively influenced the ability of persons with aphasia to communicate with others and develop meaningful relationships. Three major themes emerged from the data detailing the contextual elements leading to communication accessibility and inclusion: (a) lack of support, (b) social hierarchy, and (c) focus on performance.

CONCLUSIONS

Findings highlighted several barriers in LTCFs that worked to discourage persons with aphasia from living social and expressive lives. Specific obstacles included a misunderstanding of aphasia and its influence on communicative exchanges and performance-oriented environment that overlooked psychosocial needs. Speech-language pathologists have an important role for advocacy in LTCFs. Clinical implications for assessment and treatment in institutions are discussed.