Working with the disabled patient: exploring student nurses views for curriculum development using a SWOT analysis

Transformative care for people with disabilities: Empowering senior nursing students with competency based clinical education-A qualitative study of the impact

BACKGROUND

People with disabilities (PWD) constitute 26 % of the U.S. population yet no nursing schools have compulsory clinical education specific to PWD. Inadequate education and negative attitudes lead to lack of preparedness for working with PWD. To meet the needs of this highly underserved population, nursing students need training and experience in the care of PWD.

OBJECTIVE

The objective of this paper is to report three themes from the qualitative evaluation of two immersive clinical experiences with PWD for undergraduate nursing students designed to evaluate competencies for working with PWD.

DESIGN

Curriculum evaluation using qualitative methods.

METHODOLOGY

During and after the clinical experience, qualitative data (reflection papers, debriefing responses, and group interviews) were collected with a volunteer sample of senior nursing student participants of the clinical experiences with PWD. Thematic analysis was used to identify changes in students' attitudes, perceived competence, and motivation for working with PWD.

FINDINGS

Three major themes are reported in this paper: A positive shift in perspective of PWD (attitudes), impact of the experience on students' practice with PWD (comfort, confidence, awareness and motivation), and revelations from the experience (attitudes and resource awareness).

CONCLUSIONS

A comprehensive immersive clinical experience caring for PWD provides a real-world laboratory with important experiential learning activities that help students acquire and apply knowledge about the healthcare needs of PWD. Reflection activities facilitate synthesis of that knowledge. Results from this study suggest that this clinical experience can transform students' attitudes toward PWD, enhance their clinical skills, and motivate them to consider a nursing career with this highly under-served population.

Strengths, weaknesses, opportunities and threats analysis of being an oncology nurse: a Turkish oncology nurses' perspective

BACKGROUND

Oncology nurses play a key role in providing high-quality treatment and care to cancer patients.

AIM

The aim of this study was to determine oncology nurses' views of the strengths, weaknesses, opportunities, and threats to oncology nurses.

METHODS

This descriptive pilot study was conducted online between December 2018 and January 2019. The study population consisted of 845 nurses who were members of the Oncology Nursing Association of Turkey. The sample consisted of 80 oncology nurses. Data were collected using an online survey. Participants' responses were grouped and evaluated. Data were analysed using numbers and percentages.

RESULTS

The mean age of participants was 34.34±8.23 years. A total of 48 participants (60.5%) were university hospital nurses, and 63 (79.5%) were medical oncology nurses. Participants had 8.06±6.72 (mininum 1 and maximum 22) years of work experience as oncology nurses. For participants, the central strengths of oncology nurses were speed, self-confidence, neatness, composure, patience, compassion or attention (72.4%); psychosocial support (64.5%); and training and consultancy (58.1%). For participants, the first three weaknesses of oncology nurses were over-sentimentality, helplessness or burnout (54.2%); working conditions (50%); and limited knowledge (47.3%). For participants, the first three opportunities of oncology nursing were attending organisations on oncology nursing (62.4%), education and research (50%), and developing patience, strength, empathy, and critical thinking skills (48.6%). For participants, the first three threats to oncology nurses were employee safety issues (76.6%), psychosocial problems (65%) and physical problems (48.8%).

CONCLUSION

Weaknesses and threats should be eliminated for the development of oncology nursing in the light of its strengths and opportunities.

Cocurricular Clinical Opportunity: Addressing Student Attitudes, Knowledge, and Skills With Disability Education

BACKGROUND

Multiple organizations have urged inclusion of disability content in health care professional's education and training. Few nursing schools in the United States have adopted dedicated disability curricula nor studied its impact on attitudes, knowledge, and skills of disability education. Evidence suggests that inadequate education contributes to health care disparities and unmet needs of people with disabilities.

METHOD

A 2-hour cocurricular clinical experience was developed, using established competencies, and offered to senior nursing students. Students participated in multimodal experiences, with an emphasis on clinical exposure in various facilities serving children and adults with disabilities.

RESULTS

Five cohorts of students (N = 34) participated in the fellowship. Data illustrate the strong need to continue and require the curricula.

CONCLUSION

Faculty should develop disability education secondary to population prevalence and in accordance with the American Association of Colleges of Nursing's essential competencies. [J Nurs Educ. 2021;60(11):637-641.].

Barriers and enablers to participating in regular screening programmes for women with cerebral palsy: A qualitative life course study

AIMS

To determine the barriers and enablers to regular, women-oriented screening programmes for women with cerebral palsy (CP); and to discuss the participants' suggestions for change.

DESIGN

Qualitative life course approach.

METHODS

Twenty-five life course interviews were conducted with women in 2020 who identified as having a diagnosis of CP. Interviews were conducted in person or using electronic platforms. Framework analysis was used to interpret the data.

FINDINGS

Access and utilization of regular screening programmes for women with CP across the life course are determined by multiple socioecological factors. Three themes are discussed focusing particularly on cervical and breast screening: 1. barriers, 2. enablers and 3. women's suggestions for change. Some women chose to opt out of sexual health checks for fear they would be too uncomfortable or the procedure would be too difficult. Practitioner attitudes towards disability in general, as well as the extent to which they understood the effects of CP for women, was highlighted as a barrier. Accessibility and adaptability of the environment also influenced women's uptake of screening.

CONCLUSION

Women with CP face many challenges to their sexual and reproductive healthcare. These can deter them from participating in regular women-oriented screening programmes, which puts them at higher risk of preventable diseases. Understanding the lifelong effects of CP for women, and the interaction with their reproductive health could help to reduce unmet needs and increase participation in relevant screening across the life course.

IMPACT

Knowledge of the challenges to regular screening programmes experienced by women with CP across the life course is crucial to provide appropriate preventative healthcare for women with CP across different stages of life. Elements of this knowledge could have benefits for the care of all disabled women.

Appraisal of disability attitudes and curriculum of nursing students: a literature review

Worldwide, more than one billion people live with a disability (World Health Organization. (2011). World report on disability. Retrieved from https://www.who.int/disabilities/world_report/2011/report/en/). People with a disability (PWD) have unmet needs with the delivery of health care, secondary to nursing student's negative attitudes, knowledge, and skill deficits. This integrative literature review evaluated nursing student's education and attitudes towards PWD. Deficient education, attitudes, knowledge, and skills are addressed. Combined search terms utilized included: healthcare students; healthcare education; nursing students; clinical experience; clinical rotation; attitude of health care students; and exposure to PWD. Thirty articles were analyzed with common themes identified. Educational methods that produced improved attitudes, knowledge and skills included standardized patients with disabilities; phenomenological approaches; curriculum enhancement; empathy exercises and clinical experiences (Anderson, E. S., Ford, J., & Thorpe, L. (2011). Learning to listen: Improving students' communication with disabled people. Medical Teacher, 33(1), 44-52. doi: 10.3109/0142159X.2010.498491; Castro, S. S., Rowe, M., Andrade, L. F., & Cyrino, E. G. (2018). Developing competencies among health professions students related to the care of people with disabilities: A pilot study. Interface: Comunicacao, Saude, Educacao, 22(65), 551-563. doi: 10.1590/1807-57622016.0684; Hensel, D., Malinowski, C., & Watts, P. A. (2015). Implementing a pediatric camp clinical for pre-licensure education. Nursing Education Perspectives, 36(1), 60-61. doi: 10.5480/12-871.1; Levett-Jones, T., Lapkin, S., Govind, N., Pich, J., Hoffman, K., Jeong, S. Y., . . . Everson, N. (2017). Measuring the impact of a 'point of view' disability simulation on nursing students' empathy using the comprehensive state empathy scale. Nurse Education Today, 59, 75-81. doi: 10.1016/j.nedt.2017.09.007; Smith, P., Ooms, A., & Marks-Maran, D. (2016). Active involvement of learning disabilities service users in the development and delivery of a teaching session to pre-registration nurses: Students' perspectives. Nurse Education in Practice, 16(1), 111-118. doi: 10.1016/j.nepr.2015.09.010). Nursing schools must incorporate disability education to fully realize its impact and eliminate barriers to transform care.

Dental students' perception on Disability Equality Training as part of the special care dentistry curriculum

INTRODUCTION

The Special Care Dentistry (SCD) undergraduate program increasingly aims to address student attitudes toward people with disabilities (PWD). One of the efforts made by the Faculty of Dentistry, University of Malaya (FODUM), is to introduce Disability Equality Training (DET) as part of the learning activity in the SCD curriculum. This study aimed to explore students' perception about the DET program.

METHODS

This was a qualitative research project exploring students' perception toward DET in 2 cohorts of third-year dental students from FODUM (n = 100). The reflection notes were analyzed using Luborsky's method of thematic analysis. Identification of themes was based on statements that were most frequently reported by students.

RESULTS

The majority of the students gave positive feedback for the training, which includes enhanced knowledge, attitudes, and skills about treating PWD. They also reflected that the DET improved their understanding of social and professional responsibility. In terms of learning experience, many reported that the training was useful and enjoyable. Students' suggestions for improvement included learning "sign language", visiting special needs centers, and providing simulation exercises involving real PWD.

CONCLUSION

Students' comments on the DET were positive and they enjoyed the learning experience. The findings support the continuation of DET as part of the undergraduate dental curriculum. Dental institutions seeking to implement or refine the SCD curriculum are encouraged to include DET based on its potential benefits for undergraduate students.

Promoting Physical Activity in Group Home Settings: Staff Perspectives through a SWOT Analysis

PURPOSE

The aim of the study was to investigate perceptions of staff about the promotion of physical activity (PA) in selected group residences of Hong Kong (HK), some of which had experienced a multi-component PA program.

METHOD

Focus group interviews with nineteen staff members from four group homes (two of which received the program) were conducted.

FINDINGS

A SWOT analysis provided important insights into residential staff views about key influences on the quality of PA programs for residents with intellectual disabilities (ID). Positive (strengths and opportunities) and negative (weaknesses and threats) influences were identified. They were associated with characteristics of residents, staff, and group residence. Increasing age and low motivation are impediments to PA engagement of adults with ID. Staff competence and prior unsuccessful experience in promoting PA are also implicated.

CONCLUSION

The PA program quality is mediated by the quality of staff interpersonal interactions with their clients and their commitment in encouraging such adults with ID to join and persistent in PA as well as staff seeking external resources and support as well as using initiative to adapt PA promotion activities in their specific group residential context.

GnRH agonist trigger for the induction of oocyte maturation in GnRH antagonist IVF cycles: a SWOT analysis

Gonadotrophin releasing hormone agonist (GnRHa) trigger is effective in the induction of oocyte maturation and prevention of ovarian hyperstimulation syndrome during IVF treatment. This trigger concept, however, results in early corpora lutea demise and consequently luteal phase dysfunction and impaired endometrial receptivity. The aim of this strenghths, weaknesses, opportunities and threats analysis was to summarize the progress made over the past 15 years to optimize ongoing pregnancy rates after GnRHa trigger. The advantages and potential drawbacks of this type of triggering are reviewed. The current approach to the management of GnRHa trigger in autologous cycles is based on the peak serum oestradiol level or follicle number and aims at a fresh embryo transfer or a segmentation approach with elective cryopreservation policy. We recommend intensive luteal support with transdermal oestradiol and intramuscular progesterone alone if peak serum oestradiol is 4000 or more pg/ml after GnRHa trigger or dual trigger with GnRHa and HCG 1000 IU if peak serum oestradiol is less than 4000 pg/mL. On the contrary, we recommend HCG 1500 IU 35 h after GnRHa trigger if there are less than 25 follicles, or freeze all oocytes or embryos if there are over 25 follicles.