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Luciani M, Ardenghi S, Rampoldi G, Russo S, Bani M, Strepparava MG, Di Mauro S, Ausili D. Caring for nursing students is caring for patients: A multicentre cross-sectional study on the relationship between nursing students' caring and the perception of instructors' caring. NURSE EDUCATION TODAY 2024; 137:106154. [PMID: 38508021 DOI: 10.1016/j.nedt.2024.106154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Caring in nursing is a fundamental aspect, yet teaching and fostering caring behaviours in nursing students remain challenging. Clinical instructors play a crucial role in this process. OBJECTIVES The aims of this study were a) to describe nursing students' caring behaviours and perceptions of instructor caring, b) to assess sex-related and year of course differences in students' caring behaviours and perceptions of nursing caring, and c) to investigate the association between nursing students' caring and their perception of instructors' caring. DESIGN A multi-centre, cross-sectional observational study was conducted. SETTING The study involved undergraduate nursing students from four teaching hospitals of a university in Northern Italy. PARTICIPANTS A total of 316 nursing undergraduate students participated in the study (83.9 % female, 16.1 % male, 23.1 % 1st year, 48.1 % 2nd year, 28.8 % 3rd year). METHODS Participants completed online self-reported surveys assessing caring behaviours, empathy, burnout, and perceptions of instructor caring. Caring behaviours, expressive and instrumental caring, were measured using the Caring Behaviour Inventory (CBI), and perceptions of instructor caring were assessed using the Nursing Students' Perceptions of Instructor Caring (NSPIC) questionnaire. RESULTS Students' caring behaviours were positively associated with their perceptions of instructor caring, particularly in relation to a supportive learning climate and instructor flexibility. Female students displayed higher scores in expressive caring, while students in their second and third years demonstrated increased instrumental caring behaviours. Responding to Individual Needs was significantly lower in third-years students, compared to first- and second-year ones. CONCLUSIONS This study emphasizes the crucial role of clinical instructors in shaping nursing students' caring attributes. However, the influence of sex on caring behaviours remains unclear, necessitating further investigation. These findings underscore the significance of nurturing caring behaviours in nursing education and offer insights for selecting, training, and supporting clinical instructors, to foster more compassionate and competent nurses.
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Affiliation(s)
- Michela Luciani
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Stefano Ardenghi
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy; Fondazione I.R.C.C.S. San Gerardo dei Tintori, Monza, Italy.
| | - Giulia Rampoldi
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Selena Russo
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Marco Bani
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Maria Grazia Strepparava
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy; Fondazione I.R.C.C.S. San Gerardo dei Tintori, Monza, Italy
| | - Stefania Di Mauro
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
| | - Davide Ausili
- Department of Medicine and surgery, University of Milano - Bicocca, Monza, Italy
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Ardenghi S, Russo S, Rampoldi G, Bani M, Strepparava MG. Medical students' attitude toward patient-centeredness: A longitudinal study. PATIENT EDUCATION AND COUNSELING 2024; 118:108003. [PMID: 37820544 DOI: 10.1016/j.pec.2023.108003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/05/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES This study explored the trajectories of patient-centered orientation in a sample of Italian medical students throughout medical school. METHODS Four consecutive student cohorts were longitudinally assessed at the second (T0) and fifth year (T1) of medical school. Students completed a questionnaire including demographics and the Italian validated version of the Patient-Practitioner Orientation Scale. RESULTS 352 students completed both administrations. Students became more patient-centered in terms of Sharing along the course of their clinical curriculum, whereas there were no significant changes in Caring. Groups with distinct developmental trajectory patterns of both Caring and Sharing were identified. Students high in patient-centeredness at T0 reported significantly lower scores at T1 while students with lower scores at T0 significantly increased from the first to the last measurement. Female students significantly outscored their male colleagues on Caring and Sharing in both administrations. CONCLUSIONS Findings call for innovative education strategies to sustain patient-centeredness attitudes in medical students entering hospital-based clinical medicine. Further research is needed to identify characteristics of the medical curriculum that are primarily involved in fostering students' patient-centeredness. PRACTICE IMPLICATIONS Including the assessment and monitoring of patient-centeredness throughout the medical school can inform tailored education aiming to foster this dimension.
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Affiliation(s)
- Stefano Ardenghi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Selena Russo
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giulia Rampoldi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Bani
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
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Guttmann KF, Raviv GN, Fortney CA, Weintraub AS. Defining Neonatal Serious Illness: Perspectives of Nurses and Social Workers. J Palliat Med 2023; 26:1266-1269. [PMID: 37155713 DOI: 10.1089/jpm.2023.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Objectives: To explore (1) how neonatal nurses (NN) and social workers (SW) define serious illness and (2) how physician, nurse, and SW perceptions of serious illness differ. Design: Prospective survey study. Setting/Subjects: Members of the National Association of Neonatal Nurses or the National Association of Perinatal Social Workers. Measurements: We circulated a modified version of a previously developed survey. Participants were given a list of definition components and asked to rank components by importance and to suggest modifications. Results: Eighty-eight percent of participants agreed with our definition of neonatal serious illness. NN and SW differ in important ways in their views of neonatal serious illness when compared with physicians and parents. Conclusions: Our definition of neonatal serious illness has broad acceptability and may be useful for clinical care and research. Future work should prospectively identify patients with neonatal serious illness and establish the usefulness of our definition in real time.
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Affiliation(s)
- Katherine F Guttmann
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Gabriella N Raviv
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christine A Fortney
- The Ohio State University College of Nursing, Martha S. Pitzer Center for Women, Children, and Youth, Columbus, Ohio, USA
| | - Andrea S Weintraub
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Ardenghi S, Rampoldi G, Montelisciani L, Antolini L, Donisi V, Perlini C, Rimondini M, Garbin D, Piccolo LD, Strepparava MG. Emotional intelligence as a mediator between attachment security and empathy in pre-clinical medical students: A multi-center cross-sectional study. PATIENT EDUCATION AND COUNSELING 2022; 105:2880-2887. [PMID: 35393226 DOI: 10.1016/j.pec.2022.03.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the association of emotional intelligence (EI) and attachment security (AS) with empathy dimensions in medical students by examining the mediating role of EI. METHODS In a cross-sectional design, the Interpersonal Reactivity Index (IRI), the Emotional Quotient Inventory (EQ-i), the Attachment Style Questionnaire (ASQ), and demographic questions were administrated to second-year medical students of two medical schools in Northern Italy. RESULTS 253 medical students (56.13% female), aged 19-29, participated in this study. AS positively correlated to Empathic Concern (r = 0.17, p = 0.008) and Perspective Taking (r = 0.24, p < 0.001), and negatively to Personal Distress (r = -0.33, p < 0.001). Individuals with the same level of AS and a higher score on EQ-i had a higher score (β = 0.072, p = 0.033) on empathy latent factor (at the basis of Empathic Concern and Perspective Taking) and a lower score (β = -0.290, p < 0.001) on Personal Distress than those with a lower EQ-i score. CONCLUSION This study shows that EI completely mediated the relationship between AS and empathy dimensions among medical students. PRACTICE IMPLICATIONS EI training and workshop should be considered when designing educational interventions and programs to enhance empathy and decrease interpersonal distress in medical students.
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Affiliation(s)
- Stefano Ardenghi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giulia Rampoldi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Laura Montelisciani
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), University of Milano-Bicocca, Monza, Italy
| | - Laura Antolini
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), University of Milano-Bicocca, Monza, Italy
| | - Valeria Donisi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michela Rimondini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Davide Garbin
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lidia Del Piccolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Maria Grazia Strepparava
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Department of Mental Health, Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza, Italy.
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Ardenghi S, Russo S, Luciani M, Salvarani V, Rampoldi G, Bani M, Ausili D, Di Mauro S, Strepparava MG. The association between dispositional mindfulness and empathy among undergraduate nursing students: A multicenter cross-sectional study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02829-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThe aim of this study was to explore the role of gender, age, and academic year in shaping dispositional mindfulness (DM) and the association between DM facets and empathy dimensions in a sample of undergraduate nursing students. In a multicenter cross-sectional study design, the Five Facet Mindfulness Questionnaire (FFMQ), the Interpersonal Reactivity Index (IRI), and socio-demographic questions were administrated to a convenience sample of Italian nursing students. 622 nursing students (82.2% female) participated in the study (response rate = 86.15%). Females had higher levels of Acting with Awareness (p < .001, d = .54) and lower levels of Non-reacting (p < .001, d = .52) facets of DM than males. Older students displayed higher scores on the Observing (r = .112, p = .005) and on the Non-reacting (r = .187, p < .001) FFMQ subscales than younger ones. No statistically significant differences in DM levels between the three academic years were found (ps > .202). After controlling for socio-demographic factors, DM facets were generally positively related to Perspective Taking (βs from .131 to .208, ps < .007) and Empathic Concern (βs from −.156 to .189, ps < .001), whereas negatively related to Personal Distress (βs from −.141 to −.261, ps < .001). Nursing students with higher levels of DM were more able to consider others’ cognitive perspective and to feel compassion, and were less emotionally distressed when facing tense interpersonal situations. Tailored mindfulness interventions might be useful to foster functional empathy within nursing undergraduate programs.
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Ardenghi S, Russo S, Bani M, Rampoldi G, Strepparava MG. The role of difficulties in emotion regulation in predicting empathy and patient-centeredness in pre-clinical medical students: a cross-sectional study. PSYCHOL HEALTH MED 2021; 28:1215-1229. [PMID: 34753373 DOI: 10.1080/13548506.2021.2001549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
While empathy and patient-centeredness (PC) are considered core variables in high-quality healthcare education and care, research suggests that empathy and PC decrease during the clinical years of study and that impairments in empathy and PC may be related to difficulties in emotion regulation. There is a growing interest in identifying the psycho-social variables that sustain and foster empathy and PC in medical students throughout their education. This study explored whether and to what extent emotion dysregulation predicted empathy and PC in medical students controlling for gender. Three hundred ninety-eight pre-clinical medical students enrolled at a university in northern Italy completed the Difficulties in Emotion Regulation Scale (DERS), the Interpersonal Reactivity Index (IRI) and the Patient-Practitioner Orientation Scale - 8 Items - Italian version (PPOS-8-IT). All statistically significant correlation coefficients between DERS, IRI and PPOS-8-IT scores were negative (rs from -.130 to -.336, ps ≤ 01), except for IRI Personal Distress and IRI Fantasy Scale that were mainly positively related to DERS scores (rs from .130 to .305, ps ≤ .01). Hierarchical multiple-regression analyses showed that DERS scores accounted for a significant amount of additional variance in both IRI and PPOS-8-IT components above and beyond gender. Emotion dysregulation was positively associated with Personal Distress (βs from .135 to .250, ps ≤ .007), whereas Empathic Concern, Perspective Taking, and the PC components were negatively predicted by emotion regulation difficulties (βs from -.131 to -.309, ps ≤ .005). Female students showed higher levels of all empathy and PC measures than males (ts from -3.49 to -5.54, ps ≤ 001) except for Perspective Taking. Tailored educational approaches that provide medical students with emotion regulation strategies implemented along the pre-clinical curriculum may sustain empathy and PC and equip students to appropriately and functionally face the emotional and interpersonal aspects of the clinical internship experience.
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Affiliation(s)
- Stefano Ardenghi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Selena Russo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Bani
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giulia Rampoldi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Maria Grazia Strepparava
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Department of Mental Health, Clinical Psychology Unit, San Gerardo Hospital, ASST-Monza, Monza, Italy
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