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Orgun F, Özkütük N, Akkoç CP, Çonoğlu G. Use of standardized patients in patient education practices of senior nursing students: A mixed-methods study. NURSE EDUCATION TODAY 2024; 139:106212. [PMID: 38669862 DOI: 10.1016/j.nedt.2024.106212] [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: 07/24/2023] [Revised: 03/06/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND There is a need for innovative teaching practices in nursing education due to many factors, such as global changes, the rapid development of technology, the increasing number of students, and the recent pandemic. OBJECTIVES This research was conducted using standardized patients to evaluate the attitudes and skills of senior nursing students toward patient education practices following the implementation of a patient education training program. DESIGN Mixed-methods design. SETTINGS The study was conducted at a nursing faculty. PARTICIPANTS The sample of the study consisted of 47 senior nursing students. INTERVENTION The students participating in the study were given a four-hour patient education training that included the preparation of patient education, preparation of materials, and effective presentation. METHODS A descriptive information form prepared by the researchers, the Patient Education Implementation Scale (PEIS), the Turkish version of the Patient Education Materials Assessment Tool for Printable Materials (PEMATTR-P), and the presentation skill evaluation form (PSEF) were used to collect quantitative data. Semi-structured interview forms were utilized to collect qualitative data. SPSS for Windows v. 25.0 and MAXQDA20 were used for the data analyses. Results with a p value of <0.05 were considered statistically significant. RESULTS The post-test mean PEIS scores of the students increased in the total scale and in all subdimensions. A significant difference was found in the understandability and actionability of patient education materials evaluated with PEMATTR-P (p < 0.05). The mean PSEF score of the students was 85.14 ± 9.25 points. Within the scope of the research, two main themes, namely emotions and efficacy, were determined. CONCLUSIONS This study confirms that structured patient education training, including the use of standardized patients, is important for supporting and developing nursing senior students' attitudes and skills toward patient education.
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Affiliation(s)
- Fatma Orgun
- Department of Nursing Education, Faculty of Nursing, Ege University, İzmir, Turkey.
| | - Nilay Özkütük
- Department of Nursing Education, Faculty of Nursing, Ege University, İzmir, Turkey.
| | - Cemre Paylan Akkoç
- Department of Nursing Education, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey.
| | - Gülsüm Çonoğlu
- Department of Nursing, Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey.
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Wang S, Liu K, Tang S, Wang G, Qi Y, Chen Q. Barriers and facilitators to patient education provided by nurses: A mixed-method systematic review. J Clin Nurs 2024; 33:2427-2437. [PMID: 38476038 DOI: 10.1111/jocn.17111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/02/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
AIM To investigate the factors that facilitate or hinder nurses in providing patient education. DESIGN A mixed-method systematic review. DATA SOURCES Six databases (Cochrane Library, PubMed, EMBASE, Web of Science, MEDLINE and ERIC) were systematically searched for relevant publications. METHODS The study was conducted following the JBI for mixed-method systematic reviews, and the reporting followed the PRISMA guideline. Two researchers independently performed literature screening, literature evaluation, data extraction and synthesis. PROSPERO registration number: CRD42023427451. RESULTS Twenty-six eligible articles were included, including 15 quantitative articles, 10 qualitative articles and 2 mixed-methods articles. The resultant synthesis of key findings led to the identification of these barriers and facilitators, categorised into five distinct levels: nurse-related factors, organisational factors, patient-related factors, the nurse-patient relationship and interdisciplinary collaboration. CONCLUSIONS The findings highlight the factors that facilitate or hinder nurses in providing patient education, suggesting that multifaceted interventions can enhance the practice of patient education in nursing and support the development of appropriate patient education guidelines or public policies. RELEVANCE TO CLINICAL PRACTICE This review delineates the facilitators and barriers influencing nurses' provision of patient education, offering an initial framework for nursing managers to craft interventions aimed at enhancing the quality of patient education provided by nurses, consequently elevating the overall quality of nursing.
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Affiliation(s)
- Shuyi Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ke Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation: A JBI Centre of Excellence, Changsha, China
| | - Guiyun Wang
- School of Nursing, Shandong Xiehe University, Jinan, China
| | - Yanxia Qi
- School of Nursing, Shandong Xiehe University, Jinan, China
| | - Qirong Chen
- Xiangya School of Nursing, Central South University, Changsha, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation: A JBI Centre of Excellence, Changsha, China
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Khamaiseh AM, Altarawneh FZ. Factors and barriers influencing practice of health education among nursing students in Jordan. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:441. [PMID: 38464626 PMCID: PMC10920721 DOI: 10.4103/jehp.jehp_165_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/05/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND Health education or client teaching is an aspect of nursing care recognized as a vital and professional nursing role. As a part of the nursing community, nursing students learn the importance of health education during the study period and are trained to make use of the principles of health education during their encounters with clients and their families. Aim: This article aims to examine the factors and barriers influencing health education practices among third- and fourth-year nursing students in Southern Jordan. MATERIALS AND METHODS Cross-sectional approach is used with a study sample of 286 nursing students enrolled in the undergraduate program. A self-reported questionnaire as an instrument to collate data. The questionnaire consists of two sections. The first section is related to the demographic data of the participants. The second section comprises the participant's responses to the items related to health education barriers. Descriptive statistics, including mean, standard deviation, and frequencies are utilized to analyze the demographic characteristics and questionnaire items. RESULTS The majority of nursing students report that they have not engaged in health education with patients. The first three factors identified by the students as barriers to health education are (Little time is given to patient health education due to paperwork and other assignments) (M = 4.22 and SD = 1.11), (Discharging patients from the hospital at a short time interrupts health education) (M = 4.15 and SD = 1.39), and (Evaluation of health education outcome is inapplicable due to intermittent days of training) (M = 4.05 and SD = 1.39). CONCLUSION The findings indicate that various barriers are suggested to explain the disparity between the expectation and practice of student nurses in health education. Identifying these barriers undermining health education is a positive step toward furnishing better health education for nurses in the future. Nursing students shall be fully supported to be independent and responsible professionals working within the nursing professional practices.
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Affiliation(s)
- Abdullah M Khamaiseh
- Faculty of Nursing - Community and Mental Health Nursing Department, Mutah University, Mutah, Al-Karak, Jordan
| | - Falah Z Altarawneh
- Faculty of Nursing - Community and Mental Health Nursing Department, Mutah University, Mutah, Al-Karak, Jordan
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Wang L, Wang Y, Wang X, Xue C. Effects of mind mapping based on standardized patient program in patient education among postgraduate nursing students in clinical setting. BMC MEDICAL EDUCATION 2023; 23:982. [PMID: 38124105 PMCID: PMC10731707 DOI: 10.1186/s12909-023-04944-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Patient education as an important process of postgraduate nursing education, however in previous studies there was limited study focus on the improvement of nursing students' patient education in clinical practice.This study examined the effects of a mind mapping based on standardized patient program in the patient education knowledge and communication competence of postgraduate nursing students in clinical setting. METHODS The present quasi-experimental study was performed in 2022 on 74 postgraduate nursing students who had taken clinical practice courses at affiliated hospital of Zunyi Medical University. Students were underwent two weeks of mind mapping based on standardized patient program. The outcome measures were patient education knowledge and communication competence evaluated were by the self-designed questionnaire consisting of 6 questions based on the Likert scale and nurse-patient communication competency rating scale respectively, self-efficacy was evaluated by the general self-efficacy scale, and patients' satisfaction were measured using a self-designed question. Data collection was conducted before and after intervention. Data analysis was performed using SPSS 19.0 software, and descriptive statistics and inferential statistics were performed. RESULTS Significant improvements in patient education knowledge, patient education communication competence, and self-efficacy (all P = 0.000)were observed after intervention. Improvements were also seen in measures of patients' satisfaction; 12/74 (16.22%) patients reported satisfied at baseline but only 53/74 (71.62%) at the end of intervention. CONCLUSIONS A web-based mind maps integrated with standardized patient program could improve patient education knowledge, communication competence,and self-efficacy of postgraduate nursing students in clinical setting.
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Affiliation(s)
- Lianhong Wang
- Nursing Department of Affiliated Hospital of Zunyi Medical University, ZunYi, Guizhou, 563000, China.
| | - Yousha Wang
- Nursing Department of Affiliated Hospital of Zunyi Medical University, ZunYi, Guizhou, 563000, China
| | - Xueting Wang
- Nursing Department of Affiliated Hospital of Zunyi Medical University, ZunYi, Guizhou, 563000, China
| | - Caixiu Xue
- Nursing Department of Affiliated Hospital of Zunyi Medical University, ZunYi, Guizhou, 563000, China
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Thompson DL, May EJ, Leach MJ, Smith CP, Fereday JA. Applying Learning Principles Within Parent Education: Exploring Nurses' Practice and Parents' Experiences. Patient Prefer Adherence 2023; 17:2949-2970. [PMID: 38027081 PMCID: PMC10656838 DOI: 10.2147/ppa.s426043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose In parent-education practice nurses use Learning Principles (LPs) when helping parents to develop the knowledge and skills required to care for their children. LPs are basic precepts of learning, comprising people's beliefs, behaviors and reasoning processes. LPs underpin parents' active engagement, confidence building and decision-making, as information provided becomes usable knowledge. However, the ways nurses apply LPs in parent-education practice are poorly explained in healthcare. Likewise, descriptions of parents' learning experiences, associated with the use of LPs in nurse/parent-education interactions, are lacking. This study aimed to explore and describe nurses' perceptions and use of LPs, and parents' learning experiences in one healthcare organization. Participants and Methods Using an action research design, 25 nurses and 18 parent participants were purposively recruited across metropolitan Adelaide, Australia. Data were collected through observations and semi-structured interviews and thematically analyzed simultaneously June-December 2017. Results The LPs nurses used, and those important to parents' learning experiences created three overarching themes: 1) collaborative relationships, 2) deepening learning insights, 3) the learning environment. Despite their apparent use, nurses struggled to explicitly describe how they perceived LPs, believing their knowledge and use was sub-conscious - tacit. However, tacit knowledge hinders communication and explanation of LPs used within parent-education to other nurses. The member-checking of interview data helped to stimulate the nurses' metacognition (thinking about their thinking), unlocking their LPs awareness. Conclusion Nurses used LPs in practice but their knowledge was tacit. Through metacognition, nurses started to recognize the ways LPs influenced their practice and parents' learning capabilities. Increasing healthcare constraints, including time allowed for parent-education, require nurses to optimize their use of LPs. Future research should identify ways nurses can communicate their use of LPs, potentially enhancing parents' active learning experiences and concordance with health recommendations.
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Affiliation(s)
- Deryn L Thompson
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Esther J May
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - Colleen P Smith
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jennifer A Fereday
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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Eskolin SE, Inkeroinen S, Leino-Kilpi H, Virtanen H. Instruments for measuring empowering patient education competence of nurses: Systematic review. J Adv Nurs 2023. [PMID: 36808623 DOI: 10.1111/jan.15597] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/04/2023] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
AIM This review aimed to identify validated self-reported instruments used to measure nurses' competence or attribute(s) of competence in empowering patient education, to describe their development and main content and critically appraise and summarize the quality of the instruments. DESIGN Systematic review. DATA SOURCES Electronic databases of PubMed, CINAHL and ERIC were searched from January 2000 to May 2022. REVIEW METHODS Data was extracted following predetermined inclusion criteria. With the support of the research group, two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist (COSMIN). RESULTS A total of 19 studies reporting 11 instruments were included. The instruments measured varied attributes of competence and the contents were heterogenous reflecting the complex nature of both empowerment and competence as concepts. Overall, the reported psychometric properties of the instruments and methodological quality of the studies were at least adequate. However, there was variation in the testing of the instruments' psychometric properties and lack of evidence limited the evaluation of both the methodological quality of the studies and quality of instruments. CONCLUSION The psychometric properties of the existing instruments assessing nurses' competence in empowering patient education need to be tested further, and future instrument development should be built on a clearer definition of empowerment as well as on more rigorous testing and reporting. In addition, continued efforts to clarify and define both empowerment and competence on the conceptual level are needed. IMPACT Evidence on nurses' competence in empowering patient education and its valid and reliable assessment instruments is scarce. Existing instruments are heterogenous and are often missing proper testing of validity and reliability. These findings contribute to further research on developing and testing the instruments of competence in empowering patient education and strengthening nurses' empowering patient education competence in the clinical practice.
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Affiliation(s)
| | - Saija Inkeroinen
- Department of Nursing Sciences, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Sciences, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Heli Virtanen
- Department of Nursing Sciences, University of Turku, Turku, Finland
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Bazezew AM, Nuru N, Demssie TG, Ayele DG. Knowledge, practice, and associated factors of preoperative patient teaching among surgical unit nurses, at Northwest Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, 2022. BMC Nurs 2023; 22:20. [PMID: 36681844 PMCID: PMC9862840 DOI: 10.1186/s12912-023-01175-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Preoperative teaching practice is very important to surgical clients in freeing them from anxiety and post-operative complications. The preoperative education received by the patients depends on the knowledge and experience of nurses. The diversity in the degree of knowledge and experience possessed by nurses may result in inadequate and ineffective preoperative preparation of patients. Therefore, this study aimed to assess the knowledge, practice, and associated factors of preoperative patient teaching among nurses working at surgical units in Northwest Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, 2022. METHOD An institutional-based cross-sectional study triangulated with a qualitative approach was conducted from April to June 2022. The data were collected using a semi-structured self-administered questionnaire and in-depth interviews. The descriptive statistics were presented in text and tables. Analytical analysis schemes including bivariable and multivariable logistic regression were computed considering P-value < 0.05 to identify statistically significant factors. Qualitative data were analyzed with thematic analysis. RESULT A total of 406 participants were involved in this study with a 95.8% response rate. The adequate knowledge of nurses was 61.6% with 95% CI: (56.7, 66.3) and significantly associated with being male, nurse use of guidelines, nurses they have been trained, and nurses' who say they do not a staff shortage had good knowledge than the counterparts. Good practice of nurses regarding preoperative patient education was 46.3% with 95% CI (41.4, 51.0) significantly associated with the presence of preoperative teaching guidelines, took training on patient education, nurses who said no staff shortage, and knowledge of preoperative patient education.. Nurses have a positive interaction with the patient and much work experience had good practice but lack of training; inadequate supplies and lack of professional prerequisites are some of the barriers identified. CONCLUSION Nurses' knowledge and practice regarding preoperative patient teaching were found to be inadequate. So, it is better to strengthen training, adequate staffing, equip wards with standardized guidelines and teaching materials, motivate and create a safe working environment. Most nurses explore factors of preoperative patients' teaching as institutional, Nurse's related, and patient-related factors.
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Affiliation(s)
- Astewil Moges Bazezew
- grid.59547.3a0000 0000 8539 4635Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Nurhusen Nuru
- grid.59547.3a0000 0000 8539 4635Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tizta Gebeyehu Demssie
- grid.59547.3a0000 0000 8539 4635Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Desalegn Getachew Ayele
- grid.59547.3a0000 0000 8539 4635Department of Surgical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Sarkhosh S, Abdi Z, Ravaghi H. Engaging patients in patient safety: a qualitative study examining healthcare managers and providers' perspectives. BMC Nurs 2022; 21:374. [PMID: 36581873 PMCID: PMC9801597 DOI: 10.1186/s12912-022-01152-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Patients can play an essential role in improving patient safety by becoming actively involved in their health care. The present study aimed to qualitatively explore healthcare providers' (HCPs) and managers' perceptions on patient participation in patient safety processes. METHODS This qualitative study carried out in three teaching hospitals in Tehran, Iran. The data were collected through semi-structured interviews with 31 HCPs and managers working at public teaching hospitals, medical universities and the Ministry of Health. The data were analyzed using thematic analysis. RESULTS Three main themes and 21 sub-themes emerged from the interviews. Participants believed that patients and their families can play an effective role in maintaining and improving patient safety through different roles. However, a variety of barriers were identified at patients, providers, and system levels hindering patient participation in delivering safe care. CONCLUSION The participants identified facilitators and barriers to patient engagement in safety-orientated activities at multiple patients, providers, and system levels, indicating that complex, multifaceted initiatives must be designed to address the issue. This study encourages further research to enhance the understating of the problems and solutions to patient involvement in safety initiatives in the Iranian healthcare setting.
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Affiliation(s)
- Samaneh Sarkhosh
- grid.411746.10000 0004 4911 7066Master of Health Services Administration, School of Health Management and Information Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zhaleh Abdi
- grid.411705.60000 0001 0166 0922National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran (TUMS), Tehran, Iran
| | - Hamid Ravaghi
- grid.411746.10000 0004 4911 7066School of Health Management and Information Sciences, Iran University of Medical Sciences (IUMS), No. 6, Rashid Yasemi St. Vali-E-Asr Ave, P.O Box: 1996713883, Tehran, Iran
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Iranpour A, Mirafzali S, Borhaninejad V, Alizadeh S. Communication barriers to education to referrals from the perspective of referrals to health centers and health care providers. J Public Health Res 2022; 11:22799036221127634. [PMID: 36310826 PMCID: PMC9608057 DOI: 10.1177/22799036221127634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/02/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction One of the most important factors affecting the increase of clients' satisfaction is how health care providers (HCP) communicate with clients. On the other hand, different factors can hinder proper communication and thus education, which is one of the main tasks of HCP. Therefore, the purpose of this study was to investigate communication barriers to education to referrals from the perspective of referrals to health centers (RHC) and HCP. Method This descriptive-analytical study was conducted on RHC and HCP in Kerman in 2021. Using a multi-stage sampling method, 162 HCP and 414 RHC were included in the study. The data collection tool was two researcher-made questionnaires. Data were analyzed using SPSS 16. Findings From the perspective of RHC and HCP, most communication barriers were related to environmental and then socio-cultural factors. Among the demographic variables of HCP, level of education showed a significant relationship with the physical-psychological, verbal-non-verbal, and informational domains. And in relation to RHC, a significant relationship was found between education and job in the socio-cultural field and environmental barriers (p < 0.05). Conclusion HCP face a variety of barriers in educating people, most of which are related to environmental factors. Given the cost-effectiveness of education to the public, it is essential that planners and policymakers use strategies to eliminate environmental factors as well as the placement of indigenous HCP in health facilities to reduce communication barriers.
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Affiliation(s)
- Abedin Iranpour
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Vahidreza Borhaninejad
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayeh Alizadeh
- Department of Health Education and Promotion, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran,Somayeh Alizadeh, Department of Health Education and Promotion, School of Public Health, Kerman University of Medical Sciences, Medical University Campus, Haft-Bagh Highway, Kerman, 7616913555, Iran.
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Firoozehchian F, Zareiyan A, Geranmayeh M, Behboodi Moghadam Z. Domains of competence in midwifery students: a basis for developing a competence assessment tool for iranian undergraduate midwifery students. BMC MEDICAL EDUCATION 2022; 22:704. [PMID: 36199088 PMCID: PMC9533548 DOI: 10.1186/s12909-022-03759-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/02/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Current study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students. METHODS Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth. RESULTS Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20-56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories. CONCLUSION The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.
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Affiliation(s)
- Firoozeh Firoozehchian
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Zareiyan
- Department of Public Health, Department of Health in Disaster & Emergencies, Nursing Faculty, Aja University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Geranmayeh
- Department of Reproductive Health and Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Behboodi Moghadam
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Pueyo-Garrigues M, Pardavila-Belio MI, Canga-Armayor A, Esandi N, Alfaro-Díaz C, Canga-Armayor N. nurses' knowledge, skills and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional study. Nurse Educ Pract 2021; 58:103277. [PMID: 34929565 DOI: 10.1016/j.nepr.2021.103277] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/18/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022]
Abstract
AIM To explore nurses' knowledge, skills and personal attributes for competent health education practice and their association with potential influencing factors. BACKGROUND Clinical nurses are expected to perform effective health education interventions, but they do not feel competent. The self-assessment of the health education competence and its conditional factors is paramount for professional development. DESIGN A cross-sectional study. METHODS A total of 458 clinical nurses from two health specialized centers in Spain participated in this study. Data were collected using the Nurse Health Education Competence Instrument and a second self-report questionnaire from January to February 2019. Descriptive statistics, t-test, analysis of variance, Pearson's and Spearman's correlation and multiple linear regression were used to analyse the data. The STROBE guideline was used RESULTS: The mean scores of the knowledge (70.10 ± 15.11), skills (92.14 ± 15.18) and personal attributes scales (32.32 ± 5.89) were found to be low to moderate. The main influencing factors for the health education implementation were lack of education and training (71.4%), lack of time (67.5%) and high workload (67.3%). Nurses with higher educational level and perceived self-efficacy for competently providing health education, more extensive professional experience and previous training in health education rated higher in knowledge, skills and personal attributes. Age and years of experience were negatively correlated with knowledge scores, but positively with the rest of domains of the competence and self-efficacy. The regression models for the overall health education competence's domains were significant (p < 0.001) with R2 values ranging from 28.0% to 49.3%. Self-efficacy, previous health education training and working in intensive care units were found to be significant in all cognitive, psychomotor and attitudinal scales. CONCLUSION Clinical nurses reported on some skills and personal attributes for health education practice, but they seem to lack health education knowledge necessary for a competent practice. This study suggested that effective education and training and supportive organizational cultures are key to enhance nurses' health education competence. Identifying nurses' educational needs on the main domains of the competence and its intrinsic/extrinsic influential factors may assist in both planning and organizing tailored training strategies and in promoting appropriate environments to support a high-quality health education practice TWEETABLE ABSTRACT: Nurses' knowledge, skills and attitudes about health education competence are low to moderate. Training and organizational support are key.
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Affiliation(s)
- M Pueyo-Garrigues
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain.
| | - M I Pardavila-Belio
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain.
| | - A Canga-Armayor
- University of Navarra, School of Nursing, Nursing Care for Adult Patients Department, Campus Universitario, 31008 Pamplona, Spain.
| | - N Esandi
- University of Navarra, School of Nursing, Nursing Care for Adult Patients Department, Campus Universitario, 31008 Pamplona, Spain.
| | - C Alfaro-Díaz
- University of Navarra, School of Nursing, Nursing Care for Adult Patients Department, Campus Universitario, 31008 Pamplona, Spain.
| | - N Canga-Armayor
- University of Navarra, School of Nursing, Community, Maternity and Pediatric Nursing, Campus Universitario, 31008 Pamplona, Spain.
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Promoting parental education of infants hospitalized in a children's hospital in Tabriz, Iran: a best practice implementation project. JBI Evid Implement 2020; 19:288-295. [PMID: 34491924 DOI: 10.1097/xeb.0000000000000259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Parents of infants admitted to hospital have high information needs. A good educational program will improve the outcomes and communication needs of these parents. Results from some studies have shown that patient education in Iran is inappropriate and should be improved. OBJECTIVES The aim of this evidence implementation project was to evaluate the current practice and implement the best practice related to promoting patient education in a children's hospital in Tabriz, Iran. METHODS A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Eight audit criteria that represent the best practice recommendations for patient education were used. A baseline audit was conducted followed by implementing multiple strategies, and the project was finalized with a follow-up audit to determine a change in practice. RESULTS Significant improvements in the follow-up audit in comparison with the baseline audit were as follows: evaluation of patient learning has been undertaken to determine met and unmet needs (from 65 to 77%); patients' learning needs, readiness to learn, and their learning style have been assessed before the implementation of an educational initiative (from 55 to 66%); and educational resources in different formats (e.g., written handouts, brochures, and links to online materials) are available in the ward (from 33 to 77%). Strategies that were implemented to achieve change in practice included conducting workshops and conferences, determining a trained nurse as responsible for educating parents, training in discharge time, the presentation of educational films daily, conducting group training, and installing related posters in the department and patient's room. The other five criteria were less compliant with best practice in the follow-up audit rather than the baseline audit; however, all of them except one (Criterion 3) were still up to 75% compliant, which is considered excellent by the audit team. CONCLUSION The follow-up audit results indicated an improvement in providing parental education. It can be concluded that these interventions can facilitate the implementation of evidence into clinical practice.
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Jung MJ, Roh YS. Factors influencing the patient education performance of hemodialysis unit nurses. PATIENT EDUCATION AND COUNSELING 2020; 103:S0738-3991(20)30328-1. [PMID: 32563706 DOI: 10.1016/j.pec.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/03/2020] [Accepted: 06/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study aimed to identify the perceptions, barriers, and facilitators of patient education and factors influencing the performance of patient education among hemodialysis unit nurses. METHODS This study used a descriptive correlational design in which a total of 262 nurses from 27 hemodialysis facilities in six provinces in the Republic of Korea participated. Self-administered questionnaires were used to identify the perceptions, barriers, facilitators, and performance of patient education. Data were analyzed using a t-test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression. RESULTS Factors influencing patient education performance were nurses' total clinical experience, perceptions, working experience in a hemodialysis unit, facilitators, number of nurses in the hemodialysis unit, and barriers. These variables accounted for 37.2 % of the variance in the final model. CONCLUSION Nurses' performance in patient education was significantly influenced by perceptions, facilitators, and barriers. Nurses' total clinical experience, working experience in a hemodialysis unit, and number of nurses in the unit also influenced patient education performance. PRACTICE IMPLICATIONS A nurse training program should be developed to reinforce nurses' patient education competency.
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Affiliation(s)
- Myung Jin Jung
- Chung-Ang University, Red Cross College of Nursing, Seoul, Republic of Korea
| | - Young Sook Roh
- Chung-Ang University, Red Cross College of Nursing, Seoul, Republic of Korea.
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14
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Design and Validation of Education Multimedia Program for Patients With Fecal Diversions. J Wound Ostomy Continence Nurs 2020; 47:39-44. [DOI: 10.1097/won.0000000000000603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Abstract
AIM The aim of this article was to assess how and to what degree nursing students are prepared for patient discharge teaching (DT). BACKGROUND The process of discharging patients has become more complex. Despite the expectation that nursing students will be competent in providing effective DT upon graduation, the preparation of new graduates is a problem for hospitals. METHOD A review of the literature was conducted. REVIEW The review showed that novice nurses enter the workforce unprepared to provide adequate DT due to limited communication and limited time during their education, which led to low confidence and limited knowledge. CONCLUSION Methods to overcome current barriers in DT, including simulation practices, the teach-back method, dedicated education units, collaborative efforts, discharge checklists, and health literacy identification, are presented as recommendations for nursing education.
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Khoshnood Z, Dehghan M, Iranmanesh S, Rayyani M. Informational Needs of Patients with Cancer: A Qualitative Content Analysis. Asian Pac J Cancer Prev 2019; 20:557-562. [PMID: 30803220 PMCID: PMC6897024 DOI: 10.31557/apjcp.2019.20.2.557] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/04/2018] [Indexed: 11/25/2022] Open
Abstract
One of the most important needs of patients with cancer is informational needs. Getting relevant information about the disease can lead to a proper decision making, better response to treatment, lower levels of anxiety, and higher levels of quality of life. Therefore, the current study aimed to determine the informational needs of patients with cancer in southeast Iran. Materials and Methods: This conventional qualitative content analysis was done using a descriptiveexplorative design. Data collection was done through conducting deep semi-structured interviews from September 2017 to March 2018 in cancer treatment centers of Kerman University of Medical Science, Iran. Data saturation was achieved after interviewing with 13 patients during 15 interviews. The patients were asked to narrate their experience about informational needs of cancer patients. The following concepts were considered: the unit of analysis, meaning unit, condensation, code, sub-category, category, and main category. Results: The results of the present study showed that informational needs of these patients could be categorized under one main category called awareness-oriented needs, including three subcategories. These subcategories included lack of knowledge about the nature of the disease, inappropriate control of the disease due to lack of knowledge, and lack of knowledge about cancer treatment methods. Conclusion: Results showed that patients with cancer tended to know what is the cancer and the ways of cancer treatment and complications. Therefore, it is suggested to perform further studies cultivating the awareness of cancer patients in these areas. Therefore So, It should be noted that designing and implementation of this needs assessment provide a comprehensive way to consult and collaborate with health care professionals, patients, and their families.
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Affiliation(s)
- Zohreh Khoshnood
- Nursing Research Center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
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17
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Abbasi M, Rabiei L, Masoudi R. Experience of nursing students about the barriers to patient education: a qualitative study in Iran. KOREAN JOURNAL OF MEDICAL EDUCATION 2018; 30:327-337. [PMID: 30522261 PMCID: PMC6288616 DOI: 10.3946/kjme.2018.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/16/2018] [Accepted: 05/13/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE Patient education is a dynamic and continuous process that should be implemented during the entire time of hospital stay and even afterward. Studies have shown the typically poor quality of patient education in Iran and its failure to convey the required knowledge and skills to patients. The purpose of this study was to survey the experience of nursing students in regard to the challenges of patient education in hospitals. METHODS This qualitative study was conducted using the conventional qualitative content analysis approach on a sample of 21 undergraduate nursing students (4th semester and beyond), which was drawn from the Qom Nursing and Midwifery School through purposive sampling with maximum variation. Data were collected through semi-structured interviews conducted over a period of 45 to 75 minutes, and were analyzed using the conventional qualitative content analysis. RESULTS Results were derived from the experiences of 21 nursing students (nine males, 12 females) about the research subject. The primary themes identified in the study were the student-related, patient-related, instructor-related, education environment-related, and curriculum-related barriers to patient educations. CONCLUSION Participants believed that patient education in Iranian hospitals is faced with many challenges. Nursing instructors and curriculum planners should ensure more emphasis on patient education at the initial semesters of nursing education curriculum and make sure that it is included in the evaluation of students. Hospital officials should provide a dedicated education environment with suitable facilities, tools, and atmosphere for patient education. Also, special education programs need to be developed for less educated patients.
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Affiliation(s)
- Mohammad Abbasi
- Department of Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
| | - Leili Rabiei
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Reza Masoudi
- Community Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Crawford T, Roger P, Candlin S. Supporting patient education using schema theory: A discourse analysis. Collegian 2018. [DOI: 10.1016/j.colegn.2017.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McKenna L, Irvine S, Williams B. ‘I didn't expect teaching to be such a huge part of nursing’: A follow-up qualitative exploration of new graduates' teaching activities. Nurse Educ Pract 2018; 32:9-13. [DOI: 10.1016/j.nepr.2018.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 06/18/2018] [Accepted: 06/24/2018] [Indexed: 11/26/2022]
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20
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Pinchera B, DelloIacono D, Lawless CA. Best Practices for Patient Self-Management: Implications for Nurse Educators, Patient Educators, and Program Developers. J Contin Educ Nurs 2018; 49:432-440. [DOI: 10.3928/00220124-20180813-09] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/22/2018] [Indexed: 12/16/2022]
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Lelorain S, Bachelet A, Bertin N, Bourgoin M. French healthcare professionals' perceived barriers to and motivation for therapeutic patient education: A qualitative study. Nurs Health Sci 2017; 19:331-339. [PMID: 28681481 DOI: 10.1111/nhs.12350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 01/20/2023]
Abstract
Therapeutic patient education is effective for various patient outcomes; however, healthcare professionals sometimes lack the motivation to carry out patient education. Surprisingly, this issue has rarely been addressed in research. Therefore, this study explores healthcare professionals' perceived barriers to and motivation for therapeutic patient education. Healthcare professionals, mainly nurses, working in different French hospitals were interviewed. Thematic content analysis was performed. Findings included a lack of skills, knowledge, and disillusionment of the effectiveness of therapeutic patient education were features of a demotivated attitude. In contrast, a positive attitude was observed when therapeutic patient education met a need to work differently and more effectively. A key factor motivating professionals was the integration of therapeutic patient education in routine care within a multidisciplinary team. To keep healthcare professionals motivated, managers should ensure that therapeutic patient education is implemented in accordance with its core principles: a patient-centered approach within a trained multidisciplinary team. In the latter case, therapeutic patient education is viewed as an efficient and rewarding way to work with patients, which significantly motivates healthcare professionals.
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Affiliation(s)
- Sophie Lelorain
- University of Lille, CNRS, Teaching Hospital of Lille, UMR 9193 - SCALab - Cognitive & Affective Sciences, Lille, France
| | - Adeline Bachelet
- University of Lille, CNRS, Teaching Hospital of Lille, UMR 9193 - SCALab - Cognitive & Affective Sciences, Lille, France
| | - Nicole Bertin
- Teaching Hospital of Lille, Transversal Unit of Patient Education, Lille, France
| | - Maryline Bourgoin
- Teaching Hospital of Lille, Transversal Unit of Patient Education, Lille, France
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Crawford T, Roger P, Candlin S. The interactional consequences of 'empowering discourse' in intercultural patient education. PATIENT EDUCATION AND COUNSELING 2017; 100:495-500. [PMID: 27743732 DOI: 10.1016/j.pec.2016.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/24/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Patient education is an important part of nurses' roles; however the inconsistent quality of communication skills, including those of registered nurses (RNs) from culturally and linguistically diverse (CALD) backgrounds, risk patient safety. Empowerment in patient education has been found to influence patients' self-efficacy and participation in decision-making. Discourse analysis of a whole interaction is used in this paper to trace the consequences of patient education where empowering discourse is displayed by an RN from a CALD background. METHODS Ethnographic techniques of participant observation and audio recordings of naturally occurring interactions between nurses from CALD backgrounds and their patients were conducted and analysed using interactional sociolinguistic (IS) and theme oriented discourse analytic approaches. RESULTS The interactional consequences of the nurse's empowering approach are readily observable in the data. The RN addresses the patient's education needs through a respectful encounter that illustrates the patient's active involvement. CONCLUSION Examining the interactional consequences of empowering discourse demonstrates its effectiveness, and illustrates how empowering behaviour can be integrated into patient education, thus offering an alternative to traditional approaches. PRACTICAL IMPLICATIONS Greater awareness of how to use empowering discourse will offer an alternative and consistent approach that enables nurses to facilitate patient-centred education.
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Affiliation(s)
- Tonia Crawford
- Linguistics Department, Macquarie University, Balaclava Road, North Ryde, Lecturer, University of Sydney, NSW 2109, Australia.
| | - Peter Roger
- Linguistics Department, Macquarie University, Sydney, Australia.
| | - Sally Candlin
- Linguistics Department, Macquarie University, Sydney, Australia.
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Karimi Moonaghi H, Emami Zeydi A, Mirhaghi A. Patient education among nurses: bringing evidence into clinical applicability in Iran. INVESTIGACION Y EDUCACION EN ENFERMERIA 2016; 34:137-151. [PMID: 28569983 DOI: 10.17533/udea.iee.v34n1a16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/04/2015] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of this study was to present a comprehensive review of the literatures describing barriers and facilitators of patient education (PE) perceived by Iranian nurses in order to explain clinical applicability of patient education. METHODS Review of the literature was undertaken using the international databases including PubMed/Medline, Scopus, ScienceDirect, as well as Google Scholar. Also, Persian electronic databases such as Magiran, SID and IranMedex were searched. Electronic databases were searched up from conception to September 2014 using search terms: "patient education", " patients education", "patient teaching", "patient training", "nurse", " nurses", " nursing", " and "Iran". Only studies were included that were related to barriers and facilitators of PE among Iranian nurses. RESULTS Twenty-seven studies were included. The main influential barriers were categorized into three major areas: 1) Nurse-related factors: nursing shortage 2) Administration-related factors: unsupportive organizational culture, and 3) Patient-related factors: low compliance. The most perceived facilitators were recognized as "increasing, selecting and training special nurses for providing PE" and "providing PE courses for nurses and appropriate facilities for PE". CONCLUSION Iranian nurses encounter barriers in PE, and the most frequently encountered barriers were related to administration factors. These findings have implications for administrators and managers in health settings. In order to promote PE among nurses, administrators should create a supportive environment and use effective strategies to smooth the progress of PE by nurses in their practice in order to ensure optimal outcomes for patients.
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Affiliation(s)
| | | | - Amir Mirhaghi
- Mashhad University of Medical Sciences, Mashhad, Iran,
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Yousefy A, Yazdannik AR, Mohammadi S. Exploring the environment of clinical baccalaureate nursing students' education in Iran; A qualitative descriptive study. NURSE EDUCATION TODAY 2015; 35:1295-1300. [PMID: 26298274 DOI: 10.1016/j.nedt.2015.07.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 07/24/2015] [Accepted: 07/30/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Today's students are the nurses of tomorrow. They need appropriate clinical learning opportunities in order to shape their professional identity, attitudes and values. Despite undeniable progresses of nursing education in Iran, the quality of the clinical education in Iran is not favorable. There is a need to explore the environment of clinical baccalaureate nursing students' education for developing, maintaining and enhancing the quality of clinical program. METHOD This is a qualitative study and was conducted based on content analysis multimethod design. Data were collected by individual interviews, focus groups and direct observations. 54 nursing students and 8 clinical educators from the four geographically diverse universities in the Iran composed the study sample. A purposive sampling was used. RESULT Five themes were emerged from data analysis including; ambiguity in the nursing care role, routine-based nursing care, uncritical and dependent thinking climate, incompetency of clinical educators and patient education as important component of nursing. CONCLUSIONS The findings of this study describe a clearer understanding of the real environment of the clinical education in Iran. All of themes that emerged from the study play an important role in student learning and nursing education. It is crucial to pay more attention to reconsider care concept as an operational component of nursing, maximize meaningful learning opportunities, reevaluate clinical instructor as role models and prepare effective operational plan to combine theoretical and evidence based knowledge with clinical practice.
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Affiliation(s)
- Alireza Yousefy
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ahmad reza Yazdannik
- Critical Care Department, Nursing and Midwifery Faculty, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sepideh Mohammadi
- Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
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