Health education and competency scale: Development and testing

Assessing the Competence of Nursing Students in Clinical Practice: The Clinical Preceptors' Perspective

Nursing students' integration of theoretical knowledge and practical abilities is facilitated by their practice of nursing skills in a clinical environment. A key role of preceptors is to assess the learning goals that nursing students must meet while participating in clinical practice. Consequently, the purpose of this study was to explore the current evidence in relation to competency assessment and assessment approaches, and the willingness of preceptors for assessing nursing students' competency in a clinical setting. The scoping review used the five-stage methodological framework that was developed by Arksey and O'Malley, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Relevant studies were searched by applying a comprehensive literature search strategy up to April 2024 across the following databases: CINAHL, OVID MEDLINE, EMBASE, and PUBMED. A total of 11,297 studies published between 2000 and April 2024 were revealed, and 38 were eligible for inclusion, which the research team categorised into three main themes: definitions of competence, tools for assessing competence and preceptors' and mentors' viewpoints in relation to the assessment of nursing students' competence. This review established that there are a multitude of quantitative instruments available to assess clinical competence; however, a lack of consistency among assessment instruments and approaches between countries and higher education institutions is prevalent. Existing research evidence suggests that the preceptors carried out the assessment process clinically and they found difficulties in documenting assessment. The assessing of nursing students' competency and the complexity of assessment is a concern for educators and mentors worldwide. The main concern centers around issues such as the interpretation of competence and complex measurement tools.

Instruments for measuring patient health education competence among nursing personnel: protocol for a COSMIN-based systematic review

INTRODUCTION

Health education, as a crucial strategic measure of disease prevention and control in the 21st century, has become an important part of healthcare. As the main deliverers of patient health education, nursing personnel's patient health education competence (PHEC) has received much attention. Instruments for assessing the PHEC of nursing personnel have been developed internationally, but there is a lack of systematic reviews and evaluations of the psychometric properties of these instruments. To effectively select appropriate PHEC assessment instruments in specific contexts, a systematic and comprehensive review and evaluation of these measurement instruments are needed. The goal of this systematic review is to systematically evaluate the psychometric properties of existing PHEC instruments.

METHODS AND ANALYSIS

In this study, eight databases will be searched between 1 March 2023 and 31 2023 to retrieve studies that include instrument(s) measuring the PHEC of nursing personnel. Two researchers will independently perform literature screening, data extraction and literature evaluation. In case of disagreement, a third researcher will be involved in the resolution. The measurement properties of PHEC assessment instruments will be systematically reviewed based on the consensus-based standards for the selection of health measurement instruments (COMSIN) methodology and guideline.

ETHICS AND DISSEMINATION

Ethical approval is not applicable for this study. We will share the findings from the study at national and/or international conferences and in a peer-reviewed journal in the fields of health education and/or patient education.

PROSPERO REGISTRATION NUMBER

CRD42023393293.

Instruments for measuring patient health education competence among nursing personnel: A COSMIN-based systematic review

AIM

The goal of this systematic review was to systematically evaluate the psychometric properties of existing patient health education competence instruments.

BACKGROUND

The patient health education competence of nursing personnel is a crucial factor that determines the quality of patient education, patients' quality of life, and patients' health-related outcomes. Although different instruments have been developed to assess patient health education competence, there is no comprehensive and rigorous systematic review to provide an overview and critical appraisal on these instruments. Therefore, a comprehensive systematic review of the measurement properties of such instruments is necessary.

DESIGN

A systematic review based on COSMIN methodology.

METHODS

In this study, six English databases and two Chinese databases were systematically searched for relevant publications, to retrieve studies that include instrument(s) measuring the patient health education competence of nursing personnel. Two researchers independently performed literature screening, data extraction, and literature evaluation.

RESULTS

A total of 13 studies reporting 11 eligible instruments were included. No studies have reported cross-cultural validity, measurement error, or responsiveness of the instruments.

CONCLUSION

Based on the findings of this study, five instruments were recommended as Grade A, and the remaining six instruments were recommended as Grade B. The Nurse Health Education Competence Instrument is considered the most appropriate tool for assessing patient health education competence among the available instruments. Future related instrument development should be based on more rigorous testing and reporting, to ensure the validity and reliability of the instruments.

Instruments for measuring empowering patient education competence of nurses: Systematic review

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.

Health education competence: An investigation of the health education knowledge, skills and attitudes of nurses in Kazakhstan

AIMS

This study assessed the nurses' knowledge of, skills on and attitudes toward health education among nurses working at the University Medical Center Corporate Fund (UMC) in Kazakhstan. The personal and professional factors influencing the nurses' knowledge of, skills on and attitudes toward health education were also investigated.

BACKGROUND

Health education is one of the nurses' fundamental responsibilities. Nurses' role in health education is critical in empowering patients and their families to live healthier lives, thus ensuring optimum health, well-being and quality of life. However, in Kazakhstan, where the nursing profession is still establishing its professional autonomy, data concerning the competence of Kazakh nurses in health education is unknown.

DESIGN

A quantitative study, specifically the cross-sectional, descriptive and correlational designs.

METHODS

The survey was performed at UMC in Astana, Kazakhstan. Using a convenience sampling technique, 312 nurses participated in the survey from March to August 2022. The "Nurse Health Education Competence Instrument" was used to collect data. The personal and professional characteristics of the nurses were also collected. Standard multiple regression analysis examined the personal and professional variables influencing the nurses' health education competence.

RESULTS

The respondents' average score in the "Cognitive domain," "Psychomotor domain," and "Affective-attitudinal domain" was 3.80 (SD = 0.66), 3.99 (SD = 0.58) and 4.04 (SD = 0.62), respectively. The nurses' category as a nurse, medical center, attendance to health education training/seminars in the last 12 months, provision of health education to a patient in the last week and perception of health education's significance in nursing practice were significant predictors of the nurses' health education competence contributing an approximately 24.4 %, 29.3 % and 27.1 % of the variance of the health education knowledge (R² = 0.273, Adjusted R² = 0.244), skills R² = 0.320, Adjusted R² = 0.293) and attitudes (R² = 0.299, Adjusted R² = 0.271).

CONCLUSIONS

The nurses reported high levels of health education competence (knowledge, attitudes and skills). The personal and professional factors influencing the nurses' competence in health education are essential to consider when developing interventions and healthcare policies to ensure nurses' competent provision of health education to patients.

Peer-led interventions to reduce alcohol consumption in college students: A scoping review

Risky alcohol consumption among college students is a significant public health issue. In the college setting, students can collaborate in the implementation of peer-led interventions. To date, evidence of peer-led programmes in reducing harmful alcohol consumption in this population is inconclusive. The aim of the current scoping review is to provide a broad overview by systematically examining and mapping the literature on peer-led interventions for preventing risky alcohol consumption by college students. The specific aims were to (1) identify the underlying focus of the interventions and assess their (2) effectiveness and (3) feasibility. A comprehensive search was conducted in PubMed, PsycINFO, CINAHL, Cochrane Library, Web of Science, DART-Europe, RCAAP, Trove and ProQuest. The inclusion criteria were peer-led interventions that exclusively addressed alcohol consumption, college students as the target population and interventional studies (randomised controlled trials, quasi-experimental studies, systematic reviews and meta-analyses of interventions). The methodological quality of the articles was evaluated. From 6654 potential studies, 13 were included. Nine interventions were described within these studies: Voice of Reason programme, Brief Advice sessions, Peer Theatre, Alcohol Education programme, Perceptions of Alcohol Norms intervention, Motivational Intervention, Alcohol Skills Training programme, Lifestyle Management Class and the Brief Alcohol Screening and Intervention for College Students. Only the last showed significant reductions in three of the four outcome measures: quantity and frequency of drinking, estimated peak blood alcohol concentration and alcohol-related consequences. It did not significantly decrease the number of heavy-drinking episodes. Peer interventions may be effective in preventing alcohol use among college students, although the evidence is weak and scarce. Further research is needed to strengthen the findings about peer-led interventions.

A Validation Study of the Korean Version of the Nurses' Patient Education Questionnaire

This study aimed to investigate the internal consistency reliability and construct validity of the Korean version of the Nurses’ Patient Education Questionnaire. An accurate assessment of nurses’ perceived patient education competency is required, and these needs assessment results can provide the evidence for designing a continuing education to empower and equip nurses with optimal competency for patient education. A cross-sectional study was used to which a convenience sample of 262 hemodialysis unit nurses in the Republic of Korea. In the exploratory factor analysis, the questionnaire consisted of 26 items belonging to seven factors: (1) nurse belief and knowledge; (2) documentation of patient education activities; (3) collegial teamwork; (4) educational environment; (5) interdisciplinary cooperation; (6) education foundation; and (7) health care organization, all of which accounted for 70.2% of the variance. The internal consistency reliability was 0.91 for the overall scale and each factor at 0.70 to 0.77. The questionnaire provides a valid and reliable instrument to assess nurses’ patient education competency.

Nurses' knowledge, skills and personal attributes for competent health education practice: An instrument development and psychometric validation study

AIM

To develop and psychometrically test the Nurse Health Education Competence Instrument for assessing nurses' knowledge, skills and personal attributes concerning competent health education practice.

DESIGN

A psychometric instrument development and validation study.

METHODS

A four-step approach was used: Step 1) operational definition based on an up-to-date concept analysis and experts' judgement; step 2) item generation and content validation by expert panel and target population; step 3) item analysis based on acceptability, internal consistency and face validity; and step 4) psychometric evaluation based on construct validity, criterion validity, internal consistency and stability, conducted from January -February 2019 with 458 hospital-care nurses.

RESULTS

The operational framework and expert groups showed good content validity, resulting in the first version. From the initial 88-item pool, 58 items were retained after item analysis. Exploratory factor analysis revealed three scales concerning the cognitive (three-factor solution with 23 items), psychomotor (two-factor solution with 26 items) and affective-attitudinal (one-factor solution with nine items) competency domains, which respectively accounted for 58%, 53% and 54% of the variance. Known-group study demonstrated significant differences by years working in the service and training received in health education, providing evidence for the measure's sensitivity. The three scales correlated positively with the criterion variable. Overall Cronbach alphas for the cognitive, psychomotor and affective-attitudinal scales were 0.95, 0.95 and 0.90, respectively. Intraclass correlation coefficients were >0.70.

CONCLUSIONS

The newly developed Nurse Health Education Competence Instrument is an original and tested self-reporting psychometric tool, being the first to identify nurses' knowledge, skills and attributes necessary for planning and assessing health education practice competency.

IMPACT

The instrument permits measurable insights into nurses' perceptions regarding their health education competence and related educational needs. This study provides a valid and specific learning tool that is appropriate to use both in clinical practice and in nursing education programmes.

Factors influencing the patient education performance of hemodialysis unit nurses

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.

Scale for evaluating food and nutrition education practices in Primary Health Care

ABSTRACT Objective To develop, validate and analyse intra- and inter-raters’ agreement and reliability of a scale for the evaluation of food and nutrition education practices in primary health care. Methods Three theoretical references were used for the development of items with answers on a 4-point scale (not observed, partially/satisfactorily/fully observed): the Brazilian Dietary Guidelines, the Interprofessional Collaborative Practice and the Family Health Strategy as models for organizing primary health care. The scale was submitted for content and face panel validation and it was further reevaluated online. Thirty specialists used the scale for the rating of 4 videos produced for the study showing food and nutrition education practices in primary health care settings. Intra- and inter-raters agreement and reliability were analyzed by test at one time point and retest 30 days later. Results The scale initially included 72 items but was reduced to 17 items after content and face validation, together with a fill-out manual that was reviewed by experts. In the re-evaluation, all 17 items were maintained, and content adjustments were made in the manual. Thirty raters applied the scale to the videos in the test, and 28 in the retest. All videos obtained combined kappa values of >0.4. In the test-retest, 19 raters showed >80% agreement; in the inter-rater evaluation, 14 raters generated kappa values >0.75. Conclusion The scale underwent content and face validation and showed to be useful to diagnose the absence and the full addressing of the Brazilian Dietary Guidelines content with good intra- and inter-rater agreement and reliability in different settings of Primary Health Care.