Evaluation of antenatal simulation-based learning on satisfaction and self-confidence levels among Thai undergraduate nursing students during the COVID-19 pandemic: a mixed-method study

BACKGROUND

During the COVID-19 pandemic, simulation-based learning (SBL) serves as an alternative teaching strategy for nursing students facing restricted access to antenatal clinical practicum. However, the factors predicting nursing students' satisfaction, self-confidence, and their learning experiences remain unclear.

OBJECTIVE

To identify factors predict satisfaction and self-confidence and explore the learning experiences of antenatal SBL.

METHODS

A Mixed methods research of the cross-sectional study design and descriptive qualitative research was conducted. A total of 100 third year nursing students who finished the Maternity-Newborn Nursing and Midwifery Practice course using antenatal simulation-based learning were invited to complete the online questionnaires. A total of seven questionnaires were administered, including a demographic questionnaire, the Attitude Scale toward Simulation-Based Education (SBE), the Professional Identity Scale for Nursing Students, the Perceived Stress Scale, the Evaluation of Teaching Competencies Scale, the Simulation Design Scale: Student Version, and the Student Satisfaction and Self-Confidence in Learning. The 20 nursing students who completed survey were asked to participate a qualitative focus group discussion. Multiple regression analysis was performed to investigate predictors, while qualitative data were analyzed using content analysis.

RESULTS

The quantitative results showed high levels of satisfaction (mean = 20.55, SD = 3.17) and self-confidence (mean = 32.44, SD = 4.76) after completing the antenatal SBL. In regression analysis, attitude toward SBE (Beta = 0.473, t = 5.376, p < 0.001) and attitude toward antenatal care simulation design (Beta = 0.338, t = 2.611, p < 0.011) were significantly associated with a high level of satisfaction with antenatal SBL, which accounted for 44.0% of the variance explained in satisfaction. Only attitude toward SBE was significantly associated with a high level of self-confidence in antenatal SBL (Beta = 0.331, t = 3.773, p < 0.001), which accounted for 45.0% of the variance explained in self-confidence. The qualitative results generated four themes: (1) positive attitude toward antenatal simulation; (2) turning reassurance into confidence; (3) I am really happy to learn; and (4) being a good nurse motivates and stresses me.

CONCLUSIONS

Antenatal SBL is an effective teaching strategy that can support nursing students to build clinical confidence. Creating a positive learning environment allows students to have a positive attitude and experience with simulations.

Exploring nurses' experiences of value congruence and the perceived relationship with wellbeing and patient care and safety: a qualitative study

Background

Values are of high importance to the nursing profession. Value congruence is the extent to which an individual's values align with the values of their organisation. Value congruence has important implications for job satisfaction.

Aim

This study explored nurse values, value congruence and potential implications for individual nurses and organisations in terms of wellbeing and patient care and safety.

Method

Fifteen nurses who worked in acute hospital settings within the UK participated in semi-structured telephone interviews. Thematic analysis was utilised to analyse the data.

Results

Four themes were identified: organisational values incongruent with the work environment; personal and professional value alignment; nurse and supervisor values in conflict; nurses' values at odds with the work environment. Perceived value incongruence was related to poorer wellbeing, increased burnout and poorer perceived patient care and safety. The barriers identified for nurses being able to work in line with their values are described.

Conclusions

Value congruence is important for nurse wellbeing and patient care and safety. Improving the alignment between the values that organisations state they hold, and the values implied by the work environment may help improve patient care and safety and support nurses in practice.

Concept analysis of nurses' work values

This study aimed to clarify the nature and definition of nurses' work values. To this end, we adopted Walker and Avant's (2019) concept analysis procedure. We searched PubMed, CINAHL, Scopus, and Web of Science for previous literature that sampled nurses and nursing students published before September 2020. From 104 studies, 30 were analyzed. Citation sources for the definition of work values were also included in the target literature. After clarifying all usages of the concept, important attributes were determined, and model cases, borderline cases, related cases, antecedents, consequences, and empirical referents were identified. Nurses' work values were defined as: enduring beliefs about the preferable conditions and outcomes nurses desire through their work, that place importance on their work, and that are the principles and standards that guide attitudes, judgments, and behaviors. Additionally, the antecedents for nurses' work values included basic human values, gender, and generation, and the consequences comprised attitudes, judgments, and behaviors related to work. Clarification of the concept enables the proper utilization of knowledge regarding nurses' work values and the development of a related theory.

Personal values among first-year medical and nursing students: A cross-sectional comparative study

BACKGROUND

Collaboration in healthcare is essential but differences in personal values can be a potential source of disagreements between physicians and nurses.

OBJECTIVES

The purpose of this study was to verify if and to what extent there were divergences in the personal values profile between medical and nursing students at the beginning of their education and training. A second aim was to explore gender differences in personal values.

DESIGN

This is an observational cross-sectional study.

SETTINGS

This study was conducted at one University in northern Italy.

PARTICIPANTS

We compared the personal values of 393 first-year medical students with those of 403 first-year nursing students.

METHODS

The Portrait Values Questionnaire-40 was administered and analyses of variance were performed to assess degree group and gender differences in terms of personal values.

RESULTS

Medical students scored significantly higher than nursing ones on values related to dominance over others and personal success. Female students significantly outscored males on personal values that reflect other-oriented and social focus, whereas male students obtained higher scores than females on personal values related to personal and selfish orientation.

CONCLUSIONS

Schwartz's Theory of Basic Human Values may be a valuable theoretical framework for interprofessional education to promote a common reflection on personal values held by medical and nursing students since the early years of study.

Influences of nursing students' career planning, internship experience, and other factors on professional identity

BACKGROUND AND OBJECTIVE

Nursing professional identity is an important factor in the development of nursing education and clinical practice. Career-planning curriculums enable students to learn relevant knowledge and skills in a targeted manner, in addition to achieve career targets. Assessment and analysis of the present situation of Chinese nursing students' career planning and professional identity may provide an important guidance for the improvement of teaching content and quality of the career-planning curriculum. This study aimed to describe nursing students' professional identity, and to find out influences of nursing students' career planning, internship experience, and other factors on professional identity.

METHODS

A descriptive cross-sectional research method was employed to conduct a questionnaire on 453 full-time junior and senior undergraduate nursing students in China in December 2019.

RESULTS

The average score for nursing students' professional identity was 101.42, which is at a moderately low-level. There was a significantly positive correlation between the level of nursing students' career planning and professional identity (r = 0.529, P < 0.01). Nursing students' professional identity was also influenced by grade, age, acceptance of career-planning curriculums, and other factors.

CONCLUSION

The results indicated that the level of professional identity in nursing students is closely associated with their career planning. One strategy to improve this situation is to motivate universities to pay further attention to the effectiveness of career-planning curriculums and, to improve the quality of teaching and guidance system.

Personal values among undergraduate nursing students: A cross-sectional study

BACKGROUND

Personal values influence nursing students' development of professional values, which affect professional outcomes, and how nursing students react to different situations. Personal values can be shaped by different factors, including culture, gender, and age.

AIMS

To explore personal values held by nursing students, and to verify if and how gender and year of study affect nursing students' personal values.

RESEARCH DESIGN

A multicenter, cross-sectional study was used.

PARTICIPANTS AND RESEARCH CONTEXT

The whole population of nursing undergraduate students available at the time was recruited from eight centers of two Universities, composing a sample of 947 students. Demographic data were collected and it was administered the Portrait Values Questionnaire.

ETHICAL CONSIDERATIONS

Ethical approval was obtained from the Institutional Review Boards of the University of the participating centers.

FINDINGS

The study sample was mainly composed of young (92.6%, n = 877), female (77.3%, n = 732), Italian (95.8%, n = 907), and unmarried (98.6%, n = 934) nursing students. The most important value for nursing students, consistently through the years of nursing school, was Self-transcendence, which has the motivational emphasis on helping others and selflessness. Then, we found that male students had higher levels of Power (p < 0.001) and Achievement (p = 0.031), while female students outscored male students in Benevolence (p = 0.005) and Security (p = 0.006). Year of study showed no statistically significant difference.

DISCUSSION

Nursing students express high levels in hetero-directed values. Male nursing students, although they choose a stereotypically feminine profession, outscored females in stereotypical masculine values such as dominance and success. This is the first study that describes the personal value profile of undergraduate nursing students, according to the Theory of Basic Human Values, and it is a starting point for future research.

CONCLUSION

Nursing educators might want to consider the findings from this study while guiding students in developing awareness for their personal values.

Effectiveness of spiritual care training to enhance spiritual health and spiritual care competency among oncology nurses

Background

Although spiritual care is a basic element of holistic nursing, nurses’ spiritual care knowledge and abilities are often unable to satisfy patients’ spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care.

Design

A nonrandomized controlled trial.

Objective

To establish a spiritual care training protocol and verify its effectiveness.

Methods

This study recruited 92 nurses at a cancer treatment hospital in a single province via voluntary sign-up. The nurses were divided into two groups—the study group (45 people) and the control (wait-listed) group (47 people)—using a coin-toss method. The study group received one spiritual care group training session every six months based on their routine nursing education; this training chiefly consisted of lectures by experts, group interventions, clinical practice, and case sharing. The control group participated in monthly nursing education sessions organized by the hospital for 12 continuous months.

Results

After 12 months of intervention, the nurses in the study group had significantly higher overall spiritual health and spiritual care competency scores as well as significantly higher scores on all individual dimensions compared with those in the control group (P < 0.01).

Conclusions

A spiritual care training protocol for nurses based on the concept of mutual growth with patients enhances nurses’ spiritual well-being and spiritual care competencies.

Effects of perceived stress and professional values on clinical performance in practice nursing students: A structural equation modeling approach

BACKGROUND

Clinical performance is regarded as a basic and core content of nursing quality. Professional values of nursing students may play an important role in improving clinical performance. Few studies reveal the relationship between professional values, perceived stress and clinical performance. This research has found that professional values play a moderating role in the relationship between perceived stress and clinical performance.

OBJECTIVE

To examine the negative association between perceived stress and clinical performance among practice nursing students, and to determine whether professional values plays a moderating role in the relationship between perceived stress and clinical performance among Chinese practice nursing students.

DESIGN

A cross-sectional descriptive design has been used.

METHODS

From May to June 2017, a total of 435 Chinese practice nursing students from 4 hospitals filled out the questionnaires. The response rate was 94.57%. Three questionnaires including the Perceived Stress Scale (PSS), Nursing Professional Value Scale-Revised (NPVS-R), and Clinical Performance Scale (CPS). Structural equation modeling was used to deal with the relationships among perceived stress, professional values, and clinical performance.

RESULTS

Perceived stress was negatively associated with clinical performance (P < 0.01). Professional values significantly affected clinical performance (P < 0.01) and moderated the relationship between perceived stress and clinical performance (P < 0.01).

CONCLUSIONS

Perceived stress is negatively related to clinical performance among Chinese practice nursing students, and professional values moderates the relationship between perceived stress and clinical performance, which can form scientific evidence to develop intervention strategies to improve clinical performance.

The development of the Professional Values Model in Nursing

One of the most important criteria for professionalism is accumulation of knowledge that is usable in professional practice. Nursing models and theories are important elements of accumulating nursing knowledge and have a chance to guarantee the ethical professional practice. In recent years, there has been an increase in the use of models in nursing research and newly created terminology has started to be used in nursing. In this study, a new model, termed as the Professional Values Model, developed by the authors was described. Concepts comprising the conceptual framework of the model and relations between the concepts were explained. It is assumed that awareness about concepts of the model will increase not only the patients’ satisfaction with nursing care, but also the nurses’ job satisfaction and quality of nursing care. Contemporary literature has been reviewed and synthesized to develop this theoretical paper on the Professional Values Model in nursing. Having high values in nursing increases job satisfaction, which results in the improvement of patient care and satisfaction. Also, individual characteristics are effective in the determination of individual needs, priorities, and values. This relation, proved through research about the Professional Values Model, has been explained. With development of these concepts, individuals’ satisfaction with care and nurses’ job satisfaction will be enhanced, which will increase the quality of nursing care. Most importantly, nurses can take proper decisions about ethical dilemmas and take ethical action when they take these values into consideration when giving care. The Professional Values Model seems suitable for nurse managers and it is expected that testing will improve it. Implementation of the Professional Values Model by nurse managers may increase motivation of nurses they work with. It is suggested that guidance by the Professional Values Model may help in enhancement of motivation efforts of the nurse managers and therefore should be taken into account.

Job satisfaction and attitudes towards nursing care among nurses working at Mzuzu Central Hospital in Mzuzu, Malawi

BACKGROUND

Job satisfaction is a major determinant of performance at the workplace. Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and attitude towards nursing care at Mzuzu Central Hospital in Mzuzu, Malawi.

METHODS

This was a descriptive correlational study. Eighty-nine nurses were selected using simple random sampling. A self-administered questionnaire was used to collect data. Data were analysed using Stata (version 12). Frequencies, means, and standard deviations were used to summarise sociodemographic data and also to determine job satisfaction and attitudes towards nursing care among the participants. Independent t-tests were used to determine if differences in professional qualifications, job title, work experience, or the clinical setting in which the nurses worked were associated with differences in job satisfaction and attitude. Pearson's product-moment correlation was used to determine the relationship between job satisfaction and attitude in the study sample.

RESULTS

The nurses who participated in this study generally had positive attitudes towards nursing care and were moderately satisfied with their jobs. There was a significant variation in attitude depending on the amount of time a nurse worked at a particular post (P = 0.0308), as well as the amount of time a nurse had worked at the hospital (P = 0.0012). There was a significant positive relationship between job satisfaction and attitude (r = 0.226, P = 0.033).

CONCLUSIONS

The nurses in the study sample were moderately satisified with their work and generally had positive attitudes towards nursing care. There was a positive correlation between attitude towards nursing care and job satisfaction. Addressing factors which dissatisfy nurses can promote nurses' attitudes and likely improve performance and patient care.

Caring for elder patients: Mutual vulnerabilities in professional ethics

BACKGROUND:

Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent.

OBJECTIVES:

The goal was to understand caregivers' concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of professional ethics within the care setting.

RESEARCH DESIGN:

A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland.

PARTICIPANTS AND RESEARCH CONTEXT:

A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels.

ETHICAL CONSIDERATIONS:

Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland] (2014-015).

FINDINGS:

Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation.

DISCUSSION:

Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics.

CONCLUSION:

Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities.

[Opinions and nurse' satisfaction with INICIARE 2.0 scale: A qualitative study in a hospital setting]

OBJECTIVE

To know the opinions and satisfaction of nurses with the use of INICIARE, an instrument developed for assessment of nursing care needs in hospitalized patients. INICIARE is based on Virginia Henderson's conceptual model, and built up with indicators of Nursing Outcomes Classification (NOC) taxonomy.

METHOD

Exploratory qualitative study, using focus group technique for data collection. The sessions were recorded until saturation of information. A content analysis of syntactic, semantic and pragmatic levels of transcripts was performed. Participants' informed consent was obtained.

RESULTS

Three focus groups were developed; 24 nurses from two Public Hospitals in Andalusia (Southern Spain) participated; and four thematic categories were created to measure satisfaction with the instrument. INICIARE helped the nursing process. Its closed format, and items in NOC taxonomy streamline evaluation, facilitates its inclusion in Electronic Information Systems, and strengthens effective communication at all levels.

CONCLUSIONS

Nurses are satisfied with the use of INICIARE scale as a tool to enhance quality of care. It also has potential to be used as a tool for decision making in management of nursing care.

Spiritual well-being and moral distress among Iranian nurses

BACKGROUND

Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues.

OBJECTIVE

This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses.

RESEARCH DESIGN

A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised.

ETHICAL CONSIDERATIONS

This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered.

FINDINGS

Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress.

DISCUSSION AND CONCLUSION

This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being.

Reliability and validity of the Salford-Scott Nursing Values Questionnaire in Turkish

BACKGROUND

Developing professional values among nursing students is important because values are a significant predictor of the quality care that will be provided, the clients' recognition, and consequently the nurses' job satisfaction. The literature analysis showed that there is only one validated tool available in Turkish that examines both the personal and the professional values of nursing students.

OBJECTIVE

The aim of this study was to assess the reliability and validity of the Salford-Scott Nursing Values Questionnaire in Turkish.

DESIGN OF THE STUDY

This study was a Turkish linguistic and cultural adaptation of a research tool. Participants and research context: The sample of this study consisted of 627 undergraduate nursing students from different geographical areas of Turkey. Two questionnaires were used for data collection: a socio-demographic form and the Salford-Scott Nursing Values Questionnaire. For the Salford-Scott Nursing Values Questionnaire, construct validity was examined using factor analyses. Ethical considerations: The study was approved by the Cumhuriyet University Faculty of Medicine Research Ethics Board. Students were informed that participation in the study was entirely voluntary and anonymous.

RESULTS

Item content validity index ranged from 0.66 to 1.0, and the total content validity index was 0.94. The Kaiser-Meyer-Olkin measure of sampling was 0.870, and Bartlett's test of sphericity was statistically significant (x² = 3108.714, p < 0.001). Construct validity was examined using factor analyses and the six factors were identified. Cronbach's alpha was used to assess the internal consistency reliability and the value of 0.834 was obtained.

CONCLUSION

Our analyses showed that the Turkish version of Salford-Scott Nursing Values Questionnaire has high validity and reliability.

Professional values, job satisfaction, career development, and intent to stay

BACKGROUND

Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse-an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future.

RESEARCH OBJECTIVE

The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system.

RESEARCH DESIGN

A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system.

FINDINGS

Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention.

DISCUSSION

Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future.

CONCLUSION

Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.

Levels of Conscience and Related Factors among Iranian Oncology Nurses

BACKGROUND

Having a conscience is one of the main pre-requisite of providing nursing care. The knowledge regarding levels of conscience among nurses in eastern countries is limited. So, the purpose of this study was to examine the level of conscience and its related factors among Iranian oncology nurses.

MATERIALS AND METHODS

This descriptive-correlational study was conducted in 3 hospitals in Tabriz, Iran. Overall, 68 nurses were selected using a non-probability sampling method. The perceptions of conscience questionnaire was used to identify the levels of conscience among nurses. The data were analyzed using SPSS version 13.0.

RESULTS

The mean nurses' level of conscience scores was 72.7. In the authority and asset sub-scales nurses acquired higher scores. The mean of nurses' scores in burden and depending on culture sub-scales were the least. Also, there were no statistical relationship between some demographic characteristics of participants and their total score on the perceptions of conscience questionnaire.

CONCLUSIONS

According to study findings Iranian nurses had high levels of conscience. However, understanding all the factors that affect nurses' perception of conscience requires further studies.

Values in nursing students and professionals

Background:

Many studies have explored personal values in nursing, but none has assessed whether the predictions made by the theory of intergenerational value change are true for the different generations of nursing professionals and students. This theory predicts a shift in those personal values held by younger generations towards ones focussed on self-expression.

Research question:

The purpose of the study was to identify intergenerational differences in personal values among nursing professionals and nursing students and to determine whether generational value profiles fit the predictions made by the theory.

Research design:

An exploratory comparative design with a cross-sectional survey method was used.

Participants and research context:

Participants were recruited from four public hospitals and 10 Primary Care Centres in medium-size cities in Spain. A sample of 589 nurses and 2295 nursing students participated in the study. An open survey method was used to collect data that were classified grouping reported values into categories following a method of value lexicon construction and analysed by contingency tables with Pearson’s χ2 and standardized residuals.

Ethical considerations:

Approval to conduct the study was obtained from the Deans of the nursing schools and the Directors of Nursing of the institutions. Anonymity was guaranteed, participation was voluntary and participants were informed of the purpose of the study.

Findings:

The results can be synthesized in two age-related trends in the reporting of values among three groups of participants. First, among younger nurses and students, some nursing core values (e.g. ethical and professional) decreased in importance, while other values centred on social relationships and personal well-being increased.

Discussion and Conclusion:

This study shows intergenerational change in personal values among both nursing students and young nursing professionals. Findings suggest the need to pay more attention to value training and professional socialization during the schooling period.