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Rahimi M, Haghani F, Kohan S, Shirani M. A model for improving the learning environment in high-stress and emotion-bound clinical settings. MEDICAL TEACHER 2024; 46:1099-1107. [PMID: 38122811 DOI: 10.1080/0142159x.2023.2292977] [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: 10/05/2022] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION In clinical settings, it is necessary to create a clinical learning environment that provides the ground for the learners to acquire competencies especially in high-stress and emotion-bound clinical settings. METHODS In the present study, a model for improving the learning environment in high-stress and emotion-bound clinical settings was designed by conducting a multi-method study in the form of three sub-studies. RESULTS This model was designed with 3 pivotal concepts; organizing learning opportunities around safe care, fair participation in learning opportunities and creating a positive emotional climate and 6 peripheral concepts; designing physical space and appropriate equipment for education and care, preparing learners to attend the clinical setting, preparing learners to participate in learning opportunities, balancing the learner role and the care provided by the learners, the presence of a competent educator and providing education to all learners, and acquiring the ability to manage emotions by learners, faculty and staff. CONCLUSIONS The implementation of the model obtained from this study provides the basis for solving the challenges of clinical learning environments, especially in high-stress and emotion-bound clinical settings, and improves clinical education and the realization of educational and care outcomes.
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Affiliation(s)
- Masoumeh Rahimi
- Education Development Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
- Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Haghani
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Kohan
- Faculty of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Shirani
- Department of Urology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Ji X, Guo X, Soh KL, Japar S, He L. Effectiveness of stress management interventions for nursing students: A systematic review and meta-analysis. Nurs Health Sci 2024; 26:e13113. [PMID: 38566439 DOI: 10.1111/nhs.13113] [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: 08/23/2023] [Revised: 02/29/2024] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
Elevated stress levels are related to diminished mental health, potentially leading to decreased well-being and performance of nursing students. While researchers have focused on developing stress management interventions, there is a need to synthesize the evidence. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of stress management interventions in nursing students. A systematic literature search identified controlled stress management interventions employing a validated psychological or physiological stress measure. Forty-one studies were included, with 36 forming a pool of 2715 participants in the meta-analysis. The overall effect on psychological stress was positive. Intervention type, delivery modality, intervention duration in weeks, and number of sessions were moderators of intervention effectiveness, with more significant effects for mind-body programs, on-site delivery methods, durations of 9-12 weeks, and 15-30 sessions. For physiological stress, the biomarkers of blood pressure, heart rate, and cortisol levels decreased significantly. Future research is necessary for promising outcomes related to currently underrepresented indicators and to investigate the long-term effects of interventions.
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Affiliation(s)
- Xuan Ji
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
- Department of Nursing, Changzhi Medical College, Changzhi, China
| | - Xiaoyan Guo
- Department of Nursing, Changzhi Medical College, Changzhi, China
| | - Kim Lam Soh
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Salimah Japar
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
| | - Liping He
- Department of Nursing, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), Serdang, Malaysia
- Department of Nursing, Changzhi Medical College, Changzhi, China
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Efimov I, Agricola CJ, Nienhaus A, Harth V, Zyriax BC, Mache S. Stress perception, coping behaviors and work-privacy conflict of student midwives in times of COVID-19 pandemic: the "Healthy MidStudents" study in Germany. BMC Health Serv Res 2024; 24:594. [PMID: 38714981 PMCID: PMC11075225 DOI: 10.1186/s12913-024-10823-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/04/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Student midwives deliver care for women under challenging job demands, which may affect their mental health- thus creating a high need for health promotion. Given the lack of research addressing this topic, the aim of this study is to examine the links between stress perception, coping behaviors, work-privacy conflict, and perception of COVID-19 pandemic impact on studies of student midwives in northern Germany. METHODS Data were collected using a cross-sectional online-survey at nine midwifery study sites in northern Germany from October 2022 to January 2023. 342 student midwives (response rate: 61.3%) were surveyed on stress perception, coping behaviors, work-privacy conflict, and perceived impact of the COVID-19 pandemic on their studies. Descriptive, linear regression and moderation analyses were run to test explorative assumptions. RESULTS Results revealed that higher levels of perceived stress were reported by 13.4% of student midwives. Social support (M = 13.76, SD = 2.19) and active stress coping (M = 10.72, SD = 2.01) were identified as most prevalent coping behaviors in the present sample. It was found that work-privacy conflict was positively associated with stress perception (ß = 0.53, p =.001) and maladaptive coping behaviors (alcohol and cigarette consumption: ß = 0.14, p =.015), and negatively associated with adaptive coping behaviors (positive thinking: ß = - 0.25, p =.001, social support: ß = - 0.23, p =.001). Students with children reported significantly lower levels of social support than students without children. 55.6% of student midwives perceived a negative impact of the COVID-19 pandemic on their studies (mostly on lectures, seminars, and contact with fellow students). CONCLUSIONS Key findings highlighted moderate stress levels among student midwives during theoretical study stage. Based on current research, prevalence of high stress levels among student midwives remains unclear. Given the overall heterogeneous, limited research on student midwives' stress perception, coping behaviors, work-privacy conflict and perceptions of COVID-19 pandemic impact on studies, implications for research are suggested, e.g. longitudinal studies at different time points and settings and interventional studies. Findings provide a starting point for implementation of workplace health promotion in theoretical and practical stages of midwifery science study programs, e.g. training courses on stress prevention and adaptive coping, and for improvement of working conditions.
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Affiliation(s)
- Ilona Efimov
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany.
| | - Caroline Johanna Agricola
- Midwifery Science Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Albert Nienhaus
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
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Nazir T, Özçiçek A. Adjustment challenges and coping strategies of Arab female international university students. Front Psychol 2023; 14:1125368. [PMID: 37275721 PMCID: PMC10232752 DOI: 10.3389/fpsyg.2023.1125368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/27/2023] [Indexed: 06/07/2023] Open
Abstract
Background Over the past decade, Türkiye has experienced an increasing influx of international students, particularly from various Arab countries. The significant number of Arab international university students has prompted researchers to pay more attention to the experiences of this population in the country. This study examined the adjustment problems experienced by Arab female international university students in Türkiye. Method The research has a mixed methods design and includes both quantitative and qualitative studies. In the quantitative study, the International Students Adjustment Scale (ISAS) was used with 373 participants to examine the challenges in which dimensions of adjustment (academic, sociocultural, or personal) were more challenging for the study group. In the qualitative study, semi-structured interviews were conducted with 19 Arab female international university students to gain a deeper understanding of their experiences in the domain that is found the issues are more profound. Results Data from the quantitative study revealed that these students experienced similar challenges in each dimension of adjustment; however, problems in the sociocultural domain were much more profound. In line with the quantitative study, the interview questions of the qualitative study were prepared to explore the sociocultural domain and included the pre-arrival expectations, the post-arrival adjustment challenges, and the coping strategies of the study group. The Results of the qualitative study showed that although their prearrival expectations were almost met, they encountered various problems, ranging from cultural differences in daily activities to discrimination. It was also found that many of them were reluctant to ask for help, and to cope with adjustment problems, they usually used maladaptive or dysfunctional coping strategies such as avoidance and isolation. Discussion The findings of the quantitative study are in line with the previous studies that the overall adjustment of international students is influenced by different domains that are broadly academic, sociocultural, and personal. Among them, the sociocultural domain is found as the one in the study population that encounters more challenges. The results of the qualitative study support the findings of previous studies related to prearrival expectancies, provide more understanding of adjustment challenges and bring more information about adopted coping strategies.
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Kamali M, Mousavi SK, Saed O. Personality Traits and the Clinical Environment`s Stress Resources in Nursing Students. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:167-173. [PMID: 37332369 PMCID: PMC10275460 DOI: 10.4103/ijnmr.ijnmr_42_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 06/20/2023]
Abstract
Background The clinical environment always has been the most stressful course of nursing education. Personality traits can be influential factors in stress resources and responding to stress. The present study investigates the correlation between personality traits and nursing students' stress resources in the clinical environment. Material and Methods This descriptive correlational study was planned and performed on Zanjan University of Medical Sciences nursing students. The research population was 215 students selected by stratified random sampling method from all nursing students in the third to eighth semesters. We used an electronic questionnaire for data gathering, including three sections: demographic characteristics, NEO personality traits, and stress resources in the clinical environment. The data were analyzed using descriptive and inferential statistics. Results The most and least stressful resources were related to the score of unpleasant emotions and interpersonal relationships. We found a significant positive correlation between neuroticism personality traits and all four stress resources (p < 0.05). The results also showed a significant correlation between all scores of personality traits and perceived stress from unpleasant emotions except the openness to experience trait (p < 0.05). Furthermore, the relationship between age, gender, semester, interest, and stress resources in the clinical environment was statistically significant (p < 0.05). Conclusions Paying attention to the nursing student's clinical performance to maintain the patient's health is vital and unavoidable. Therefore, more than ever in the preclinical course of nursing education, improving the psychological readiness and simulation training method can reduce the harmful effects of the clinical environment's stress resources on their clinical performance.
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Affiliation(s)
- Mohsen Kamali
- Department of Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran, PhD Candidate of Medical Education, Department of Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Kazem Mousavi
- Department of Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran, PhD Candidate of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Omid Saed
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Schneider-Matyka D, Świątoniowska-Lonc N, Polański J, Szkup M, Grochans E, Jankowska-Polańska B. Assessment of The Effect of Stress, Sociodemographic Variables and Work-Related Factors on Rationing of Nursing Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2414. [PMID: 36767779 PMCID: PMC9915080 DOI: 10.3390/ijerph20032414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
(1) Rationing of nursing care is withholding, limiting or not fulfilling the necessary nursing activities for patients. It may have a negative effect on patient safety and the quality of care. The aim of the present paper is the assessment of the effect of stress on the rationing of nursing care. (2) The current research has a cross-sectional, observational design. The study sample comprised 567 nurses. The following questionnaires were used in the study PIRNCA and PSS-10. (3) It was demonstrated that nurses with a high level of perceived stress rationed nursing care to a greater extent and showed lower assessment of nursing care and lower job satisfaction in comparison with nurses with average and low levels of perceived stress. (4) 1. Stress in nurses has a negative effect on rationing of nursing care and job satisfaction. It is recommended that actions aimed at developing effective stress coping skills be implemented as early as at the stage of training to become a nurse. 2. Factors such as marital status, sex, form of employment, place of employment and the level of professional burnout syndrome may have an influence on the level of experienced stress. In turn, the level of experienced stress, marital status, education, place of work as well as the place of residence may have an effect on rationing of nursing care and, consequently, affect the quality of care.
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Affiliation(s)
- Daria Schneider-Matyka
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | | | - Jacek Polański
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska Street, 50-556 Wrocław, Poland
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Beata Jankowska-Polańska
- Center for Research and Innovation, 4th Military Hospital, 5 Weigla Street, 50-981 Wrocław, Poland
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Nurse Educators’ Experiences of Fostering Undergraduate Students’ Ability to Manage Stress and Demanding Situations: A Phenomenological Inquiry. Nurse Educ Pract 2022; 65:103501. [DOI: 10.1016/j.nepr.2022.103501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/19/2022] [Accepted: 11/03/2022] [Indexed: 11/10/2022]
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Zarzecka-Francica EJ, Gala A, Gębczyński K, Pihut M, Wyszyńska-Pawelec G. The Influence of Preventive Activities on Stress Perception among Dentistry Students in the Period of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13129. [PMID: 36293722 PMCID: PMC9603399 DOI: 10.3390/ijerph192013129] [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: 07/21/2022] [Revised: 09/26/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic resulted in the strengthening of the earlier stressors and the appearance of new pandemic-related stressors. Many students of dentistry fit the profile of a group who are particularly susceptible to stress related to the pandemic. Thus, it was necessary to implement preventive activities, reducing their stress perception. This was understood as a means of significantly influencing the student's well-being, thus improving the quality of education. Therefore, the aim of the study was to assess the impacts of implemented preventive activities on stress perception among students of dentistry during the pandemic, as well as their influence on this assessment of the selected students' personal experiences regarding the pandemic. METHODS The study was performed one year after the outbreak of the pandemic on students of dentistry at Jagiellonian University Medical College, Krakow, Poland. It consisted of the completion of a self-designed, voluntary, anonymous, online questionnaire. The respondent's task was to assess the influences of implemented preventive activities on stress perception using a five-point scale. The activities were divided into external (national, global) and internal (institutional). The material was statistically analysed for all students, including pre-clinical and clinical groups. Additionally, the impact of the selected students' personal experiences regarding the COVID-19 pandemic on the assessment was studied. RESULTS All preventive activities (in total) significantly reduced stress perception (p ≤ 0.001), but the intensity of their impacts (mean rank) was different. The most highly assessed activities were all external preventive activities, with the greatest intensity belonging to the prospect of receiving vaccination against SARS-CoV-2. The remaining external activities were the prospect of developing an effective COVID-19 treatment and the increase in knowledge about SARS-CoV-2. The internal activities were assessed and ascribed lower positions, with the exception of the theoretical classes held online. This activity was placed slightly lower than the highest-rated activity, the prospect of receiving vaccination. CONCLUSIONS The studied preventive activities reduced stress perception with different levels of intensity. The highest-ranked activities were external activities. One exception was the theoretical classes held online, an internal activity. Due to the lower impact of the internal activities and the ability to modify them by the educators, there is a need to strengthen their effectiveness. The possibility of monitoring and tailoring some preventive activities to the students' needs was the practical aspect of the conducted study. Students' personal experiences related to the COVID-19 pandemic influenced their assessment of the preventive activities, in some cases significantly.
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Affiliation(s)
- Elżbieta Joanna Zarzecka-Francica
- Department of Prosthodontics and Orthodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Andrzej Gala
- Department of Prosthodontics and Orthodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Krzysztof Gębczyński
- Department of Conservative Dentistry with Endodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Małgorzata Pihut
- Department of Prosthodontics and Orthodontics, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Grażyna Wyszyńska-Pawelec
- Department of Cranio-Maxillofacial Surgery, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
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Aydın M, Erdöl H, Görgöz M, Aksu EF. Turkish validity and reliability study of "Nursing Students' perceptions of Clinical Stressors Scale". Nurse Educ Pract 2022; 64:103440. [PMID: 36049394 DOI: 10.1016/j.nepr.2022.103440] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Clinical education is a significant part of nursing education, but students frequently perceive it as stressful. There is no valid and reliable scale to determine the clinical stressor perceptions of nursing students in Turkey. OBJECTIVE The study aims to adapt the "Nursing Students' Clinical Stressor Perceptions Scale" (NSPCSS) into Turkish and perform its validity and reliability study for nursing students. METHOD The research was conducted in a methodological design between 30 September 2021 and 1 November 2021. The sample consisted of 304 nursing students. RESULTS "The Cronbach's alpha" reliability coefficient of the NSPCSS is 0.912. The retest coefficient is 0.90 and the item correlation values are between 0.404 and 0.689. CONCLUSION The study has shown that the NSPCSS-TR is a valid and reliable assessment tool to evaluate clinical stressors in nursing students.
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Affiliation(s)
- Merve Aydın
- Karadeniz Technical University, Faculty of Health Sciences, Mental Health and Psychiatric Nursing Department, Trabzon, Turkey.
| | - Hacer Erdöl
- Karadeniz Technical University, Faculty of Health Sciences, Mental Health and Psychiatric Nursing Department, Trabzon, Turkey.
| | - Mehmet Görgöz
- Ordu University, Health Sciences Institute, Mental Health and Psychiatric Nursing Department, Ordu, Turkey.
| | - Enes Furkan Aksu
- Ordu University, Health Sciences Institute, Mental Health and Psychiatric Nursing Department, Ordu, Turkey.
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Zheng YX, Jiao JR, Hao WN. Prevalence of stress among nursing students: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29293. [PMID: 35945725 PMCID: PMC9351890 DOI: 10.1097/md.0000000000029293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Our main purpose is to evaluate the prevalence of stress among nursing students systematically. METHODS Adhering to the preferred reporting items for Systematic Reviews and Meta-analyses guidelines, we carefully searched ten databases, including PubMed, Cochrane, Web of Science, Scopus, ScienceDirect, SpringerLink, EMBASE, CNKI, Wanfang, and China Biomedical Literature Service System, to collect cross-sectional studies on nursing students. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. RESULTS From 1397 studies, 27 cross-sectional studies were included, including 7116 subjects. Meta-analysis showed that the prevalence of low-level stress was 0.24% [95% CI (0.24% to 0.25%)], the prevalence of middle level stress was 0.35% [95% CI (0.35% to 0.35%)], and the prevalence of high-level stress was 0.10% [95% CI (0.10% to 0.10%)]. The results of subgroup analysis showed that stress levels are different in different genders, diagnostic criteria for stress, years of publication, and regions. CONCLUSIONS This review identified the stress levels of nursing interns, which were mainly moderate. This result makes nursing administrators and nursing educators pay more attention to the mental health problems of nursing interns, which can actively take measures to promote the physical and mental health of nursing students, improve the quality of nursing students' practice, and further promote the development of the nursing profession.
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Affiliation(s)
- Yan-xue Zheng
- School of nursing, Inner Mongolia medical university, Hohhot, Inner Mongolia, China
| | - Jia-Ru Jiao
- School of nursing, Inner Mongolia medical university, Hohhot, Inner Mongolia, China
| | - Wen-Nv Hao
- Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
- *Correspondence: Wen-Nv Hao, Department of Emergency, Affiliated Hospital of Inner Mongolia Medical University, No. 1 Tongdao North Road, Huimin District, Hohhot 010050, Inner Mongolia, China (e-mail: )
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Hajiesmaello M, Hajian S, Riazi H, Majd HA, Yavarian R. Challenges facing clinical midwifery education in Iran. BMC MEDICAL EDUCATION 2022; 22:407. [PMID: 35619125 PMCID: PMC9137190 DOI: 10.1186/s12909-022-03485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Delivering high-quality midwifery services requires a professional, educated and competent workforce. The challenges of clinical training and education for midwives in Iran have prevented midwifery students from fully gaining the clinical competency required of midwifery graduates. METHODS This qualitative study was conducted to identify and explain the challenges of clinical training for midwives in Iran and to determine their underlying factors within the sociocultural and educational context of this country. Data were collected from a purposive sample in a western province of Iran, which included clinical midwives working in public and private maternity units, midwifery instructors working at educational institutes, and midwifery students. After receiving an ethics approval for the project and informed consent from the participants, data were collected through focus group interviews held with midwifery students (n = 9) and semi-structured interviews held with midwifery instructors (n = 6) and clinical midwives (n = 7). Data were then analyzed using the framework proposed by Graneheim and Lundman using MAXQDA-10. FINDINGS The analysis of the data led to two themes: "Discriminatory approach in the health system" and "Professional nature of midwifery". The noted discrimination was caused by the insecure position of midwives in the health system, inequalities related to education and training opportunities, and the demotivation of midwives. The professional nature of midwifery discussed the community in transition, functional paradoxes and high-risk labor. CONCLUSION The findings revealed numerous challenges facing clinical midwifery education and training in the study setting, which may in part be explained by the sociocultural context of maternity services in Iran. The learning opportunities provided to midwifery students should be improved by making significant revisions to the structure of clinical settings where students are placed. Tackling discrimination against a profession and its students is essential, and it is equally important to value the contributions of midwifery students and midwives to their practice and their efforts to ensure safe maternity care for women and newborns. The quality of the clinical learning environment must therefore be improved for this group, and the active participation of competent and autonomous midwifery instructors in this environment can have a facilitatory role.
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Affiliation(s)
| | - Sepideh Hajian
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Hedyeh Riazi
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Roya Yavarian
- Department of Psychiatry, Urmia University of Medical Sciences, Urmia, Iran
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Aghamohammadi F, Saed O, Ahmadi R, Kharaghani R. The effectiveness of adapted group mindfulness-based stress management program on perceived stress and emotion regulation in midwives: a randomized clinical trial. BMC Psychol 2022; 10:123. [PMID: 35562792 PMCID: PMC9103483 DOI: 10.1186/s40359-022-00823-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background Midwives' stress can have negative consequences on their emotional state, burnout, and poor quality of midwifery care. This study aimed to determine the effectiveness of an adapted mindfulness-based stress management program on perceived stress and the emotional regulation of midwives. Methods The study was a parallel randomized clinical trial on the midwives working in general hospitals of Zanjan, Iran. In this study, 121 midwives registered to participate based on the census sampling method were screened using a cut point of ≥ 28 in the Perceived Stress Scale (PSS). From the initial sample, 42 subjects had inclusion criteria assigned to two groups of control (n = 21) and intervention (n = 21) using online random allocation. The intervention group received an 8-week adapted mindfulness-based stress management program. This program emanates from the Kabat-Zinn's MBSR program, which has been adjusted according to the Iranian culture. The ANCOVA and repeated measure analysis of variance test were used to compare groups over time. Results The results showed that the group intervention effectively affected perceived stress (P = 0.001) and difficulty in emotion regulation during the post-intervention period (P = 0.001). Moreover, the interventions were effective in emotion regulation (P = 0.003), but it was not effective on perceived stress (P = 0.125) at the 3-month follow-up. Conclusions This adapted mindfulness-based program successfully reduced stress and increased emotion regulation strategies in midwives; however, the long-term outcomes of this treatment program need further consideration.
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Affiliation(s)
- Fatemeh Aghamohammadi
- School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Omid Saed
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Ahmadi
- Department of Clinical Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Roghieh Kharaghani
- Department of Midwifery, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran.
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Mulligan K, Frawley T. The lived experience of being an undergraduate midwifery student in the neonatal unit. Nurse Educ Pract 2021; 59:103273. [PMID: 35078070 DOI: 10.1016/j.nepr.2021.103273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/25/2021] [Accepted: 12/05/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study is to examine the experience of undergraduate student midwives in the neonatal unit. BACKGROUND Clinical experience is an essential component of education for the development of competent midwives. Literature has highlighted the pivotal effects of precepting and how it contributes to student experience. Although there is a plethora of research examining undergraduate student midwives' experience, to our knowledge this is the first study exploring their experience in the neonatal unit. DESIGN Based in phenomenology, eight semi-structured interviews were conducted producing rich data. METHODS Following informed consent and ethical approval, post transcription, the data were coded using Colaizzi's (1978) framework. RESULTS Significant themes and sub-themes emerged such as course design, environmental experience, sources of stress and preceptor experience. The student experience very much depends on the preceptor, how busy the environment is and if appropriately staffed. CONCLUSIONS Based on these findings there are suggested recommendations including adjusting the timing and length of the placement and how to improve the environment based on the preceptor-student relationship. Also, suggestions on how consistency and communication can be improved are proposed.
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Affiliation(s)
- Kevin Mulligan
- National Maternity Hospital, Holles Street, Dublin 2 D02 YH21, Ireland; Centre for Midwifery Education, Coombe Women and Infants University Hospital, Dublin 8 D08 XW7X, Ireland.
| | - Timothy Frawley
- Room C125, UCD School of Nursing, Midwifery and Health Systems, Belfield, Dublin 4 D04 V1W8, Ireland
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Chisholm-Burns MA, Berg-Poppe P, Spivey CA, Karges-Brown J, Pithan A. Systematic review of noncognitive factors influence on health professions students' academic performance. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1373-1445. [PMID: 33772422 DOI: 10.1007/s10459-021-10042-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Increased importance has been placed on noncognitive skills in professional development and by accrediting bodies of health professions programs in recent years. Therefore, the purpose of this study was to conduct a comprehensive systematic review of evidence examining effects of academic resilience, grit, perceived stress, locus of control, and Big Five Personality Traits on academic performance of health professions students. A literature search of peer-reviewed, English-language articles describing select noncognitive factors was performed using seven databases. Searches were performed from the earliest index date through May 2020. The following data from included studies were extracted and summarized: research design hierarchy, hierarchy of study outcomes (modified from Kirkpatrick), association between noncognitive factors and academic outcomes, and quality assessment criteria. 149 articles met inclusion criteria. Almost 80% of studies were Level III (observational). Medical students were the most frequently studied population (n = 73 articles). The most studied academic outcome was grade point average (n = 61). Perceived stress and Big Five Personality Traits accounted for greater than 50% of studies. Most studies were rated as fair to good quality. Associations between noncognitive factors and academic outcomes were largely inconsistent, although greater perceived stress was generally associated with poorer academic performance outcomes, while higher conscientiousness, academic resilience, and grit were generally associated with better outcomes. This systematic review represents a large body of evidence concerning select noncognitive factors and their association with academic performance of health professions students. Support services addressing noncognitive factors should be deliberated and tailored for specific health professions education programs and student populations.
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Affiliation(s)
- Marie A Chisholm-Burns
- University of Tennessee Health Science Center College of Pharmacy, 881 Madison Ave., Suite 264, Memphis, TN, 38163, USA.
| | - Patti Berg-Poppe
- University of South Dakota School of Health Sciences, 414 E. Clark Street, SCSC A383, Vermillion, SD, 57069, USA
| | - Christina A Spivey
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, 881 Madison Ave., Suite 258, Memphis, TN, 38163, USA
| | - Joy Karges-Brown
- Department of Physical Therapy, University of South Dakota School of Health Sciences, 414 E. Clark Street, SCSC A830, Vermillion, SD, 57069, USA
| | - Anne Pithan
- Department of Nursing, University of South Dakota School of Health Sciences, 414 E. Clark Street, Lee Medicine and Science Hall 303, Vermillion, SD, 57069, USA
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Kowalska W, Szwamel K. Stress management strategies and quality of life in undergraduate nursing and midwifery students in Poland: A pilot study. Nurs Open 2021; 9:824-838. [PMID: 34227744 PMCID: PMC8685852 DOI: 10.1002/nop2.982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/16/2021] [Accepted: 06/08/2021] [Indexed: 11/06/2022] Open
Abstract
AIM To establish the level of the quality of life (QOL) and its determinants in nursing and midwifery students, evaluate stress management strategies and find the correlation between the frequency of specific strategies and the QOL. DESIGN Diagnostic survey. METHODS The study was conducted in June 2019. Two hundred thirty-four undergraduate students were examined with the use of Mini-Cope Inventory of Stress Management Measurement (Mini-Cope) and World Health Organization Quality of Life Instrument Brief Form. RESULTS The average QOL of the respondents was found as good (4.06 ± 0.73). The students graded their QOL in the social relationship domain the highest (15.98 ± 2.97) and the lowest in the physical health domain (14.38 ± 2.75). The QOL was influenced by material status and the source of income. In stressful situations, the respondents most commonly used Active Coping (2.09 ± 0.57) and Seeking Emotional Support (2.09 ± 0.77) strategies. The latter correlated most positively with the QOL in social relationship (r = .514, p < .001) and environmental (r = .387, p < .001) domains.
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Toosi M, Modarres M, Amini M, Geranmayeh M. A survey of midwifery graduates' opinions about midwifery education in Iran: a cross-sectional study. BMC MEDICAL EDUCATION 2021; 21:340. [PMID: 34112177 PMCID: PMC8194225 DOI: 10.1186/s12909-021-02764-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Attaining high-quality education requires continuous evaluation and revision of the curriculum. The view of the graduate students can provide valuable insight into the necessary evaluations and revisions. Therefore, this study aimed to evaluate the opinions of midwifery graduates about midwifery education in Iran METHODS: This was a descriptive cross-sectional study and the research data were collected through a census sampling procedure from all (82) midwifery graduates of the Nursing and Midwifery School of Shiraz University of Medical Sciences between 2018 and 2020. The data collection instrument was a validated researcher-made questionnaire derived from the Graduation Questionnaire (GQ) developed by the Association of American Medical Colleges (AAMC). The data were then analyzed using SPSS 22. RESULTS In this study, about 62% of the graduates were satisfied with the quality of the midwifery education they had received during the four-year program. Moreover, 61% of the graduates maintained that theoretical courses were well-integrated with the clinical experience they needed. The quality of the internships in different wards and departments was also evaluated from the viewpoints of the graduates, and the results indicated that they were relatively satisfied with their internship experiences. However, only 40% of the graduates were satisfied with the quality of their clinical evaluation, since they faced the most significant challenges in the clinical and maternity wards (47%) with the midwifery staff and gynecology residents and found the quality of facilities in the clinical program to be lacking. According to the participants, the quality of teaching was not good for some courses such as biochemistry and microbiology. CONCLUSION It seems that the midwifery curriculum needs to be constantly revised, aiming to improve student satisfaction with their midwifery education. Some effective measures in this regard are employing experienced professors, developing cooperation between midwifery instructors and clinical departments, and trying to improve the educational environment. Attention to the improvement of facilities and equipment and agreement between the content of the theoretical education and practical topics are also recommended to improve the quality of midwifery education.
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Affiliation(s)
- Monireh Toosi
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Modarres
- Department of Reproductive Health and Midwifery, Member of Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Amini
- Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrnaz Geranmayeh
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, 1419733171 Iran
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The relationship of sleep quality among internship nurses with clinical learning environment and mental stress: a cross-sectional survey. Sleep Med 2021; 83:151-158. [PMID: 34020227 DOI: 10.1016/j.sleep.2021.04.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous evidence has supported an association between sleep quality and psychological stress. However, the association between internship nurses' sleep status and its relevant factors is poorly understood. OBJECTIVE The aim of this study was to investigate sleep quality and its related factors in clinical learning environment and mental stress. METHODS A cross-sectional survey was conducted by three instruments: Clinical Learning Environment, Supervision, and Nurse Teacher Evaluation Scale (CLES + T), Stress Rating Scale for practicing nurses (SRS) and Pittsburgh Sleep Quality Index (PSQI). RESULTS A total of 508 (91.86%) of 553 students experienced poor sleep quality. The structural equation model showed a correlation of the PSQI with the CLES + T (r = -0.21, p < 0.001), a correlation of the PSQI with the SRS (r = 0.32, p < 0.001), and a correlation of the SRS with the CLES + T (r = -0.22, p < 0.001). Linear regression analysis showed that education (B = -0.56, p < 0.001), willingness to engage in nursing after graduation (B = -0.75, p < 0.001), pedagogical atmosphere in the ward (B = -0.05, p < 0.001) measured by the CLES + T, workload (B = 0.11, p = 0.01), interpersonal relationships (B = -0.12, p = 0.03), and conflicts between study and work (B = 0.12, p < 0.001) on the SRS were significant factors influencing the PSQI. CONCLUSIONS Poor sleep quality is common among internship nurses and it's affected by clinical environment and mental stress. It's necessary to apply more tailored education programs to promote nursing development.
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