Caring for Self While Learning to Care for Others: A Challenge for Nursing Students

Health-promoting behaviors in staff and students of Ardabil University of Medical Sciences

BACKGROUND

The staff of health and dentistry schools can play an important role in encouraging students and their clients to adopt health and preventive behaviors. The aim of this study was to compare health-promoting behaviors in staff and students of health and dental schools in Ardabil University of Medical Sciences (ARUMS).

MATERIALS AND METHODS

This cross-sectional descriptive-analytical study was conducted in 2021. The research population was staff and students of health and dental schools. Staff sampling was by census and students were sampled by simple random sampling. The data collection tool was a questionnaire whose validity and reliability had been confirmed in previous studies. Data analysis was performed using descriptive and analytical statistics tests using SPSS version 20 software. Linear regression was performed using stepwise method.

RESULTS

The results showed that the mean score of the individuals was 99.2 ± 20.24. In the leveling, the behaviors of 33 people (17.55%) were appropriate, desirable and good, and the health-promoting behaviors, 154 people (82.45%), were moderate and low. The correlation between age, gender, marital status, and workplace of the individuals with health-promoting behaviors was not statistically significant (P > 0.05). The output of stepwise regression analysis showed that the variables were significant and could predict the scores of health-promoting behaviors.

CONCLUSIONS

Health-promoting behaviors in <20% of students and staff are desirable, and in more than 80% of them are moderate and poor. Therefore, educational administrators should use these results in curriculum planning to increase health-promoting behaviors of students and staff. The score of health-promoting behaviors is related to the above-mentioned areas, but the relationship may not be linear.

Comparison of Health-Promoting Behaviors of Nursing Students From Different Racial/Ethnic Groups

BACKGROUND

Despite the known benefits of maintaining a healthy lifestyle in preventing many health-related issues, few nursing students practice health-promoting behaviors (HPB).

METHOD

This cross-sectional, descriptive, correlational study included 866 undergraduate nursing students who were members of the National Student Nurses' Association.

RESULTS

The difference in mean Health-Promoting Lifestyle Profile-II scores between White people and Asian Americans was statistically significant (F [4, 861]) = 2.95, p = .019). The difference in the mean self-efficacy scores between Black people and Asian Americans also was statistically significant (F [4, 861] = 4.41, p = .002). The regression model was significant (F [1, 862] = 6.683, p = .001, R2 =.235)], and self-efficacy (β = .457, t = 15.178, p = .001) significantly predicted nursing students' HPB.

CONCLUSION

The differences between racial/ethnic groups noted in this study indicate nursing faculty need to render culturally sensitive interventions to promote self-efficacy and HPB among undergraduate nursing students. [J Nurs Educ. 2021;60(9):500-508.].

Enhancing conceptual clarity of self-care for nursing students: A scoping review

OBJECTIVE

This paper aims to explore how self-care is currently defined and conceptualized in nursing education literature and identify gaps in current conceptualizations of self-care for nursing students.

BACKGROUND

Given the considerable stressors experienced by nursing students, self-care is an important concept for enhancing well-being. However, self-care has been poorly defined in the literature to date, contributing to challenges in integrating self-care into nursing education in support of student mental health and well-being.

DESIGN

A scoping review was undertaken in accordance with Arksey and O'Malley's (2005) framework and Levac et al.'s (2010) subsequent guidance.

METHODS

The search was conducted up to 1 September 2020 across three databases: Medline (OVID), PsycINFO and CINAHL. Search terms 'self-care', 'nursing students' and 'nursing education' were used. Criteria for inclusion of articles included peer-reviewed articles published in English that addressed self-care in the context of nursing education and/or nursing students and provided a definition of self-care. Two reviewers independently screened 1181 records by title and abstract, with a third reviewer resolving discrepancies. Subsequently, full-text review was completed for 119 articles.

RESULTS

Twenty-seven studies were included in the review, including 21 empirical articles and 6 non-empirical articles. Sixteen (59%) articles described an educational intervention, including self-care courses, assignments, or integration of self-care modalities as a classroom activity. Qualitative thematic analysis of article aims, and self-care definitions illustrated three central themes in the conceptualization of self-care: self-care as an aspect of holistic nursing; self-care as practices that ensure a healthy lifestyle; and self-care as activities undertaken in response to stress.

CONCLUSIONS

There is considerable variability in how self-care for nursing students is conceptualized, contributing to inconsistencies in the integration of this concept into nursing education. Nurse educators are encouraged to support students in identifying their own self-care strategies and engage in reflection and action toward shifting systemic contributors to stress and burnout among nursing students.

Examining the associations between self-care practices and psychological distress among nursing students during the COVID-19 pandemic

There is limited research regarding the impact of self-care practices on psychological distress, specifically on nursing students during a pandemic, such as COVID-19 (Corona Virus Disease- 2019). A 10-minute electronic survey was sent to nursing students at a large academic-medical center, and data from 285 student respondents were analyzed to assess psychological status, attitudes and behaviors in regards to the COVID-19 pandemic. Significant differences were found when comparing self-care practice scores by school grade for total scores (F = 4.48 [df = 4,250], p = .002), emotional subscale (F = 4.78 [df = 4,250], p = .001), and relationship subscale (F = 3.44 [df = 4,250], p = .009). While there were no significant differences in psychological distress by school grade, graduate students had the lowest self-care practice score compared to all the other grades. Finally, the subscale and total self-care practice scores were significantly and negatively associated with psychological distress. These findings suggest that utilization of self-care practices is associated with lower psychological distress, and should therefore be promoted among nursing student populations and integrated into curricula. Future studies should assess specific needs geared towards populations that may have poor self-care practices, such as graduate students, and understand ways to improve sleep quality to mitigate rates of psychological distress during a pandemic.

Examining the Occupational Therapy Definition of Self-Care: A Scoping Review

Self-care practices such as exercise and meditation are commonly identified as strategies to address stress and chronic disease. However, in occupational therapy, the term self-care has traditionally referred to basic activities of daily living (ADL), potentially limiting the profession's ability to promote wellness among clients. This scoping review aimed to clarify how the term self-care has been used in select occupational therapy literature. We found that of 1,254 included articles, 54.9% use the term self-care ambiguously and that authors primarily apply the term to basic ADL. This understanding contrasts with the evidence from the wellness literature and the concept's use by the general population and other health professions. Findings serve as a call to redefine the term self-care to articulate clearly the profession's value in promoting population health and well-being.

Are formal self-care interventions for healthy people effective? A systematic review of the evidence

Introduction

Preventative interventions are shown to be effective in reducing 40% of the mortality due to unhealthy behaviours and lifestyles. Health-promoting self-care has been recognised as a promising strategy in preventative health. However, self-care research is being done around the self-management of chronic illnesses and the promotion of self-care practices among healthy populations has been overlooked by many healthcare systems.

Method

The study methodology was a systematic review with a narrative synthesis. The search was done through seven academic databases, reference tracking of selected articles and grey literature. The scoping, selection, screening and quality assessments of the articles were reviewed independently by two reviewers.

Results

Sixteen studies met the inclusion criteria. Self-care behaviour, health-promotive lifestyle changes and medical care utilisation were some of the main outcomes evaluated in the studies. Positive effects were seen in increasing self-care and health-promotive behaviours in most interventions although limited or mixed impact was seen in health attitudes, beliefs and utilisation of medical services. Most studies were from high income settings with low-quality study designs. The complexity of the word ‘self-care’ and inconsistencies in the terminology used in health-promotive self-care were significant highlights of the study.

Conclusion

Health-promoting preventative self-care interventions show promise in increasing the well-being of healthy people. However, the methodological drawbacks limit the generalisability of the findings. As the demand for self-care interventions increases, the lack of a formal globally accepted definition and framework and complexity of behaviour change are key limitations to consider moving forward.

Exploring the implications of a self-care assignment to foster undergraduate nursing student mental health: Findings from a survey research study

BACKGROUND

Nursing students experience numerous personal, academic, and practice-related stressors, impacting their mental health. Nursing programs often contribute to student stress and should incorporate strategies to support students' mental health. Self-care has the potential to enhance students' ability to manage current stressors and to build capacity for addressing future stress and burnout; however, the concept has been limitedly integrated into nursing education.

OBJECTIVES

To examine students' responses to a self-care assignment integrated into core nursing coursework.

DESIGN

Cross-sectional study using an online survey.

SETTINGS

An accelerated two-year undergraduate nursing program in Western Canada.

PARTICIPANTS

Undergraduate nursing students in first- and second-year of a two-year program.

METHODS

A 16-question survey, including closed- and open-ended response fields was developed by the research team. Survey questions were grounded in Bloom's Cognitive, Psychomotor, and Affective learning domains to comprehensively examine the impact of the assignment on students' learning and self-care capacity.

RESULTS

89 participants completed the survey (49% response rate). Participants' increase in self-care practices pre- and post-assignment was statistically significant (p = 0.023). Results further demonstrate that students' knowledge of self-care and capacity to identify and manage stressors were enhanced. Participants reported that overall the assignment supported their well-being. However, some participants described that aspects of the assignment detracted from well-being, including challenges with grading and feelings of guilt when not practicing self-care.

CONCLUSIONS

A self-care assignment is an effective strategy for nursing educators to foster students' capacity to cope with stressors.

Health-promoting behaviors in nursing students: is it related to self-efficacy for health practices and academic achievement?

Background Nursing students play a role in promotion of public health as health promoters and professional care providers. Therefore, health-promoting behaviors in nursing students and their self-efficacy for health practices are important in providing better services to patients and clients. With regard to the importance of these factors in the academic progress of students, this study was conducted to examine the level of health-promoting behaviors among nursing students and its relationship with self-efficacy for health practices and academic achievement. Methods This descriptive and correlational study was conducted on 217 nursing students of a large university of medical sciences in the south of Iran in 2016. Data were collected using the Persian version of the health promotion lifestyle profile (HPLP II), self-rated abilities for health practices scale (SRAHPS) and the grade point average of the students (levels A, B, C). Results The mean health-promoting behaviors (2.48 ± 0.35) and self-efficacy for health practices of the students (2.55 ± 0.62) were moderate. The mean score of the students' academic achievement was at level B (16.02 ± 1.85). The health-promoting behaviors were significantly correlated with self-efficacy for health practices (r = 0.623, p < 0.0001) and academic achievement (r = 0.285, p < 0.0001). Moreover, self-efficacy for health practices was significantly correlated with academic achievement (r = 0.282, p < 0.0001). Conclusion The correlation between the health-promoting behaviors and health self-efficacy with academic achievement can be a good basis in devising health and educational programs for students. In planning for promoting academic achievement and health-promoting behaviors of students, it is essential to pay special attention to enhancement of self-efficacy for health practices.

Faculty-Student Caring Interaction in Nursing Education: An Integrative Review

Introduction: Faculty- student caring relationship in nursing education has been offered as enhancing students’ learning experiences to care , desire to care for others and self-actu­alization. This review therefore was carried out to analyze faculty-student caring interactions in nursing education.

Methods: This concept analysis of caring in the nursing education was conducted based on Broom methodology of integrative review. The literature was consisted of two books from two known theorists, and 47 relevant articles. They retrieved from English data bases including MEDLINE, CINAHL, ERIC, SCOPUS, and SID, with based on the keywords of caring and "nursing education", during the period 2005-2014.

Results: Caring in nursing education refers to faculty-student interaction based on ethical and human values. The development of values and moral principles in education, flexibility in educational processes, application of objective patterns in learning, and dynamism in educational processes are identified as caring concept attributes in teaching-learning process. This requires environmental support, constant human relationship, and knowing. Internalization of values, achieving self-esteem, peace, and towards human evolution were the main achievements of the concept of caring in nursing education.

Conclusion: The details obtained from the dimensions of "caring" concept in this study could be utilized by nursing education researchers and designers in order to develop content and structure for educational programs.

Care for the Caregiver: Evaluation of Mind-Body Self-Care for Accelerated Nursing Students

Stress affects the well-being of both nursing students and the individuals with whom they work. With the theory of cognitive appraisal as a framework for this study, it is proposed that mind-body self-care strategies promote stress management by stabilization of emotions. Outcomes will be a perception of less stress and more mindful engagement with the environment. Objective of the study was to describe an evaluation of student perceived stress and mindfulness to 1-hour per week of class time dedicated to mind-body self-care (yoga, mindful breathing, Reiki, and essential oil therapy). It was a quasi-experimental study; data collection took place at 4 time points. Participants were entry-level accelerated nursing students from 3 US universities: 50 in the treatment group, 64 in the comparison group. Data included health-promoting practices using Health-Promoting Promotion Lifestyle Profile II as a control variable, stress and mindfulness (Perceived Stress Scale [PSS] and Mindful Attention Awareness Scale [MAAS]), and demographic information; analysis using mixed-design repeated-measures analysis of variances. There was a statistically significant interaction between intervention and time on PSS scores, F(3, 264) = 3.95, P = .009, partial η(2) = 0.043, with PSS scores of the intervention group decreasing from baseline to T3 when intervention ended whereas PSS scores of the comparison group increased from baseline. The average scores on the MAAS did not differ significantly. Evaluation of an embedded mind-body self-care module in the first nursing course demonstrated promising improvements in stress management. The findings support the appropriateness of integrating mind-body self-care content into nursing curricula to enhance students' ability to regulate stress.

RN-BS Students' Reports of Their Self-Care and Health-Promotion Practices in a Holistic Nursing Course

PURPOSE

This study explored RN-BS students' self-care and health-promotion (SCHP) practices in a semester-long holistic nursing course with emphasis on the utility of self-reflection through journal writing.

DESIGN

A qualitative single case study blended in practical action research.

METHOD

Fifteen RN-BS students enrolled in the holistic nursing course completed (a) three reflective journal entries (beginning, midterm, and conclusion); (b) two IHWA-short form surveys (beginning and conclusion); and (c) one demographic form (beginning) of the course.

FINDINGS

Three reflective journals indicated that students' understanding of their SCHP practices progressed from novice, to advanced, and finally to competent from the beginning, middle, and at the conclusion of the course. Four findings emerged in relation to reports of their SCHP practices: (a) new awareness of self, (b) application of SCHP practices knowledge, (c) role modeling, and (d) dedication to SCHP practices beyond the semester. Four findings emerged in relation to participation in the reflective journaling about reports of their SCHP practices: (a) self-discovery, (b) retrospective self-evaluation, (c) useful intervention for SCHP, and (d) beneficial learning tool in academic environment.

CONCLUSIONS

Reflective journaling enhanced students' SCHP practices and was recognized as useful instructional strategy to improve learning in the classroom.

Nurses as Instruments of Healing

Objective: To better understand current self-care practices and health-promoting behaviors of nursing staff in a rural hospital and determine if there is a need for further development of a holistic self-care program for nursing staff in the hospital. Method: In this cross-sectional, descriptive study, a structured questionnaire was used to collect data on current self-care practices and health needs and interests of hospital registered nurses, licensed practical nurses, and certified nursing assistants from inpatient, outpatient, and emergency departments. A convenience sample of 45 was employed. Results: Most prevalent self-care practices included humor/laughter/play, music, spirituality/prayer, healthy sleep habits, reading, healthy nutrition, and walking. At least 75.6% answered to be extremely or likely to use three of five fitness programs (95% confidence interval [CI: 63.05%, 88.15%]). All four nutrition education programs were rated extremely likely or likely by at least two thirds of respondents (66.7%; 95% CI [52.93%, 80.47%]). Other programs of interests included health education programs and job stress management programs. Majority would participate in self-care program at work if one was offered (73.3%; 95% CI [60.37%, 86.23%]). Conclusions: Majority of nursing staff recognize the importance of self-care. There is a strong preference toward fitness programs and nutrition education programs at work to other programs.

Calming and Focusing: Students' Perceptions of Short Classroom Strategies for Fostering Presence

PURPOSE

Presence is the essence of professional nursing in the nurse-patient connection. Nursing students have little exposure to strategies fostering presence. This pilot study explored students' perceptions of strategies to encourage presence in the classroom.

DESIGN

A three-question survey was distributed to students in the last week of classes. Faculty not teaching that course administered the survey.

METHOD

Four faculty used strategies aimed at encouraging presence. These strategies included starting class with a mindfulness minute, mindful movement, singing bowl, peace and power check in, and a discussion of a current event. Each class used only one strategy consistently through the semester. Participants were undergraduate and graduate students enrolled in one of seven classes taught by these faculty.

FINDINGS

Overall the students found strategies to be beneficial. In reflecting on the experience with the strategies, four themes emerged: calming/relaxing; focusing/centering; setting aside distractions; and feeling community and connection.

CONCLUSION

These brief strategies were acceptable to most students and were helpful to the students in preparing for class. The response to mindfulness minute was most positive. Further research is needed on the introduction of strategies that help students in the classroom and may also increase presence at the bedside.

Principle-based concept analysis: Caring in nursing education

INTRODUCTION

The aim of this principle-based concept analysis was to analyze caring in nursing education and to explain the current state of the science based on epistemologic, pragmatic, linguistic, and logical philosophical principles.

METHODS

A principle-based concept analysis method was used to analyze the nursing literature. The dataset included 46 English language studies, published from 2005 to 2014, and they were retrieved through PROQUEST, MEDLINE, CINAHL, ERIC, SCOPUS, and SID scientific databases. The key dimensions of the data were collected using a validated data-extraction sheet. The four principles of assessing pragmatic utility were used to analyze the data. The data were managed by using MAXQDA 10 software.

RESULTS

The scientific literature that deals with caring in nursing education relies on implied meaning. Caring in nursing education refers to student-teacher interactions that are formed on the basis of human values and focused on the unique needs of the students (epistemological principle). The result of student-teacher interactions is the development of both the students and the teachers. Numerous applications of the concept of caring in nursing education are available in the literature (pragmatic principle). There is consistency in the meaning of the concept, as a central value of the faculty-student interaction (linguistic principle). Compared with other related concepts, such as "caring pedagogy," "value-based education," and "teaching excellence," caring in nursing education does not have exact and clear conceptual boundaries (logic principle).

CONCLUSION

Caring in nursing education was identified as an approach to teaching and learning, and it is formed based on teacher-student interactions and sustainable human values. A greater understanding of the conceptual basis of caring in nursing education will improve the caring behaviors of teachers, create teaching-learning environments, and help experts in curriculum development.

Care-of-Self in Undergraduate Nursing Students: A Pilot Study

Poor management of care-of-self behaviors can contribute to job dissatisfaction, burnout, and attrition in nurses. This pilot study, designed to explore self-care among nursing students, was used to examine feasibility for a future long-term study. A descriptive cross-sectional design was used. The data suggest a downward trend of care-of-self behaviors as students assume more responsibility for care of others. Findings substantiate the need for development and implementation of care-of-self-promoting interventions in order to increase lifelong health-promoting behaviors.

The efficacy of an educational intervention on health behaviors in a sample of Turkish female nursing students: a longitudinal, quasi-experimental study

BACKGROUND

Unhealthy behaviors are a key factors leading to health problems. It remains unclear whether an educational intervention has a long term effect on health behaviors of nursing students.

OBJECTIVES

The aim of this study was to evaluate the long term effect of an educational intervention on the health behaviors and examine predictors of change in these behaviors in Turkish female baccalaureate nursing students.

DESIGN

Quasi-experimental design with one-group, pre- and posttest, and 3-year follow-up.

SETTING

The study was conducted in a school of nursing in Turkey.

PARTICIPANTS

One hundred-eight students participated in this study.

METHODS

Data were collected before and after the implementation of the educational intervention by using the Health-Promoting Lifestyle Profile-I (HPLP-I). Descriptive statistics, the one-way analysis of variance for repeated measures and multiple linear regression analysis were used.

RESULTS

There were significant differences among the three time points in terms of the HPLP-I total and subscales scores (self-actualization, health responsibility, exercise, nutrition and stress management), except for interpersonal support (p<.05). The positive effect of intervention on the HPLP-I total and health responsibility subscale scores was maintained during the 3-year follow-up period (p<.05). The amount of change from pretest to posttest in the total HPLP-I score was the only predictor of the 3-year change in the total scale score (unstandardized β=0.538; p<.001), after adjustment for the potential confounding factors.

CONCLUSIONS

The educational intervention was partially effective in improving all health behaviors of the nursing students over the long term. Nursing students who demonstrated higher levels of benefit from the intervention were more likely to have more positive health behaviors at the 3-year point. The findings of this study highlight the importance of the integration of health behaviors within the nursing curriculum.

Health-promoting behaviors and their association with certain demographic characteristics of nursing students of Tehran City in 2013

Background and Objectives:

Nursing students provide health services and their behavior may affect the clinical services that they provide to clients. In addition, Health-promoting behaviors among nursing students may affect the quality of patient education. Therefore, the aim of this study was to determine the relationship between health-promoting behaviors and certain demographic characteristics of nursing students in Tehran.

Methods:

This cross-sectional study was performed on 404 undergraduate nursing students (107 males and 297 females) of universities of Tehran who were selected through stratified random sampling procedure. The data collection tools were: demographic characteristics questionnaire and health-promoting lifestyle profile 2. This standard instrument has 6 subscales of nutrition, physical activity, spiritual growth, health responsibility, interpersonal relations, and stress management. In order to keep the weight of the expressions of the tool and subscale scores the mean were calculated. For this purpose, each expression was scored on a scale of 1 to 4. Internal consistency (Cronbach’s Alpha) of this tool was a=0.86. Data was analyzed by using statistical tests of Chi Square, Independent T and ANOVA.

Results:

According to the results, health-promoting behaviors among the students scored highly. The analysis of subscales of health-promoting lifestyle profile 2 showed that the highest mean belongs to the subscale of spiritual growth and the lowest mean belongs to the subscale of physical activity. The mean of health-promoting behaviors among married students was higher than among single students. Moreover, as students advanced through academic years, health responsibility increased and stress management reduced.

Discussion:

Undoubtedly, physical activity and stress management have a significant role in personal health and occupational satisfaction of students, which consequently help them provide better services to clients. Therefore, considering the low scores of students in these sections, nursing education managers, policymakers and planners should pay attention to these problems.

“Not Just a Theory”

Purpose: The purpose of this study was to evaluate the effect of training nurses in Jin Shin Jyutsu® self-care methods and to correlate the training with measurement of the nurses’ personal and organizational stress and their perceptions of their caring efficacy for patients. Design: A quasi-experimental, pretest, posttest, and 30- to 40-day posttest design was used. Method: In all, 20 participants received three 2-hour Jin Shin Jyutsu self-care training sessions from a certified Jin Shin Jyutsu self-care trainer (who was also a registered nurse). The training took place over a 1-month period, and participants agreed to practice the self-care daily. Two study instruments, one measuring organizational and personal stress and the second measuring caring efficacy, were completed before the first training, after the last training, and 1 month after the trainings had been completed. Findings: Analysis of data from the Personal and Organizational Quality Assessment–Revised by paired t tests showed significant increases in positive outlook, gratitude, motivation, calmness, and communication effectiveness and significant decreases in anger, resentfulness, depression, stress symptoms, time pressure, and morale issues. Nurses reported less muscle aches, sleeplessness, and headaches. Analysis of the Coates Caring Efficacy Scale measures showed statistically significant increases in nurses’ caring efficacy in areas of serenity in giving care, tuning in to patients, relating to patients, providing culturally congruent care, individualization of patient care, ability to decrease stressful situations, planning for multiple needs, and creativity in care. Conclusions: This small study suggests that Jin Shin Jyutsu self-care may be a valuable tool for nurses, to decrease stress, both emotional and physical, and increase caring efficacy. Administrators may wish to invest in such a program, which may improve quality of care delivered. The Watson caring model, which reminds us that nurses who care for themselves and feel good about their work can better care for others, proved an accurate framework for this study.

The effect of a pedagogy of curriculum infusion on nursing student well-being and intent to improve the quality of nursing care

AIM

The aim of this study was to determine if a pedagogy of curriculum infusion promotes nursing student well-being and intent to address quality care indicators of Quality and Safety Education for Nurses (QSEN) and American Association of Colleges of Nursing.

METHODS

This mixed-method experimental design study is based on 86 students' experiences with curriculum infusion as an intervention in two undergraduate nursing courses from August to December 2011. Student reflections, case analyses, and narrative evaluations were examined.

FINDINGS

Students experiencing curriculum infusion demonstrated intention to provide quality care as evidenced by case analysis and personal reflections.

CONCLUSION

Students acknowledged the importance of self-care and demonstrated intention to provide quality nursing care in five of the six QSEN competencies. Educators must be mindful to educate the whole student.

Effect of Practitioner Self-Care and Anxiety on Relationships within the Context of Organizational Change

This paper reviews the literature and suggests a causal model of the relationships between practitioner anxiety and effective caring practitioner – patient and practitioner – practitioner relationships within the context of organizational change through introduction of an electronic healthcare record. In the authors’ model, self-care is introduced as a mediating variable using a conceptual framework of Relationship-centered Care. Engaging in frequent and regular self-care interventions has been shown to be related to practitioner – patient caring ability and caring efficacy. According to a published model of Relationship-centered Care, it is anticipated that self-care will mediate the effect of practitioner anxiety on the ability to engage in effective therapeutic relationships with patients and other practitioners. Through this lens and within the context of organizational changes such as implementation of the electronic health record, a conceptual model for research is proposed, research hypotheses are stated, and methodology for a future stream of research is discussed.

How healthy are our nurses? New and registered nurses compared

This study examined the health behaviour of nursing staff, comparing registered and pre-registered nurses in terms of their self-reported health and lifestyle behaviour. In total, 325 pre-registered nurses and 551 registered nurses, based at the same university teaching hospital and located within an acute NHS trust, completed a self-administered health and lifestyle questionnaire survey. With the exception of smoking behaviour, registered nurses generally had a healthier lifestyle compared with pre-registered nurses. However, when examining the overall health profile of the sample, the study reveals that there is room for improvement in the health and lifestyle behaviour exhibited by both registered and pre-registered nurses. Almost half of the sample failed to meet public health recommendations for levels of physical activity, almost two-thirds did not consume five portions of fruit or vegetables daily and almost half ate foods that were high in fat and sugar content on a daily basis. These findings are alarming given the current government emphasis on the health of NHS staff and the important role that nurses play in influencing lifestyle choices among their patients. There is an urgent need to target education and support services to improve the diet and exercise habits of nursing professionals.

O cuidado de enfermagem em situações de alteração da imagem facial

A pesquisa analisou a percepção de pacientes, acadêmicas de enfermagem e docentes, quanto ao cuidado frente à alteração da imagem facial, suas implicações no processo formativo. Caracterizou-se pela abordagem qualitativa exploratória, realizada em um hospital universitário em Santa Maria, Rio Grande do Sul, entre julho de 2008 e abril de 2009. Participaram seis pacientes com alteração da imagem facial, sete acadêmicas de Enfermagem e cinco docentes. Utilizou-se entrevistas semi-estruturadas e grupo focal. As informações organizadas e submetidas à técnica de análise de conteúdo. Evidenciou-se duas categorias: significado da imagem facial alterada e formação do enfermeiro e o cuidado. O cuidado a esses pacientes é percebido como uma vivência complexa, difícil e impactante constituindo-se oportunidades ímpares para o desenvolvimento das competências necessárias para a formação da enfermeira. Constatou-se a necessidade de inserção de temáticas durante a formação que abordem temas pertinentes às necessidades dos acadêmicos, possibilitando aos mesmos refletirem sobre o vivido no curso.

Relationships Among Nurses’ Professional Self-Concept, Health, and Lifestyles

According to the American Nurses Association, the entire profession of nursing exists to serve and improve society’s health. Thus, to become a nurse, individuals must master a body of knowledge surrounding numerous health aspects. While acquiring the unique knowledge, skills, and values of their profession, nurses form perceptions of personal adequacy in their role, known as professional or nurse self-concept. Given the centrality of health to the profession, it would seem logical that nurses would personally value health and integrate core health behaviors into their professional self-concept and everyday lives. Yet the prevailing evidence leaves in question whether nurses associate their personal health and lifestyles with their professional roles. This article explores the relationships among nurse self-concept, health status, and healthy lifestyle practices in a sample of Midwestern nurses in an attempt to better understand if nurses who integrate healthy behaviors into their everyday lives feel a stronger sense of professional adequacy relative to nurses who do not.

The Effect of a Holistic Program on Health-Promoting Behaviors in Hospital Registered Nurses

Purpose: The purpose of the study was to examine the effect of a holistic program, the Collaborative Care Model (CCM) Program, and the development of a self-care plan on health-promoting behaviors in hospital nurses. Design: A quasi-experimental, pretest, posttest, repeated measure, comparison-group design was used. Method: The study was conducted in a large, academic medical center in the northeast. The experimental group included registered nurses (RNs) from units in one institution introduced to the CCM and development of a self-care plan in an 8-hour program. The control group received no intervention. Data were collected using the Health Promoting Lifestyle Profile II instrument (HPLP II); a 52-question Likert-type scale with six subscales examining health-promoting behaviors. Findings: Using repeated measures analysis of variance there was a significant increase ( p = .02) in the overall HPLP II mean, spirituality ( p = .04), interpersonal relations ( p = .04), and nutrition scores ( p = .04) of the experimental group as compared over time with the control group. Conclusions: The CCM plus the development of a self-care plan significantly increased overall health promoting behaviors, and spirituality, interpersonal relations, and nutrition scores in these RNs.

Expert Holistic Nurses’ Advice to Nursing Students

Purpose: The purposes of this study were to describe the advice that expert holistic nurses gave to nursing students regarding the theory and practice of holistic nursing and to describe nursing students’ experience and perceptions of their interaction with the experts. Design: This was a qualitative descriptive study. Methods: Nursing students who attended the 2008 and 2009 conferences of the American Holistic Nurses Association interviewed expert holistic nurses, asking them for advice for beginners. Students recorded the interviews on paper and wrote their perceptions of interacting with experts. The data were examined for recurring themes. Findings: The most common advice from the experts was regarding the importance of self-care, person-centered care, touch, and lifelong learning. Students’ perceptions of the interviews included feeling empowered to accomplish goals, gaining a greater understanding of holistic nursing, and feeling admiration for the holistic nurse experts. Conclusion: Giving students the opportunity to interact with nurse experts in an individual, informal setting is a useful educational strategy that increases knowledge, promotes socialization to the nursing profession, and offers students opportunities for professional networking.

Health promotion in nurses: is there a healthy nurse in the house?

The purpose of this pilot study was to examine the health-promoting lifestyle behaviors of acute-care nurses using the Health Promotion Model. Statistical analysis of 149 returned Health-Promoting Lifestyle Profile II surveys indicates areas of weakness in stress management and physical activity. No significant difference is found between unit, demographic factors, and subscale scores at the p < .01 level, but medical-surgical nurses consistently scored better than the critical-care nurses in health promotion. Findings support the need for the development of holistic nursing interventions to promote self-care in the identified areas. Strategies include educational/experiential classes in holistic nursing; individualized unit-based activities fostering stress management, such as massage, reflexology, and imagery; and development of an employee wellness program.

Self-Renewal in Nursing Leadership

Nurse leaders are often vulnerable to stress as experienced in the workenvironment, including long hours, patient overloads, and challenging work settings. If ignored, these stressors may lead to physical, emotional and behavioral symptoms with possible resulting medical errors, absenteeism, health challenges, and job burnout. Purpose: This study was designed to assess the meaning of caring for self by registered nurse leaders who had participated in a holistic caring-for-self project. Design/Setting: Hermeneutic phenomenology was the research method used in this study to explore the lived experience of caring for self from the perspective of 10 nursing leaders. Individual taped interviews were conducted with the participants in a private room in their work setting, a 185-bed community hospital. Findings: The nursing leaders communicated four common themes: Reflections on the Journey of Life, Why to Care for Self on the Journey, How to Care for Self on the Journey, and the Wisdom Learned Along the Path. Conclusions: Based on the reflections of the nursing leaders, recommendations include implementing creative, holistic methods to encourage self-renewal in the work environment.

Health-promoting lifestyle and body mass index among College of Nursing students in Kuwait: a correlational study

This cross-sectional, descriptive survey of 202 nursing students in Kuwait assessed their body mass index and health-promoting lifestyle to determine any association between them. The body mass index was calculated by dividing the weight by the height squared (kg/m(2)). The health-promoting lifestyle was measured using Walker's Health Promoting Lifestyle Profile II instrument. The participants had a normal body mass index with a tendency towards being overweight and obese, particularly for the males. The students also had a low positive health-promoting lifestyle. A significant association was noted between the sociodemographic variables, particularly age, marital status, and nationality, with the body mass index and Walker's Health Promoting Lifestyle Profile. A significant relationship was established between the body mass index and the overall Walker's Health Promoting Lifestyle Profile and the nutrition subcategory. The findings warranted interventions for improved health behaviors and implied the need for the integration of healthy lifestyle programs into the nursing curricula to meet the escalating demands of the students' role in health promotion and disease prevention.

Correlation of the health-promoting lifestyle, enrollment level, and academic performance of College of Nursing students in Kuwait

This descriptive study of 224 nursing students assessed their health-promoting lifestyle profile and correlated it with the levels of enrollment in nursing courses and academic performance. The health-promoting lifestyle profile was measured by Walker's Health-promoting Lifestyle Profile II instrument. Academic performance was measured by assessing the nursing grade point average and general grade point average of the students. The students had positive health-promoting lifestyles with significant differences noted between males and females in the overall profile, physical activity, interpersonal relations, and stress management. Sociodemographic variables, such as age, nationality, and marital status, but not income, showed an association with students' health-promoting lifestyles. A significant correlation was noted between students' nursing enrollment and level of health responsibility. No significant correlation was established between a health-promoting lifestyle and academic performance. This study poses a challenge for nurse educators to provide an effective environment to maximize students' potential to be future vanguards of health.

Nursing student descriptions that suggest changes for the classroom and reveal improvements needed in study skills and self-care

This article describes a longitudinal study that took place in a college of nursing with baccalaureate students between 2002 and 2004 at a university medical center. Its purpose was to provide a climate of success for the students yet challenge them to make additional efforts to complete the program. The qualitative section of the study consisted of students answering the following open-ended questions: (1) Describe ways that faculty can help you be successful in the future and (2) What can you do for yourself to achieve the goal of finishing the program? Students identified what change could be made in the classroom, how increased study time and skills might help, and how self-care would facilitate success. Descriptions were shared with faculty and students in an effort to improve classroom delivery, provide study tips to students, and help students become aware of increased self-care. Students as future nurses, enter practice and care for patients who will need the best care and self-care instruction. Using techniques that students identified to be successful, making efforts through hard work (increased study skills), and realizing how to better care for themselves could assist RNs in providing comprehensive and best care to patients.