Literature review of the research on nursing students' professional self-concept

OBJECTIVE

To understand the current situation and progress of nursing students' professional self-concept, this review aimed to perform a general analysis of research related to the connotation of professional self-concept, measurement tools, influencing factors, effects, and intervention experiments.

METHODS

Three databases (Web of Science, PubMed, and CNKI) were searched for relevant articles. Research articles that met specific criteria were included, with identified articles initially screened by title and keyword. Then the abstracts were screened for relevance, and the full text was read for validation before inclusion. Descriptive analysis was performed with relevant findings from data retrieved from various sources.

RESULTS

Finally, 54 articles that met the criteria were included, which organised the connotation of self-concept of nursing speciality, and introduced six measurement scales, such as Professional Self-Concept of Nurses Instrument and Nurse's Self-Concept Questionnaire. A total of 16 investigations on influencing factors were described, and the results showed that there were internal individual and external environmental factors. The professional self-concept was formed by analysing both factors. This paper described 17 effect surveys and found that professional self-concept had an important impact on students' mental health, academic performance, and professional values, and so on. Eight intervention experiments including attribution training and hierarchical teaching were evaluated.

CONCLUSIONS

Research articles on the professional self-concept included in this review were rich. These articles clarified the basic connotation of the concept, developed relatively mature measurement tools, found many influencing factors and effects, and proposed effective intervention strategies. They were of great value for understanding the professional self-concept and could provide a reference for scholars to conduct relevant research and practice. It also presents research prospects in this field, aiming to inspire future research.

Prospective association between perceived stress and anxiety among nursing college students: the moderating roles of career adaptability and professional commitment

BACKGROUND

Anxiety may stay with nursing students throughout their internship and even persist afterwards. Although many studies have explored the effects of perceived stress on anxiety, the relationship between pre-internship perceived stress and post-internship anxiety levels has not been clarified. In addition, none had focused on the moderating roles of career adaptability and professional commitment between perceived stress and anxiety. This study aims to investigate the influence of pre-internship perceived stress on the post-internship anxiety level of nursing college students, and to analyze the moderating effects of career adaptability and professional commitment on their relationships.

METHODS

A longitudinal study design was employed. Full-time nursing college students from a Chinese medical university were recruited by convenient sampling. All surveys were conducted via Wen Juan Xing ( www.wjx.cn ), a widely used web-based survey platform in China. Two waves of surveys were collected in the pre-internship and post-internship periods, with an interval of one year. Among 823 nursing students recruited, 692 students completed all two waves of the survey (response rate: 84.08%). Participants completed a series of questionnaires examining general demographic characteristics, perceived stress, anxiety, career adaptability, and professional commitment both before and after the internship. The bias-corrected bootstrap technique of the Hayes PROCESS macro (Model 2) was used to test the moderation effect.

RESULTS

Pre-internship perceived stress was positively associated with post-internship anxiety (β = 0.474, p < 0.001). Career adaptability would mitigate the effect of perceived stress on anxiety (β = -0.009, p < 0.01, 95% CI = [-0.013, -0.004]), and this influence became stronger for nursing college students with higher levels of career adaptability. Instead, the professional commitment would enhance the effect of perceived stress on anxiety (β = 0.004, p < 0.05, 95% CI = [0.001, 0.009]).

CONCLUSIONS

Adequate career adaptability was key to alleviating anxiety among nursing interns. Nursing educators and clinical nursing managers should pay attention to cultivating the career adaptability of nursing college students in order to help them successfully achieve identity transformation and career development. Meanwhile, it is crucial to guide them to develop appropriate professional commitment.

The effect of professional portfolio learning on nursing students' professional self-concepts in geriatric adult internship: a- quasi-experimental study

BACKGROUND

Professional self-concept is one of the important outcomes of nursing professionalism. There is a lack of adequately planned curriculum may limit nursing students' practical knowledge, skills and professional self-concept in providing comprehensive geriatric-adult care and promoting nursing professionalism. Professional portfolio learning strategy has allowed nursing students to continue professional development and enhance nursing professionalism in professional clinical practice. However, there is little empirical evidence in nursing education to support the use of professional portfolios in blended learning modality among internship nursing students. Therefore, this study aims to examine the effect of the blended professional portfolio learning on professional self-concept among undergraduate nursing students during Geriatric-Adult internship.

METHODS

A quasi-experimental study two-group pre-test post-test design. A total of 153 eligible senior undergraduate students completed the study (76 in the intervention group and 77 in the control group). They were recruited from two Bachelor of Sciences in Nursing (BSN) cohorts from nursing schools at Mashhad University of Medical Sciences (MUMS), in Iran, in January 2020. Randomization was undertaken at the level of school via a simple lottery method. The intervention group received the professional portfolio learning program as a holistic blended learning modality, though the control group received conventional learning during professional clinical practice. A demographic questionnaire and the Nurse Professional Self-concept questionnaire were used for data collection.

RESULTS

The findings imply the effectiveness of the blended PPL program. Results of Generalized Estimating Equation (GEE) analysis was indicated significantly improved professional self-concept development and its dimensions (self-esteem, caring, staff relation, communication, knowledge, leadership) with high effect size. The results of the between-group comparison for professional self-concept and its dimensions at different time points (pre, post and follow up test) showed a significant difference between groups at post-test and follow up test (p < 0.05),while at pre-test there was no important dissimilarity between two groups (p > 0.05).The results of within-group comparison for both control and intervention showed that there were significant differences in professional self-concept and for all its dimensions across the time from pre-test to post-test and follow-up (p < 0.05), and also from post-test to follow-up it was significant (p < 0.05) for both groups.

CONCLUSION

This professional portfolio learning program demonstrates as an innovative and holistic blended teaching-learning approach to improve professional self-concept during professional clinical practice among undergraduate nursing students. It appears that the use of a blended designed of professional portfolio can promote a link between theory and the advancement of geriatric adult nursing internship practice. The data obtained from the present study can be useful for nursing education to evaluate and redesign a curriculum for development of nursing professionalism as a quality improvement process and groundwork to develop new models of teaching-learning and assessment.

Influence of psychological stress and coping styles in the professional identity of undergraduate nursing students after the outbreak of COVID-19: A cross-sectional study in China

Aim

To investigate the influencing factors in professional identity of undergraduate nursing students after the outbreak of COVID‐19.

Design

Cross‐sectional study.

Methods

The study covered 2,999 nursing students in six undergraduate nursing schools. Several self‐report questionnaires were used to collect the general information, psychological stress, coping styles and professional identity of the undergraduate nursing students.

Results

The overall average score of the professional identity of nursing students (3.67 ± 0.51) has increased significantly after the outbreak of COVID‐19. The professional identity of the undergraduate nursing students was negatively correlated with psychological stress (r = −0.23, p < .001), expectation (r = −0.12, p < .001) and avoidance (r = −0.16, p < .001), but was positively correlated with solving problems (r = 0.18, p < .001) and seeking support (r = 0.12, p < .001). Academic performance, positions, grades, reasons for choosing a nursing profession, parents or relatives engaged in nursing work and the risk degree of residence were the factors influencing the professional identity score of undergraduate nursing students' (p < .001).

Trajectory of growth in Taiwanese nursing students' professional self-concept over two years and its association with critical thinking and class climate

BACKGROUND

Nursing is a practice-oriented profession, and the goal of education is to cultivate confidence and assertiveness for future clinical practice. Nurturing a professional self-concept at school is expecting to help students to approach their success in the nursing profession.

PURPOSE

Using a hierarchical model associated with critical thinking, academic achievement, class climate, and work experience, this longitudinal correlational study explored the growth trajectory of professional self-concept over two years in students attending 2- or 4-year baccalaureate nursing programs.

METHOD

This was a longitudinal and correlational study with five repeated measurements. Questionnaire data were collected by using the Chinese version of the Nurses Self-Concept Instrument (NSCI-C) and the California Critical Thinking Disposition Inventory (CCTDI).

RESULTS

Scores for overall professional self-concept ranged from 84.51 (standard deviation [SD] 12.34) when the students began this study to 89.28 (SD 11.23) at graduation. Hierarchical linear modeling yielded the growth trajectory of professional self-concept was significantly associated with time (β = 0.93, p < .01), CCTIDI (β = 0.13, p < .001), and class climate (β = 5.20, p < .01). An intraclass correlation coefficient was 55.48%.

CONCLUSION

This study confirmed the positive growth trajectory of the professional self-concept in the nursing students' two academic years. The continuous development of the professional self-concept of nursing students is encouraged. Development of critical thinking through their studies, feelings of belonging in their classes, and campus culture all contributed to this trend. To construct a comprehensive hierarchical model, future investigations should use large sample sizes from various classes and conduct multisite evaluations.

Pedagogical practices that influence professional identity formation in baccalaureate nursing education: A scoping review

OBJECTIVES

The purpose of this review was to identify pedagogical practices that contribute to professional identity formation in undergraduate nursing education and to map the components of professional identity described within these practices.

DESIGN

A scoping review using a six-stage methodological framework was used to capture a range of evidence describing how professional identity has been conceptualized and integrated into nursing curriculum.

DATA SOURCES

Databases searched included: Ovid MEDLINE: Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE® Daily and Ovid MEDLINE® 1946-Present, EBSCO CINAHL (1981 to present), OVID PsycINFO (1806 to Present), ProQuest ERIC, ASSIA, and Sociological Abstracts. Additional studies were identified by scanning the reference lists of relevant articles.

REVIEW METHODS

The study team collaboratively designed the data charting table and two coauthors independently screened the studies using Covidence software. Qualitative content analysis was used to categorize learning outcomes into five components of professional identity that were associated with pedagogical practices identified in the studies.

RESULTS

A total of 114 peer-reviewed journal articles were initially charted. Articles were categorized as intervention studies (46, 40%), perspective studies (40, 35%), theoretical papers (17, 15%), or reviews (11, 10%). To ensure feasibility in collating and reporting the results, the review focused on the 46 empirical intervention studies that described associations between pedagogical practices and professional identity formation learning outcomes for students.

CONCLUSIONS

This scoping review illustrates the range of contexts in which nursing students learn, the multidimensional nature of identity formation, as well as the breadth of pedagogical practices and learning outcomes that guide course design. The results can be used to inform future curriculum planning and to identify focused research questions to extend our understanding of evidence-based teaching practices supporting professional identity formation.

The relationship between a disposition of gratitude, clinical stress, and clinical satisfaction in nursing students

PURPOSE

This study assessed a disposition of gratitude, and clinical practice stress and satisfaction in nursing students, to determine the relationship between them and provide some basic information towards improving their satisfaction with clinical practice.

DESIGN AND METHODS

This descriptive research was conducted on 171 nursing students from three universities in South Korea using a structured questionnaire.

FINDINGS

Students who had a stronger disposition of gratitude (t = 3.482; P < .001), lower clinical practice stress (t = -2.998; P < .003), and better health (t = 2.900; P < .004) were more satisfied with their Clinical practice (R² = 0.298; F = 13.853; P < .001).

PRACTICE IMPLICATIONS

The findings emphasized the development of programs to improve disposition of gratitude in curriculum or extracurricular activity to enhance Clinical practice satisfaction.

The Influence of Self-Concept on Clinical Decision-Making in Nurses and Nursing Students: A Cross-Sectional Study

The aim of this study is to examine the influence of nurses’ self-concept (NSC) on clinical decision-making (CDM) among nursing students and hospital nurses. A further aim is to examine whether there is a difference in CDM and NSC between hospital nurses with various levels of experience and nursing students. A cross-sectional study was conducted during 2018 in the Faculty of Dental Medicine and Health and the University Hospital Center, in Osijek, Croatia, EU. The respondents consisted of 568 hospital nurses, and 129 BSc nursing students. Data were collected with the clinical decision-making in nursing scale (CDMNS) and the nurses’ self-concept questionnaire (NSCQ). There was no correlation between CDM and NSC in either students or hospital nurses. Hospital nurses generally had significantly higher scores in CDM than nursing students. On the other hand, students had a significantly higher total NSC level. The results of this study suggest that experience has a positive impact on nurses’ CDM skills. The high NSC estimated by students enables them to easily take up their clinical roles and approach the patient in a holistic manner, which is an attitude that gradually develops during studies and with clinical experience.

Effects of Pilates Exercises on Professional Self-concept in Nurses Working in Intensive Care Units and Emergency Departments

BACKGROUND

Professional Self-Concept (PSC) affects one's way of thinking, role evolution, professional behavior, and performance. The present study aimed to determine the effect of Pilates exercises on PSC in nurses working in Intensive Care Units (ICU) and emergency departments.

MATERIALS AND METHODS

This quantitative study was a randomized controlled field trial. The study population consisted of all nurses working in ICUs and emergency departments from 2016 to 2017. Based on the inclusion and exclusion criteria, 110 nurses were assigned to intervention and control groups using a permuted block randomization method. The Nurses' Self-Concept Questionnaire (NSCQ) was completed by both groups. The intervention group performed Pilates 30 min each session at home for 8 weeks. The Chi-squared test, Mann-Whitney U, Kruskal-Wallis test, and t-test were employed to analyze the collected data.

RESULTS

Mean and standard deviation of the PSC score was 223.73 (23.35) in the intervention group and 215.75 (34.54) in the control group at baseline; it reached 229.17 (23.36) in the intervention group and 217.77 (34.44) in the control group at the end of the study. The difference was not significant. The paired-samples t-test showed that the score of PSC was increased by 5.45 points on average in the intervention group after the Pilates exercises, which was statistically significant (t54= 25.80, p < 0.001).

CONCLUSIONS

Pilates enhances the score of PSC in nurses working in ICUs and emergency departments. The designing and implementation of these easy and safe exercises may prove beneficial for nurses.

A Phenomenological Investigation of the Interplay Among Professional Worth Appraisal, Self-Esteem and Self-Perception in Nurses: The Revelation of an Internal and External Criteria System

Nurses’ professional self-concept is strongly associated with professional worth appraisal, which encompasses their feelings and perceptions regarding their task efficacy and value of input to clinical outcomes. Professional self-concept and professional worth appraisal are incorporated in one’s overall professional role perception. Data show that the way nurses think and feel about themselves personally and professionally, is associated with their well-being, the quality of provided patient care, their job satisfaction and retention. Although researchers indicate that professional self-concept is a different entity from personal self-concept, however, a clear differentiation and possible interaction between these constructs has not been yet adequately described in nursing literature. Personal self-concept mirrors the way people interpret them-selves, incorporating their self-awareness and personal effectiveness. Following purposeful sampling and informed consent, a phenomenological approach based on Munhall’s methodology was employed to explore the living experience of professional role perception in 16 critical and emergency nurses, with special focus on their perceptions and feelings about personal and professional-role worth appraisal. Data and theoretical saturation criteria were implemented, along with all nine Munhall’s criteria for the rigor and trustworthiness of phenomenological studies. The participants’ narratives suggested a possible interaction between professional attitude and personality traits, illuminating as the core theme an interplay among self-perception, personal and professional worth appraisal process. Additionally, the present study emphasized the way self-evaluation criteria system may be associated with the personal and professional self-concept in nurses. In particular, it was highlighted that the way nurses think and feel about themselves is associated with the way they experience their professional role and vice versa, and that professional role-based self-concept and professional worth perception can be linked with their well-being. Furthermore, positive feelings about the self and personal competencies seemed to enhance the perception of effectiveness in clinical settings and adequacy of professional skills, resulting in empowered professional identity and vice versa. Overall, the present findings are discussed in relation to nurses’ experience of work-related stressors and relevant interventions. Further exploration of the effectiveness of interventions for facilitating adaptive personal and professional self-appraisal are suggested.

The status of professional identity and professional self-efficacy of nursing students in China and how the medical documentaries affect them: A quasi-randomized controlled trial

OBJECTIVES

Professional identity and self-efficacy are important for the education and career development of students. However, how to improve these factors among Chinese nursing students needs further study. This quasi-randomized control trial was designed to explore the effect of medical documentaries on professional self-efficacy and identity among nursing students in Chinese technical schools.

METHODS

A total of 277 nursing students were enrolled in this study and divided into an experimental group (n = 135) and a control group (n = 142). The experimental group was invited to watch Chinese medical documentaries, whereas the control group remained on a waiting list. A self-designed general questionnaire, along with professional identity and professional self-efficacy questionnaires, was completed by the nursing students.

RESULTS

No significant change in professional self-efficacy was observed (-3.55 ± 14.23, P = 0.173) in the experimental group, while professional identity significantly declined (-6.24 ± 12.85, P = 0.002) after the intervention. No significant change was found in the two aspects in the control group.

CONCLUSION

Medical documentaries negatively affect professional identity but do not affect professional self-efficacy. Further researches should be conducted to explore the real reasons.

Stress and anxiety among nursing students: A review of intervention strategies in literature between 2009 and 2015

Undergraduate nursing students experience significant stress and anxiety, inhibiting learning and increasing attrition. Twenty-six intervention studies were identified and evaluated, updating a previous systematic review which categorized interventions targeting: (1) stressors, (2) coping, or (3) appraisal. The majority of interventions in this review aimed to reduce numbers or intensity of stressors through curriculum development (12) or to improve students' coping skills (8). Two studies reported interventions using only cognitive reappraisal while three interventions combined reappraisal with other approaches. Strength of evidence was limited by choice of study design, sample size, and lack of methodological rigor. Some statistically significant support was found for interventions focused on reducing stressors through curriculum development or improving students' coping skills. No statistically significant studies using reappraisal, either alone or in combination with other approaches, were identified, although qualitative findings suggested the potential benefits of this approach do merit further study. Progress was noted since 2008 in the increased number of studies and greater use of validated outcome measures but the review concluded further methodologically sound, adequately powered studies, especially randomized controlled trials, are needed to determine which interventions are effective to address the issue of excessive stress and anxiety among undergraduate nursing students.

Incorporating Spirituality into Health Sciences Education

Researchers are beginning to collect empiric data about coping mechanisms of health science students. Yet, there is an important aspect of coping with stress that is only partially addressed in health sciences curricula: students' spiritual well-being. In this essay, we describe a course in spirituality and health care that we offered to fourth-year medical students, as well as a small empirical study we conducted to assess students' spiritual needs and practices. We then offer reflections on the broad applicability of this work to students in the health sciences more generally, including suggestions for curriculum interventions that may ensure students' success.

A Study of the Relationship Between Nurses' Professional Self-Concept and Professional Ethics in Hospitals Affiliated to Jahrom University of Medical Sciences, Iran

Background:

Commitment to ethics usually results in nurses’ better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses’ professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences.

Methods:

This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses’ self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics.

Results:

The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16).

Conclusion:

In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses’ self-concept, which can boost their commitment to ethics, be given more consideration.

Determinants of nursing competence of nursing students in Taiwan: the role of self-reflection and insight

BACKGROUND

A nursing practicum course is critical to strengthening the nursing competence of nursing students. Research has found that practice stress and coping behaviors can have either a negative or positive influence on the learning and practice performance of nursing students. Nevertheless, there are few evidence-based studies related to the relationship between self-reflection and insight and nursing competence in Taiwanese nursing students.

OBJECTIVE

To test the determinants and the effect of self-reflection and insight on nursing competence in nursing students during the first 2 months of their practice experience.

DESIGN

Cross-sectional and correlational research designs were employed.

METHODS

From September to November 2013, a total of 312 nursing students at a junior college in southern Taiwan served as participants in this study. Four questionnaires were used to collect data: Self-reflection and Insight Scale (SRIS), Perceived Stress Scale (PSS), Coping Behavior Inventory (CBI), and Holistic Nursing Competence Scale (HNCS). The research model was evaluated through structural equation modeling (SEM), with the use of the partial least squares (PLS) method.

RESULTS

Results indicated that self-reflection and insight, practice stress, and practice coping behavior were statistically significantly associated with nursing competence. In addition, self-reflection and insight were significantly and positively associated with practice coping behavior and negatively associated with practice stress. Students' coping behavior partially mediates the effect of self-reflection and stress on nursing competence. Overall, these variables explained 39.4% of the variance in these students' nursing competence.

CONCLUSION

Self-reflection and insight affected nursing competence during the practice period. These variables have not only had a direct influence on nursing competence but also an indirect effect through the mediating effect of coping behavior and stress.

A cross-sectional study of drinking patterns, prelicensure nursing education, and professional identity formation

BACKGROUND

Professional identity has been described as being an important outcome of nursing education, but how this identity forms is not well understood. Even less is known about how students' personal substance use/abuse patterns factor into their professional identity formation.

OBJECTIVES

The purpose of this study was to describe drinking behaviors and professional identity formation among baccalaureate of nursing students.

DESIGN

This cross-sectional, descriptive study used a survey design.

SETTING

The study took place on three campuses of a large system university in the Midwestern United States.

PARTICIPANTS

The convenience sample consisted of 333 students enrolled in the first semester of the second, third, and last year of a traditional baccalaureate of nursing program.

METHODS

Data were collected using the Nurse Self-Concept Questionnaire and the Student Alcohol Questionnaire. ANOVA and Pearson r statistical tests were used to analyze data.

RESULTS

Self-perceptions related to leadership were found to be the weakest aspect of the students' self-concepts, and the only dimensions of professional self-concept that differed significantly among students enrolled at varying program levels were knowledge and communication. A negative relationship was found between increased alcohol use and general self-concept and communication, but the associations were very weak.

CONCLUSIONS

More research is needed to understand how best to facilitate the acquisition of an identity consistent with the profession's values and how to recruit candidates that embody nursing's preferred future.

The effects of a hardiness educational intervention on hardiness and perceived stress of junior baccalaureate nursing students

Baccalaureate nursing education is stressful. The stress encompasses a range of academic, personal, clinical, and social reasons. A hardiness educational program, a tool for stress management, based on theory, research, and practice, exists to enhance the attitudes and coping strategies of hardiness (Maddi, 2007; Maddi et al., 2002). Research has shown that students who completed the hardiness educational program, subsequently improved in grade point average (GPA), college retention rates, and health (Maddi et al., 2002). Little research has been done to explore the effects of hardiness education with junior baccalaureate nursing students. Early identification of hardiness, the need for hardiness education, or stress management in this population may influence persistence in and completion of a nursing program (Hensel and Stoelting-Gettelfinger, 2011). Therefore, the aims were to determine if an increase in hardiness and a decrease in perceived stress in junior baccalaureate nursing students occurred in those who participated in a hardiness intervention. The application of the Hardiness Model and the Roy Adaptation Model established connections and conceptual collaboration among stress, stimuli, adaptation, and hardi-coping. A quasi-experimental non-equivalent control group with pre-test and post-test was used with a convenience sample of full-time junior level baccalaureate nursing students. Data were collected from August 2011 to December 2011. Results of statistical analyses by paired t-tests revealed that the hardiness intervention did not have a statistically significant effect on increasing hardiness scores. The hardiness intervention did have a statistically significant effect on decreasing perceived stress scores. The significant decrease in perceived stress was congruent with the Hardiness Model and the Roy Adaptation Model. Further hardiness research among junior baccalaureate nursing students, utilizing the entire hardiness intervention, was recommended.

Student Impressions of an Art Therapy Class

Art therapy facilitates the expression of thoughts and feelings and thus may serve as a self-care strategy. This paper describes the implementation of an expressive art therapy class to teach self-care during a required sophomore level nursing wellness course and the outcomes of the class through the eyes of six students. While students were initially reluctant to engage in the activity, the shared stories revealed feelings of relaxation, empowerment, value clarification, and increased self-awareness. The implication for nursing education is that the integration of art therapy into curricula may serve as an effective strategy to teaching self-care and core professional values.

Humor in the classroom using faculty skits

The infusion of humor in the classroom through faculty-developed skits is a teaching-learning strategy that engages nursing students in the learning process. Gardner's Multiple Intelligence Theory for Adult Learners provides the framework for the use of humor as a strategy in higher education. Three exemplars are presented with a description of the specific strategy, an objective for each strategy, and the effect of the strategy on student engagement in nursing education. In the exemplars, the authors provide "ready to use" ideas with some "pearls of wisdom" for other faculty interested in developing similar learning activities.

Stress ratings and health promotion practices among RNs: a case for action

OBJECTIVE

: The objective of this study was to investigate associations between RN perceptions of their stress levels, health-promoting behaviors, and associated demographic variables.

BACKGROUND

: Stress and burnout are occupational hazards resulting in absenteeism, illness, and staff turnover, factors important to nurse administrators. Personal health behaviors among nurses have been linked to less stress and the delivery of health-promotion teaching.

METHOD

: An electronic survey with 2 standardized measures and demographic questions was completed by 2,247 staff nurses from a large Midwestern academic medical center.

FINDINGS

: Stress levels were inversely correlated with overall health-promoting behavior scores. Outside caregiver responsibilities were associated with higher stress and lower health-promoting behaviors scores.

CONCLUSIONS

: Findings support work-site interventions that promote nurses' health and wellness, reduce work and home stress, and influence positive patient care and outcomes.