Development and validation of the questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication

OBJECTIVE

The purpose of this study was to develop and analyze the psychometric properties of an instrument that could analyze the communication of nursing professionals in nurse-patient therapeutic communication.

METHODS

A literature review and a panel of experts were used (N = 10) to develop the questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication. The final version of the questionnaire was composed of 49 items and applied to a convenience sample of 370 nurses.

RESULTS

The construct validity was assessed by an exploratory factor analysis (EFA) and the reliability using Cronbach's Alpha. Three dimensions were identified that determine therapeutic communication: professional, contextual and/or situational and patient. The Cronbach's α total coefficient was 0.90, ranging from 0.71 to 0.81 for the dimensions.

CONCLUSION

The questionnaire to analyze the communication of nurses in nurse-patient therapeutic communication represents a valid and reliable questionnaire to measure nurses' communication with patients in the clinical setting.

IMPLICATIONS FOR PRACTICE

The use of the questionnaire enables the analysis of elements that interfere with effective communication. This can assist in developing interventions to improve nurses' therapeutic communication with patients.

The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals

AIMS AND OBJECTIVES

To analyse nursing students' perceptions of the clinical learning environment and supervision and the connection between their satisfaction and intention of staying in their placement hospitals.

BACKGROUND

Global nursing shortage necessitates strategies for the recruitment and retention of nurses. It is believed that nursing students' clinical placement experiences can affect their learning outcomes, as well as influence their choice of future workplace.

DESIGN

Cross-sectional, correlational study.

METHODS

One hundred and eighty nursing students participated in the study. The data were collected in person using The Clinical Learning Environment, Supervision and Nurse Teacher scale tool. Students' satisfaction with the clinical learning environment and learning process was measured using a 4-point Likert scale developed by the researchers. The STROBE checklist was used in this paper.

RESULTS

Nursing students perceived a favourable clinical learning environment and supervision in the hospitals where they undertook clinical placements, recording high levels of satisfaction and high levels of intention to stay and work there. The clinical learning environment and supervision established positive correlations with student satisfaction.

CONCLUSIONS

This study promotes the development of knowledge and understanding of how student satisfaction and intention to stay and work in their placement hospitals relates to the quality of the clinical learning environment and supervision, which could be helpful to the management of healthcare facilities and faculties in improving nursing education and retention/recruitment strategies.

RELEVANCE TO CLINICAL PRACTICE

Nursing students represent the future of the nursing workforce, so managers of healthcare facilities and faculties should move towards promoting a clinical learning and supervisory environment where supervisors, tutors and staff are aware of their commitment to student education and promote optimal learning and positive experiences in order for students to feel satisfied and motivated to work in their placement hospitals.

Guess it (SVUAL): An app designed to help nursing students acquire and retain knowledge about basic and advanced life support techniques

To design an app that helps nursing students to acquire and retain knowledge of Basic and Advanced Life Support techniques, as well as analyze the students' gamification experience. The study had two phases: 1) App design and development and 2) experimental study. A total of 184 students participated, with 92 in the experimental group and 92 in the control group. The instruments used were the Guess it (SVUAL) app, a test on knowledge and the Gameful Experience Scale. The app was deemed to have a suitable level of content and user-friendliness of 97%. The experimental group obtained a higher average score on the knowledge test than the control group (U = 2835.500; Z = -3.968; p < 0.05). On the re-test, the experimental group also obtained a higher average score than the control group. As for the experience within the game, all the dimensions scored higher than average, except the absence of negative effects dimension, which indicates that the app had very few negative consequences on the participants. The developed app has proven to have a good level of content and to be user-friendly, improving knowledge levels and retention of information in nursing students.

Magnet hospital attributes in nursing work environment and its relationship to nursing students' clinical learning environment and satisfaction

AIMS

To analyse nursing students' perception of the Magnet hospital attributes of the work environment at the hospitals where they perform their clinical placement and the relationship of this factor to their clinical learning environment and supervision, satisfaction and intention to stay in those hospitals once graduated.

DESIGN

This study had a cross-sectional, correlational, design.

METHODS

Data were collected using self-reported questionnaires from 180 nursing students at a university in southeast Spain between September-October 2018. Nursing work environment and clinical learning environment were measured using the Practice Environment Scale of the Nursing Work Index and Clinical Learning Environment, Supervision and Nurse Teacher scale, respectively. Students' satisfaction with the work environment and with the clinical learning process were measured using a four-point Likert scale developed by the researchers. Percentages, frequencies, mean, standard deviation, χ² test, Mann-Whitney U test, Spearman and phi correlation were used to analyse the data.

RESULTS

Nursing students' perception of greater Magnet-like features at work environment was associated with better clinical learning environment (Spearman rs = |0.22-0.54|; p < .01) and satisfaction with the work environment (Spearman rs = 0.18; p = .01) and with their learning process (Spearman rs = 0.21; p < .01). Greater intention to stay working in the hospital after graduation was significantly associated with greater satisfaction with the learning process (phi = 0.31; p < .01) and the work environment (phi = 0.23; p = .02).

CONCLUSION

Magnet-like features at the work environment lead to superior clinical learning environment and higher students' satisfaction, two factors that play a decisive role in their decision to stay at hospitals where they performed clinicals after graduation.

IMPACT

In the face of a global nurse shortage, nursing managers and faculty leaders should consider the improvement of nursing workplaces as a strategic alliance to promote satisfactory clinical learning experience and aid recruitment of nurses.

Systematic review of measurement properties of self-reported instruments for evaluating therapeutic communication

A systematic review was carried out to examine measurement tools of therapeutic relational communication, using an electronic search of the following databases: PubMed, LILACS, CINAHL, CiberIndex, Scielo and Scopus. The project followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the protocol recommended by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) panel. Thirteen instruments were included in the review. and their measurement properties were tested. The most common communication elements found in the measuring instruments were: empathy, respect, listening, contact, communicative competence, communication quality, and communication skills. Studies that used a theoretical foundation were based on patient-centered humanistic models. Empathy, respect, controlled contact, and other basic elements of interpersonal communication were most commonly found among the measuring regents. In conclusion, this review analyzed the theoretical foundations of the components of instruments used to measure therapeutic relational communication in the nursing field.

Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey

OBJECTIVE

To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type.

BACKGROUND

Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date.

METHODS

The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha.

RESULTS

Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest.

CONCLUSION

The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.

Interpersonal communication, empathy, and stress perceived by nursing students who use social networks

AIM

The objective of this study was to explore interpersonal communication, empathy, and stress perceived by nursing students who use social networks.

DESIGN

A cross-sectional study was performed.

METHODS

A convenience sample of 135 nursing students. For data collection, the following instruments were used: The WhatsApp Negative Impact Scale, The Perceived Stress Scale, The Interpersonal Communication Competence Inventory, and the Jefferson Scale of Empathy. Data collection took place in February 2020.

RESULTS

A negative correlation was found between the WhatsApp Negative Impact and the Jefferson Scale of Empathy (rs = -0.204; p = .019). Conversely, a positive correlation was also observed between the Interpersonal Communication Competence Inventory and the Jefferson Scale of Empathy (rs = 0.212; p = .014).

CONCLUSION

Nursing students' use of new technology could be problematic and interfere with their therapeutic communication skills.

IMPACT

This study addresses the problem of social network use in the clinical setting and how this can influence nursing students' therapeutic communication skills with patients. The results of this study have showed that, among nursing students, social network use has a negative impact, showing decreased empathy. Likewise, students who show a greater level of empathy have better interpersonal communication skills. However, significant results were not found between psychological distress and problematic social network use. Therefore, it is necessary to perform additional studies that would further explore this aspect. This study allows us to explore the negative impact of social networks on therapeutic communication, with the aim of developing prevention strategies at university institutions.

Educational Interventions for Nursing Students to Develop Communication Skills with Patients: A Systematic Review

INTRODUCTION

Nursing students establish therapeutic relationships with their patients and as future nursing professionals, they should be trained to be effective communicators. The objective of this systematic review was to know the impact of educational interventions on nursing students to develop their communication skills with patients.

METHODS

A systematic review of literature was carried out. The following databases were consulted: CINAHL, PubMed (Ovid Medline), SCOPUS and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this review. As for inclusion criteria, published articles in English from 2000 to 2020 were included. The methodological rigor of the included articles was evaluated with the JBI Critical Appraisal Checklist for Randomized Controlled Trial or Quasi-Experimental Studies. Changes in communication skills with the patient after the implementation of an intervention were analyzed.

RESULTS

Of the included studies in this systematic review (N = 19), two studies were randomized controlled trials, others were single group quasi-experimental studies (N = 11) and two group quasi-experimental studies (n = 6). The majority of the studies were carried out in the USA (n = 7). The most frequent educational intervention was simulation (n = 11). As for the improvement of communication skills, 13 of the 19 articles found statistically significant differences in patient-centered communication skills of nursing students.

CONCLUSIONS

This systematic review provides preliminary evidence of the effectiveness of interventions used to train nursing students in patient-centered communication. Although all the interventions obtained significant results in communication skills, it has not yet been determined which methodology is more effective.

How to measure gamification experiences in nursing? Adaptation and validation of the Gameful Experience Scale [GAMEX]

BACKGROUND

There has been an increasing amount of research in the last few years on the use of gamification in nursing. However, there is not yet a suitable measuring instrument that fully captures the emotional qualities that arise with the use of gamification.

OBJECTIVES

To culturally adapt and validate the Gameful Experience Scale used among nursing students as well as understand their game experience.

DESIGN

The study was divided into two phases 1) cross-cultural adaptation and 2) validation of the scale and cross-sectional descriptive study.

SETTINGS

Faculty of Health Sciences at the University of Almeria, Spain.

PARTICIPANTS

226 students studying an undergraduate nursing degree.

METHODS

In the first phase, a cross-cultural adaptation was carried out using a forward-back translation, with the collaboration of a panel of experts. In the second phase, the corresponding analyses were performed, to measure the reliability and the validity of the instrument.

RESULTS

The Kaiser-Meyer-Olkin test that measures the appropriateness of the sample had a result of 0.875. Bartlett's sphericity test was significant (X²(351) = 3755.142, p < 0.05). A structure of 6 factors was confirmed. The total Chronbach α value was 0.855. In the analysis of the test-retest reliability, a correlation level of 0.89 was obtained (p < 0.05). The participants showed high scores in all the dimensions, except that of absence of negative effects.

CONCLUSIONS

The adapted version of the scale showed good results in regards to reliability and validity, which indicates that it is an effective tool to be used to measure the game experience in nursing students' training.

Adaptation of the Spanish version of the Self-Efficacy Consumption of Fruit and Vegetables Scale

The objective of this study was to analyse the psychometric properties of the Spanish version of the Self-Efficacy Consumption of Fruit and Vegetables Scale among the Spanish population. The sample was made up of 506 subjects who were selected through a convenience sample. The original version was translated from English to Spanish and later was translated back into English, by different translators. Upon translating, not only did the translators keep in mind the grammatical and linguistic aspects of the text, but also the cultural aspects. In order to validate the content of the Scales, the adapted and agreed-upon version of the scale was evaluated by a panel of experts, in order to obtain the final version. Data collection took place between March and September 2017.The internal consistency was tested using Chronbach’s alpha. For the analysis of the structural validity, a factor analysis was carried out on the Self-Efficacy Consumption of Fruit and Vegetables Scale-Spanish version. Kaiser-Meyer Olkin and Bartlett’s test of sphericity (0.90) confirmed that the analysis was suitable. A two-factor structure was confirmed, as in the original scale. The value of Chronbach’s α for the total questionnaire was 0.877, which shows a good internal consistency. In the analysis of the reliability test-retest, a correlation value of 0.79 (p<0.05) was found, demonstrating its temporal stability. The Self-Efficacy Consumption of Fruit and Vegetables questionnaire is a reliable tool to measure self-efficacy in the consumption of fruits and vegetables in the Spanish context.

Development of a web-based tool to evaluate competences of nursing students through the assessment of their clinical skills

BACKGROUND

Assessing the clinical ability of nursing students continues to be a fundamental challenge within the nursing degree. Designing innovative teaching strategies while ensuring an educational experience that results in safe nursing practices is an additional challenge for all educators.

OBJECTIVES

To design, develop and implement a tool to evaluate the clinical skills of nursing students.

DESIGN

A two-phase study. In the second phase, a pre-experimental study was conducted.

SETTINGS

Health Sciences Department of the University of Almería, Spain.

PARTICIPANTS

250 Nursing students in the second year of their degree.

METHODS

The study was divided into 2 phases: 1st) Web-based tool design and development and 2nd) Usability testing. In the second phase, a pre-experimental study was conducted both with an experimental group and a control group.

RESULTS

In the first phase, a panel of 15 experts confirmed that the content and technical aspects of the tool were adequate (scores of 4-5/5). In the second phase, the participants of the experimental group showed higher final scores in the evaluated skills section, as well as shorter evaluation time and a greater number of observations and registered incidents than the participants in the control group. Finally, the students of the experimental group indicated a greater degree of satisfaction with the evaluation system used.

CONCLUSIONS

The web-based tool designed is an effective strategy to evaluate clinical skills. It is important to have strategies and instruments that allow us to demonstrate the development and acquisition of the skills required for future nursing professionals.

The relationship between nomophobia and the distraction associated with smartphone use among nursing students in their clinical practicum

Background

The increasing concern about the adverse effects of overuse of smartphones during clinical practicum implies the need for policies restricting smartphone use while attending to patients. It is important to educate health personnel about the potential risks that can arise from the associated distraction.

Objective

The aim of this study was to analyze the relationship between the level of nomophobia and the distraction associated with smartphone use among nursing students during their clinical practicum.

Methods

A cross-sectional study was carried out on 304 nursing students. The nomophobia questionnaire (NMP-Q) and a questionnaire about smartphone use, the distraction associated with it, and opinions about phone restriction policies in hospitals were used.

Results

A positive correlation between the use of smartphones and the total score of nomophobia was found. In the same way, there was a positive correlation between opinion about smartphone restriction polices with each of the dimensions of nomophobia and the total score of the questionnaire.

Conclusions

Nursing students who show high levels of nomophobia also regularly use their smartphones during their clinical practicum, although they also believe that the implementation of policies restricting smartphone use while working is necessary.

Analysis of home-based rehabilitation in patients with motor impairment in primary care: a prospective observational study

Background

The purpose of health and social policies is to encourage older people more longevity, remain free of disability and experience quality of life while living in their homes.

The aim of this study was to describe the characteristics of 473 patients diagnosed with motor impairment in primary care, the objectives of home-based rehabilitation and its functional impact.

Methods

This prospective observational study was conducted in the Almería Health District. The analysed variables included age, gender, secondary diagnosis, Barthel Index (BI), physiotherapeutic objectives and techniques, and number of sessions.

Results

The sample had a mean age of 83 years, and 59% were women. The assessed conditions with a high prevalence included osteoarticular pathology (55%), Alzheimer’s disease (15.1%), cardiovascular disease (13.7%) and stroke (6.5%). The techniques applied mainly consisted of functional exercises (57.1%), caregiver education (13.8%), and technical assistance (5.7%). There were statistically significant differences (t = −15.79; p < 0.001) between initial (X = 34.8) and final BI (X = 48.1), with an improvement of 13.4 points in patients’ functional capacity (95% confidence interval [CI]: −15.0 to −11.7). An equation was constructed to predict patients’ final BI as a function of the initial BI using a multiple linear regression model. The regression model explained 78% of the variance in patients with motor impairment.

Conclusions

Important improvements were obtained in terms of functional capacity with a mean of ten sessions of physiotherapy. Lower patient age was correlated with higher initial and final functional capacities in primary care. This study aimed to present a useful starting point for decision making among management and health administration regarding this population group by approaching the process from the reality of practice and in relation to the rehabilitation provided.

Trial registration

ClinicalTrials.gov identifier: NCT02715245; Date of registration: 18 January 2016.

Sexual Behavior in Patients with Psychosis Admitted to a Hospital Unit

The sexual dimension is part of a person's functionality. Patients with mental disorders have the same sexual needs as any other person, although they may not always be recognized. This is a retrospective observational study to describe the information on sexuality of patients with mental disorders, admitted to an acute short-stay inpatient unit between 2011 and 2015. We analyzed 293 clinical histories of patients, comprising diagnoses in the ICD-10 (International Classification of Diseases) between F20 and F29, inclusively. The information collected corresponded to the beginning of hospitalization, its duration and discharge. The results showed that 24% of the patients had sexual delusions. These delusions were more frequent in women, who in turn had more emotional symptoms, persecutory deception being the most common. There were few reports found on sexual dysfunction. In conclusion, the lack of data in the reports shows little recognition of sexuality in hospitalized patients with mental disorder, highlighting the need to promote the training of health personnel.

Attitudes and Beliefs of Nursing Students Toward Mental Disorder: The Significance of Direct Experience With Patients

PURPOSE

The objective of this study was to analyze nursing students' beliefs and attitudes toward mental disorder before and after clinical placements.

DESIGN AND METHODS

A cross-sectional design was chosen. One hundred ninety-four first- and third-year students in a three-year nursing degree course completed the Attribution Questionnaire AQ-27 regarding Mental Health, the Questionnaire of Beliefs, and a Socio-Demographic Questionnaire.

FINDINGS

Significant differences were found between students who had experienced mental illness and those who had not. Differences were also found between students with friends who suffered from mental health problems and those who did not.

PRACTICE IMPLICATIONS

These results emphasize the need for nursing students to have direct interaction with people with a mental illness.

Teachers' Knowledge and Beliefs About Child Sexual Abuse

Child sexual abuse is one of the main types of abuse still to be addressed within the field of education, yet the education system itself can serve as a primary tool for its prevention. A better understanding of teachers' knowledge and beliefs about child sexual abuse will allow us to establish key starting points from which to utilize the system for prevention. Four hundred and fifty teachers participated in this study, completing a questionnaire regarding their knowledge and beliefs about child sexual abuse. The study revealed that over half the teachers, 65.3% (n = 294), had never received any type of training in child sexual abuse education and that the majority were not familiar with methods of identifying child sexual abuse, 90.7% (n = 279). Various mistaken beliefs were identified among the participating teachers, such as pathological profiles of abusers, that the vast majority of child sexual abuse implies violent behavior, and that there cannot be abusers the same age as the victim. These results indicate that knowledge deficiencies do exist about child sexual abuse among teachers and highlight the need for training in this field.

A longitudinal study of symptoms beliefs in hypertension

A longitudinal study was conducted to assess the presence of beliefs about symptoms related to hypertension and the time since diagnosis in which they appear. A randomly selected sample of hypertensive patients (67% women, mean age 53.27 years and range 20-65) was divided into four groups according to the time from diagnosis. All patients (N = 171) were interviewed at the beginning (initial assessment) and 12 months later (final assessment) and the patients (n = 75) who did not report beliefs about symptoms at the initial assessment were interviewed in a follow-up schedule. The results showed that 56% of patients reported beliefs about symptoms at the initial assessment, and this percentage increased to 77% at the final assessment (p < .001) finding significant differences between the two groups with a more recent diagnosis and the two groups of long-standing patients. Longitudinal analysis of the group with the recent diagnosis showed that the critical period for the emergence of beliefs was the first year from diagnosis. This period could be decisive in order to prevent them. Healthcare professionals should pay attention to the emergence of these beliefs, as they could negatively affect treatment adherence.

Valores personales en estudiantes y profesionales de Enfermería

El estudio explora el contraste intergeneracional entre valores personales en estudiantes y profesionales de enfermería y su ajuste a las predicciones de la teoría del cambio de valores. La muestra estuvo formada por 369 estudiantes y profesionales de enfermería distribuidos en tres grupos: estudiantes (n = 150), profesionales menores de 40 años (n = 114), y profesionales entre 41 y 60 años (n = 105). Los participantes informaron de sus valores en orden de prioridad en un cuestionario abierto. Los informes se organizaron en categorías de valores para analizar las diferencias entre grupos. Se encuentran dos tendencias en el informe de valores personales, que se ajustan en algunos casos a lo predicho por la teoría del cambio de valores y, en otros casos, la contradicen. Se discute la importancia de estos hallazgos y la necesidad de potenciar una formación orientada hacia los valores de la profesión de enfermería. El estudio contribuye al conocimiento del cambio de valores personales en profesionales de enfermería.

[Communication and satisfaction among primiparas in a public health service]

OBJECTIVE

To analyze first-time mothers communication with health professionals, and to explore satisfaction, needs and expectation towards healthcare services.

METHOD

Qualitative design using in-deep interviews and phenomenology was used. First-time mothers from Huercal-Overa (Almería) were intentionally selected in 2010 and were included in the study. A hermeneutic analysis was performed.

RESULTS

Six meta-categories were obtained. Saturation of information was found with nine interviews. The meta-categories were the following: 1) Health professionals; 2) Pregnancy, partum and postpartum; 3) Communication; 4) Child nutrition; 5) Feelings; 6) Others. The mothers perceived as exciting this new experience and expressed feelings of fear, anguish and high sensitiveness. These feelings are increased by the information received from the family circle and the professionals which is referred low and contradictory. All professionals were positively considered, specially the midwife. The following negative experiences were identified: contractions, dilation and delivery. The end of the stay at the hospital was considered early and the time for consultation was short for the mothers. There is a demand about more information on breast feeding. Mothers wish health professionals to respect their decisions.

CONCLUSIONS

The study found some areas for improvement in the communication between firs-time mothers and health professionals which could be taken into account in satisfaction promotion plans in regards to healthcare services.

Connective tissue reflex massage for type 2 diabetic patients with peripheral arterial disease: randomized controlled trial

The objective of this study was to evaluate the efficacy of connective tissue massage to improve blood circulation and intermittent claudication symptoms in type 2 diabetic patients. A randomized, placebo-controlled trial was undertaken. Ninety-eight type 2 diabetes patients with stage I or II-a peripheral arterial disease (PAD) (Leriche-Fontaine classification) were randomly assigned to a massage group or to a placebo group treated using disconnected magnetotherapy equipment. Peripheral arterial circulation was determined by measuring differential segmental arterial pressure, heart rate, skin temperature, oxygen saturation and skin blood flow. Measurements were taken before and at 30 min, 6 months and 1 year after the 15-week treatment. After the 15-week program, the groups differed (P < .05) in differential segmental arterial pressure in right lower limb (lower one-third of thigh, upper and lower one-third of leg) and left lower limb (lower one-third of thigh and upper and lower one-third of leg). A significant difference (P < .05) was also observed in skin blood flow in digits 1 and 4 of right foot and digits 2, 4 and 5 of left foot. ANOVA results were significant (P < .05) for right and left foot oxygen saturation but not for heart rate and temperature. At 6 months and 1 year, the groups differed in differential segmental arterial pressure in upper third of left and right legs. Connective tissue massage improves blood circulation in the lower limbs of type 2 diabetic patients at stage I or II-a and may be useful to slow the progression of PAD.