The effect of service-based learning on health education competencies of students in community health nursing internships

AIM

This study investigated the impact of service-based learning on the health education competencies of students in community health nursing internships. community health nursing internship is one of the areas where students acquire health education competencies. Studies have shown that some students have poor health education competencies, and new educational interventions, such as service-based learning, can help improve their competencies.

METHOD

This quasi-experimental study was conducted in 2021-2022. The participants were final-year nursing students affiliated to Kerman University of Medical Sciences. All participants (n = 72) were selected via the census method and randomly divided into intervention and control groups (36 participants in each group). The students in the intervention group attended a service-based learning program for 20 days. The data were collected before and one month after intervention using a 48-item health education qualification questionnaire. The collected data were analyzed using SPSS22 software.

RESULTS

The results showed that the mean health education competencies scores were lower before intervention in the intervention and control group (165.75 ± 23.09) (170.16 ± 28.58)(p > 0.05). There was no significant difference between the two groups in terms of their mean scores on health education competencies(p > 0.05). The health education competencies score increased significantly for the participants in the intervention group (191.58 ± 28.35) compared to the control group (165.97 ± 28.11) after intervention.

CONCLUSION

Nursing administrators and professors need to take effective steps to empower nursing students as much as possible and incorporate service-based learning techniques in clinical education programs for nursing students.

The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study

INTRODUCTION

Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students.

METHOD

This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students' Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests.

RESULTS

The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05).

CONCLUSION

The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.

Education as an effective strategy to promote nutritional knowledge, attitudes, and behaviors in street children

BACKGROUND

Lack of nutritional knowledge and ineffective attitudes can complicate the problems faced by this group of street children and have significant effects on their behaviors. This study aimed to examine the effect of nutrition education on nutritional knowledge, attitudes, and behaviors of street children in Kerman in 2021.

METHODS

This experimental study was conducted on 70 street children supported by Aftab Children Support Center in Kerman in 2021. The participants were selected using convenience sampling and were divided into two intervention and control groups using a random number table. A nutrition distance education program was implemented using an educational compact disk (CD) for the participants in the intervention group, while the children in the control group did not receive any training. The children's nutritional knowledge, attitudes, and behaviors were assessed before and one month after the intervention using the Nutritional Behavior Questionnaire. The collected data were analyzed with SPSS software (version 22) using the chi-square test, paired and independent samples t-test, and analysis of covariance (ANCOVA).

RESULTS

The results revealed a significant difference in nutritional knowledge, attitudes, and behaviors after the intervention (p < 0.001) due to the effect of the nutrition training program. Accordingly, the mean scores of the participants in the intervention group for nutritional knowledge, attitudes, and behaviors increased by 11.45, 14.80, and 6.05 units after the intervention compared to their scores before the intervention. Furthermore, the effects of the training program on the participants' nutritional knowledge, attitudes, and behaviors were 89.6%, 91.5%, and 64.3%, respectively.

CONCLUSION

The findings of this study concluded that training based on nutrition education improved the children's nutritional knowledge, attitudes, and behaviors. Thus, the officials in charge of promoting the health of vulnerable groups in the community need to provide the necessary facilities to implement effective training programs for street children and encourage them to participate in training programs.

The design and psychometric evaluation of the Supportive-Care Needs Scale (ZOKH-SCNS29) in patients living with cancer

BACKGROUND

Understanding the needs of cancer patients and planning to meet these needs is a major concern of the health system.

AIM

The present study aimed to design and conduct a psychometric evaluation of supportive-care needs scale in patients with cancer.

METHODS

This study was conducted in both qualitative and quantitative stages. In the qualitative phase, the questionnaire items were generated by analysing the data from 16 interviews, after which, face, content and construct validity were tested. To construct the validity, the questionnaire was completed by 229 cancer patients. The reliability of the questionnaire was assessed by internal consistency. Data were analysed using SPSS (version 18).

FINDINGS

In this study, 4 factors were extracted from 29 items through exploratory factor analysis: 'Need to be understood by the spouse and family' (10 items), 'Need to manage existential and psychological challenges' (7 items), 'Need to manage lack of knowledge about the disease' (7 items), 'Need organisational-therapeutic support '(5 items). These factors accounted for 50.1%. of the total variance. Internal consistency was 0.88, and also the Cronbach's alpha coefficient was also 0.89 after construct validity for the scale items'. The Cronbach's alpha was 0.91 after the construct validity.

CONCLUSION

The findings of the present study showed that this supportive care needs scale is a valid and reliable scale for identifying the supportive care needs of patients with cancer.

The Relationship Between Authenticity and Death Anxiety in Cancer Patients

One of the many problems cancer patients experience is death anxiety. This descriptive-analytical cross-sectional study aimed to investigate the relationship between authenticity and death anxiety in cancer patients. The participants were 172 cancer patients who referred to medical centers in southeast Iran. The data were collected using authenticity inventory, and death and dying anxiety scale. There was a negative correlation between authenticity and death anxiety, i.e. patients who indicated higher authenticity scores showed lower levels of death anxiety. It seems that developing a comprehensive care program for increasing awareness of authenticity in patients, may be effective in reducing patient death anxiety.

The impact of logo-therapy on disease acceptance and self-awareness of patients undergoing hemodialysis; a pre-test-post-test research

BACKGROUND

Acceptance is considered a key variable in chronic diseases such as chronic renal failure. To achieve adaptation and acceptance, people face obstacles, and identifying these obstacles primarily requires self-awareness. logo-therapy can help a person achieve this goal. To this end, this study aimed to investigate the effect of logo-therapy on disease acceptance and self-awareness of patients undergoing hemodialysis referred to a medical centers supervised by Kerman medical science university in 2021.

METHODS

This quasi-experimental study was conducted with a pre-test-post-test research design on 80 patients with chronic renal failure undergoing hemodialysis in Kerman. The patients who met the inclusion criteria were selected using convenience sampling and were then randomly assigned to intervention and control groups (40 patients in each group). The logo-therapy training program was performed for the participants in the intervention group during 4 sessions of 45-60 min, individually and three times a week. The instruments used for data collection were a demographic information questionnaire, the Acceptance of Illness Scale (AIS), and the Self-Awareness Outcomes Questionnaire (SAOQ). The collected data were analyzed using SPSS software (version 22).

RESULTS

The analysis didn't show a significant difference in the acceptance of illness scores in the intervention group before and after the intervention (P > 0.05). Besides, a statistically significant difference was observed between the intervention and control groups in terms of self-awareness, indicating that the intervention improved the dialysis patients' self-awareness (P < 0.05). Also, the patients' age, marriage length, and the number of children had statistically significant correlations with self-awareness and acceptance (P < 0.05).

CONCLUSION

The results of this study showed that meaning therapy intervention can positively affect disease acceptance and self-awareness of patients undergoing hemodialysis. Since logo-therapy has been effective in other patients and the patients in this study, health officials and managers are recommended to use this intervention method to promote disease acceptance and self-awareness in these patients.

Improving psychiatric nurses' competencies in spiritual care and integration of clients' religion/spirituality into mental healthcare: outcomes of an online spiritual care training program

BACKGROUND

Religion/spirituality (R/S), which is associated with individuals' well-being and psychological health, plays a significant role in most clients' lives in healthcare systems. Although clients in mental healthcare settings prefer their R/S to be employed in nursing care, R/S has neither been adequately integrated into mental healthcare nor discussed in the assessment and nursing interventions of mental healthcare. Evidence shows that most psychiatric nurses receive little or no training in spiritual care (SC) and are unable to integrate clients' R/S into mental healthcare. To address this gap, the present study aimed to investigate the effects of an online SC training program on psychiatric nurses' competencies in SC and the integration of clients' R/S into mental healthcare.

METHODS

This experimental study was conducted with nurses working in a psychiatric hospital affiliated with a large University of Medical Sciences in southeast Iran. Random sampling was performed and 95 nurses were assigned to the intervention (n = 50) and control (n = 45) groups. Online SC training was conducted for the intervention group in four sessions over four weeks. Data were collected using the Self-Assessment of Spiritual Care Competency and R/S Integrated Practice Assessment Scale before and one month after the training program.

RESULTS

There were no significant differences between the two groups before training (p > 0.05). After the training, nurses in the intervention group obtained significantly higher scores in competencies in SC and integration of clients' R/S into mental healthcare compared to the control group, with a considerable effect size (P < 0.05).

CONCLUSION

The online training program positively affected psychiatric nurses' competencies in SC and the integration of clients' R/S into mental healthcare. Since SC is a critical need for clients, specifically in mental healthcare settings, nurses must receive continuous education to provide SC to various clients.

Exploring the care needs of Iranian patients with cancer: a qualitative content analysis

BACKGROUND‏: Cancer is currently one of the most critical health problems worldwide. Different studies have shown that disease can reduce people's ability to take care of themselves and this makes them face many needs. Therefore, this study aimed to investigate unmet needs faced by patients with cancer‏. METHODS: This study employed a conventional, qualitative content analysis method. Data saturation was achieved after interviewing 13 participants in 15 interview sessions. With the in-depth semi-structured approach, the participants were asked to narrate their experiences of self-care needs in the process of disease. The collected data were analyzed using Graneheim and Lundman's method through the following steps: Construction of the units of analysis, construction of codes of meaning, condensation, extracting codes, and categorization (subcategories, categories, and the core category) ‏. RESULTS‏: Data analysis revealed two main categories. The first category was "Deficiency in disease management" with three subcategories: "the need to get rid of annoying physical symptoms"," the need for a caregiver to help with the daily routine", and "feeling frustrated and giving up treatment". The second main category covered "the need for sympathetic and knowledgeable caregivers" with the following five subcategories:" the need for sympathy and interaction with the nurse", "the need to hear the truth about the illness ", "the need for appropriate therapeutic interaction from physicians", "Inadequate qualification of medical secretaries about the patient", and" need for advice from psychologists for psychological adaptation‏". CONCLUSION‏: The most critical need reported by the patients was the need for compassionate and informed caregivers. So nursing management and care with kindness, competence, and conscience is the fundamental right of patients with cancer. Identifying patients' needs and problems can be used as a background for increasing the knowledge and experience of nurses and providing care for patients with cancer‏.

Development and psychometric testing of nursing students' perceptions of clinical stressors scale: an instrument design study

BACKGROUND

In clinical environments, nursing students experience a range of stressors that can affect their health, learning, and quality of patient care. This study aimed to develop a Nursing Students' Perceptions of Clinical Stressors Scale (NSPCSS) and to evaluate its psychometric properties.

METHODS

This exploratory, sequential mixed-method study was conducted in 2 phases. In the qualitative (item generation) phase, NSPCSS items were generated using the data collected from semi-structured interviews and a literature review. In the quantitative (psychometric evaluation) phase, face, content, construct, convergent, and discriminant validity and reliability of the scale were tested. To evaluate construct validity, exploratory and confirmatory factor analyses were performed on the data collected from 430 nursing students. Reliability was also assessed through internal consistency and composite reliability.

RESULTS

In this study, 6 factors were extracted from 30 itemes through exploratory factor analysis: (1) instructor's limited competence in clinical environments, (2) inappropriate clinical environment, (3) inadequate knowledge and skills, (4) inefficient education in clinical planning, (5) instructor's inappropriate conduct, and (6) concerns about the characteristics of nursing career. These factors accounted for 58.8% of the total variance. The results of the confirmatory factor analysis suggested the goodness-of-fit indices was acceptable. Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7.

CONCLUSIONS

The NSPCSS is a valid and reliable instrument for assessing clinical stressors among nursing students.

The effect of the Continuous Care Model on treatment adherence in patients with myocardial infarction: a randomised controlled trial

Background

Adherence to treatment is one of the behaviours associated with successful outcomes following a myocardial infarction, which leads to successful treatment in the disease.

Aims

This study aimed to investigate the effect of the Continuous Care Model (CCM) on treatment adherence in patients with myocardial infarction.

Methods

This was a randomised controlled trial performed on 82 patients with myocardial infarction. Convenience sampling was used to select the participants, and then they were allocated into two groups by the stratified random method. In the intervention group, a CCM was implemented. In the intervention group, 4-6 educational sessions (1-2 h) were conducted during one month in the form of spoken questions and answers about the presented subjects. The control group received routine care. A questionnaire of demographic information and treatment adherence was completed by samples in the two groups, intervention and control, before and immediately after training and after follow-up.

Results

The results of this study showed that treatment adherence was significantly higher in the intervention group than in the control group immediately after training and after the follow-up phase (three months) (p < 0.001). Also, diet, drug and physical activity adherence were significantly higher in the intervention group than in the control group immediately after training and after follow-up (p < 0.001).

Conclusions

Implementation of CCM led to an increase in adherence to the treatment in patients with myocardial infarction. Therefore, it is suggested that this model could be used as a nursing intervention to increase treatment adherence in cardiac-rehabilitation programmes.

The Effect of Positive Psychotherapy on the Meaning of Life in Patients with Cancer: A Randomized Clinical Trial

Background and Aim:

Cancer, as a social phenomenon, disrupts the daily functions and social activities of a person and changes his ability to perform roles and responsibilities and reach the meaning of life. The purpose of this study was to investigate the effect of positive psychotherapy on understanding the meaning of life in patients with cancer.

Materials and Methods:

This was a randomized clinical trial study. Sixty-one patients with cancer were selected by convenience sampling method and were assigned randomly into two positive psychotherapeutic (n = 30) and control (n = 31) groups. Positive psychotherapy included eight 90-min sessions held weekly in group form. The life attitude profile-Gary Reker was completed before and after the intervention.

Results:

The results showed that there was no significant difference between the mean scores of meaning of life and all its dimensions (purposes, existential vacuum, death acceptance, goal seeking, coherence and responsibility choice) before intervention, but there was a significant difference between the two groups after intervention (P < 0.05). Also in the control group, the mean score was reduced after the intervention.

Conclusion:

The positive psychotherapy is effective in increasing the level of meaningful life, enjoyable and committed life of people with cancer. Therefore, based on the results of this study, health-care managers can plan to train and increase the empowerment of nurses in providing these interventions to patients in need.

Informational Needs of Patients with Cancer: A Qualitative Content Analysis

One of the most important needs of patients with cancer is informational needs. Getting relevant information about the disease can lead to a proper decision making, better response to treatment, lower levels of anxiety, and higher levels of quality of life. Therefore, the current study aimed to determine the informational needs of patients with cancer in southeast Iran. Materials and Methods: This conventional qualitative content analysis was done using a descriptiveexplorative design. Data collection was done through conducting deep semi-structured interviews from September 2017 to March 2018 in cancer treatment centers of Kerman University of Medical Science, Iran. Data saturation was achieved after interviewing with 13 patients during 15 interviews. The patients were asked to narrate their experience about informational needs of cancer patients. The following concepts were considered: the unit of analysis, meaning unit, condensation, code, sub-category, category, and main category. Results: The results of the present study showed that informational needs of these patients could be categorized under one main category called awareness-oriented needs, including three subcategories. These subcategories included lack of knowledge about the nature of the disease, inappropriate control of the disease due to lack of knowledge, and lack of knowledge about cancer treatment methods. Conclusion: Results showed that patients with cancer tended to know what is the cancer and the ways of cancer treatment and complications. Therefore, it is suggested to perform further studies cultivating the awareness of cancer patients in these areas. Therefore So, It should be noted that designing and implementation of this needs assessment provide a comprehensive way to consult and collaborate with health care professionals, patients, and their families.

Body-Mind Healing Strategies in Patients with Cancer: a Qualitative Content Analysis

Background: Cancer is a major health problem around the world. The use of coping strategies among patients with cancer depends on several issues. This study was conducted to determine coping strategies used by patients with cancer in south-east Iran. Methods: This study is a conventional, qualitative content analysis with a descriptive explorative approach. Data saturation achieved after interviewing 13 participants in 15 interviews. Using an in-depth individual semi-structured approach the participants were asked to narrate their experiences of strategies that they used to cope with cancer. The following were considered: unit of analysis, meaning unit, condensation, code, sub-category, category, and main category. Results: Data analysis led to extraction of two main categories of body-mind healing strategies: being connected to the body and mindfully reconnected to the self. The first category was explained with reference to two sub-categories, being aware of intelligence and body nurturing. The second category was explained with the three sub-categories of using embodying knowledge, living for the moment, and being connected to nature. Conclusion: According to the results of this qualitative study, it is possible to form discussion groups with peers or to have self-reflective practice learning groups to reflect patients’ questions and strategies that they use for body-mind healing.

Theory analysis for Pender's health promotion model (HPM) by Barnum's criteria: a critical perspective

Background Analysis of nursing theoretical works and its role in knowledge development is presented as an essential process of critical reflection. Health promotion model (HPM) focuses on helping people achieve higher levels of well-being and identifies background factors that influence health behaviors. Objectives This paper aims to evaluate, and critique HPM by Barnum's criteria. Methods The present study reviewed books and articles derived from Proquest, PubMed, Blackwell Databases. The method of evaluation for this model is based on Barnum's criteria for analysis, application and evaluation of nursing theories. The criteria selected by Barnum embrace both internal and external criticism. Internal criticism deals with how theory components fit with each other (internal construction of theory) and external criticism deals with the way in which theory relates to the extended world (which considers theory in its relationships to human beings, nursing, and health). Results The electronic database search yielded over 27,717 titles and abstracts. Following removal of duplicates, 18,963 titles and abstracts were screened using the inclusion criteria and 1278 manuscripts were retrieved. Of these, 80 were specific to HPM and 23 to analysis of any theory in nursing relating to the aim of this article. After final selection using the inclusion criteria for this review, 28 manuscripts were identified as examining the factors contributing to theory analysis. Evaluation of health promotion theory showed that the philosophical claims and their content are consistent and clear. HPM has a logical structure and was applied to diverse age groups from differing cultures with varying health concerns. Conclusion In conclusion, among the strategies for theory critique, the Barnum approach is structured and accurate, considers theory in its relationship to human beings, community psychiatric nursing, and health. While according to Pender, nursing assessment, diagnosis and interventions are utilized to operationalize the HPM through practical application and research.

Getting Out or Remaining in the Cage of Inauthentic Self: The Meaning of Existential Challenges in Patients' with Cancer

Context:

Cancer as a life-threatening disease develops a range of existential challenges in persons. These challenges cause the patients to encounter some existential questions and tensions. This study method focuses on a person's experience about them.

Aims:

The aim of this study is to illuminate the meaning of existential challenges in patients with cancer in Iran.

Subjects and Methods:

A hermeneutic phenomenological approach, influenced by the philosophy of Ricoeur, was used to analyze the experiences of 10 Iranian patients with cancer. Data analysis was based on three stages of simple and fast understanding, structural analysis, and comprehensive understanding.

Results:

The present study showed that existential challenges in patients with cancer can be considered as getting out or remaining in the cage of inauthentic self. This theme consists of two subthemes “Being exposed to the light of awareness that revealed the cage of inauthentic self” and “The tension between getting out of the cage or remaining.” First, being exposed to the light of awareness revealed the cage of inauthentic self which subjectively refers to the emergence of existential questions, the past, the fear of future, and the collapse of physical body identity. Second, the tension between getting out of the cage or still staying which is characterized by anger, denial, sense of loneliness, and depression.

Conclusions:

According to the results of this qualitative study, it is possible to form discussion groups with peers or have self-reflective practice teaching groups to reflect patients' questions and existential challenges. In this way, participants can express themselves, share their experiences, challenges, learn, and find the answers.