Nursing Students' Self-Efficacy and Performance in Self-Management Support for Patients in Rural Primary Care.

ABSTRACT: There is currently no evidence of undergraduate nursing students' self-efficacy and performance in self-management support for chronic diseases in rural primary care. Using the Self-Efficacy and Performance in Self-Management Support instrument, this quasi-experimental study assessed students' self-efficacy and performance in self-management support before and after implementation of a primary care enhanced curriculum. Nursing students (n = 140) reported a significant increase in total mean scores (pretest, M = 268.01; posttest, M = 289.51), p = .0001. Providing a primary care enhanced curriculum increased nursing students' self-efficacy and performance in self-management support.

Evaluating Knowledge of Public Health Nursing Competencies in Baccalaureate Nursing Students.

ABSTRACT: Community health workers are projected to grow in number by 17 percent by 2030. A baccalaureate degree in nursing (BSN) provides a foundation for public health nursing practice. The Competencies for Public Health Nursing Practice instrument was distributed to BSN students at a Midwestern university before and after an educational intervention. Students completed a pretest ( n = 269) and posttest ( n = 154). All four subscales and total score indicated a significant increase in competence ( p < .001). There is a need to develop interactive public health nursing simulations with an interprofessional venue to help students improve teamwork and communication competencies.

Nursing Faculty and Students' Satisfaction With Telepresence Robots During the COVID-19 Pandemic.

BACKGROUND: Telepresence robots provide real-time audio, video, and mobility features, allowing faculty and students to engage in learning experiences without being physically present. PROBLEM: With multiple students and faculty members needing to quarantine due to the COVID-19 pandemic, a flexible learning environment was essential. APPROACH: The telepresence robots were used as an innovative approach for both faculty and students to engage in learning experiences offered in a variety of settings. OUTCOME: Feedback was obtained from faculty and students about the use of and satisfaction with telepresence robots. The robots were easy to use and posed only a few technological challenges, which were easily overcome. CONCLUSIONS: Telepresence robots were effective tools in overcoming teaching and learning barriers caused by the COVID-19 pandemic. The telepresence robots have many applications, including use in clinical and community settings.

The Impact of COVID-19: Nurses Occupational Stress and Strategies to Manage It.

OBJECTIVE: The aim of this study was to explore the occupational stress perception of nurses and how they manage it during the COVID-19 pandemic. BACKGROUND: The management of occupational stress is a key factor in promoting nurses' well-being. METHODS: A descriptive cross-sectional study was conducted. RESULTS: The top occupational stressors from the nurses' perspectives (N = 236) as measured by using an updated version of the Nursing Stress Scale (NSS) included wearing a face mask at all times in the hospital, unpredictable staffing and scheduling, not enough staff to adequately cover the unit, feeling helpless in the case a patient fails to improve, and being assigned to a COVID-19 patient. The mean stress score was 31.87. The updated NSS Cronbach's α was 0.92, and the interclass interclass correlation coefficient was 0.914. CONCLUSION: Nurse administrators are in a strategic position to develop interventions (eg, open door policy, meetings, and employee assistance programs) to assist nurses in effectively managing stress.

Collaborating With Rural Practice Partners to Provide a Primary Care Experience for Prelicensure Nursing Students.

BACKGROUND: Prelicensure nursing education has generally emphasized acute care; however, as primary care changes in the United States, academia must transform. The national call for transforming primary care requires innovation in the education of prelicensure nursing students. PROBLEM: To ensure future RNs can function in the primary care setting and assume enhanced roles within the interprofessional team, prelicensure nursing students need to be exposed to primary care. A key barrier to providing this essential education is the lack of partnerships with primary care facilities. APPROACH: The purpose of this project was to collaborate with rural practice partners to provide a primary care clinical experience for prelicensure nursing students. OUTCOMES: Collaboration between academic-practice partners to develop a clinical experience for prelicensure nursing students allowed exposure to the role of RNs in rural primary care. CONCLUSIONS: By sharing the process for planning the clinical experience, other interested academic institutions may replicate similar opportunities.

Perceptions of Stress: Patient and Caregiver Experiences With Stressors During Hospitalization.

BACKGROUND: Hospitalization for a cancer diagnosis and treatment may trigger stressful experiences for patients and family caregivers. OBJECTIVES: The purpose of this study was to identify patients' and caregivers' perceptions of stressors during hospitalization and evaluate their education needs. METHODS: A descriptive correlational research design was used to determine whether there is any correlation between the stress perceptions of patients and family caregivers and their need for additional education on health-related issues. FINDINGS: Patients reported experiencing mild to extreme stress for sleep deprivation, pain, tube and line restrictions, and financial issues. In addition to these stressors, family caregivers also perceived that waiting for test results was a main reason for stress in patients. A positive significant correlation was found between the total sample mean stress scores of patients and their need for additional education on health-related issues.

Current Trends and Practices of Intensive Care Unit Visitations.

BACKGROUND: Few topics have existed for decades and created as much of a debate as when discussing appropriate visitation policies for patients. Studies have continued to document the conflicted opinions of nurses to commit to fully open visiting hours for various reasons. Family members are very definite in their desire to be at their loved one's bedside. OBJECTIVE: To review the visiting policies of acute care hospitals in California and compare them to the American Association of Critical-Care Nurses recommendations. METHODS: This descriptive study collected data from California acute care hospital websites about critical care visiting hours to assess visiting hours and the type, age, and number of visitors. RESULTS: Review of 363 hospital websites demonstrated a wide variation in policies when listed. Those that did post their visitation rules had no consistent policies regarding visiting hours or age, relationship, or number of visitors. CONCLUSIONS: Hospital visitation policies in California are inconsistent and not evenly enforced. They do not reflect current evidence and practice guidelines. IMPLICATIONS FOR NURSING: Ethics require the nurses to advocate for their patient. In this role, nurses need to become proactive in implementing policy changes in their institution based on current evidence and practice guidelines.

Understanding Supportive Care Factors Among African American Breast Cancer Survivors.

INTRODUCTION: Comprehensive breast cancer care includes not only diagnosis, staging, and treatment of cancer but also assessment and management of the physical, psychological, social, and informational needs, collectively known as supportive care. Several studies have documented the importance of addressing supportive care factors among breast cancer survivors. However, there appears to be a paucity of research concerning African American breast cancer survivors (AABCS). Therefore, the purpose of this study was to describe and understand the patient-centered supportive care factors among self-identified AABCS. METHOD: Using a qualitative descriptive approach, an open-ended question explored supportive care factors that were used by N = 155 AABCS. RESULTS: Four supportive care factors were identified: faith, supportive structures, optimism, and access to information. DISCUSSION: An understanding of these factors might facilitate discussion between survivors and the health care team. The resultant effect could also inform and promote the delivery of culturally specific health care to address the supportive care needs among these women.

Patients' and Health Care Providers' Perception of Stressors in the Intensive Care Units.

PURPOSE: The purposes of this study is first, to investigate intensive care patients' perceptions of stressors; second, to investigate the health care provider's perception of what constitutes a stressor from the patient's perspective; and third, to describe how health care providers manage their patients' stressors. This was a mixed-methods study; the quantitative section replicated Cornock's 1998 study of stress in the intensive care unit (ICU), with difference in sampling to include all health care providers in the ICU, in addition to nurses. The qualitative section added information to the current literature by describing how health care providers manage their patient's stressors. This article reports the quantitative findings of this study, as the qualitative section is presented in a separate article. BACKGROUND AND SIGNIFICANCE: It is important to describe ICU patients' stressful experiences to assess patient's stressors, provide holistic care to eliminate stressors, and provide feedback to health care providers. There is a need to describe the clinical practice related to stress perception and management of stressors in the critical care environment. METHODOLOGY: A mixed-methods comparative descriptive design was used for the quantitative section, and a phenomenological approach guided the qualitative section. Lazarus and Folkman's theory formed the bases for integrating all variables investigated in this study. The sample included 70 ICU patients and 70 ICU health care providers. After consenting to participate in this study, subjects were given a demographic form and a paper-based tool, the Environmental Stressors graphic data form Questionnaire. Questionnaires were filled out by subjects anonymously in the ICU and returned to the researcher in the same setting. FINDINGS: Descriptive statistics were analyzed using SPSS data analysis software. The top 3 most stressful items ranked by the patients included "being in pain," followed by "not being able to sleep" and "financial worries"; on the other hand, health care providers perceived "being in pain" followed by "not being able to communicate" and "not being in control of yourself" as the top 3 stressors perceived by their patients. IMPLICATIONS FOR PRACTICE: The findings of this study are crucial and may inform nursing assessments and care of the ICU patient. In addition, this information may encourage the ICU staff to manipulate and redesign the ICU environment to be less stressful. Also, the findings of this study guided the development of an ICU stressor control policy.

Literature review: patients' and health care providers' perceptions of stressors in critical care units.

The purpose of this article was to provide a historical review and analysis of the research literature focusing on patients', nurses', and health care providers' perceptions of stressors in the critical care setting. A narrative historical literature review method was used. The inclusion criteria include English-language studies of stressors as perceived by patients and health care providers from 1984 to 2011. Several studies investigated perceptions of stressors using the Environmental Stressors Questionnaire and the findings did not show any significant changes of stress perception over time since 1989 until the present. There is a need to further investigate stress perceptions in the health care setting using a mixed qualitative and quantitative approach to provide a more precise description of stressors and stress perceptions in the critical care setting.