Effectiveness of a perinatal and pediatric End-of-Life Nursing Education Consortium (ELNEC) curricula integration.

BACKGROUND: Educational practices and national guidelines for best practices of providing palliative care to children and their families have been developed and are gaining support; however, the dissemination of those practices lags behind expectations. Incorporating education for pediatric palliative care into nursing pre-licensure programs will provide guidelines for best practices with opportunities to enact them prior to graduation. OBJECTIVE: To evaluate the effect of an integrated curriculum for palliative care on nursing students' knowledge. DESIGN: Matched pretest-posttest. SETTING: One private and one public university in the northeastern United States. PARTICIPANTS: Two groups of baccalaureate nursing students, one exposed to an integrated curriculum for palliative care and one without the same exposure. METHODS: Pre-testing of the students with a 50-item multiple choice instrument prior to curriculum integration and post-testing with the same instrument at the end of the term. RESULTS: This analysis demonstrated changes in knowledge scores among the experimental (n=40) and control (n=19) groups that were statistically significant by time (Wilks' Lambda=.90, F(1, 57)=6.70, p=.012) and study group (Wilks' Lambda=.83, F(1, 57)=11.79, p=.001). CONCLUSIONS: An integrated curriculum for pediatric and perinatal palliative and end-of-life care can demonstrate an increased knowledge in a small convenience sample of pre-licensure baccalaureate nursing students when compared to a control group not exposed to the same curriculum. Future research can examine the effect on graduates' satisfaction with program preparation for this specialty area; the role of the use of the curriculum with practice-partners to strengthen transfer of knowledge to the clinical environment; and the use of this curriculum interprofessionally.

Psychological type and explanatory style of nursing students and clinical faculty.

Health care providers' collaboration and effective teamwork are essential to patient safety and quality care. Part of an ongoing project, this study focused on nursing faculty-student communication characteristics, specifically examining psychological type (Myers-Briggs Type Indicator) and explanatory style (Attributional Style Questionnaire) of participating first-year baccalaureate nursing students (n = 286) and clinical nursing faculty (n = 59) from both 2-year and 4-year nursing programs. Modal student psychological type was ESFJ, and modal faculty psychological type was ISTJ. The two groups demonstrated significant differences in information processing styles and in making decisions and judgments. Students demonstrated slightly more optimistic outlooks than did faculty. Psychological type and level of optimism did not appear to correlate. Data from this study provide an initial framework on which to base research to examine quality of teamwork among health care providers and, consequently, the quality of patient care.

First-year nursing students' accounts of reasons for student depression.

This study used content analysis and hermeneutics to examine 53 first-year nursing students' surmised reasons for their own or their peers' experiences of feeling down or depressed. Study data were confidential e-mail responses (n = 53) to the question, "If you or another student you know has been feeling down or depressed, can you describe a reason?" Content analysis reflected respondents' sense of their own relatedness to the experience; a general sense of awareness of the occurrence of feeling down or depressed among students; suggested reasons, from general to specific, for those experiences among students; and sense of ownership, from self to others to individuals unspecified, as they described the experience of feeling down or depressed among first-year college students. Hermeneutic analysis revealed seven themes characterizing student experiences of feeling down or depressed. The authors address the context of depression frequently associated with college student life.

Toward a qualified yes: personal characteristics of postbaccalaureate nursing students and implementation of the clinical nurse leader role.

Anecdotal and research data suggest that psychological type and explanatory style influence individuals' day-to-day functioning. The assessment of these characteristics among postbaccalaureate students will support faculty in planning for students' educational programs and guide them as they provide support for the expansive role functions of, among others, the graduates of the newly proposed clinical nurse leader program. This article is a report of one study included in a longitudinal project examining the influence of psychological type and explanatory style on students' academic success. The questions addressed in this article are as follows: "How do psychological type and explanatory style differ between entering baccalaureate students and entering postbaccalaureate students?" and "How do experiences of depression and fatigue differ between these two groups of novice nursing students?" Findings suggest that postbaccalaureate students, although similar in psychological type to baccalaureate students, are significantly less depressed, less fatigued, and less positive in explanatory style than traditional baccalaureate students, indicating a potential need for support in addressing the demands of the roles that they will encounter as nurses.

Maternal stress and the white coat syndrome: a case study.

Coping with the birth of a preterm infant is a stressful event for mothers for many reasons, including parental role alterations, perception of the infant's illness severity, and uncertainty about the infant's prognosis. Stressors evoke many physiological responses. Fingertip temperature, an electrophysiologic indicator, is a good measure of stress. This case study describes the experience of one mother's negative response to a surgeon's visit to her baby's bedside. Researchers refer to the "white coat" syndrome, in which personnel can significantly affect autonomic function. Increasing our understanding of maternal stress could help ameliorate some of the deleterious effects persistently elevated levels of stress can produce. Further research might focus on the effects of communication with other familiar health care professionals, as well as the influence of Kangaroo Care (skin-to-skin, chest-to-chest contact between caregiver and infant) on maternal stress.

Neonatal staff and advanced practice nurses' perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants.

BACKGROUND: Parents need compassionate care when an infant dies. Nurses can provide such care and possibly facilitate grieving, yet often have inadequate preparation in bereavement/end-of-life care. OBJECTIVE: To describe neonatal nurses' perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants. METHODS: A cross-sectional, descriptive, correlational mailed survey design was used. The 55-item Bereavement End-of-Life Attitudes About Care: Neonatal Nurses Scale containing 4 sections (comfort, roles, involvement, and demographics) was mailed to 240 hospitals in the United States. RESULTS: The final response rate was 52% (190 completed data sets from 125 hospitals). Respondents were comfortable with many aspects of bereavement/end-of-life care. Comfort and roles scores correlated significantly with number of years as a neonatal intensive care nurse. Respondents agreed about many important aspects of their roles with patients' families, especially the importance of providing daily support to the families. Most respondents identified caring for a dying infant, the actual death of an infant, and language or cultural differences as influential factors in the level of their involvement with families. CONCLUSIONS: Education on bereavement/end-of-life care could affect nurses' comfort with caring for families of critically ill and/or dying infants. Additional education on cultural competence would be helpful. Educators must promote the inclusion of content on bereavement/end-of-life care in nursing curricula. Finally, researchers must focus more attention on factors that promote and inhibit bereavement/end-of-life care of families of critically ill and/or dying infants.

Learning and living health: college students' experiences with an introductory health course.

Despite the Healthy People 2010 initiative and the national focus on promoting healthy lifestyle strategies, studies indicate that U.S. citizens are becoming more obese, and that rates of depression, diabetes, hypertension, homicide, and suicide are increasing. The college campus provides a microcosm of the health issues facing the nation, with college students' reports of increased risk behaviors evident in higher rates of smoking and binge drinking. Faculty in schools of nursing are in an ideal position to develop and provide health promotion and illness prevention programs, both for their own nursing students and for a broader campus-wide student population. This article describes a research study that course faculty conducted during the first year of implementation, designed to evaluate the extent to which participation in the "Introduction to Health" coursework and related activities influenced students' health-related behaviors.

Kangaroo care: national survey of practice, knowledge, barriers, and perceptions.

PURPOSE: A national survey was conducted to assess practice, knowledge, barriers, and perceptions regarding Kangaroo Care (KC)--the holding of diaper-clad preterm infants skin-to-skin, chest-to-chest by parents. DESIGN: A descriptive survey was conducted. METHODS: Kangaroo Care Questionnaires (KCQs), developed for the study, were sent to nurse managers in all hospitals in the United States that were identified as providing neonatal intensive care services (N = 1,133), and were to be completed by the nurse most familiar with the practice of KC in that unit. A second KCQ was sent to non-respondents. Descriptive statistics were used to summarize the data. RESULTS: A response rate of 59% (N = 537) was achieved. Over 82% of the respondents reported practicing KC in their neonatal intensive care units (NICUs). Nurses were knowledgeable about KC. Major barriers to practicing KC for certain types of infants were infant safety concerns, as well as reluctance by nurses, physicians, and families to initiate or participate in KC. Many NICUs do not permit KC for certain types of infants (e.g., those on vasopressors or high-frequency ventilation). Over 60% of respondents agreed that low gestational age or weight were not contraindications. Respondents from NICUs in which KC is practiced were more positive in their perceptions than respondents from NICUs that do not practice KC. CLINICAL IMPLICATIONS: The findings suggest that in order to overcome barriers to the practice of KC, nurses need educational offerings highlighting the knowledge and skills needed to provide KC safely and effectively. These educational offerings should also emphasize the value of KC to infants and parents. In addition, knowledgeable practitioners need to develop evidence-based policies and procedures that will lead to successful KC.