Exploring the Evolution of Nursing Procedurals Skills, Mastery, and Competence Through Online Learning Among Students: A Qualitative Study.

Introduction: Online learning has changed the educational environment and may influence the development of nursing skills, mastery, and competence in students. Objective: The study aimed to investigate how nursing students acquire procedural skills, achieve mastery, and build competence through online learning, considering the growing use of technology in healthcare education. Methods: This study utilized a qualitative descriptive research approach to investigate the experiences of 32 nursing students from the Nursing Department who had undergone online procedural learning. Semistructured interviews were conducted to collect in-depth insights. Purposive sampling was used to gather data with a profound understanding of the phenomenon. The data analysis encompassed a methodical content analysis coding procedure. Independent researchers reviewed the results to validate the findings. Results: Content analysis of the data identified three key themes: achieving nursing procedural knowledge through online learning, achieving nursing procedural skills with the power of online learning, and gaining procedural competence through online social and collaborative learning. Conclusions: Online learning played a significant role in shaping and enhancing nursing procedural knowledge, skills, and competence, emphasizing the importance of integrating technology training modules and staying updated with emerging technologies.

Understanding Clinical Learning Quality Aspects in Mental Health Nursing Practice Course among Students: A Comprehensive Examination.

There is a growing demand for comprehensive evaluations of the clinical learning quality of nursing education and the necessity to establish robust predictors and mediators for enhancing its outcomes within the context of mental health practice. This study is threefold: 1. Evaluating nursing students' clinical learning quality before and after mental health nursing practice; 2. Establish if the grade of a theoretical course in mental health nursing and the student's perception of their theoretical knowledge level predicts the grade of mental health nursing practice; 3. Explore how model learning opportunities, self-directed learning, safety, and nursing care quality mediate learning environment quality and tutorial strategies quality following mental health nursing practice. Using a before and after the study, 107 undergraduate nursing students at an Israeli university completed a questionnaire and the Clinical Learning Quality Evaluation Index tool to assess their perceptions of clinical learning quality before and after mental health nursing practice. The results showed a decline in students' perceptions of tutorial strategy quality following mental health practical learning in clinical settings, with the theoretical course grade predicting the practical experience grade and underscoring the mediating role of learning opportunities between the learning environment and tutorial strategies. The study's findings emphasize the importance of an adaptive learning environment and a solid theoretical foundation in fostering effective tutorial strategies and enhancing the overall learning outcomes for nursing students in mental health education.

Analysis of the mediating effect of resistance to change, perceived ease of use, and behavioral intention to use technology-based learning among younger and older nursing students.

BACKGROUND: To date, research has not examined the mediating mechanism of ease of use and emotional reaction on the short-term focus of resistance to change and behavior intention to participate in technology-based course activities. OBJECTIVES: The study compares resistance to tech-based learning changes in younger and older nursing students and examines how ease of use and emotional reaction mediate between a short-term focus of resistance to change and intentional behavior to participate in technology-based course activities. METHODS: The researcher recruited 218 nursing students from the School of Health Sciences for a cross-sectional survey. Participants voluntarily completed the online survey, consisting of four sections: perceived ease of use, behavioral intention to use technology, resistance to change scale, and background characteristics. The survey was analyzed using Model 6 via Process software, and ethical considerations such as informed consent and confidentiality were maintained. RESULTS: The study found that younger nursing students had a more robust emotional response to changes in technology-enhanced learning, and older students were more cognitively rigid. The study also found statistically significant serial multiple mediations of emotional response and perceived ease of use in the relationship between short-term focus and intended behavior. CONCLUSIONS: The study highlights the importance of considering learner diversity, including age, in designing technology-based learning programs and the role of ease of use and emotional reaction as mediating factors in determining students'' behavioral intention to participate. The findings contribute to the literature on inclusive education and the relationship between resistance to change, ease of use, and intention behaviors in technology-based learning.

A multifaceted training tool to reduce weight bias among healthcare students: A randomized controlled trial.

BACKGROUND: Weight bias toward people with obesity (PwO) is common in healthcare settings. Efforts to address weight bias in healthcare settings should begin during university studies. This study aimed to explore the effect of a multifaceted intervention on weight bias among undergraduate healthcare students. METHODS: An open label randomized controlled trial. The intervention tool consisted of short video lectures on obesity, vignettes simulating interactions between health professionals and PwO, and open discourse with a PwO. The control group received a short-written document on obesity. Online questionnaires on Anti-Fat Attitudes ('AFA'), short form of the Fat-Phobia Scale ('FPS'), Weight Implicit Association Test ('Weight-IAT'), and knowledge about obesity were administered at baseline, 1-week, and 6-week post-intervention. RESULTS: A total of 162, 152, and 146 students participated in the study at baseline, 1-week, and 6-week post-intervention, respectively. Their mean age was 25.8 ± 6.7 years and 88.3% were women. Means of AFA total scores and FPS scores decreased significantly over time only within the intervention group (P Time*Group = 0.002 and 0.014). Both groups showed a similar trend over time in mean scores of Weight-IAT (P Time*Group = 0.868) and knowledge about obesity (P Time*Group = 0.115). CONCLUSIONS: A multifaceted intervention resulted in a significant reduction in explicit weight bias but did not yield any additional advantages over the control group in implicit weight bias and knowledge about obesity. GOV NUMBER: NCT05482802.

The effects of the Friendship Online Intervention Program on physical activity, substance abuse, psychosomatic symptoms, and well-being among at-risk youth.

INTRODUCTION: At-risk youth are those who are currently or potentially exposed to physical, mental, or emotional danger. The Friendship Online Intervention Program (FOIP) was created to encourage physical activity (PA) and reduce risky behavior among vocational secondary-school youth in Israel. We wanted to evaluate the effect of FOIP on PA, substance abuse, and psychological factors, including psychosomatic symptoms and well-being. METHODS: From October 2021 to June 2022, nonrandom sampling was employed to select at-risk youth from vocational secondary schools for participation in the FOIP. Before and after the intervention, questionnaires were administered to the intervention and control groups. The effects of FOIP were evaluated by univariate and multivariable analyses. RESULTS: The intervention (n = 103) and control (n = 77) groups showed similar levels of PA, cigarette smoking, and alcohol consumption at the beginning of the study. At follow-up, the intervention group showed a 57% increase in PA versus no change for the control group and decreased levels of smoking compared to the control group (p < .001). Similarly, in the intervention group, the number of psychosomatic symptoms decreased (effect size = 1.68) and life satisfaction increased (effect size = 0.86). Group assignment (intervention or control group) significantly predicted PA level, cigarette smoking, psychosomatic symptoms, and life satisfaction (adjusted R2 = .46, .20, .08, and .28, respectively) with participants in the intervention group showing more favorable results compared with the control group. CONCLUSIONS: FOIP was effective in increasing PA and decreasing risky behaviors among youth. FOIP may help at-risk youth build resilience and promote their physical and mental health.

The perspectives of health sciences students the new way of learning: Mixed methods design.

Objectives: The study aimed to determine the following four differences between students in the fields of nursing and health systems management: (a) attitudes towards web-based learning, (b) online course anxiety, (c) online course self-efficacy, and (d) intentional use of technology for learning and find factors that influence students' intentional learning with technology. Methods: The study utilized an explanatory sequential mixed methods design. The study was performed according to the checklist for assessment and reporting of document analysis for mixed methods design and research in health professions education. We included students from the School of Health Sciences, including those studying nursing and health systems management. There were 304 students included in our study. Results: Students from health systems management had more positive attitudes toward web-based learning than nursing students. Health science students' years of study, online course self-efficacy, and web-based learning influence intentional learning with technology among students. The qualitative finding corresponds only with the qualitative result demonstrated that online course self-efficacy predicts the intentional use of technology for learning. Conclusions: It is needed to consider factors for designing effective online learning experiences in health science, enabling educators to enhance intentional technology-based learning for nursing and health systems management students through web-based learning optimization.

Health promotion programs in prison: attendance and role in promoting physical activity and subjective health status.

Introduction: Maintaining an inmate's health can serve as a challenge due to unhealthy background, risky behavior, and long imprisonment. This study aimed to analyze the prevalence of participation in health promotion activities among Israeli inmates and its association with their physical activity levels and subjective health status. Methods: A cross-sectional study was designed to examine 522 inmates (429 males, 93 females). The data were collected by trained face-to-face interviewers and self-report questionnaires. Results: Most of the participants (82.37%) did not meet the recommended physical activity level. Half of the participants reported that their physical activity levels decreased since they were in prison compared with 29.50% who reported that their physical activity levels increased. Physical activity and subjective health status were significantly higher among younger male inmates. Furthermore, participation in health-promoting activities was associated with higher levels of physical activity and subjective health status. Discussion: Health promotion activities may play an important role in addressing the challenges of maintaining inmate health. Implications of the findings are further discussed.

Trust in Health Care Providers, Anxiety, Knowledge, Adherence to Guidelines, and Mental Healthcare Needs Regarding the COVID-19 Pandemic.

The mechanisms of the connections among anxiety, mental healthcare needs, and adherence to the COVID-19 pandemic guidelines are unknown. The study aims to explore model assumptions: (H1) Anxiety about COVID-19 will influence the perception of mental health needs via knowledge about COVID-19 as a mediator. (H2) Anxiety will influence adherence to guidelines via knowledge about COVID-19 as a mediator. (H3) Trust in health care will positively influence adherence to guidelines. We conducted a cross-sectional design study with a convenience sample. Participants consisted of 547 people across Israel. The questionnaire included trust in health care, anxiety, knowledge, adherence to guidelines, and mental health care needs regarding COVID-19 variables. Path analysis revealed knowledge about COVID-19 as partly mediating anxiety and mental healthcare needs during the pandemic, as well as partly mediating anxiety and adherence to the pandemic guidelines. Moreover, we found that trust in healthcare affects adherence to the pandemic guidelines. Therefore, it is important to design an intervention program for the public providing accessible, reliable information about the pandemic, including, and emphasizing mental healthcare needs and rationale of adherence to the guidelines.

Converting qualitative data into quantitative values using a matched mixed-methods design: A new methodological approach.

BACKGROUND: Quantifying qualitative data as part of mixed-methods research (MMR) can add to the study results' analysis. Comparable results may reinforce the conclusions, while differences hold an opportunity for an in-depth discussion. To date, there is little guidance for researchers seeking to quantify their qualitative data. OBJECTIVES: Describing conversion of qualitative data to quantitative values, comparison with matched questionnaire results, discussing the benefits of this process and the matched MMR design. METHODS: We describe in detail how qualitative data from 46 interviews were converted into quantitative values (i.e., quantitative-qualitative values, QQVs) using MMR design, enabling a comparison of results from interviews and questionnaires obtained from the same participants. This process was embedded in a larger MMR study on family-caregivers caring for people-with-end-stage-dementia conducted between the years 2020-2021. RESULTS: A QQV was generated for three main themes and compared to the questionnaires' scores regarding the same topics. There were no significant differences between the scores regarding 'satisfaction with nurses and physicians care', and 'discussion with nurses and physicians about end-of-life care'. However, for 'burden', the QQV score was significantly higher than the questionnaires' score. DISCUSSION: We described how to use a matched MMR design to produce and compare QQV from interviews with questionnaire scores. This methodology may allow further valuable discussion if the results are either similar or not, and for better integration and easier presentation of the results. Comparable results can reinforce the conclusions from both parts of the MMR study, while differences hold an opportunity for an in-depth discussion regarding their meaning and context. Although we claim that this methodology can be embedded in the MMR structure and contribute significantly to the discussion's depth, it by no means replaces the traditional MMR design. PATIENT AND PUBLIC CONTRIBUTION: No patient or public contribution.

Family Caregiver's Depression, Confidence, Satisfaction, and Burden Regarding End-of-Life Home Care for People With End-Stage Dementia.

To detect differences between two care services units: regarding family-caregiver (FC) depression, perceived-burden and confidence in the provision of care to people with end-stage dementia (PWESD); examine predictors such as FC age, depression, confidence in the provision of care to PWESD and satisfaction with the community-home-care service to burden; and explore a mediation model.The participants were 139 FC, caring for PWESD living at home. The questionnaire was composed of FC background characteristics, perceived-burden, satisfaction with the community-home-care services, depression, and confidence in the provision of care to the PWESD. HCUs' FC felt significantly more burdened than HHUs' FC. Furthermore, satisfaction with the community-home-care services mediated the relationship between FC confidence in the provision of care to the PWESD and FC burden. The study results may affect the development of end-of-life care policies and services which meet the needs of PWESD and their FC.

The Effects of a Physical Activity Online Intervention Program on Resilience, Perceived Social Support, Psychological Distress and Concerns among At-Risk Youth during the COVID-19 Pandemic.

BACKGROUND: COVID-19 restrictions have led to social isolation affecting youth's health, particularly at-risk youth. OBJECTIVES: We examined whether an online mentoring health intervention (OMHI) would strengthen characteristics that can prevent risky behaviors: resilience, perceived social support, psychological distress, and crisis concerns. METHODS: Fifty-six secondary-school students participated, 27 in the intervention group and 29 in the control group (mean age 16.18, SD 0.83 vs. 16.62, SD 0.82, respectively). The study took place between March and August 2020. RESULTS: The intervention group was less resilient pre-test, with similar resilience levels as the control group post-test. Intervention group participants presented a significantly higher crisis level pre- and post-test than the control group, as well as an increase in resilience (effect size = 1.88) and social support (effect size = 1.22), while psychological distress significantly decreased (effect size = -1.03). Both groups (intervention vs. control) predicted changes from pre-to-post test for resilience and crisis (adjusted R2 = 0.33, p = 0.001 and R2 = 0.49, p = 0.0001 respectively). CONCLUSIONS: OMHI participation was associated with improved resilience and social support, and decreased psychological distress, making it an effective strategy in health promotion for at-risk youth. An online intervention program combining mentoring in physical activity and interpersonal connections may constitute an effective health promotion strategy for at-risk youth, especially in times of crisis.

Weight Management for Students with Attention-Deficit Hyperactivity Disorder (ADHD): A Qualitative Study.

(1) Background: Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) are more likely to respond with an ineffective coping behavior, combined with an increased risk of weight gain and unhealthy food consumption. The aim of the study was to examine coping strategies adopted by overweight adults with ADHD to promote healthy behaviors and weight-control management. (2) Methods: Descriptive qualitative research using semi-structured interviews analyzed through a thematic content-analysis approach. The study included 30 college students diagnosed with ADHD, with a BMI ≥25.5, who had lost ≥10 kg within at least one year and successfully maintained that weight for the past three years. (3) Results: The study yielded two main themes. The first is struggling with disappointments and negative feelings in the past, and the second is the reciprocity between weight management and coping skills strategies. The second theme includes three subthemes-cognitive strategies, behavioral strategies, and emotional strategies. (4) Conclusions: It is essential to understand the variety of coping strategies used by adults to cope with ADHD challenges that can potentially improve weight control management and healthy behaviors to design better, more accurate interventions, promoting the target population's well-being and health.

Beliefs, emotions, and usage of information and communication technologies in distance learning during the COVID-19 pandemic: Health sciences students' perspectives.

Objectives: First, to examine Health Sciences students' discipline, educational level, number of online courses taken, and emotions regarding distance learning; second, to explore a model in which information and communication technologies' (ICT) beliefs serve as mediators among ICT's emotions and ICT usage. Methods: This is a cross-sectional study. Participants consisted of 210 students from the School of Health Sciences at the University. Perceptions toward ICTs in Teaching-Learning Process Scale and Computer Emotion Scale were used. Results: Nursing students report significantly more ICT-related negative emotions than Management of Health Systems students. Students who took a low or medium number of online courses report significantly more ICT-related positive emotions than students who took a high number of online courses. In addition, ICT-related beliefs did not mediate the effects of ICT-related positive emotions and ICT usage but did mediate ICT-related negative emotions and ICT usage. Conclusions: The digital tools in online courses should be appropriately combined with the learning method, and course content. It requires not only a solid technical foundation but also an educational mentality, as well as an adjustment period.

"Fighting for life and losing": Intensive Care Unit Nursing Staff's Experience With COVID-19 Patient Deaths During the First Two Waves: A Qualitative Study.

The study explored the experiences of intensive care unit nursing staff caring for COVID-19 patients who eventually died during the two first pandemic waves. We used - descriptive-qualitative-phenomenological. The findings included four main themes-the first vs the second COVID-19 waves, fighting for life and being unable to win, a chronicle of pre-determined death, and nurse's emotional coping with patient death. Based on these findings, we have concluded that in order to enhance nurses' mental health, policy makers and governments need to create an appropriate support system for them.

The Communication Challenges and Strength of Nurses' Intensive Corona Care during the Two First Pandemic Waves: A Qualitative Descriptive Phenomenology Study.

Intensive care nurses working with patients with severe COVID-19 illness are at the center and frontline of the dynamic pandemic, which poses communication challenges and demands of unusual strength on their part. The study aim was to capture the lived experience of intensive care COVID nurses' communication challenges and strengths as they cared for COVID-19 intensive care patients during the two first pandemic waves. The study used qualitative descriptive-phenomenology research designs. Twenty-two nurses were selected using snowball sampling, and online interviews were conducted with them. Data were recorded and transcribed, then reflexively double-coded for increased rigor. Four major themes emerged from the data. The first two expressed the communication challenges and difficulties communicating with patients due to the extreme protection needed and/or their medical condition. However, the other two themes expressed the nurses' strengths-sharing feelings with other caregivers and family. Accordingly, we recommend using simple language and ensuring patient comprehension, as well as creating an optimistic environment for fostering caregiver bonding.

The Role of Fundamental Nursing Practices Simulation on Students' Competencies and Learning Satisfaction: Repeated Measured Design.

Few studies have examined the simulation of fundamental nursing practices regarding nursing competencies and learning satisfaction via repeated measured methods. OBJECTIVES: To evaluate a simulation of fundamental nursing practices on nursing students' competencies and learning satisfaction in three time points: before (T1), immediately after (T2), and one month after simulation (T3), and to examine nursing students' competency predictors to learning satisfaction, immediately after conducting the simulation and one month after. METHODS: The study design was a one-group, repeated measures study. Ninety-three undergraduate nursing students were convenience sampled and conducted a simulation of fundamental nursing practices. The students completed a questionnaire at T1, T2, and T3. The Competency Inventory for Registered Nurses questionnaire was distributed, and question about the level of learning satisfaction were asked. RESULTS: All nursing competencies and learning satisfactions increased significantly. Only the legal/ethical practice competency succeeded in predicting the learning satisfaction in T2 and in T3 after conducting simulations. CONCLUSIONS: This study has established that a simulation of fundamental nursing practices is effective not just immediately after performing the simulation but also one month after the simulation. Therefore, it is recommended to implement a pedagogical structure of simulations of fundamental nursing practices in other nursing education areas.

Primiparous and Multiparous Women's Mode of Birth and Negative Emotions.

Negative childbirth experiences may result in negative emotions that may lead to negative outcomes, such as post-traumatic stress disorder. We aimed to examine the differences in emotions between primiparous and multiparous women and mode of birth. We used a retrospective cross-sectional study design with three hundred and fifty women. Primiparous women reported higher levels of fear, lack of control, and dissociation emotions compared to multiparous women. The EmCs (emergency cesarean section) group experienced the most fear, lack of control, anger, and conflict emotions. It is important to conduct follow up work with women who underwent unplanned birth procedures since negative childbirth experiences may lead to further negative effects on women's psychosocial health and well-being.

Seniors' eHealth literacy, health and education status and personal health knowledge.

Background: The COVID-19 pandemic made eHealth literacy skills and online health activities essential for seniors. Research aims: (a) To examine the differences in eHealth literacy dimensions (awareness of sources, recognizing quality and meaning, understanding information, perceived efficiency, validating information) as related to participants' health status and education level. (b) To explore the effect of eHealth literacy dimensions on participants' personal health knowledge. Methods: We used a cross-sectional design with a convenience sample of 298 Israeli seniors aged 65 or over during the second lockdown. The questionnaire was composed of three sections: (a) background characteristics, (b) an eHealth Literacy scale, and (c) perceived personal health knowledge. Results: Participants with an excellent health status reported higher levels of awareness of sources and perceived efficiency than participants with poor or good health statuses. Furthermore, participants with a graduate degree understand online information better than participants with a high school education. Moreover, it was found that participants with a high school education sense that they are being smart on the net more than participants with an undergraduate degree. Finally, we found that eHealth literacy dimensions influenced the participants' personal health knowledge. Conclusion: As the population ages, it becomes more at risk for disease, and as a result, its health status weakens. Therefore, it is important to provide seniors with appropriate intervention programs for improving their eHealth literacy, which may eliminate health inequality. In addition, caregivers need to develop patients' eHealth literacy skills-finding, evaluation, and interpretation of online health knowledge relevant to them.

Risk Behaviors, Family Support, and Emotional Health among Adolescents during the COVID-19 Pandemic in Israel.

We investigated the prevalence of risk behaviors among Israeli adolescents (tobacco smoking, alcohol consumption, drug use) during the COVID-19 pandemic. Associations between different risk behaviors were examined and so was whether specific characteristics could predict risk behaviors in adolescents. The study consisted of 1020 Israeli adolescents aged 15-18. Study subjects completed an online survey between the first and second lockdowns in Israel (April 2020 to September 2020). Participants reported the frequency at which they engaged in four different risky behaviors: general risky behavior, tobacco smoking, alcohol consumption (binge drinking), and cannabis use. The most prevalent risky behavior in the sample was binge drinking (33.8%). The four measured risky behaviors were significantly correlated. Among participants who had previously engaged in a risky behavior assessed, most did not change the behavior frequency during the pandemic. All independent variables (sociodemographic characteristics, family support, and emotional, health excluding friends' support, physical activity volume, and coronavirus restrictions) were significantly different between participants engaging vs. not engaging in risky behaviors. Our findings suggest that family support is one of the most influential factors in preventing risky behavior during the pandemic, and they emphasize the importance of family-based interventions with children and adolescents from elementary to high school.

Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries.

Cardiovascular diseases (CVDs) are the number one cause of death globally and are partially due to the inability to control modifiable lifestyle risk factors. The aim of this study was to analyze the profiles of adolescents from seven Mediterranean countries (Greece, Israel, Italy, Macedonia, Malta, Portugal, Spain) according to their modifiable lifestyle risk factors for CVD (overweight/obesity, physical activity, smoking, alcohol consumption). The sample consisted of 26,110 adolescents (52.3% girls) aged 11, 13, and 15 years who participated in the Health Behavior in School-aged Children (HBSC) survey in 2018 across the seven countries. Sociodemographic characteristics (sex, age, country of residence, socioeconomic status) and CVD modifiable lifestyle risk factors (overweight/obesity, physical activity, smoking, alcohol consumption) were recorded. A two-step cluster analysis, one-way analysis of variance, and chi-square test were performed. Four different cluster groups were identified: two low-risk groups (64.46%), with risk among those with low physical activity levels; moderate-risk group (14.83%), with two risk factors (unhealthy weight and low physical activity level); and a high-risk group (20.7%), which presented risk in all modifiable lifestyle risk factors. Older adolescents reported a higher likelihood of being in the high-risk group. Given that the adolescence period constitutes an important time for interventions aimed at CVD prevention, identifying profiles of moderate- and high-risk adolescents is crucial.