Measuring the effect of simulation experience on perceived self-efficacy for interprofessional collaboration among undergraduate nursing and social work students.

Barriers to effective interprofessional collaboration may include insufficient knowledge of other professional roles and inexperience using effective communication skills. Improving self-efficacy for interprofessional collaboration may enhance the ability to practice expertly within the interprofessional environment of healthcare. This article examines the results of a multiple methods pretest/posttest study that used the Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale to determine self-reported perceptions of self-efficacy development following participation in a trauma simulation. Participants included 74 undergraduate nursing students and nine undergraduate social work students. Findings included a significant increase in perceived self-efficacy from pretest to posttest for both groups. Nursing majors and participants who reported previous interaction with a member of another profession scored significantly higher on the posttest. Qualitative data were analyzed through thematic content analysis which produced three themes: an improved understanding of the importance of communication and the interconnection of interprofessional roles; a realistic simulation which challenged the students; and an increased appreciation for teamwork. These findings suggest that challenging simulations with pre-licensure students can increase undergraduate students' perceived self-efficacy for interprofessional collaboration and contribute to an improved understanding of interprofessional team roles and communication.

What Do Women Want? Looking Beyond Patient Satisfaction.

OBJECTIVE: To hear the voices of women, their partners, and nurses about expectations and priorities during the postpartum hospitalization. DESIGN: Focus groups using semistructured interview questions. SETTING: A 12-bed labor-delivery-recovery-postpartum unit at a small urban hospital in the U.S. Northeast. PARTICIPANTS: Women who planned to or had given birth, their partners, and the maternity nurses who cared for them. MEASUREMENTS: Qualitative thematic analysis of focus group transcripts. RESULTS: Thematic analysis produced the following themes for women's priorities: Need for individualized attention to maternal physical and emotional care; Fear of providing inadequate care for the newborn, including establishing infant feeding; and Transitioning to parenting as a new mother versus as an experienced mother. Themes for nurses' priorities included Safety issues around sleep and breastfeeding, Transitioning to parenting with an emphasis on maternal self-care, and Addressing barriers to effective discharge education. Response comparisons between the women/partners and nurses suggest that there is a disconnection between women's and nurses' priorities and expectations for care during the postpartum period. CONCLUSION: Women and nurses identified unmet needs in the postpartum period, consistent with the current literature. Providing standardized education during the transitional period around discharge from the hospital to home may not be optimal and may even detract from meeting the needs for rest and connection with family and the health care team. Nursing care that extends beyond the maternity hospitalization may be needed to individualize care and meet previously unmet needs.

Understanding experiences of spousal caregivers with health as expanding consciousness.

The purpose of this study was to recognize a unitary pattern within the lives of spousal caregivers following their spouses' discharge from the hospital after coronary artery bypass graft surgery. The unitary pattern emerged through four themes: dyadic relationship life patterns influenced caregivers' roles and responsibilities, life patterns of caring for self and others were altered, life patterns of certainty and knowing were limiting, awareness of life pattern gave meaning, and new perception on life left to live. The study added empirical support to the theory of health as expanding consciousness and provided a new way to examine the spousal caregiving experience.

Challenges to intervention implementation: lessons learned in the Bathing Persons with Alzheimer's Disease at Home study.

BACKGROUND: The pressing need for interventions to improve outcomes for vulnerable caregivers of individuals with Alzheimer's disease (AD) is hindered by inadequate knowledge of variables affecting intervention delivery, receipt, and enactment. OBJECTIVE: To analyze intervention implementation issues encountered within the Bathing Persons with Alzheimer's Disease at Home (BATH) study. METHODS: The BATH study, a home-based, randomized, controlled trial of interventions to improve behavioral symptoms and caregiver self-efficacy, consisted of 130 intervention visits to 42 care recipients-caregiver dyads. Data include direct observation, nurse interventionist field notes, case analyses, and caregiver journals, reflecting various perspectives. Content analysis was used to identify key treatment process themes. RESULTS: Issues that affected the delivery, receipt, and enactment of interventions reflect the intersection of in vivo caregiving and research design. DISCUSSION: The primary lessons learned were: (a) early identification of caring dyads prior to crisis must be improved; (b) in vivo observation is essential to individualized interventions targeting behavioral etiologies and developing caregiver skills; (c) intervention delivery depends on the nurse interventionist's skills and a flexible, trusting researcher-dyad relationship; (d) complex caregiver situations affect treatment receipt and enactment; and (e) intervention enactment requires coaching, practice, and support over time. These findings help to explain issues impacting intervention implementation to a vulnerable population. Recommendations for intervention research design to maximize internal and external validity in real-life care contexts can inform future outcome studies, aid in the search for improved care, and lead to supportive public policy for families living with AD.