Nurses' attitudes toward death and caring for dying patients.

PURPOSE/OBJECTIVES: To examine possible relationships among the demographic variables of nurses and their attitudes toward death and caring for dying patients. DESIGN: Descriptive. SETTING: A private hospital and Visiting Nurses Association office in an ethnically diverse metropolitan area in the Midwest. SAMPLE: 403 nurses, predominantly female (90%) and Caucasian (70%), with a mean age of 41.8 years. METHODS: Participants completed the Frommelt Attitude Toward Care of the Dying Scale, the Death Attitude Profile-Revised (DAP-R), and a demographic questionnaire. MAIN RESEARCH VARIABLES: Attitudes toward death and caring for dying people. FINDINGS: DAP-R scores were related to sex, religious affiliation, and current contact with terminally ill patients. Frommelt scale scores (e.g., showing acceptance of death) were positively related to current contact with dying patients, negatively correlated with two DAP-R subscales (Fear of Death and Death Avoidance), and positively correlated with two other DAP-R subscales (Approach Acceptance and Neutral Acceptance). CONCLUSIONS: Nurses' attitudes toward death and their current contact with terminally ill patients were predictive of their attitudes toward caring for terminally ill patients. IMPLICATIONS FOR NURSING PRACTICE: Professionals who are responsible for designing educational programs focused on nurses' attitudes toward caring for terminally ill patients may want to include an assessment of death attitudes and interventions aimed at decreasing negative attitudes and increasing positive attitudes toward death in such programs.

A curriculum self-study of writing assignments and reflective practice in nursing education.

Reflective practice is an ongoing process of purposeful thinking about one's clinical practice to develop understanding, insight, and clinical judgment. It can be enhanced through careful use of writing assignments that require reflection, evaluation, and thoughtful analysis. The uses of writing assignments in the undergraduate nursing programs at a midwestern college of nursing were studied over a 2-year period, using survey methodology. A purposive sample of all faculty who taught in baccalaureate or associate of science (ASN) programs (n=21) completed a questionnaire and were interviewed about the number and purpose of writing assignments in courses they taught. Quantification of the results in tabular form allowed the faculty to look at all writing assignments required of students across both programs with regard to the number, length, and nature of those assignments. Results were then recategorized by type of assignments, changes needed, and faculty assessment of the usefulness of these writing assignments. The summary of written assignments was then cross-referenced according to program, semester, and program level. This produced a working document that illustrated the quantity and type of writing assignments that each student, in each program, at a given level and semester must complete. Information was used by faculty teaching across courses to make changes that more effectively linked course writing assignments by association, themes, concepts, or areas of study. This process enables faculty to collaboratively develop writing assignments that facilitate the adult student's linking and associating concepts across courses, as a true exercise in critical thinking.

The use of a multicultural conceptual model in perinatal addiction treatment.

Using a culturally competent approach to address perinatal addiction is essential for promoting a positive response to nursing interventions. Such a health care approach would include sensitivity to cultural values beliefs, and practices specific to the backgrounds of ethnically diverse clients. Clients of Project Hope, a government-funded perinatal addiction treatment program in a midwestern city, are low-income, predominantly African American single parents with a history of substance, family, and/or environmental abuse. A majority had been treated at least once previously for a sexually transmitted disease, placing them in high-risk category for hepatitis and HIV infection. Women remain in the intensive outpatient program an average of 8 months. During that time, the multidisciplinary treatment team use a variety of interventions to address the needs of the clients, which include stable housing, health care, parenting resources, and ongoing social support. The Rooda Conceptual Model of Multicultural Nursing provides a framework for enhancing nurses' understanding of the unique needs of this ethnically diverse population.

School-based aftercare for adolescents recovering from substance abuse: a secondary school needs assessment.

Adolescent substance abuse is a critical problem facing an increasing number of families. Abuse and subsequent treatment and recovery often have negative effects on students' educational experience. The purpose of this study was to assess the need for school-based aftercare for recovering adolescents in a secondary school setting. A purposive sample of 37 secondary students responded to a Likert-type survey as well as two open-ended questions. The data indicated generally negative attitudes of where the students perceived themselves to be in their recovery process, but also revealed the respondents' desire for aftercare support at school.

The development of a model for delivery of religio-specific nursing care.

Religiousness has been described as a component of culture. It provides the patient with a way to cope with disease and illness. Consideration of religiousness allows the nurse a way to fine-tune a holistic, patient-centered approach to nursing care. In response to the mandate issued by the National League for Nursing to include multicultural content in nursing education, the concept of culture can be dissected and analyzed for components that have a positive influence on the patient's health. As a component of culture, religiousness has been extracted for the purpose of developing a conceptual model of religio-specific nursing. This model, based on Rooda's Conceptual Model of Multicultural Nursing, provides direction for research and practice. Regardless of cultural or ethnic background, religio-specific nursing offers a way for nurses to interpret their patients' religiousness in a way that is deliberate and systematic.

Effects of mind mapping on student achievement in a nursing research course.

Nurse educators face the problem of getting students to understand massive amounts of content and see relationships between concepts. The author addresses this problem by comparing the effectiveness of one technique, mind mapping, to more traditional approaches. In addition, creative teaching strategies such as mind mapping can make a class not only more interesting, but fun.

Staff development for culturally sensitive nursing care.

This article describes a workshop conducted to address the need to incorporate cultural sensitivity into nursing care. Three major points are explained: (a) how ethnicity and culture of patients affect health care attitudes, values, and practices; (b) how knowledge of cultural characteristics can improve nursing and health care effectiveness; and (3) the cultural awareness strategies generated by those who participated in the workshop.

Knowledge and attitudes of nurses toward culturally different patients: implications for nursing education.

This exploratory study was designed to examine the knowledge and attitudes of nurses toward patients from culturally different backgrounds. The Cultural Fitness Survey (CFS) was used to collect data from subjects randomly selected from a pool of registered nurses employed in acute care hospitals in an urban midwestern county. Significant differences were noted in the nurses' knowledge about, and their attitude toward, Black American, Asian American, and Hispanic cultures and health care practices. Of the six demographic variables, only the level of educational preparation was significantly correlated with knowledge and biases of nurses toward culturally different patients. Nurse educators must examine the differences in objectives, content, and learning experiences related to cultural diversity that might account for these differences. Such an examination is essential in preparing nurses to practice in a global society.

The development of a conceptual model for multicultural nursing.

Cultural diversity exists among all humans, and nurses and patients are no exception to this general phenomenon. The cultural backgrounds of individual nurses and patients are composed of learned norms, values, customs, and beliefs. If nurses are to be as effective as they might in providing holistic nursing care to patients of culturally diverse backgrounds, their technical expertise must be complemented by knowledge of and respect for the various cultures. This is particularly true in situations where nurses are from cultural and ethnic backgrounds different from the patients for whom they are caring. The development of a conceptual model for multicultural nursing practice, based on King's Theory of Goal Attainment, provides direction for both practice and research in nursing and is an essential initial step toward better preparing nurses to provide holistic care in a global society.

Attitudes of nurses toward culturally diverse patients: an examination of the social contact theory.

This investigation uses the Social Contact Theory to explore to what extent does level of exposure to culturally different patients affect White nurses attitudes toward these patients. Attitudes and biases of 346 hospital-based nurses toward culturally different patients were measured using a self-administered, Likert-type questionnaire titled the Ethnic Attitude Scale. The results of between group t-tests indicated that there were statistically significant differences in biases expressed by White nurses who worked with predominantly African American patients compared to their counterparts who work in a setting with a few African American patients. This study has implications for nursing in education, development, staffing and improvement of the overall quality of nursing care in a global society.

Development and use of a clinical evaluation tool.

Literature in nursing education reveals that there are few standardized clinical evaluation methods or tools used by nurse educators. Faculty at a Midwest school developed a clinical evaluation tool and have used it for one year. A questionnaire, developed and pilot tested, measured student and faculty satisfaction with the tool. Both students and faculty agreed that the tool was an accurate measure of clinical performance. This tool is adaptable to the hospital setting, where it may be used to evaluate the performance of staff nurses. The tool was cited for excellence by NLN visitors during a recent accreditation visit.