Impact of Watson's human caring-based health promotion program on caregivers of individuals with schizophrenia.

BACKGROUND: Caring for people with schizophrenia is accompanied by challenges that impact caregiver health. We conducted this study to explore the effect of a Caring Science-Based health promotion program on the sense of coherence and well-being among caregivers of persons with schizophrenia. METHODS: This randomized clinical trial with the Solomon four-group design was conducted on 72 caregivers randomly allocated into two intervention and two control groups. A health promotion program based on Watson's theory was performed individually through five face-to-face sessions and a four-week follow-up. Settings were the psychiatric centers of the three educational, specialty, and subspecialty Ibn-e-Sina, Moharary, and Hafez hospitals affiliated with Shiraz University of Medical Sciences (SUMS), south of Iran. The data were collected using a demographic information form, the Sense of Coherence Scale, and the Caregiver Well-Being Scale. One-way ANOVA, chi-square, Kruskal-Wallis, and independent t-test were used to determine the homogeneity at baseline. In the post-test, multiple between-groups and pairwise comparisons were assessed by One-way ANOVA and Tukey's post-hoc. Within-group comparisons were evaluated using paired t-tests. All tests were two-tailed, and the statistical level was considered 0.05. RESULTS: Data analysis showed that the mean scores of caregiver sense of coherence and well-being from pre-intervention to post-intervention were significantly increased in the intervention groups (p < 0.001). At the same time, there were no significant differences in the control groups. CONCLUSION: The health promotion program based on Watson's human caring theory facilitated ongoing intrapersonal, and holistic caring and improved the sense of coherence and well-being in caregivers of persons with schizophrenia. Hence, this intervention is recommended for developing healing care programs. TRIAL REGISTRATION: https://www.irct.ir/trial/55040 : IRCT20111105008011N2 (11/04/2021).

Exploring the Usefulness of Theory-Guided Reflection During the COVID-19 Pandemic.

During 2 massive open online course sessions in 2020-2021, learners shared lived experiences during the coronavirus disease-2019 (COVID-19) pandemic within a framework of theory-guided online discussion. We analyzed 211 COVID-19-related learner narratives from online discussion boards. Themes included sharing concerns and strategies related to patients separated from loved ones, honoring strengths in self and colleagues, valuing shared support among work colleagues, realizing the importance of self-care, voicing concerns about working conditions, and recognizing the impact of theory-guided shared reflection. Themes reflected personal knowing and attributes related to the American Association of Colleges of Nursing Essentials for Nursing Education. A Supplemental Digital Content video abstract is available at http://links.lww.com/ANS/A56 .

Student Perceptions Related to Immediate Workplace Usefulness of RN-to-BSN Program Content.

BACKGROUND: Despite a national directive for associate degree in nursing (ADN) nurses to complete BSN degrees, there is limited research related to student perceptions of the value added by BSN education. PURPOSE: The purpose was to explore perceptions of immediate workplace usefulness of RN-to-BSN content for ADNs. METHODS: Qualitative narrative data provided by 263 RN-BSN students in their final semester before graduating with a BSN were analyzed. Students were asked, "How have you used what you are learning in the RN-BSN program at work?" RESULTS: Themes included the following: research and evidence-based practice, leadership, professionalism, communication, intentional holistic caring, critical thinking, cultural competence, safety and quality improvement, interdisciplinarity, population-based care, and fiscal awareness. CONCLUSION: Results clarified content that students found useful and provided insight into specific benefits that employers might expect to see when ADNs complete BSN-level education.

Usefulness of Watson's Caring Science for Online Educational Practices in Disciplines Outside of Nursing.

Human caring has long been considered the primary domain of nurses and the primary function of nursing practice. Results related to the study of a Caring Science, Mindful Practice Massive Open Online Course (MOOC), suggest that Watson's Caring Science tenets are meaningful and useful for professionals who work in disciplines outside of nursing. Further study was needed to explore the degree to which Caring Science might be useful and applicable to the practices of non-nurse professionals. The study that is the focus of this article explored perceived usefulness of Watson's Caring Science for professionals from a wide array of disciplines who teach and work in online settings. Results confirm applicability and usefulness across disciplines and in diverse settings. Results also suggest that nurse-mediated Caring Science education and training may help establish common ground upon which further interprofessional and transdisciplinary understanding and collaboration may be built.

Creating a Global Community of Learners in Nursing and Beyond: Caring Science, Mindful Practice MOOC.

AIM: The aim was to examine the usefulness of a massive open online course (MOOC) on caring and mindfulness to a broad international audience that included nurses, allied health professionals, and others. BACKGROUND: MOOCs in higher education have been evident since 2008. Very few MOOCs on nursing topics have appeared since that time. Exploration was needed regarding how MOOCs could be employed to share nursing knowledge with national and international communities. METHOD: Two "Caring Science, Mindful Practice" MOOC sessions were examined. Demographics, learner satisfaction, course flow, and perceived usefulness of content were analyzed. RESULTS: Learners from varied backgrounds participated. Higher than expected course activity levels and completion rates suggested effective learner engagement. Excellent course ratings demonstrated that content and delivery methods were effective. Active learners communicated specific plans to apply new knowledge in the future. CONCLUSION: MOOCs facilitate learning where participants learn about topics of interest in nursing and beyond.

What Student Cues Prompt Online Instructors to Offer Caring Interventions?

AIM: The aim was to describe how instructors respond to students' demonstrating a need for caring in online classrooms. BACKGOUND: Previous studies have documented student perceptions of caring in online classrooms. Knowledge development of instructor perceptions was needed. METHOD: Fifty-six online nurse educators from 10 states and 20 institutions completed an online survey requesting information about student cues that prompt caring interventions, what instructors do in response to those cues, and how students respond to the interventions. RESULTS: Identified student cues fell into six categories: Academic Struggle, Appeals for Help, Concerning Behaviors, Withdrawal, Personal Problems, and Positive Events. Instructor responses fell into three categories: Reaching Out, Concrete Academic Support, and Intentional Caring Comportment. Student responses to caring interventions fell into three categories: Gratitude, Finding Their Voice, and Academic Improvement. CONCLUSION Results clarify the dynamics of unstructured caring interactions between teachers and students in the online setting.

Mindful Communication for Caring Online.

Six studies containing information related to conveying and sustaining caring in online nursing classrooms were analyzed for communication patterns among faculty and students. Six consistent communicative elements emerged from this analysis: offering full presence, acknowledging shared humanity, attending to the individual, asking for and providing frequent clarification, demonstrating flexibility, and pointing out favorable opportunities while acknowledging challenges. These elements reflected key aspects of Jean Watson's Caring Science and Thich Nhat Hanh's Mindfulness trainings, prompting guidelines and suggestions for engaging in mindful caring communication online.

Provision and use of personal protective equipment among home care and hospice nurses in North Carolina.

BACKGROUND: We investigated the frequency with which home care/hospice nurses are provided with and use personal protective equipment (PPE) and factors associated with use. METHODS: We conducted a mail survey among home care/hospice nurses in North Carolina in 2006. RESULTS: The adjusted response rate was 69% (n = 833). Between 68% and 86% of nurses were always provided with the relevant types of PPE; these nurses were 2.5-3 times more likely to use the PPE in scenarios involving a potential for blood exposure compared with nurses who were not always provided with PPE. Nurses who always had sufficient time during home visits were 50% more likely to use PPE. Nurses who visited more homes with adverse working conditions were less likely to use PPE. CONCLUSION: The public health policy of providing PPE to health care workers and ensuring that they use that equipment to prevent occupational blood exposure is not being fully implemented for home care and hospice nurses. Greater provision of PPE could reduce blood exposure in this population. Conditions of the home care/hospice work environment may be impeding nurses' ability to use PPE.

Student-preferred caring behaviors for online nursing education.

Better understanding of how to convey and sustain caring in online nursing classrooms will support caring as a core value in nursing. Sitzman and Leners (2006) identified online instructor behaviors that supported students feeling cared for in online classroom settings. In this study, 122 baccalaureate online students from five universities completed an online survey in relation to prioritizing these previously identified caring instructor behaviors. Respondents also answered one open-ended question identifying other caring behaviors not presented in the survey. Twelve caring practices for online nurse educators were developed based on analysis of the survey results.

Documentation of incidental factors affecting the home healthcare work environment.

Working conditions related to unrestrained pets, unruly children, clutter, and poor lighting during home healthcare visits are considered normal aspects of care providers' jobs. To date, there has been no documentation related to how often these factors are present in the home healthcare setting during home visits. In this study, 833 home healthcare nurses practicing in North Carolina answered a questionnaire that included items related to how often unrestrained pets, unruly children, poor lighting, and clutter existed in the homes they visited. Results showed that one-third to one-half of the respondents usually or always visited homes with unrestrained pets, clutter, or poor lighting and few nurses usually or always visited homes with uncontrolled children. Better understanding of the prevalence of these factors will facilitate further study related to their effects on safety, efficiency, and job satisfaction for home healthcare workers.

Blood exposure incidence rates from the North Carolina study of home care and hospice nurses.

BACKGROUND: Home care/hospice nurses may be at elevated risk of blood exposure because of the nature of their work and work environment. However, little is known about the incidence of blood exposure in this population. METHODS: A mail survey (n = 1,473) was conducted among home care/hospice nurses in North Carolina in 2006. RESULTS: The adjusted response rate was 69%. Nine percent of nurses had at least one exposure/year. Overall incidence was 27.4 (95% confidence interval: 20.2, 34.6)/100,000 visits. Nurses who had worked in home care < or =5 years had higher exposure rates than other nurses-seven times higher for needlesticks and 3.5 times higher for non-intact skin exposures. Nurses who worked part time/contract had higher exposure rates than nurses who worked full time-seven times higher for needlesticks and 1.5 times higher for non-intact skin exposures. The rates for part-time/contract nurses with < or =5 years experience were extremely high. Sensitivity analysis showed that it is unlikely that response bias had an important impact on these results. CONCLUSIONS: Approximately 150 North Carolina home care/hospice nurses are exposed to blood annually. If these results are representative of other states, then approximately 12,000 home care/hospice nurses are exposed each year nationwide. Improved prevention efforts are needed to reduce blood exposure in home care/hospice nurses. Am. J. Ind. Med. 52:99-104, 2009. (c) 2008 Wiley-Liss, Inc.

Diversity and the NCLEX-RN: a double-loop approach.

The United States is increasingly ethnically diverse. To provide culturally congruent care to this changing population, nursing programs must attract and support ethnically diverse students through to successful completion of the National Council Licensure Examination for Registered Nurses. Critically examining the literature on this topic revealed three themes: need for a diverse nursing workforce, lack of formal evidence, and narratives of concern. A double-loop theoretical approach that encompasses interventions in elementary and secondary schools, traditional student support services, faculty development initiatives focused on cultural competence, formative and summative evaluations, quantitative and qualitative research, and evidence-based interventions is proposed to address this multifaceted concern.

Twenty-first century doctoral education: online with a focus on nursing education.

The acute shortage of doctorally prepared nursing faculty has prompted the nursing profession to look to new and creative ways of delivering doctoral-level preparation to currently employed nurse educators. The development of an online PhD program, based on recommended benchmark guidelines for a "best practice" approach to Internet-based education, led to a program evaluation matrix for formative and summative student advising and program review. In addition, efforts to seek the student voice in formative as well as summative evaluation provided a well-rounded plan to monitor program outcomes based on recommended benchmark guidelines. The results of first-year student feedback and perceptions reflect that online PhD program delivery promotes high quality professional socialization, mentoring, and student-faculty interaction. The online education experience has served as a stimulus for the incorporation of new learning into the student workplace setting, provides opportunity for educational access not previously available, and builds strong personal and professional relationships among nurse educators.

Perceptions of nursing student clinical placement experiences.

There is an unprecedented shortage of registered nurses (RNs) in the United States of America. Efforts to educate more RNs have been limited by a shortage of both clinical placements and preceptors for nursing students. The purpose of this study was to examine nursing education issues associated with student clinical placement as experienced by hospital personnel who coordinate the placements with various schools of nursing. A qualitative study involving 15 state-wide participants directly associated with clinical placement of nursing students was conducted. Emergent themes from the data included lack of consistent terminology and definition of student and preceptor roles, preference of clinical scholars, process of site placements, rewards for supervision of students, dis-satisfiers to the supervision of students and suggested strategies for change. Recommendations which developed from the research are summarized and discussed.

Student perceptions of caring in online baccalaureate education.

The concept of caring in nursing education is foundational. Knowledge development regarding caring in face-to-face classroom settings, effective online teaching approaches, differences between online and face-to-face classroom settings, and supporting student success in online settings is extensive. However, the question of whether caring can be effectively conveyed in online nursing classroom settings remains unanswered. This qualitative study explored the perceptions of one cohort of RN to BSN students regarding how instructors convey caring in online education. Thirteen students were emailed surveys consisting of eight open-ended questions; II students responded. Eight themes emerged from the data: frequent feedback, timeliness, reciprocity of caring online, personal connection and empathy, clarity, multiple contact opportunities, second-fiddle worries, and teacher's commitment to learning.

Graduate student perceptions: feeling the passion of caring online.

The concept of caring in nursing education has been addressed with regard to traditional classroom settings. In addition, research on effective online teaching approaches, differences between online and face-to-face classroom settings, and supporting student success in online settings is readily found in published literature. The question of whether caring can be effectively conveyed in online nursing classroom settings remains unanswered. This qualitative study explored graduate nursing student perceptions of caring in online classes. Doctoral and master's nursing students at a research-intensive university were invited to participate in an online survey regarding how instructors may best convey caring online. Survey questions were open-ended. Themes uncovered in the data included empathetic perspective, timeliness of communications, tone of appreciation, being the best I can be, finding a chord of harmony, and feeling the passion of caring online.

Avoid sleepiness while driving.

Returning to the office after a long work day, Kristin, a hospice nurse, learns that the nighttime on-call nurse is ill. Kristin agrees to take call and hopes it will be a slow night. Now it is 2 am and Kristin has to travel to a client's home. Yawning repeatedly and driving over the rumble strip on the highway, she turns on the radio and opens the car window to the chill air, trying to shock herself into alertness.