[AN INSTRUMENT TO ASSESS HOSPITAL NURSES' PERCEIVED SELF-EFFICACY IN PROVIDING PALLIATIVE END-OF-LIFE CARE: A VALIDATION STUDY]

BACKGROUND: The trend of increasing numbers of terminally ill patients hospitalized in general wards requires nursing staff to be able to provide palliative care (PC). The self-efficacy (SE) to provide PC was found to be a leading factor predicting future professional behavior. There is no tool in the Hebrew language to evaluate SE for symptoms management and provision of psychosocial care within the PC. OBJECTIVES: To validate a Hebrew version of the "Palliative Care Self-Efficacy Scale )PCSES)" among nursing staff employed in various hospital wards. METHODS: A cross-sectional study was performed among nursing staff employed at four Israeli hospitals in oncology, internal medicine, surgical and emergency care wards. RESULTS: The PCSES questionnaire was translated into Hebrew and was completed by 588 nurses. Cronbach's alpha coefficients for the translated tool were high: 0.89 for the tool as a whole, 0.82 for the scale regarding ability to deal with questions regarding end-of-life care, and 0.85 for the symptoms management scale. As in the original tool, two factors that in combination explain 58.6% of the variance were found: ability to deal with questions regarding end-of-life care (46.43%) and symptoms management (12.2%). CONCLUSIONS: The psychometric characteristics of this tool demonstrate that it can be used to estimate SE in providing PC among nurses employed in various hospital wards. DISCUSSION: This tool should be used and evaluated among additional professionals involved in providing PC. It should also be tested as a method to identify changes in SE over time.

The influence of simulated medication administration learning on the clinical performance of nursing students: A comparative quasi-experimental study.

BACKGROUND: Medication administration is a main role of nurses, and by mastering this skill, medication errors can be reduced. Simulation provides a safe environment for learning and improving medication administration. Simulation design may influence the students' learning curve and ability to transfer skills into the clinical setting. OBJECTIVE: To examine the influence of simulation-based learning of the medication administration process, on satisfaction, self-perception of preparedness, and clinical performance of students who practice simulation either individually or in a group. DESIGN: A comparative quasi-experimental study. SETTING: A public university in southern Israel. PARTICIPANTS: Third-year nursing students in two consecutive academic years (78 in the individual sample and 50 in the group sample). METHODS: Nursing students participated in a scenario-based simulation for medication administration either individually or in a group. Self-reported questionnaires evaluated participants' satisfaction with the simulation experience, and perception of preparedness before and after the simulation. Faculty members observed and evaluated participants' medication administration during the simulation and in the clinical setting. Paired t-tests were performed to compare preparedness before and after the simulation experience. Linear regression models were formulated to elicit the predictors of preparedness after simulation and evaluations for medication administration in the clinical setting. RESULTS: The simulation experience increased participants' preparedness both when designed for an individual student and for a group of students. Simulation performance was the main contributor to the participant preparedness among the individual sample (ß = 0.51, p < 0.01), whereas previous preparedness was the main contributor among the group sample (ß = 0.42, p < 0.01). The association between simulation performance and clinical performance was mediated by preparedness after simulation in the individual sample, but not in the group sample. CONCLUSIONS: Simulation improves students' preparedness for medication administration. Individual simulation also impacts clinical performance, via preparedness. Further research is needed to identify other factors that facilitate skills transfer into the clinical setting.

Health-related quality of life and sense of coherence among partners of women with breast cancer in Israel.

PURPOSE: To compare HRQOL of husbands of women with non-metastatic breast cancer to husbands of healthy women. Additionally, to examine the impact of Sense of Coherence (SOC), socio-demographic, and clinical variables, on HRQOL of spouses in both groups. METHOD: This study used a comparative, matched, convenience sample. Husbands of women with non-metastatic breast cancer (n = 50), undergoing chemotherapy during 3-6 months after diagnoses and spouses of healthy women (n = 50) participated in a study. HRQOL was measured using the Medical Outcomes Study (MOS SF-36), and coping characteristics were measured using the Short Sense of Coherence scale. Socio-demographic factors, cancer stage, and treatments were collected. The groups were matched by age, education, employment (working/not working). The physical and mental component summary scores were dependent variables in the regression analysis. RESULT: Physical and Mental Component Summary indexes in the study group were significantly lower than in the control group. Higher education level, greater income, or more daily working hours were associated with better physical health index (added 30% to explaining the variance). The only personal variable predicting the mental component of QOL was financial situation (added 7%). Higher SOC was associated with higher HRQOL. Disease and treatment characteristics were found to have no influence upon the husbands' QOL. CONCLUSIONS: While the main influence found in this study of a woman's breast cancer on her partner's quality of life is on the mental component, the partner's physical health should also be taken into account.