Development and validation of satisfaction with clinical practice questionnaire for mentors and students.

OBJECTIVES: To develop and validate a questionnaire on satisfaction with clinical practice for mentors (QSCP-M) and a questionnaire on satisfaction with clinical practice for students (QSCP-S). METHODS: Two versions of the questionnaires were constructed: a version for mentors and a version for students. Both surveys were conducted at two time points. The first survey was completed by 252 students and 86 mentors, and the second by 291 students and 94 mentors. RESULTS: Several exploratory factor analyses were performed on the results obtained, and two factors were identified for the QSCP-M and one factor for the QSCP-S. The coefficients of internal reliability for both questionnaires indicated stable and reliable measuring instruments. CONCLUSIONS: Clinical practice satisfaction questionnaires for mentors and students showed good metric characteristics. The validation shows that both questionnaires are appropriate for examining general and specific satisfaction with clinical practice.

The Commitment to Excellence: Understanding Nurses' Perspectives on Continuous Professional Development.

Continuous Professional Development (CPD) is essential for nurses to maintain up-to-date knowledge and skills in the evolving healthcare sector. This study explores nurses' attitudes toward CPD, its necessity, and the challenges encountered. The aim is to examine nurses' perspectives on CPD, focusing on their participation and motivation, in relation to their workplace, workplace function, and form of work. A cross-sectional study design was employed with 151 nurses from University Hospital Centre Split, Croatia. Data were collected using the "Professional Development of Nurses questionnaire (Q-PDN)" and analyzed using descriptive statistical methods, the Kolmogorov-Smirnov test, Pearson's correlation, ANOVA test, and t-test. The average level of participation in CPD activities was 4.27 (±0.63), indicating a positive inclination towards CPD. The study identified a statistically significant difference in activities related to CPD (t = 2.12; p = 0.036) among employees of surgical and intensive care units compared to other departments, where a higher level of engagement was present among employees of other departments. Notably, nurses without managerial roles showed 0.16 points higher participation in CPD activities compared to their managerial counterparts, though this was not statistically significant (t = 0.92; p = 0.357). Nurses in managerial roles valued CPD for professional development more highly, with a significant difference (t = 2.77; p = 0.006). Full-time nurses demonstrated a higher perception of the importance of personal professional development compared to part-time nurses, with a significant difference (F = 2.88; p = 0.038). The study reveals a strong commitment to CPD among nurses, with variations based on workplace roles and schedules. It underscores the need for role-specific and adaptable CPD programs to meet diverse needs and enhance professional competence in the nursing workforce.

Levels of depression, anxiety and subjective happiness among health sciences students in Croatia: a multi-centric cross-sectional study.

BACKGROUND: Previous studies have shown that symptoms of depression and anxiety were highly prevalent among health sciences students. This may lead to other professional and personal difficulties and a decrease in individuals' well-being. This study aimed to analyze levels of depression, anxiety and subjective happiness among health sciences students in Croatia. METHODS: We conducted a cross-sectional study in 10 higher education institutions in Croatia during March 2023. Eligible participants were health sciences students. Participants filled out an online survey consisting of sociodemographic questions and validated scales for determining the levels of depression (9-question Patient Health Questionnaire, PHQ-9), anxiety (General Anxiety Disorder 7-item scale, GAD-7), and happiness (Subjective Happiness Scale, SHS). RESULTS: Of 7460 invited students, 2137 students participated in the study (29% response rate). There were 41.4% of students that exhibited at least mild depressive symptoms, with 8% of students exhibiting moderately severe symptoms and 1.8% severe depressive symptoms. Mild anxiety was found in 36.8%, moderate anxiety in 23.9% and severe anxiety in 15.8% of students. The median SHS score was 19 (15.25-22). Women students had significantly higher levels of depression (p < 0.001) and anxiety (p < 0.001) than their men peers. Students in earlier study years showed higher levels of depression, anxiety and lower levels of subjective happiness compared to those in later study years. Students with lower self-assessed financial status had higher levels of depression (p < 0.001) and anxiety (p < 0.001). Students that failed an academic year had higher levels of depression (p < 0.001), but lower levels of anxiety (p = 0.005). CONCLUSION: In this study, we have shown that health sciences students exhibit high levels of depression and anxiety, at rates exceeding those in the general population reported in other studies. Our results may help educational institutions to put greater effort into the battle against mental health stigma, foster acceptance of mental health issues and encourage students to seek help when needed. Adequate mental health services are needed at universities to promote timely diagnosis and treatment of mental health problems.

Strength of Sense of Coherence among Nurses and the Relationship between Socio-Demographic and Work-Related Factors.

Sense of coherence (SOC) occupies the central place within the salutogenic model. It is an important contributor to the development and maintenance of people's health. This study aimed to assess the strength of sense of coherence (SOC) among nurses and the relationship between the strength of SOC and socio-demographic and work-related factors. A cross-sectional study was conducted in 2018. Linear regression was used to describe strength of association between SOC and socio-demographic and work-related factors. A total of 713/1300 nurses completed an SOC-29-item questionnaire for the assessment of SOC. The mean value for total SOC score (SOCS) was 145.0 points (SD 22.1, range 81-200). The results of the multivariate linear regression revealed statistically significant positive associations between SOCS and age (>40 years), level of education (master of nursing and bachelor of nursing), and transportation mode by car. Our study suggested SOC as an important and influential health-promoting personal resource of nurses which might offer protection regarding work-related stress.

Attitudes and factors that affect Croatian nursing students' choice of thesis type: A cross-sectional study.

BACKGROUND: Research in nursing, as in other biomedical professions, is of paramount importance. Nursing students are required to attend research methodology courses during their studies. However, nursing research is lagging behind other biomedical fields. OBJECTIVES: This study aimed to examine attitudes and factors that influence the choice of thesis type (original research versus essay-type literature review) among Croatian nursing students. METHODS: This cross-sectional study included nursing students from 8 health sciences studies in Croatia in the 2020/2021 academic year. Data were collected using the Students' Attitudes Toward Research (SAR) questionnaire and questions assessing potential barriers toward research. RESULTS: There were 912 students (25 % response rate) included in the study. In the regression analysis of the total sample, mentor encouragement (ß 0.200; P < 0.001), knowledge (ß 0.137; P = 0.011), and sense of ability to conduct research (ß 0.191; P < 0.001) were positively associated with the SAR score, while the expectation that a research-based thesis will extend the study duration was negatively associated with the SAR score (ß -0.124; P = 0.036). Among bachelor's students, the sense of ability to conduct research (ß 0.255; P < 0.001) was positively associated, while the expectation that a research-based thesis will extend the study duration was negatively associated with the SAR score (ß -0.157; P = 0.053). Among master's students, mentor encouragement (ß 0.415; P < 0.001), knowledge (ß 0.261; P < 0.001), and sense of ability to conduct research (ß 0.151; P = 0.045) were positively associated with the SAR score. A higher SAR score was associated with a higher likelihood of selecting a research thesis (OR [95 % CI]; P: 1.026 [1.014-1.038]; P < 0.001). CONCLUSIONS: Our study revealed modifiable factors associated with positive attitudes toward scientific research and preference for a research-based thesis among nursing students. Policy-makers should consider our results and change nursing studies' curricula and mentors should encourage students to engage in research and conduct research-based thesis even if there are other thesis options available.

Croatian nurses' and nursing students' knowledge about pressure injury prevention.

AIM: The aim of the study was to determine the knowledge of nurses and nursing students about pressure injury (PI) prevention. MATERIALS AND METHODS: A cross-sectional study was used, and the sample consisted of 312 participants, of whom 198 were nursing students and 114 were nurses from the clinical hospital. The response rate for the total population was 78%. The Pressure Ulcer Knowledge Assessment Tool PUKAT 2.0. was translated to Croatian and used in the study. Data were collected between January and March 2020. Descriptive statistics and chi square tests with Fisher correction for small samples were used to analyze the data. RESULTS: The mean number of correct answers was 10.45 points or 41.8%, which is not considered a satisfactory result. Nurses from the clinical hospital achieved 45.48% correct answers, while part-time students achieved 39.7%. Respondents achieved the best results in the theme of risk assessment and the lowest in the theme prevention of pressure ulcers. A statistically significant difference between the two groups of respondents was found in the themes of classification and observation (p = 0.004), nutrition (p = 0.015), prevention of pressure ulcers (p = 0.010), and specific patient groups (p = 0.002), as well as in the number of total correct answers (p = 0.000). CONCLUSIONS: The results showed that knowledge about PI prevention in nurses and nursing students was inadequate. Nurses showed a higher level of knowledge than the students. PIs are a significant clinical problem affecting quality of life, health care costs, and treatment outcomes in patients, so it is important that nurses have adequate knowledge.

The development of the nursing profession and nursing education in Croatia.

BACKGROUND: Nursing in the world has developed exponentially in the past few decades, and Croatia is no exception as one of the Eastern European Countries. PURPOSE: This paper will attempt to outline the main changes that have been central to nursing education evolution in the country, and how nursing has developed as an profession and intellectual discipline. METHOD: This discussion paper examined journal articles, books and legislative documents that documented the development of nursing education and profession in Croatia. RESULTS: In the past three decades nursing in Croatia has been characterized by a series of changes leading to its professionalization. The Croatian Nursing Act has been established, nurses have defined their competencies, and a regulatory body and vertical education up to the highest levels has been set up. CONCLUSION: Croatian nursing profession has made significant progress in its development. The main challenges are related to nurse shortages and poor working conditions e.g. overtime work, low salaries, decreased nursing autonomy and the impossibility of working in the full scope of practice. Besides, the image of nurses in society still needs to be improved to achieve the level of more recognized health professions.

Respiratory nursing training in Croatia.

Nursing education in the Republic of Croatia is conducted at the secondary and higher education levels (post-secondary and tertiary). Croatian nursing education is in line with the recommendations of European Directives 2005/36/EC [1] and 2013/55/EU [2]. High school (secondary level) education lasts for 5 years; after graduation, students are awarded the title "general care nurse" [3].

Changes in Nursing Students' Attitudes Towards Nursing During Undergraduate Study

The aim of this study was to determine the attitudes of nursing students towards nursing, and changes in their attitudes during the study. A quantitative study with pre-post survey was conducted among nursing students enrolled in first study year in the academic year 2012/2013 (N=115) and third study year in the academic year 2014/2015 (N=106). Students voluntarily and anonymously completed a questionnaire consisting of demographic information and the Nursing Image Questionnaire, which includes 30 items that assess how an individual looks at the roles and tasks, values, social stereotypes of nursing, professionalism and performance of nurses. The results indicated that students had positive attitude towards nursing at the beginning and during the study. During the study, there was a positive change in attitudes in the majority of items of the questionnaire, whereas at the end of the study lower attitude was expressed in only four items. The study conducted among nursing students indicated that students' attitudes changed during the study, influenced by the acquisition of knowledge and skills. During the study, students acquire a more realistic perception of nursing, and adoption of professional values emerges.

The cross-cultural (transcultural) adaptation and validation of the nursing image questionnaire.

Education of nurses in the Republic of Croatia is being developed as a result of compliance with education in the European Union and the implementation of nursing research that leads to the growth of the whole profession. However, prejudice against the nursing profession is still present and therefore it is necessary to explore the attitudes of the general population and the population of nurses in the nursing profession in order to discover the causes of such prejudices and act on them. Therefore, the aim of this paper was to present transcultural adaptation and validation of the Nursing Image Questionnaire, which was created by Toth and associates (1998). The questionnaire, which includes 30 items and measures how an individual looks at the roles, values, and professional activities of nurses, was conducted as part of a preliminary study and was culturally adapted. The final study included 905 students who in 2011 and 2012 enrolled in the first year of full-time and part-time nursing study; the questionnaire was completed by 725 students. Toth and associates assumed that the attitude toward nursing is expressed as the sum of the responses of all the items, which would mean a factor structure with high item intercorrelation, but they also split the questionnaire into five thematic units. Results showed that, contrary to expectations, intercorrelations of items were extremely low and that following the completion of factor analysis, no satisfactory construct validity was established. From the obtained results, it can be concluded that it is not justified to create a latent dimension as established by research of Toth and associates, and the items, although there is a correlation between some of them, should be interpreted and analysed as independent constructs.

Prevalence of the metabolic syndrome in the old institutionalized people in Zagreb, Croatia.

Metabolic syndrome (MeS) is defined by a cluster of abnormalities comprising obesity, hypertension, carbohydrate intolerance and dyslipidemia. MeS increases the risk of developing various diseases, including coronary heart disease, stroke, peripheral angiopathy and type 2 diabetes. In our study, the subjects were 561 persons, residents of 11 homes for the elderly in Zagreb, Croatia. There were 160 men (28.5%) and 401 women (71.5%), aged from 56 to 96 years (the average being 79 years). Physical examination was conducted, which included blood pressure measurement, and body height and weight. Blood samples were taken for biochemical analysis. Along with other biochemical parameters, the levels of glucose, triglycerides and cholesterol (LDL, HDL-C) were also measured. The results have shown the prevalence of MeS in the elderly instutionalised people to be in the range of 20.8%, according to WHO criteria. The most common MeS component was hypertension, and it was significantly more frequent in women than in men; also, the elevated triglyceride levels were more often found in women; the difference between men and women was also statistically significant. MeS is a serious and growing health problem not only in Croatia but worldwide as well. Further studies are needed to verify the prevalence of MeS in Croatia, as it is a major risk for CVD and many other severe diseases.

The history of written word in Croatian nursing.

Today the development of a unique professional language and publishing of professional and scientific publications is the basis of every profession, including the nursing profession. The task of the unique language specific to the nursing profession is to describe the nursing profession (to make it more familiar to the other team members and clients/customers), improve communication between nurses and other team members, help in health care improvement and administration, enable comparison of health care results, improve health care outcomes, as well as facilitate health care documentation and encourage research related to nursing. From the historical point of view, the development of nursing practice in Croatia was not accompanied by professional writings until the end of the 20th century, especially not by professional articles written by nurses themselves. By analyzing old writings and handbooks, the historical development of the written word of nurses is reconstructed for the first time in the region.