The relationship between feedback and evaluative judgement in undergraduate nursing and midwifery education: An integrative review

AimThis integrative review aims to explore the relationship between feedback and evaluative judgement in undergraduate nursing and midwifery education.BackgroundResearch in higher education has shown that feedback practices can lead to students’ developing evaluative judgement; thought critical for performance improvement and life-long learning. While literature in nursing and midwifery education has not yet employed the term ‘evaluative judgement’ explicitly, there might be similar concepts and practices that seek to develop students’ judgement of performance that sustain learning beyond the immediate task.DesignAn integrative review of the nursing and midwifery feedback literature.MethodsIn February 2020, six online databases (CINAHL, ProQuest, Scopus, ERIC, PsycINFO, Ovid MEDLINE) were systematically searched for literature published between January 1989-February 2020. Synonyms for feedback and evaluative judgement were used to inform our search. This review included a rigorous team-based, five-stage approach: (1) identifying the problem; (2) conducting the search; (3) evaluating the data; (4) analysing the data; and (5) presenting the integrative review.ResultsA total of 1408 studies were initially retrieved with 543 duplicates. 865 abstracts were screened using eligibility criteria, resulting in the exclusion of 835 studies. Thirty full-text studies were appraised for quality. Eighteen studies with diverse methodologies achieved a medium-high quality score for inclusion in data analysis. Conceptions of feedback and evaluative judgement were identified in all studies; despite none using the term 'evaluative judgement' explicitly. Thematic analysis of the studies resulted in seven themes: conceptions of feedback, purposes of feedback, sources of feedback, modes of feedback, conceptions of evaluative judgement, purposes of evaluative judgement and relationships between feedback and evaluative judgement.ConclusionsWhile our findings supported contemporary higher education research, the feedback-evaluative judgement relationship is novel in nursing education. We encourage educators to design feedback activities privileging students’ active engagement through dialogic feedback, reflection and self-assessment, to develop their evaluative judgement of practice.     

Nurse students’ competences in interprofessional pharmaceutical care in Europe: Cross-sectional evaluation

BackgroundSafe pharmaceutical care requires competent nurses with specific knowledge, skills and attitudes. It is unclear whether nursing students are adequately prepared to perform pharmaceutical care in practice. Mapping their pharmaceutical care competences can lead to a better understanding of the extent to which curricula fit expectations of the labour market.ObjectivesTo assess pharmaceutical care competences of final-year nursing students of different educational levels.DesignA cross-sectional survey design.SettingsIn 14 European countries, nursing schools who offer curricula for level 4 to 7 students were approached.ParticipantsThrough convenience sampling 1741 final-year student nurses of level 4 to 7 were included. Sampling strategies were country-specific.MethodsA web-platform was developed with an assessment of the level in which students mastered pharmaceutical care competences. Knowledge questions, case studies (basic/advanced level), self-reported practical skills and attitudes were evaluated.ResultsMean scores for knowledge questions differed significantly (p < 0.001) between level 5 (56/100), level 6 (68/100) and level 7 students (72/100). For basic cases level 5 students reached lower scores (64/100) compared with level 6 (71/100) and level 7 (72/100) students (p = 0.002 and p = 0.005). For more advanced cases no difference between levels was observed (overall mean 61/100). Most students (63–90 %) considered themselves skilled to perform pharmaceutical care and had positive attitudes towards their participation in pharmaceutical care (65–97 %).ConclusionsRelatively low knowledge scores were calculated for final-year student nurses. In some domains, lower levels of students might be insufficiently prepared to take up responsibilities in pharmaceutical care. Our assessment can be used as a tool for educators to evaluate how prepared nursing students are for pharmaceutical care. Its further implementation for students of different educational levels will allow benchmarking between the levels, both within and between countries.     

早产儿体位管理的最佳证据总结

目的 检索、评价并整合国内外早产儿体位管理的相关证据,为临床实践提供参考。方法 计算机检索国际指南网、英国国家健康与临床优化研究所网站、苏格兰学院指南网、美国指南网、加拿大安大略注册护士协会网站、乔安娜布里格斯研究所循证卫生保健中心数据库、BMJ Best Practice、PubMed、Embase、OVID、万方数据库、中国知网、医脉通等网站或数据库中关于早产儿体位管理的所有证据,包括指南、证据总结、最佳临床实践手册、临床决策及系统评价,检索时限为建库至2020年8月31日。结果 共纳入10篇文献,其中指南3篇、系统评价5篇、技术报告1篇、临床决策1篇。从体位评估、体位摆放、体位辅助工具及使用、特殊疾病或情境下的体位管理4个方面总结了21条证据。结论 该研究总结了早产儿体位管理的最佳证据,为规范早产儿体位管理提供了循证依据,建议护理人员在应用证据时综合考虑临床实际情况选择性应用最佳证据,促进早产儿健康。     

安徽省4所综合医院临床护士营养护理能力现状及影响因素分析

目的 调查安徽省4所综合医院临床护士的营养护理能力,并分析其影响因素,为提高临床护士营养护理能力提供理论依据。方法 采用便利抽样法,2021年1月—2月应用一般资料问卷、临床护士营养护理能力量表对安徽省北部、中部、南部4所综合性医院的863名临床护士进行横断面调查。通过多元线性逐步回归分析临床护士营养护理能力的影响因素。结果 共回收有效问卷762份,临床护士营养护理能力总分为（235.16±44.02）分,条目得分为（3.73±0.70）分,其中营养专业知识维度和临床营养评估能力维度得分较低。多元线性逐步回归分析结果显示,工作年限、科室、定期接受营养护理督查、在校学习营养课、参加营养学习班、定期参加营养业务学习是临床护士营养护理能力的影响因素（P<0.05）。 结论 临床护士营养护理能力有待提高,护理管理者应重视对临床护士进行营养相关教育及培训,强化营养专业知识和临床营养评估能力,完善定期检查与考核机制,以提高临床护士的营养护理能力。     

叙事护理在慢性病患者中的应用进展

随着老龄化社会的不断加剧，以及人们生活方式的改变，近年来慢性病的发病呈逐年上升趋势，随之而来的慢病管理问题也逐渐引起人们的关注。叙事护理是一种新型的心理护理技巧，由于治疗的有效性和操作的便捷性，其应用范围也越来越广。本文就叙事护理的概念意义，以及其在慢病患者中的应用策略、效果及注意事项等几个方面结合国内外文献进行综述，以期为未来慢病管理提供新的思路和方法。     

乳腺癌内分泌治疗患者症状评估量表的编制和信效度检验

目的 根据乳腺癌内分泌治疗患者的症状特征,编制适用于我国乳腺癌内分泌治疗患者的症状评估量表,并检验其信效度。方法 在文献回顾及参照现有症状评估量表的基础上编制量表初始条目池;通过2轮德尔菲专家函询,形成初始版量表;通过对11例患者的认知性访谈,对量表条目进一步修订,形成临床测试版量表。便利选取2020年7月—9月在浙江省某三级甲等肿瘤医院门诊或住院的325例乳腺癌内分泌治疗患者进行问卷调查,检验量表信效度。 结果 形成的最终版乳腺癌内分泌治疗患者症状评估量表包括33个条目,探索性因子分析提取7个公因子,累计方差贡献率为68.76%;各条目内容效度指数为0.78~1.00,量表内容效度指数为0.91;内在相关性检验结果显示,量表各维度与总量表相关系数为0.58~0.79（P<0.05）;维度间相关系数为0.26~0.52（P<0.05）;总量表Cronbach’s α系数为0.94,重测信度为0.95,折半信度为0.84。结论 编制的乳腺癌内分泌治疗患者症状评估量表具有良好的信效度,适用于相关人群的症状测评。     

异基因造血干细胞移植患者生活质量变化轨迹及影响因素研究

目的 探讨异基因造血干细胞移植患者3年内的生活质量变化轨迹及影响因素。方法 采用便利抽样法,选取2016年7月—2017年10月于苏州市某三级甲等医院行异基因造血干细胞移植的患者作为调查对象,在患者移植前（入仓前1~2 d）、移植后1个月、3个月、半年、1年、1年半及3年时采用一般资料调查表及癌症治疗功能评价-骨髓移植测评量表进行调查。 结果 异基因造血干细胞移植患者的癌症治疗功能评价-骨髓移植测评量表总分在移植后1个月时降至最低,此后呈逐渐上升趋势,半年时基本恢复至移植前水平,3年时总分显著高于移植前,差异具有统计学意义（P<0.05）。生理健康、功能健全及干细胞移植3个维度得分与癌症治疗功能评价-骨髓移植测评量表总分变化轨迹一致,呈波动上升型;情绪稳定维度在移植前得分最低,随移植时间延长逐渐上升;社交/家庭健全维度移植前得分与移植后各时间点得分比较,差异无统计学意义（P>0.05）。多元线性回归分析结果显示,影响患者移植后3年时生活质量的主要因素为居住地（t=3.175,P=0.002）、家庭人均月收入（t=3.320,P=0.001）、移植相关并发症（t=-6.955,P<0.001）及患者是否回归工作/学习（t=2.706,P=0.008）。 结论 异基因造血干细胞移植患者总体生活质量呈波动上升趋势,癌症治疗功能评价-骨髓移植测评量表5个维度间的恢复时间及变化轨迹存在差异。至移植后3年时,居住地为农村、家庭人均月收入较低、患有移植相关并发症及尚未回归工作/学习的患者生活质量更差。护理人员可根据患者生活质量变化轨迹动态调整护理措施,为其提供更为精准的延续性护理。     

抚触护理在病理性黄疸患儿中的应用效果

目的:观察抚触护理在病理性黄疸患儿中的应用效果。方法:选取114例病理性黄疸患儿作为研究对象,按照随机数字表法分为观察组与对照组各57例。对照组实施常规护理,观察组在对照组的基础上实施抚触护理,比较两组黄疸消退时间、护理前后血清总胆红素(TSB)水平、护理总有效率和患儿家长护理满意度。结果:观察组黄疸消退时间为(7.85±1.36)d,明显短于对照组的(9.56±2.85)d,差异有统计学意义(P<0.05);护理后,观察组血清TSB水平低于对照组,差异有统计学意义(P<0.05);观察组护理总有效率为96.5%,明显高于对照组的73.7%,差异有统计学意义(P<0.05);观察组患儿家长满意度为98.2%,明显高于对照组的82.4%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采用抚触护理可缩短病理性黄疸患儿黄疸消退时间,降低血清TSB水平,提高护理总有效率和患儿家长护理满意度,其效果优于单纯常规护理。