Can a clinical placement influence stigma? An analysis of measures of social distance

BackgroundThe way people who experience mental illness are perceived by health care professionals, which often includes stigmatising attitudes, can have a significant impact on treatment outcomes and on their quality of life.ObjectiveTo determine whether stigma towards people with mental illness varied for undergraduate nursing students who attended a non-traditional clinical placement called Recovery Camp compared to students who attended a ‘typical’ mental health clinical placement.DesignQuasi-experimental.ParticipantsSeventy-nine third-year nursing students were surveyed; n = 40 attended Recovery Camp (intervention), n = 39 (comparison group) attended a ‘typical’ mental health clinical placement.MethodsAll students completed the Social Distance Scale (SDS) pre- and post-placement and at three-month follow-up. Data analysis consisted of a one-way repeated measures analysis of variance (ANOVA) exploring parameter estimates between group scores across three time points. Two secondary repeated measures ANOVAs were performed to demonstrate the differences in SDS scores for each group across time. Pairwise comparisons demonstrated the differences between time intervals.ResultsA statistically significant difference in ratings of stigma between the intervention group and the comparison group existed. Parameter estimates revealed that stigma ratings for the intervention group were significantly reduced post-placement and remained consistently low at three-month follow-up. There was no significant difference in ratings of stigma for the comparison group over time.ConclusionsStudents who attended Recovery Camp reported significant decreases in stigma towards people with a mental illness over time, compared to the typical placement group. Findings suggest that a therapeutic recreation based clinical placement was more successful in reducing stigma regarding mental illness in undergraduate nursing students compared to those who attended typical mental health clinical placements.     

Does computer use in patient-physician encounters influence patient satisfaction?

OBJECTIVE

To assess whether computer use by physicians during the patient-physician encounter influences patient satisfaction in a family medicine teaching centre.

DESIGN

Cross-sectional mailed survey.

SETTING

Queen’s University Family Medicine Centre in Kingston, Ont.

PARTICIPANTS

A random sample of 300 patients from the family medicine centre, all of whom were older than 18 years of age and had visited their family physicians in the past year.

MAIN OUTCOME MEASURES

Patient preference for or against computer use by the physician and effect of computer use on various aspects of patient-physician interaction.

RESULTS

The response rate was 58.3%. Most respondents (51.4%) had no preference about computer use in the office, and most (88.0%) were either “very satisfied” or “satisfied” with their visits. When assessing the influence of patient and visit characteristics on computer preference, only the “doctor’s attitude toward computer use” had a positive correlation with patient preference (P = .0012). Respondents were most likely to indicate “positive” or “very positive” effects of computer use on all aspects of the patient-physician interaction, except “level of distraction of the doctor” and “time spent chatting about nonmedical matters,” which were most commonly reported as being unaffected by computer use. Specifically, 57.1% of respondents thought that computer use had either a “positive” or “very positive” effect on their overall satisfaction with their visits, with another 30.3% believing there was no effect.

CONCLUSION

Most patients expressed no preference for whether or not computers were used in their physicians’ offices, although computers did seem to have a positive effect on overall satisfaction with visits. Doctors’ attitudes toward computer use influenced their patients’ preferences.     

What do primary care nurses and radiation therapists in a Canadian cancer centre think about clinical trials?

Rationale, aims and objectives Clinical trials are integral to progress in cancer management. While doctors’ attitudes to clinical trials have been documented, there is little or no literature on the perception of trials from the perspective of other clinicians who treat trial patients. The purpose of this phenomenological study was to explore nurses’ and radiation therapists’ (RTs) perceptions of clinical trials in their cancer centre. Methods This study was conducted in a Canadian cancer centre where over 50 clinical trials actively recruit patients at any one time. Nurses and RTs were interviewed to explore their perceptions of clinical trials. Results The following themes emerged from the analysis: (1) nurses and RTs perceived a variety of ethical concerns associated with clinical trials; (2) treating patients enrolled in clinical trials was perceived to add to the workload of RTs; (3) nurses and RTs did not perceive meaningful involvement in clinical trials as an option; and (4) the additional workload and ethical concerns associated with trials were off‐set by the view that patients’ interests outweighed those of nurses and RTs. Discussion Nurses and RTs should be invited to provide input regarding trial procedures and be acknowledged for their work associated with clinical trials.     

Is telephone assessment a valid tool in rehabilitation research and practice?

Purpose: To determine if face-to-face and telephone administration of questionnaires produce comparable results in rehabilitation research studies. Method: A total of 80 participants who used eyeglasses as their primary visual assistive device agreed to participate. All completed the Life Orientation Test and the Psychosocial Impact of Assistive Devices Scale. Approximately half of the participants completed the forms after being approached by an interviewer and then were contacted by telephone 2 weeks later to complete the forms a second time. The other half of the participants initially completed the forms over the telephone and then met with an interviewer 2 weeks later and completed the forms face-to-face. Results: For the forms used no statistically significant differences were found between groups or over time. Conclusion: For some questionnaires telephone administration may provide a convenient and cost-effective method of data collection. However, it should not be automatically assumed that all questionnaires will yield the same results regardless of the mode of administration used.     

A multidiscipline exploration of college students’ perceptions of academic dishonesty: Are nursing students different from other college students?

As a result of the proliferation of technology, academic dishonesty in colleges and universities is on the rise and is a global issue. The problem of cheating behaviors in students is so pervasive that it is almost commonplace. Most students do not see their cheating actions as out of the ordinary or morally wrong. The process of neutralization is a major concern when students incorporate cheating into “normal” student culture.In a Gallup poll conducted in 2006, nursing was perceived to be the most honest of 23 professions and the one with highest ethical standards (Saad, L., 2006. Nursing tops the list of most honest and ethical professions. The Gallup Poll. www.galluppoll.com/content/?ci=25888&pg=1 (retrieved 30.07.08.)). With such a high ethical expectation of the profession, one would assume that academic dishonesty would be nonexistent in nursing programs. Yet it has been documented that nursing students engage in academically dishonest behaviors that they do not perceive as such.Thus, the purpose of this study was to explore the perceptions and attitudes of academic dishonesty in undergraduate students and to determine whether undergraduate nursing students’ perceptions of academic dishonesty were different from undergraduate students majoring in other disciplines. Results of the study revealed clear differences in student perceptions of academic dishonesty by disciplines they were majoring in. Students majoring in nursing most frequently recognized academic dishonest behaviors compared to the other students sampled in this study.     

Is there evidence of the International Classification of Functioning,Disability and Health in undergraduate nursing students’ patient assessments?

This paper reports on a secondary analysis of undergraduate nursing students' patient assessments while on clinical placement in a rehabilitation setting in search of evidence of the International Classification of Functioning, Disability and Health (ICF). It describes the evolution of the original World Health Organization's International Classification of Impairment, Disability and Handicap into the ICF. Data was analysed using the ICF categories of function, activity, participation, environmental factors and personal factors. Some evidence of ICF was revealed. Nurses are encouraged to further explore the relevance of ICF for nursing.