Designing an oral health module for the Bachelor of Midwifery program at an Australian University

Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.     

Prior experience of interprofessional learning enhances undergraduate nursing and healthcare students' professional identity and attitudes to teamwork

BackgroundHow willing are today's medical, nursing and other healthcare students to undertake some of their studies as shared learning? There is a lack of evidence of students' views by discipline despite this being a priority task for higher education sectors. This study explored the views of nursing, midwifery, nursing-emergency health (paramedic), medical, physiotherapy and nutrition–dietetics students.MethodsSenior undergraduate students from six disciplines at one university completed the Readiness for Interprofessional Learning Scale prior to participating in interprofessional clinical learning modules.ResultsFor 741 students, the highest ranked response was agreement about a need for teamwork (mean 4.42 of 5 points). Nursing students held significantly more positive attitudes towards Teamwork/Collaboration, and were more positive about Professional Identity than medical students (p < .001). Midwifery and nursing-emergency-health students rejected uncertainty about Roles/Responsibilities compared with medical students (p < .001). One-third of all students who had prior experience of interprofessional learning held more positive attitudes in each of four attitude domains (p < .05).ConclusionOverall, students' attitudes towards interprofessional learning were positive and all student groups were willing to engage in learning interprofessionally. Early introduction of IPL is recommended. Further studies should explore the trajectory of students' attitudes throughout the university degree.     

The effects of a virtual learning environment compared with an individual handheld device on pharmacology knowledge acquisition,satisfaction and comfort ratings

BackgroundVirtual reality is reported to improve post-intervention knowledge and skills outcomes of health professionals compared to traditional teaching methods or digital online media. However, providing equitable access to high quality virtual reality resources for large, diverse nursing and midwifery student cohorts within multi-campus settings remains challenging.ObjectivesThis study compared the effect on student learning, satisfaction and comfort following exposure to a three-dimensional pharmacology artefact in a virtual facility (CAVE2™)¹ with viewing of the same artefact using a mobile handheld device with stereoscopic lenses attached.DesignThe study used a pretest-posttest design.SettingSchool of Nursing and Midwifery in a regional university in Southeast Queensland, Australia.ParticipantsTwo hundred and forty-nine second year undergraduate nursing and midwifery students.MethodsOnline multiple choice tests were deployed to measure knowledge acquisition. Self-reported satisfaction scores and comfort ratings were collected using questionnaires.ResultsParticipants were not disadvantaged in terms of knowledge acquisition by using either CAVE2™ or the mobile handheld visualisation mode (P = 0.977). Significant differences in favour of the CAVE2™ environment were found in between students' satisfaction scores for clinical reasoning (P = 0.013) and clinical learning (P < 0.001) compared to the handheld mode, and there were no significant differences in their satisfaction with debriefing and reflective practice processes (P = 0.377) related to undertaking visualisation activities. A small number of students using handheld devices with stereoscopic lenses reported greater discomfort in relation to the visualisation that negatively impacted their learning (P = 0.001).ConclusionThree-dimensional artefacts using mobile devices is promising in terms of cost-effectiveness and accessibility for students with restricted access to on-campus teaching modes.     

The predictive validity of Multiple Mini Interviews (MMIs) in nursing and midwifery programmes: Year three findings from a cross-discipline cohort study

BackgroundEducation literature worldwide is replete with studies evaluating the effectiveness of Multiple Mini Interviews (MMIs) in admissions to medicine but <1% of published studies have been conducted in selection to nursing and midwifery programmes.ObjectivesTo examine the predictive validity of MMIs using end of programme clinical and academic performance indicators of pre-registration adult, child, and mental health nursing and midwifery students.Design and settingA cross-sectional cohort study at one university in the United Kingdom.ParticipantsA non-probability consecutive sampling strategy whereby all applicants to the September 2015 pre-registration adult, child, mental health nursing and midwifery programmes were invited to participate. Of the 354 students who commenced year one, 225 (64%) completed their three-year programme and agreed to take part (adult 120, child 32, mental health nursing 30 and midwifery 43).MethodsAll applicants were interviewed using MMIs with six and seven station, four-minute models deployed in nursing and midwifery student selection respectively. Associations between MMI scores and the cross-discipline programme performance indicators available for each student at this university at the end of year three: clinical practice (assessed by mentors) and academic attainment (dissertation mark) were explored using multiple linear regression adjusting for applicant age, academic entry level, discipline and number of MMI stations.ResultsIn the adjusted models, students with higher admissions MMI score (at six and seven stations) performed better in clinical practice (p < 0.001) but not in academic attainment (p = 0.122) at the end of their three-year programme.ConclusionThese findings provide the first report of the predictive validity of MMIs for performance in clinical practice using six and seven station models in nursing and midwifery programmes. Further evidence is required from both clinical and academic perspectives from larger, multi-site evaluations.     

Development and psychometric testing of the attitude and confidence with oral healthcare among nursing students (ACORN) scale

AimTo develop and test the psychometric properties of the attitude and confidence with oral healthcare among nursing students (ACORN) scale.BackgroundDelivering oral healthcare is an essential component of care, which is often overlooked and omitted. A nurse’s attitude or confidence may influence how oral healthcare is prioritised. To date, there are no scales that assess both attitude and confidence for nurses when undertaking oral healthcare and thus the ACORN scale was developed.MethodsThe 24-item scale was developed following a three-stage process, which included concept identification and item construction, pilot testing, factorial and discriminant validity and reliability testing. The survey was distributed to nursing students to assess their attitude and confidence in providing oral healthcare. This study has been registered with the Registry of Efficacy and Effectiveness Studies (12940.1v1).ResultsUsing a before and after intervention survey design, the psychometric properties of the ACORN scale were examined with data collected from two student groups. Exploratory Factor Analysis yielded a two-factor structure, which was verified using Confirmatory Factor Analysis. Importantly, aggregated scale scores were able to detect differences in attitude and confidence following oral healthcare education (4.95 versus 5.66, p < 0.01). The Cronbach’s alpha for the 24-item scale was 0.94.ConclusionThe ACORN scale is a valid and reliable tool that can be used to assess differences in attitude and confidence of students following oral health education. Further research is recommended to test the utility of this scale using other educational interventions with different groups of healthcare providers.     

Effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students: A quasi-experimental study

AimsThis study aimed to examine and quantify the effectiveness of an optional breastfeeding course for multidisciplinary undergraduate healthcare students and to provide advice for education improvement based on students’ characteristics and learning feedback.BackgroundBreastfeeding has received global awareness and educating undergraduate healthcare students is a prospective way to promote breastfeeding. This is the first report from mainland China to verify the education effects and formulate a proposal for improvement.DesignA quasi-experimental study with a one-group pretest-posttest design.MethodsAn optional breastfeeding course covering eight topics based on the Health Belief Model was conducted for multidisciplinary students in a medical college. The Breastfeeding Knowledge Questionnaire, Iowa Infant Feeding Attitude Scale and Breastfeeding Promotion Intention Scale were completed for pre- and post-education comparison. The Wilcoxon signed-rank test, MannWhitney U test, KruskalWallis test and chi-square test were used for statistical analysis. The class average normalized gain and individual students’ normalized gain were calculated to quantify the effectiveness from the perspective of learning gain.ResultsFrom March to November 2021, 102 students specialized mainly in nursing, clinical medicine, medical imaging technology and midwifery took the course. Knowledge, attitudes and intention scores improved significantly (Z = 8.70, 8.72, 7.64, respectively, p < .001) and the class average normalized gains were 81.0%, 52.3% and 70.6%, respectively. Insignificant differences were found for students of different genders and categories of specialties (p > .05). Students of first year had significantly higher individual normalized gains (p < .05). In learning feedback, the top-ranked advice for course improvement was to increase practice and experience (75.5%).ConclusionsThis optional breastfeeding course produced medium to high learning gains for multidisciplinary healthcare undergraduates. Independent breastfeeding education based on behavioral theory for multidisciplinary students is recommended to be conducted in medical colleges. The addition of practice and experience may add value to such education.     

Possible Influence of the Route of Treatment Administration on Treatment Adherence in Patients With Multiple Sclerosis

PurposeMultiple sclerosis is a chronic, demyelinating, and degenerative disease of the central nervous system with an immune-based pathologic origin. The present pilot study aimed to assess whether the change in the route of treatment administration is associated with a variation in adherence and whether there is a change in quality of life, treatment satisfaction, and fatigue.MethodsPatients with relapsing-remitting multiple sclerosis who were >18 years of age and who used to receive immunomodulatory parenteral treatment and were ready to change administration route were eligible for the study. Data were collected at baseline and 3 months later. Adherence, quality of life, treatment satisfaction, and fatigue were measured via the following questionnaires: Morisky-Green questionnaire on patient-reported medication adherence, Multiple Sclerosis Quality of Life Instrument, Treatment Satisfaction Questionnaire for Medication, and Modified Fatigue Impact Scale.FindingsThe study sample included 30 patients (mean age, 43.2 years; age range, 24–71 years; 60% female and 40% male). There was a significant improvement in adherence (p = 0.048). Mean (SD) physical and mental health quality-of-life summary scores varied from 52.50 (24.15) and 54.13 (21.24) to 67.55 (20.92) and 62.30 (21.75) (p < 0.001 and p = 0.001, d = −0.426 and d = −0.643, respectively). In the Treatment Satisfaction Questionnaire for Medication, an improvement of the score was observed in effectiveness of the medication (p = 0.0041, d = −0.563), adverse effects of the medication (p < 0.001, d = −0.976), convenience of the medication (p < 0.001, d = −1.235), and global satisfaction (p = 0.006, d = −0.725). Patients had a higher mean (SD) score (45.13 [26.7]) on the Modified Fatigue Impact Scale while receiving injectable treatment compared with that obtained with oral treatment (34.86 [23.16]; p = 0.009, d = 0.41).ImplicationsWhen the route of administration changed from injectable to oral, there was an increase in adherence, quality of life, and degree of patient satisfaction with their treatment and a decrease in the degree of fatigue.     

Effects of unfolding case-based learning on academic achievement,critical thinking,and self-confidence in undergraduate nursing students learning health assessment skills

AimTo determine whether using unfolding case-based learning for undergraduate nursing students learning health assessment skills enhanced academic achievement, critical thinking and self-confidence, in comparison to traditional learning methods.BackgroundUnfolding case-based learning is an effective strategy for nursing students to narrow the gap between classroom learning and clinical practice. Little is known about whether unfolding case-based learning can be applied effectively in learning health assessment skills for undergraduate nursing students in China.MethodsA quasi-experimental design was used in this study. One hundred and fifteen undergraduate nursing students were recruited using convenience sampling from a medical university in southern China. They were assigned to an intervention group (n = 54) receiving unfolding case-based learning of health assessment skills, or a control group (n = 61) using traditional learning methods based on students’ choices. Learning outcomes were evaluated by students’ academic achievement, critical thinking and self-confidence. Data for critical thinking and self-confidence were collected before and after using the teaching strategies.ResultsThe academic achievements of undergraduate nursing students in the intervention group were better than those in the control group. The total average scores of critical thinking (272.51 vs. 266.47) and self-confidence (24.92 vs. 21.04) for nursing students in the intervention group were also higher than those in the control group after implementing teaching strategies. There were statistical differences in the theory test (P = 0.041), skill test (P = 0.013), critical thinking (P = 0.008) and self-confidence (P = 0.036) between the two groups. Additionally, the statistical significance of the scores for critical thinking (264.36 vs. 272.51, P < 0.001) and self-confidence (18.76 vs. 24.92, P < 0.001) before and after teaching strategies were also observed among participants in the intervention group, but not in the control group (P = 0.143, P = 0.738).ConclusionsUnfolding case-based learning may be effective and suitable for undergraduate nursing students learning health assessment skills. The findings of this study provide useful information to nursing teachers for the development of unfolding case-based learning when teaching other nursing skills to undergraduate nursing students.     

Managing medical emergencies in mental health settings using an interprofessional in-situ simulation training programme: A mixed methods evaluation study

BackgroundIn the UK, people with severe mental illness die up to 20 years earlier than the general population, prompting increased focus on physical health in mental illness. However, training for mental health inpatient staff to meet patients' physical health needs has not received the same attention, with physical health training often being reactive and lacking evidence of effectiveness.ObjectivesTo evaluate an interprofessional, in situ, simulation training intervention for managing medical deterioration in mental health settings. Investigating the impact of training on: 1. Participants' knowledge, confidence, and attitudes towards managing medical deterioration; and 2. Incident reporting, as an objective index of incident management. Participants' perceptions of the impact on their practice were qualitatively explored.DesignThis evaluation employed a mixed-methods pre-post intervention design.Participants & SettingsFifty-three healthcare professionals participated including: mental health nurses, psychiatrists, healthcare assistants, and activity co-ordinators from two busy psychiatric triage wards in South London, UK.MethodsThe intervention comprised eight half-day sessions delivered weekly across two wards. Structured surveys assessed participants' knowledge, confidence, and attitudes towards medical deterioration pre and post training. Participants' experience of training was qualitatively captured through post-course surveys and focus groups three months post training. Incident reporting rates for seven-month periods pre and post training were compared.ResultsFollowing training, participants showed significant improvement in knowledge (p < 0.001), confidence (p < 0.001), and attitudes towards (p < 0.02) managing medical deterioration. Incident reporting increased by 33% following training. Participants' reported improved confidence in managing medical deterioration, better understanding of effective communication, improved self-reflection and team working, and an increased sense of responsibility for patients' physical health.ConclusionsInterprofessional, in situ simulation training for medical deterioration yielded promising outcomes for individuals and teams. Simulation is an under-used training modality in mental health, offering a holistic training approach with the potential to provide educational and clinical benefits while supporting workforce resilience.     

The effect of oral care using honey as an additional topical agent on oral health status of intubated patients in the intensive care unit

BackgroundPatients using endotracheal tubes are at high risk of oral health status dysfunction due to impaired natural airway defence, oral flora composition changes and protective substances of the teeth, medication causing xerostomia. Oral care has not been enough to manage oral mucosal dryness, so an additional topical agent is needed to protect oral mucosa to maintain oral health. Honey is one of the recommended topical agents.ObjectiveThis study aims to identify the effect of oral care with honey as topical agents on the oral health status of patients using endotracheal tube in the Intensive Care Unit.MethodsThis was an experimental study with a randomized pretest and posttest design. The sample was adult intubated patients, consisting of 36 patients. The data were analysed using the parametric test, and dependent and independent t-test.ResultsThe oral health score in the control group was found to be pre & post mean score11.94 and 13.28 (p = .004) respectively, while in the intervention group 11.89 and 8.33 (p < .001). Mean differences in both groups were 4.95 (p < .001) and the BOAS subscale differences were seen on the lips, gums & mucosa, and tongue (p < .05).ConclusionOral care with honey as a topical agent can improve the oral health status of intubated patients on the lips, gum, mucosa, and tongue subscale. Therefore, honey as an additional topical agent can be a moisturizer to maintain the oral mucosa for intubated patients in the Intensive Care Unit. Furthermore, good mucosal health will help prevent the infection and colonization of microorganisms.     

The relationship between professional values,ethical sensitivities and caring behaviors among nursing students: A structural equation modeling approach

AimTo examine the relationship between professional values, ethical sensitivity and caring behaviors among nursing students and determine whether professional values play a moderator role in the relationship between ethical sensitivity and caring behaviors among nursing students.BackgroundDeveloping professional nursing values, ethical sensitivity and caring behaviors is critical in nursing programs from the first year to graduation to prepare students for increasingly complex and diverse work environments.DesignA cross‐sectional study using structural equation modeling. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used.MethodsThis study was conducted with 189 undergraduate nursing students. The study was conducted in a four-year nursing faculty in the Mediterranean region of Turkey from February to June 2022. Data were collected using a personal information form, the Nurses’ Professional Values Scale, the Moral Sensitivity Questionnaire and the Caring Behaviors Assessment Tool Nursing Version-Short Form.ResultsWe found that nursing students' perceptions of professional values and caring behaviors were high and their ethical sensitivity was moderate. Nursing students who are successful in high school have higher professional values. In addition, it was determined that nursing students who chose the nursing profession because of altruism had higher perceptions of caring behaviors. A positive relationship exists between professional values, ethical sensitivity (r = −0.258, p < 0.001) and caring behaviors (r = 0.431, p < 0.001) (p < 0.05). Professional values have a positive effect on ethical sensitivity and caring behaviors.ConclusionProfessional values, ethical sensitivity and caring behaviors are relationships and professional values positively predict nursing students' ethical sensitivities and caring behaviors. As the professional value perceptions of nursing students increase, their ethical sensitivity and caring behaviors increase. Improving the curricula in a way that will improve professional values may enable nursing students to increase their ethical sensitivity and caring behaviors. The research contributes to a broader understanding of nursing education curriculum content.     

Clinicians’ attitudes towards escalation and management of deteriorating patients: A cross-sectional study

BackgroundInternationally, rapid response systems have been implemented to recognise and categorise hospital patients at risk of deterioration. Whilst rapid response systems have been implemented with a varying amount of success, there remains ongoing concern about the lack of improvement in the escalation, and management of the deteriorating patient. It also remains unclear why some clinicians fail to escalate concerns for the deteriorating patient.ObjectiveThe objective of this study was to explore clinicians’ attitudes towards the escalation, and management of the deteriorating patient.MethodsA cross-sectional online survey of conveniently sampled clinicians from the acute care sector in a regional health district in Australia was conducted. The Clinicians’ Attitudes towards Responding and Escalating care of Deteriorating patients scale, was used to explore attitudes towards the escalation and management of the deteriorating patient.ResultsSurvey responses were received from medical officers (n = 43), nurses (n = 677), allied health clinicians (n = 60), and students (n = 57). Years of experience was significantly associated with more confidence responding to deteriorating patients (p < .001) and significantly less fears about escalating care (p < .001). Nurses (M = 4.16, SD = .57) and students (M = 4.11, SD = .55) in general had significantly greater positive beliefs that the rapid response system would support them to respond to the deteriorating patient than allied health (M = 3.67, SD = .64) and medical (M = 3.87, SD = .54) clinicians, whilst nurses and medical clinicians had significantly less fear about escalating care and greater confidence in responding to deteriorating patients than allied health clinicians and healthcare students (p < .001).ConclusionNurses and medical officers have less fear to escalate care and greater confidence responding to the deteriorating patient than allied health clinicians and students. Whilst the majority of participants had positive perceptions towards the rapid response system, those with less experience lacked the confidence to escalate care and respond to the deteriorating patient.     

The impact of an educational program based on the reproductive health of LGBT individuals developed for nursing students to improve the knowledge,skills and attitudes of students: A quasi-experimental study

AimThis study aimed to investigate the impact of an educational program developed for nursing students to evaluate their knowledge of the lesbian, gay, bisexual and transgender (LGBT) community, their reproductive health and recording their reproductive history. The program aimed to assess the effective communication skills and attitudes of nursing students toward LGBT individuals after completion of the program.BackgroundIssues related to the reproductive health of LGBT individuals are not adequately addressed in the nursing curriculum. Innovative approaches using active learning methods will increase the knowledge and skills of the students regarding LGBT reproductive health and help them gain positive attitudes toward LGBT individuals.DesignA quasi-experimental (single group pretest-posttest) design.MethodsThis study was conducted with 48 students in the 4th year in the Spring semester of the Academic year 2020–2021 at the Faculty of Nursing in a university. The eight-week education program included a discussion of modules developed for the reproductive health of LGBT individuals, film display and analysis, sample video display and analysis, role-play activities and standardized patient interviews. The research data were collected using a semi-structured questionnaire, Information Evaluation Test for LGBT Individuals, Attitude Scale Toward LGBTI Individuals, Reproductive Health History Taking Skills Checklist, Effective Communication Skills Evaluation Form and Student Satisfaction Evaluation Form. The data were analyzed using the mean, standard deviation, frequency, percentage distributions and Wilcoxon signed-rank test.ResultsThe study identified a significant increase in the median students' knowledge about LGBT individuals (p < 0.001), a substantial positive development in their attitudes toward LGBT individuals (p < 0.001) and a significant increase in the median scores of effective communication with LGBT individuals and recording the reproductive health history (p < 0.001) at the end of the education program.ConclusionThe education program resulted in positive knowledge, attitude and skill changes in the nursing students supporting the reproductive health of LGBT individuals. Education programs based on LGBT reproductive health using active learning methods should be integrated into undergraduate nursing curricula to combat disparities toward LGBT individuals.     

Surface acting,emotional exhaustion,career calling and turnover intention among student nurses: A cross-sectional study

AimThis study aims to explore the mediating role of emotional exhaustion and the moderating role of career calling in the linkage of surface acting and turnover intention among student nurses in the final clinical practicum.BackgroundTurnover rates are especially high for graduating nursing students. Surface acting is considered an important factor that affects this rate among nurses. However, little is known about the relationships between surface acting and turnover intentions among graduating nursing students in the final clinical practicum.DesignThe current research is a cross-sectional study, and the data were collected from 8 January 2022–22 January 2022.MethodsA survey was completed by 275 graduating nursing students. This survey included Chinese translations of scales measuring surface acting, emotional exhaustion, career calling and turnover intentions.ResultsBoth surface acting (r = 0.47, p < 0.001) and emotional exhaustion (r = 0.59, p < 0.001) correlated positively with turnover intentions. Both surface acting (r = −0.41, p < 0.001) and emotional exhaustion (r = −0.62, p < 0.001) correlated negatively with career calling and career calling (r = −0.72, p < 0.001) correlated negatively with turnover intentions. The association between surface acting and turnover intention was mediated by emotional exhaustion. In addition, career calling moderated the relationship between surface acting and emotional exhaustion.ConclusionsSurface acting results in higher emotional exhaustion and higher turnover intention among graduating nursing students, which was more pronounced among nursing students with a lower sense of career calling.     

Effectiveness of a role-play simulation program involving the sbar technique: A quasi-experimental study

BackgroundAccurate, skilled communication in handover is of high priority in maintaining patients' safety. Nursing students have few chances to practice nurse-to-doctor handover in clinical training, and some have little knowledge of what constitutes effective handover or lack confidence in conveying information.ObjectivesThis study aimed to develop a role-play simulation program involving the Situation, Background, Assessment, Recommendation technique for nurse-to-doctor handover; implement the program; and analyze its effects on situation, background, assessment, recommendation communication, communication clarity, handover confidence, and education satisfaction in nursing students.DesignNon-equivalent control-group pretest-posttest quasi-experimental.ParticipantsA convenience sample of 62 senior nursing students from two Korean universities.MethodThe differences in SBAR communication, communication clarity, handover confidence, and education satisfaction between the control and intervention groups were measured before and after program participation.ResultsThe intervention group showed higher Situation, Background, Assessment, Recommendation communication scores (t = − 3.05, p = 0.003); communication clarity scores in doctor notification scenarios (t = − 5.50, p < 0.001); and Situation, Background, Assessment, Recommendation education satisfaction scores (t = − 4.94, p < 0.001) relative to those of the control group. There was no significant difference in handover confidence between groups (t = − 1.97, p = 0.054).ConclusionsThe role-play simulation program developed in this study could be used to promote communication skills in nurse-to-doctor handover and cultivate communicative competence in nursing students.     

Male student nurses need more support: Understanding the determinants and consequences of career adaptability in nursing college students

BackgroundTo better understand nursing students' high attrition rates, especially for male student nurses, it is important to understand their academic satisfaction and compare it based on gender.ObjectivesTo examine the relationships between proactive personality, core self- evaluations, types of support (emotional/instrumental/informational support), career adaptability, and academic satisfaction in nursing college students using the career construction theory.DesignThis study uses a cross-sectional design.Participants and methods1062 students recruited from one health vocational college in northwest China completed questionnaires measuring proactive personality, core self-evaluations, emotional/instrumental/informational support, career adaptability, and academic satisfaction. Data was analyzed by structural equation modeling, and mediation and moderation analyses were performed.ResultsProactive personality (Beta = 0.24, p < 0.001), core self-evaluations (Beta = 0.31, p < 0.001) and informational support (Beta = 0.21, p < 0.001) were positively correlated with career adaptability, and career adaptability was positively (Beta = 0.43, p < 0.001) associated with academic satisfaction. Career adaptability mediates the relationships between proactive personality, core self-evaluations, informational support and academic satisfaction. For male student nurses, emotional support (Beta = 0.31, p < 0.01) has a positive association with career adaptability.ConclusionsIn nursing students, personal features (e.g., proactive personality, core self-evaluations) and supporting materials (e.g., informational support) have a positive association with career adaptability, and career adaptability has a mediating role in the relationships. Male student nurses need extra emotional support to promote their academic satisfaction. Targeted interventions may improve nursing college students' academic satisfaction.     

The effect of an early oral stimulation program on oral feeding of preterm infants

PurposeTo evaluate the effect of an oral stimulation program on preterm infants.MethodsPreterm infants (n = 72) were randomly assigned to experimental and control groups. Controls (n = 36) received routine care while the experimental group (n = 36) received oral stimulation in addition to routine care. Postmenstrual age, total intake volume, body weight, the transition time from initiation of oral feeding to full oral feeding and feeding efficiency were calculated.ResultsPostmenstrual age and full oral feeding weight were significantly lower in the experimental group (p < 0.05). The time from initiation of oral feeding to full oral feeding was significantly shorter in the experimental group (p < 0.05) while feeding efficiency was higher in the experimental group (p < 0.05) compared to controls. No significant differences existed in hospital stay length or weight gain rate.ConclusionsAn early oral stimulation program is beneficial in preterm infants.     

Why is psychiatric nursing not the preferred option for nursing students: A cross-sectional study examining pre-nursing and nursing school factors

BackgroundThere is a shortage of nurses working in the mental health field globally. The aim of the present study was to examine Singapore nursing students' attitudes towards specializing in psychiatric nursing by examining the pre-nursing and nursing school factors as well as attitudes towards psychiatry and personality traits.MethodsA cross-sectional online survey was conducted with 500 nursing students from four nursing institutions in Singapore. Students' attitudes towards psychiatry (ATP-18), perception of psychiatric nursing career aspects relative to other fields, and personality traits (mini-IPIP) were assessed. The main outcome measure was likelihood of specializing in psychiatric nursing. Logistic regression was used to examine the combined effect of factors upon the outcome.ResultsTwenty-six students (5.2%) rated “definitely decided to do” psychiatric nursing. Pre-nursing school factors associated with choosing psychiatry included ethnicity, current education, parents' wishes, having personal/family experience of mental illness, prior work experience, interest in psychiatric nursing and psychology module taken prior to current school admission. Nursing school factors such as teaching methods and clinical exposure were not associated with choosing psychiatric nursing. Positive attitudes towards psychiatry, perception of better career aspects in psychiatric nursing relative to other fields, and the personality traits of extraversion and intellect/imagination were associated with likelihood of choosing psychiatric nursing. Logistic regression revealed Malay (OR: 1.90, 1.14–3.16, p = 0.013) and Indian ethnicity (OR: 2.56, 1.32–4.96, p = 0.005), interest in psychiatry (OR: 22.56, 8.22–61.92, p < 0.001), psychology module prior to current school admission (OR: 2.31, 1.28–4.17, p = 0.005), better perceived job prospects in psychiatric nursing than other fields (OR: 1.91, 1.21–3.04, p = 0.006), extraversion (OR: 1.09, 1.02–1.17, p = 0.012) and positive attitude towards psychiatry (OR: 2.72, 1.75–4.23, p < 0.001) as factors associated with students choosing psychiatric nursing.ConclusionsThe selection of psychiatry as a specialty by nursing students was affected by pre-nursing school factors. Taking these factors into consideration may improve recruitment and alleviate the shortages in the psychiatric nursing field.