Undergraduate nursing students’ stigma and recovery attitudes during mental health clinical placement: A pre/post‐test survey study

Undergraduate nursing students have been reported to hold negative and stigmatizing attitudes towards mental health consumers and to be under‐prepared for mental health clinical placement. This study aimed to investigate undergraduate nurses’ stigma and recovery attitudes to mental illness, and describe their understandings of personal recovery on entry and exit to traditional mental health clinical placement. A pre/post‐test survey was administered to N = 249 nursing students in Australia. Demographic data, attitudes towards mental health nursing and clinical placement, the Opening Minds Scale for Healthcare Providers (OMS‐HC), Recovery Attitudes Questionnaire (RAQ‐7), and an open‐ended question on understandings of personal recovery from mental illness were collected on entry (T1) and exit (T2) to placement. At T1, students reported moderate stigma and positive attitudes towards recovery (OMS‐HC mean = 34.6; RAQ‐7 mean = 4.0). At T2, there was a reduction in stigma (social distance P = 0.02, d = 0.26) and improvement in recovery attitudes (P < 0.01, d = 0.40). Attitudes towards mental health nursing and placement also improved (P < 0.01). Having a family member with mental illness predicted improvements in stigma and recovery attitudes. On entry to placement, most students described accurate understandings of personal recovery, which were maintained during placement. The findings indicate that mental health clinical placements are effective in improving students’ mental health stigma and recovery attitudes and provide a prime opportunity to attract students into the field. Co‐produced or consumer‐led education provided by peer workers during clinical placements may improve students’ stigmatizing attitudes and stimulate their interest to work in the field.     

Effectiveness of a 12‐week school‐based educational preventive programme on weight and fasting blood glucose in “at‐risk” adolescents of type 2 diabetes mellitus: Randomized controlled trial

To assess the effectiveness of a 12‐week school‐based educational preventive programme for type 2 diabetes by change in weight and fasting blood glucose level in Jordanian adolescents. Sixteen percent of Jordanian adults have obesity‐related type 2 diabetes and 5.6% of obese adolescents examined, however one‐third unexamined. Rates in Arabic countries will double in 20 years, but this can be prevented and reversed by controlling obesity. A single‐blinded randomized controlled trial was conducted in 2 unisex high schools in Irbid, Jordan, in 2012. Intervention and control participants, aged 12 to 18 years, were visibly overweight/obese. They were randomly allocated to the intervention (n = 205) or control (n = 196) groups. At‐risk students were assessed before and after the 12‐week intervention, for change in weight and fasting blood glucose level following preventive instruction and parent‐supported changes. Mean age of participants was 15.3 years with equal percentages of both males (49.4%) and females. Post intervention, the intervention group, demonstrated statistically significant reductions: mean difference of 3.3 kg in weight (P < .000) and 1.36 mg/dL (0.075 mmol/L) in fasting blood glucose (P < .000). School‐based early prevention intervention effectively reduced weight and fasting blood glucose in Jordanian at‐risk adolescents.     

Mental health placements in a general health setting: no substitute for the real thing!

Aim. To determine effectiveness of clinical placements in non‐mental health facilities in producing improvement in attitudes toward people with a mental illness and toward mental health nursing in nursing students. Background. Clinical placements in mental health settings have favourably impacted students’ attitudes and confidence in mental health settings. Placement shortages have created discussion about using non‐mental health settings to gain this experience, as mental illness is common in all health settings. To date, no research findings support or refute the efficacy of non‐mental health settings in influencing confidence and attitudes. Design. A within‐subject design was used. Participants provided self‐report data soon after the beginning and at the conclusion of the mental health component. Methods. A questionnaire was administered to a cohort of undergraduate nursing students (n = 66) to measure attitudes, preparedness for practice and interest in mental health nursing as a career, using a pre‐ and post‐test design. Results. Only 25% of participants completed clinical experience in a mental health facility. Minor improvement in attitudes, confidence and appreciating the nursing role in mental health were identified, but the impact on attitudes was considerably less favourable than when clinical experience was undertaken in a mental health facility. Conclusion. Participants who completed clinical experience in a non‐mental health facility did not demonstrate more favourable views about mental health nursing. Relevance to clinical practice. Clinical placements in mental health are essential preparation for undergraduate students to maximise improvement in attitudes to the care of people diagnosed with a mental illness and to mental health nursing.     

A spiritual education course to enhance nursing students’ spiritual competencies

The study aimed to determine the impact of an elective spiritual education course for nursing students on spiritual competencies. A convenience sample of nursing students (N = 92) was recruited from a baccalaureate school of nursing between February and July 2016. The intervention group (n = 45) was comprised of students enrolled in the elective spiritual education course which integrated non-Christian Eastern cultural beliefs; the control group was comprised of students not enrolled in the elective (n = 47). A quasi-experimental design examined pretest, posttest, and follow-up data from students' self-administered questionnaires. The intervention effect of the course was analyzed using generalized estimation equation. The results indicated posttest scores among nursing students in the intervention group were significantly better than the comparison group for spiritual health. Practicum stress and professional commitment were significantly better at follow-up. Spiritual care attitudes, caring behavior, and religious belief were significantly improved from pretest to posttest, and at follow-up for the intervention group compared with the control group. In conclusion, a spiritual education course should be considered as a regular course in the nursing curriculum, which could improve students’ spiritual competencies, individual spiritual growth, and the ability to care for patients.     

Proceedings of the 2008 Annual Meeting of the Clerkship Directors in Internal Medicine (CDIM)

Background: Obesity is the second leading cause of preventable death in the United States. However, physicians feel poorly trained to address the obesity epidemic. This article examines effective training methods for overweight and obesity intervention in undergraduate medical education. Using indexing terms related to overweight, obesity, and medical student education, we conducted a literature searched PubMed PsycINFO, Cochrane, and ERIC for relevant articles in English. References from articles identified were also reviewed to located additional articles. Summary: We included all studies that incorporated process or outcome evaluations of obesity educational interventions for U.S. medical students. Of an initial 168 citations, 40 abstracts were retrieved; 11 studies were found to be pertinent to medical student obesity education, but only 5 included intervention and evaluation elements. Quality criteria for inclusion consisted of explicit evaluation of the educational methods used. Data extraction identified participants (e.g., year of medical students), interventions, evaluations, and results. These 5 studies successfully used a variety of teaching methods including hands on training, didactic lectures, role–playing, and standardized patient interaction to increase medical students’ knowledge, attitudes, and skills regarding overweight and obesity intervention. Two studies addressed medical student bias toward overweight and obese patients. No studies addressed health disparities in the epidemiology and bias of obesity. Conclusions: Despite the commonly cited “obesity epidemic,” there are very few published studies that report the effectiveness of medical school obesity educational programs. Gaps still exist within undergraduate medical education including specific training that addresses obesity and long-term studies showing that such training is retained.     

Nursing students’ knowledge and attitude toward diabetic ulcer care and their contributing factors in Indonesia

ObjectiveThe prevalence of diabetic foot ulcer in Indonesia is far greater than the global prevalence. Nursing students are expected to have good knowledge and positive attitudes regarding diabetic ulcer care in order to deliver high-quality wound care during clinical practice. This study aimed to assess nursing students’ knowledge and attitudes toward diabetic ulcer care and to investigate the factors related to them.MethodsA cross-sectional study was conducted on 396 academic and clinical phases in three nursing schools in Indonesia from September 2021 to February 2022. Participants completed a survey including a questionnaire about knowledge and attitudes regarding diabetic ulcer care. The data were analyzed using a Chi-square test and multivariate logistic regression analysis.ResultsThe results show that 43.2% (171/396) of nursing students had inadequate knowledge of diabetic ulcer care. However, 88.9% (352/396) had a favorable attitude toward the topic. Nursing students lacked knowledge about the characteristics of diabetic ulcers, diabetic neuropathy, wound infection, and adjunctive therapy for diabetic ulcers, and many of them believe that diabetic ulcer care is too time-consuming to carry out. Students in the clinical phase of their studies had significantly better knowledge than those in the academic phase (aOR = 9.99, 95% CI 4.96–20.08, P < 0.001). Male nursing students were significantly less likely to have positive attitude toward the topic than female students (aOR = 0.42, 95% CI 0.19–0.96, P = 0.048), and students accustomed to sharing with peers as a source of knowledge had better attitudes than those who were not (aOR = 2.76, 95% CI 1.40–5.41, P = 0.003).ConclusionFindings show that almost half of the nursing students have insufficient knowledge of diabetic ulcer care. Curriculum developers and educators need to improve the curriculum regarding diabetic wound care and provide strategic programs to improve students’ knowledge and attitudes based on the factors discovered in this study.     

‘Anyone can have a mental illness’: A qualitative inquiry of pre‐registration nursing students’ experiences of traditional mental health clinical placements

Nurses play a crucial role in mental healthcare provision. Like many countries, Australian nursing students are educated in comprehensive pre‐registration programmes which include mental health clinical placements. Placements play a vital role in students’ education, providing the opportunity to engage with consumers and develop mental health nursing knowledge and skills. There is limited knowledge of student perspectives on traditional placements in contemporary recovery‐oriented mental health services. This interpretive qualitative inquiry aimed to explore nursing students’ experience of traditional mental health clinical placement and how it influenced their practice and their understandings of recovery from mental illness. Data were collected from focus groups with n = 31 nursing students in a large metropolitan public mental health service. Thematic analysis resulted in three themes of experience: humanizing people with mental illness; learning about recovery; and shifting perspectives on mental health nursing. Through a positive placement experience where they felt supported and included by staff, students came to see consumers as people rather than diagnoses, developed greater understanding of mental health nursing work and were more likely to consider mental health nursing as a career choice. Peer‐support workers were an important influence on students’ understandings of recovery and have a key role to play in educating students on placement. Students need to be prepared and supported by university and clinical staff to deal with vicarious trauma that may occur on placement. Mental health placements play a crucial role in attracting students into the field, and it is imperative they remain part of comprehensive pre‐registration education.     

The impact of simulation-based triage education on nursing students' self-reported clinical reasoning ability: A quasi-experimental study

Few studies have comprehensively examined the effectiveness of simulation-based triage education on clinical reasoning of nursing students. This study evaluated the impact of a simulation-based triage exercise on nursing students’ self-reported clinical reasoning ability. Three cohorts of third-year nursing students were divided into intervention group a (IG a, n = 62), intervention group b (IG b, n = 57), and a control group (CG, n = 53). Students in IG a and IG b participated in a simulation-based triage education consisting of 2 h of multiple patient triage simulations and an hour of structured debriefing. The CG participated in a traditional didactic triage course consisting of a 3-h lecture. Self-reported clinical reasoning ability in pre and post-triage education was measured by the Nurses Clinical Reasoning Scale. There was no significant difference in mean clinical reasoning ability scores between the three groups in pre-test (p > 0.05). Clinical reasoning ability scores in post-test among students in IG a and IG b were significantly higher than those in CG (p < 0.001). Nursing students exposed to a simulation-based triage education had more improvement in self-reported clinical reasoning ability as compared with students who participated in a lecture-based triage education program.     

Nursing students’ attitudes and experiences with mental illness: A cross-sectional study

Almost half (46%) of people will experience a mental health issue in their lifetime and all nurses need mental health knowledge and skills regardless of their area of specialization. Little is known, however, about student attitudes toward people with mental illness on entry to pre-registration nursing programs. The aims were to investigate Australian pre-registration nursing students’ attitudes toward, and prior experience with, people with mental illness on program commencement. This cross-sectional study used the Community Attitudes Toward Mental Illness (CAMI) scale with pre-registration nursing students, and questions on students’ prior experience with mental illness (self, family, friends). There were n = 311 (271 female/40 male) first year, first semester Bachelor of Nursing students at a national Australian university. Students reported prior experience with mental illness with family (49.5%/n = 154) and friends (61.4%/n = 191). Self-reported (36.3% /n = 113) mental illness, particularly anxiety and depression, significantly exceeded national averages. Most students held accepting attitudes toward people with mental illness, except for perceptions of dangerousness. This study provides new findings on nursing student attitudes and experience with people with mental illness on program entry. The high self-reported prevalence of anxiety and depression at program entry indicates a pressing need for early intervention and mental wellbeing strategies for students from commencement of their tertiary education. Fear-reducing education which challenges perceptions of dangerousness in relation to people with mental illness, and supportive mental health clinical placements during their program, may help improve students’ attitudes and reduce fear and mental health stigma.     

Attitudes Toward Obese People: A Comparative Study of Nursing,Education, and Social Work Students

Background

Stigmatization and bias toward the obese population has been studied globally in a variety of professional groups, supporting the existence of negative attitudes and weight bias against this population. Attitudes fostering the prevalence of stigmatization undermine the effectiveness and quality of health care. Studies have not compared attitudes and beliefs of graduate and undergraduate students from professional schools within the same university. As an exemplar, this study compared nursing students' attitudes and beliefs toward obese individuals with students' attitudes in other professional schools.

Attitudes of under graduate nursing students to suicide and their role in caring of persons with suicidal behaviors

This cross-sectional survey was carried out among nursing students (n = 223) to examine their attitudes towards suicide and their role in suicide prevention. The data were collected by administering a Suicide Attitude questionnaire. The majority (68.7%) of nursing students had positive attitudes towards suicide with more favorable attitudes in the “Professional role, work, and care” (33.08 ± 4.21) domain, followed by ‘Morality and mental illness’ (20.80 ± 3.61) and ‘Communication and attention’ (13.60 ± 2.81). In addition, age and education were significantly different in participants' attitudes towards suicide (p < 0.05). The results suggest that nursing students need culturally relevant suicide education programs to provide optimal care to suicide victims.     

Nursing students' attitudes toward research and development within nursing: Does writing a bachelor thesis make a difference?

The aim of this study was to investigate the effect of writing a bachelor's thesis on nursing students' attitudes towards research and development in nursing. The study sample consisted of 91 nursing students who were required to complete a bachelor's thesis and 89 nursing students who were not required to complete a bachelor's thesis. Data were collected via self‐report questionnaire that was distributed in May and June 2012. The questionnaire comprised 3 parts: (1) demographic items; (2) questions about “scientific activities,” and (3) the nursing students' attitudes towards and awareness of research and development within nursing scale (version 2). The mean age of the students was 23 (1.3) years. The students who wrote a bachelor's thesis achieved a median score of 110.0, whereas the students in the other group had a median score of 105.0 on the scale. All the items were assigned a 3 or higher. A statistically significant difference was found between the 2 groups in their attitudes towards and awareness of research (U = 3265.5; P = .025). The results of this study suggest that writing a thesis in nursing education has a positive influence on nursing students' attitudes towards and awareness of research and development in nursing.     

The impact of a palliative care educational component on attitudes toward care of the dying in undergraduate nursing students.

Nurse educators have identified that historically nurses have not been prepared to care for dying patients. Research also has identified that nursing students have anxieties about death, dying, and caring for dying patients. Several factors have been identified as affecting nurses' and nursing students' attitudes toward care of the dying. Factors addressed in this research were current and previous death education. This research incorporated experiential learning using a model of death education and transformative learning theory. The educational experiences were geared to help students understand the skills needed to care competently and compassionately for the dying. The use of the End of Life Nursing Education Consortium (ELNEC) education package along with experiences at the hospice, the funeral home, the anatomy laboratory, and role play helped facilitate transformative learning in the nursing students. The study examined the effects of an educational experience to determine if a one-time educational experience provides sufficient, lasting effects in a 6-week format. Results of this study indicate that education can have a positive effect on nursing students' attitudes toward care of the dying. Nursing students in the intervention group had a significant positive increase in their attitudes toward care of the dying after the intervention. The attitude change increased slightly after a 4-week period.     

First-year nursing students’ attitudes towards artificial intelligence: Cross-sectional multi-center study

AimTo assess the attitudes of nursing students toward artificial intelligence.BackgroundPossible applications of artificial intelligence-powered systems in nursing cover all aspects of nursing care, from patient care to risk management. Although the final acceptance of artificial intelligence in practice will depend on positive 'nurses' attitudes toward artificial intelligence, those attitudes have gained little attention so far.DesignA cross-sectional multicenter study.MethodsThe study was performed at nursing schools of four Croatian universities, surveying a total of 336 first-year nursing students (response rate 69.7%) enrolled in 2021. A validated instrument, the General Attitudes towards Artificial Intelligence Scale, consisting of 20 Likert-type items, was chosen for the study. Where applicable, the items were contextualized for nursing. Four sub-scales were identified based on the outcomes of the factor analysis.ResultsThe average attitude score was (mean ± standard deviation) 64.5 ± 11.7, out of a maximum of 100, which was significantly higher than the neutral score of 60.0 (p < 0.001). The attitude towards AI did not differ across the universities and was not associated with students’ age. Male students scored slightly higher than their female colleagues. Scores on subscales “Benefits of artificial intelligence in nursing”, “Willingness to use artificial intelligence in nursing practice”, and “Dangers of artificial intelligence” were favorable of artificial intelligence-based solutions. However, scores on the subscale “Practical advantages of artificial intelligence” were somewhat unfavorable.ConclusionsFirst-year nursing students had slightly positive attitudes towards artificial intelligence in nursing, which should make it easier for the new generations of nurses to embrace and implement artificial intelligence systems. Reservations about artificial intelligence in daily nursing practice indicate that nursing students might benefit from education focused specifically on applications of artificial intelligence in nursing.     

An interprofessional collaboration of care to improve clinical outcomes for patients with diabetes

ABSTRACT

This project addressed interprofessional team-based care to improve management and outcomes of complex patients with diabetes. A collaborative model between Family Medicine and Nursing was developed to determine if having nursing students as case managers would improve the quality of care. From 2015–2016, patients with diabetes at greatest risk for poor outcomes (N = 58) received an intervention from senior nursing students (N = 6) at a Family Practice Center. Nursing students shared responsibilities with physicians, medical students, and medical assistants to deliver high quality care. For the intervention, nursing students reviewed charts, called patients for follow-up visits, and facilitated patients’ adherence to providers’ recommendations. Students also conducted group education sessions on nutrition, medication adherence, obesity, and exercise for patients. The control group included 61 randomly selected patients with diabetes who did not receive the intervention during the same period of time. Compared to the control group, the intervention group showed significantly improved outcomes in HgA1C levels (66% vs. 40.8%; p = .009), blood pressure control (61.1% vs. 36.8%; p = .009), and urine microalbumin test completion (87.5% vs. 48.3%; p< .0001). Outpatient practices offer an optimal opportunity for nursing students to practice case management. This team-based care approach suggests better outcomes for patients with diabetes.     

Nursing students' knowledge and attitudes toward urinary incontinence: A cross-sectional survey

BackgroundNurses must have adequate knowledge to manage the complexities of urinary incontinence. Nursing students are the nurses of the future, yet little is known about urinary incontinence education in undergraduate nursing programs.ObjectivesThe aim of this study was (a) to assess the knowledge and attitudes of urinary incontinence held by undergraduate nursing students in China and (b) to explore the relationship between knowledge, attitudes and socio-demographic characteristics.DesignA cross-sectional survey using cluster random sampling.SettingsUndergraduate departments of Nursing within the Faculty of Health Sciences at six Universities, located in different areas of China.ParticipantsA random selection of 6 faculties with a total of 1313 full time undergraduate nursing students completed the survey.MethodsSelf-reported data were collected using two validated questionnaires, the Urinary Incontinence Knowledge Scale and the Urinary Incontinence Attitude Scale, to access students' knowledge and attitudes toward urinary incontinence.ResultsOverall urinary incontinence knowledge was poor (49.9%, 15.0/30) and attitudes about urinary incontinence were generally positive (71.7%, 43.0/60). A high level of interest in learning more about urinary incontinence was found. There was a weak correlation between urinary incontinence knowledge and attitudes (r = 0.135, p < 0.01). There was also a significant positive correlation between urinary incontinence knowledge and attitudes and nursing students' year of study, urinary incontinence education and training, and formal clinical practicum experience in urology (p < 0.05).ConclusionsChinese nursing students showed poor urinary incontinence knowledge but generally positive attitudes toward urinary incontinence. This study suggests there is a need to examine urinary incontinence content throughout undergraduate nursing curricula in China.     

Increasing the pipeline and diversity of doctorally prepared nurses: Description and preliminary evaluation of a health disparities summer research program

Despite calls to increase the number and diversity of doctorally prepared nurses, recent data indicate a severe shortage of PhD‐prepared nurses, especially those of racial/ethnic minority backgrounds. This is concerning, given that evidence indicates that racial/ethnic minority PhD‐prepared nurses are well‐positioned to address health disparities, by attending to the needs/concerns of medically underrepresented groups. The purpose of this article is to describe and provide a preliminary evaluation of a summer research program for minority nursing students. Online surveys were administered to assess for student satisfaction, knowledge gains, attitudes toward research, and intentions to pursue a PhD among minority undergraduate nursing students (N = 6) participating in the 10‐week program. Favorable trends were observed related to satisfaction, knowledge gains, and attitudes toward research. Fifty percent of the sample intended to pursue a PhD immediately after the program, compared to none before the program, and this result was maintained at 1‐year post‐program. The summer research program appears to be a promising strategy for increasing the number/diversity of PhD‐prepared nurses. More research on the implementation of programs exposing minority nursing students to health disparities research is needed to strengthen evidence that similar programs can serve to increase the pipeline of diverse doctorally prepared nurses.