Experiences of nursing students during clinical education in mental health clinics: A phenomenological qualitative study

AimNursing students have both positive and negative experiences during clinical education. This study was conducted to identify experiences of nursing students during clinical education in mental health clinics.DesignThis phenomenological qualitative design study was conducted with 4th year undergraduate nursing students from a university in Turkey to identify their experiences specifically in mental health clinics.MethodsThe data were collected using focus groups interviews with 40 nursing students and assessed with the 7-stage phenomenological analysis method described by Colaizzi.ResultsThree main themes were determined: (i) the need for supportive interventions to cope with negative emotions; (ii) difficulty in translating theoretical knowledge into practice; and (iii) the lack of role model nurses and teaching staff.ConclusionsThe results of this study indicate that supportive interventions should be given to nursing students before clinical education. Also, the duration of clinical education, the teaching methods to be used and role model nurses and teaching staff effectiveness in clinical education should be planned carefully.     

护理本科生对社区护理学混合式教学体验的质性研究

目的 了解护理本科生对社区护理学混合式教学的看法,为进一步完善混合式教学在护理教育中的应用提供参考。 方法 采用焦点小组访谈的形式对15名参与社区护理学混合式教学的护理本科生进行半结构化访谈,并运用Colaizzi 7步分析法分析访谈资料。 结果 提炼出6个关于护理本科生对社区护理学混合式教学体验的主题:激发学习兴趣,提高学习自主性;扩大视野,拓展思维;高效利用课堂时间,改善学习策略;多元互动,提高综合能力;学习任务增加,心理压力大;网络学习不深入。 结论 混合式教学有助于护理本科生综合能力的培养,提高教学效果,但仍需护理教育者在实践中进一步完善。     

Health personnel's experience with resident-centered care in nursing homes in Korea: A qualitative study

ObjectivesChanging the culture in nursing homes in South Korea comes with challenges, and the key issues of resident-centered care have been described. This study aims to describe health personnel's experience in providing resident-centered care in nursing homes.MethodsQualitative data were collected through individual and focus group interviews consisting of registered nurses (n = 4), certified nurse assistants (n = 2), and long-term caregivers (n = 12) working at nursing homes in South Korea. The participants (n = 18) completed the interviews from May to June 2018, and all interviews were recorded, transcribed, and analyzed by employing the content analysis method.ResultsFive main categories are conceptualized: (1) residents’ participation in decision making, (2) the sharing of the history and story of residents, (3) the recognition of facility- or task-based attitudes, (4) the guarantee of private time and space for residents, and (5) the need for standardized guidelines.ConclusionsResults corroborate that health personnel regard resident-centered care as a desirable nursing paradigm. However, facility- or task-centered care is the most effective in hectic situations. A standardized protocol on the application of resident-centered care based on the facility-tailored specification is unavailable. Therefore, health personnel's perception and practice of resident-centered care can differ. Efficient nursing intervention programs should be developed after clarifying facility culture.     

本科学历护士对护理科研认识和体验的质性研究

目的 了解本科学历护士对护理科研的认知以及在进行科研过程中的体验和感受,为制定科学合理的科研培训方案提供参考和依据。 方法 采用目的抽样的方法,对13名本科学历护士进行半结构式访谈,并采用Colaizzi分析法对访谈资料进行分析、归纳及提炼主题。 结果 在对护理科研认知方面提炼出4个主题,包括肯定护理科研重要作用、影响科研因素较多、科研感受复杂以及渴望社会支持。 结论 护理管理者应充分了解本科学历护士对护理科研的认知,重视其护理科研体验,加强科研培训,完善团队及社会支持体系建设,以提高其科研积极性和科研质量。     

护理高职男生临床实习前后的心理体验

目的了解高职护理专业男生临床实习前后不同的心理体验,为有针对性地制订护理教育措施提供依据。方法采用半结构访谈法,分别在实习前后对9名男生进行两次深入访谈,将资料进行整理、分析,提炼出主题。结果高职护理专业男生对于从事护理专业的意向倾向于消极,对护理专业的价值认同感低,存在很大的岗位流失率倾向。结论护理教育者应从入学前教育、学校教育、临床教育这一连续过程中做好男生的教育和培养,帮助他们树立正确的职业态度和职业价值观,增强职业认同感。     

护理本科生临床实践体验的质性研究

目的探索和理解护理本科生临床实践中遇到的问题及心理状态,为本科护生临床实践教学管理提供依据。方法采用质性研究中的诠释现象学研究法（hermeneutic phenomeno--logical method）,对65g本科护生的反思日记和反思小组讨论会的内容进行分析。结果经分析,萃取出4个主题：人际关系、知识和技能、情感体验、实习环境。结论护理教育者应加强本科护生人文素质和人际沟通能力的培养,同时,应采取措施,降低本科护生在知识技能和职业情感方面的认知失调。     

中国护理教育资源现状及发展趋势的研究

目的了解我国护理教育资源的现状及发展趋势。方法采用文件查阅和问卷调查法收集护理教育办学信息,采用咨询法征集有关专家的意见。结果我国护理教育体系由中专、大专、本科和研究生教育4个层次、普通和成人教育两种类型构成;1998-2007年普通护理教育招生数逐年增长,2007年全国总招生数已达39.1万名,构成比为中专71.09%、大专22.23%、本科6.68%;近些年硕士点数目增长速度快,2007年共招收硕士生341名;2004年我国开始护理学博士教育;成人大专、本科教育规模扩大。结论需要进一步调整我国护理教育的规模与结构,控制总招生规模,逐步扩大高等教育的比例;加强对办学机构的准入管理和教学质量监控;学校应加强办学的质量意识,加强教学基本建设。     

Experiences of undergraduate nursing students with faculty incivility in nursing classrooms: A meta-aggregation of qualitative studies

Faculty-to-student incivility can have detrimental impacts on both the individual students and the nursing profession. This study synthesized the current qualitative research evidence on the experiences of undergraduate nursing students with faculty incivility in nursing classrooms. A meta-aggregation approach was applied in a systematic review of qualitative studies based on the guideline of the Joanna Briggs Institute. The analysis of 11 qualitative studies identified four synthesized findings: (1) faculty incivility included a wide range of uncivil behaviors from disruptive to threatening behaviors, (2) pedagogical incompetence, including ineffective teaching, unresponsiveness, and unfairness, was perceived as uncivil, (3) faculty incivility negatively impacted on psychological well-being and learning, and (4) adaptation efforts included seeking support from family and friends and voicing the need for an official support system. Nursing faculty members need to be aware of the malicious impacts of faculty incivility, have formal teaching preparation, and develop pedagogical competency. The students and faculty members should be empowered by establishing official support systems for students and training faculty members to be role models for civility, respectively. Faculty perspectives of their incivility to students, interventions for cultivating faculty civility, and the long-term effects of faculty incivility are suggested as areas for further research.     

高等中医院校本科护理学专业课程设置的调查分析

目的 调查我国高等中医院校本科护理学专业课程设置情况,分析可能影响课程设置的因素,为促进高等中医院校本科护理学专业课程体系改革提供依据.方法 收集我国19所高等中医院校本科护理学专业课程设置的相关资料,采用比较研究法获取其特征与不足,并分析可能的影响因素.结果 19所高等中医院校护理学专业所有课程(2815.8±432.9)学时,专业基础课程(787.4±211.8)学时,专业课程(717.0±189.8)学时,人文素养课程(238.7±73.8)学时,中医相关课程(289.9±130.9)学时.我国高等中医院校本科护理学专业的课程设置已初步形成体系,但存在着中医护理特色不够突出、人文素养课程比例偏小及课程类型构成欠佳等问题.影响课程设置的因素是多方面的,包括师资队伍、教材建设、市场需求及中医护理学科体系定位等.结论 我国高等中医院校本科护理学专业课程设置有待进一步完善.护理教育者应认识影响课程设置的因素,采取具有针对性的措施,构建科学、合理及可持续发展的课程体系.     

中国注册护士能力架构的质性研究

目的确定护士能力的含义及中国注册护士能力的架构。方法采用国际护士会护士能力架构作为模板,发展2个半开放式问题,收集了38名中国护理专业人士的意见,并用内容模板法进行分析。结果护士能力的定义强调护士在临床实践中将知识、技能和态度有机结合的能力水平;中国注册护士的基本能力由8个维度构成。结论中国护理专业人士对护士能力概念的定义从某种程度上不同于国际护士会的定义;构成注册护士基本能力的维度也在很大程度上不同于国际护士会的护士能力架构。     

实习护生执行隐私部位暴露性护理操作的质性研究

目的 深入了解实习护生进行隐私部位暴露性护理操作时的心理体验。方法 运用质性研究方法,以目的抽样法对13名本科实习护生进行半结构式访谈收集资料。结果 通过资料分析,提取了4个主题：(1)羞怯紧张与无效沟通;(2)顾虑担心与心理落差;(3)逃避与无从应对;(4)坦然与积极应对。结论 对护生的伦理教育支持,增进有效的护患沟通技巧和给予其情感支持,可提高护生执行隐私部位暴露性护理操作的能力,从而缓解护生的心理压力和提升职业情感。     

肿瘤科实习护生死亡教育需求的质性研究

目的：明确在肿瘤科实习的护生对死亡教育的需求,为对其开展死亡教育提供理论依据。方法：采用目的性抽样法,选取17名实习护生进行一对一深度访谈,采用主题分析法分析资料、提炼主题。结果：提炼出3个主题：死亡教育知识的需求、死亡教育技能的多样化需求、提升自我关怀能力的需求。实习护生自述他们接受的死亡教育内容不全面,未充分掌握死亡相关理论知识和技能,无法满足其临床实践需求,不能有效应对患者死亡,且经历患者死亡后表现的自我照护能力较差。结论：建议医学院校为实习护生提供系统、全面的死亡教育相关课程;建议临床带教老师为实习护生适当提供临终护理实践机会,同时关注实习护生经历患者死亡后的自我关怀能力,帮助其树立科学的死亡观,提高其自我关怀能力,满足实习护生的死亡教育需求。     

Understanding nursing scope of practice: a qualitative study

Background

The past decade has seen increased patient acuity and shortened lengths of stays in acute care hospitals resulting in an intensification of the work undertaken by nursing staff in hospitals. This has ultimately led to a reconsideration of how nursing staff manage their work.

Aim

The aim of this study was to understand how medical and surgical nurses from two Australian hospitals conceive their scope of practice in response to the available grade and skill mix of nurses and availability of unlicensed health care workers and other health care professionals. By exploring these meanings, this study aimed to build an understanding of how nursing work patterns were shifting in the face of changing patient acuity, patient profiles and nursing skill mix.

Method

A constructivist methodology, using critical incident technique (CIT) was used to explore nurses’ role and scope of practice. Twenty nurses, 16 registered nurses (RNs) and four enrolled nurses (ENs), discussed significant events during which they perceived they were undertaking either patient care activities they should be undertaking, or activities that should have either been delegated or undertaken by a higher level of care provider.

Findings

Five themes emerged from the data: (1) good nurses work in proximity to patients providing total patient care; (2) safeguarding patients; (3) picking up the slack to ensure patient safety; (4) developing teamwork strategies; and (5) privileging patients without mental illness or cognitive impairment. A pattern woven throughout these themes was the idea of negotiation. RNs were struggling with the notions that direct patient care was sometimes not the best use of their time, and delegation did not equate with laziness.

Conclusion

Negotiation has become a fundamental aspect of nursing practice given the variety of nursing care providers currently employed in acute care settings. Negotiation has allowed nurses to redefine appropriate nurse–patient proximity, promote patient safety and find innovative ways of working in nursing teams.     

Ethical global health in nursing education: An integrative review

AimThe purpose of this integrative review is to provide a comprehensive review of ethical considerations for host communities and nursing programs in planning, implementing and evaluating global health experiences for nursing students.BackgroundGlobal health experiences for nursing students are proliferating rapidly across university settings while at the same time decreasing the average time spent in the host country engaged with local communities. Global health experiences are an area where students can experience ethics as it is applied across varied contexts including resource limited international settings. As nursing education expands its global programming, exploring the ethical implications of designing, implementing and evaluating GHEs becomes pivotal to build respectful, sustainable relationships with global partners and best prepare nursing students for ethical professional practice in an interconnected world.DesignWe conducted an integrative review to examine ethical considerations in development of ethical global health experiences that benefit, rather than harm, host communities and participating nursing student guests.MethodsThe search included articles published in English language, peer-reviewed journals between 1998 and 2021 that discussed ethics in the context of nursing students traveling internationally for global health experiences. Eighteen articles met criteria for review.ResultsOverall, findings demonstrate relatively little research specific to ethical engagement in global health experiences. The articles in this integrative review discussed a range of ethical attributes including reciprocity or collaboration, respect, sustainability or commitment, justice and openness. Recommendations based on research and non-research articles are provided.ConclusionsEthical comportment in global health experiences requires careful planning, implementation and evaluation to assure an equitable and sustainable partnership between host community, faculty and nursing student guests.     

慢阻肺患者基于“互联网+护理服务”体验的质性研究

：目的 了解COPD患者基于“互联网+护理服务”体验,探讨影响“互联网+护理服务”管理的因素。方法 采用目的性抽样策略从江苏省某三级医院参与“互联网+护理服务”的COPD患者中选取16例为研究对象,通过半结构访谈进行资料收集,运用主题分析法确定主题与亚主题。结果 共提取4个主题：①安全感 （熟悉感、便利感、获得自我掌控感）;②未被满足感 （获得针对性信息、服务途径不足、费用可报销）;③顾虑感（对护理认可度、隐私安全、增加焦虑）;④使用顺畅感（互联网技术素养、平台智能性）。结论 互联网+护理服务”的应用可以提升COPD患者安全感,减少医疗服务成本,在新冠病毒感染流行期间可以减少患者入院次数,提高生活质量,值得推广;同时管理者应优化微信平台服务内容及形式,提高患者平台使用体验感;规范护理人员准入制度,提高患者对护理认可度;加强患者出院指导,提高其平台使用能力。