Experiences after international clinical placement as nursing students in a paediatric ward

AimThe aim of this study is to investigate nurses’ experiences after participating in an international clinical placement programme as nursing students while staying for one to three weeks in a paediatric ward.BackgroundStudent mobilisation is expected to increase the quality of education. Hence, offering international clinical placement programme in low- and high-income countries is a commonly used learning activity in bachelor programmes in nursing. Many studies have mainly examined the general experiences gained from international clinical placement programme but have not specifically focussed on the setting of paediatric wards in hospitals. Nursing students are required to acquire knowledge of paediatric nursing with children as patients.Design and methodIn this qualitative study, a hermeneutic, phenomenological approach was adopted. Data were collected through individual interviews with eight nurses after they participated in an international clinical placement programme as nursing students in a paediatric ward.ResultsMeetings with children’s destinies as patients were overwhelming, being an observer provided insights into and an overview of paediatric nursing, access to the resources required for treating children is limited, nurses had a different role and parents had an extended caring role.ConclusionAll participants gained knowledge of children as patients at a hospital and also gained knowledge of the parents’ and nurses’ roles and the treatment methods of various diseases that are relevant to paediatric nursing. This helped provide them with the cultural knowledge, awareness and sensitivity required, given the contrasting situation at their home country.     

护理本科生对护理关怀行为的认知及其影响因素

目的探讨护理本科生对护理关怀行为的认知及其影响因素,为培养护生的关怀理念、关怀能力及关怀行为提供依据。方法采用关怀维度测量表（caring di mensions inventory,CDI）对4个年级210名护生集中进行问卷调查。结果护生CDI测量结果总分为（74.43±13.61）分,属于中等程度,且随着年级升高呈现下降趋势。得分最高的5项依次为：真诚对待患者,把患者视为整体的人,为患者保密,观察患者的用药效果,指导患者有关自我照顾的事宜;得分最低的5项依次为：与患者分享你的个人问题,探究患者的生活方式,与患者同座,保持患者家属的知情,把患者需要放在首位。护生每学期参加社会活动次数、对护理关怀重要性的认同、对护理课程的兴趣等因素与关怀行为的认知呈显著正相关（P〈0.01）。结论护理本科生对护理关怀行为的认知水平有待提高,应对护生加强整体护理内涵及护理观念的教育,且重视学校、社会、家庭和临床的共同参与。可以通过增加学生社会活动的次数、促进学生对护理关怀重要性的认同及提升学生对护理课程的学习兴趣等措施来提高护生护理关怀行为的认知水平。     

Pre-registration nursing students' experience of caring for cancer patients.

The preparation of nurses caring for cancer patients remains a topical subject. The recent emphasis on the preparation of an effective and informed workforce for cancer care at all nursing levels is significant, particularly as the majority of previous studies have traditionally focused on post-registration preparation of qualified nurses. Currently, there is limited information on the preparation of pre-registered nursing students and little is known about the experiences of these students, especially during their initial exposure to cancer patients. Recently, changes have also been made to the pre-registration nursing programmes in the UK in line with national recommendations leading to much earlier exposures to patient care in practice. This study provides information about nursing students' experiences of caring for cancer patients. Using self-report questionnaires each comprising of 21 Likert scale items, a survey was conducted on a total of 134 students (response rate: 88%) enrolled on the common foundation programme at the end of the first year of their undergraduate nursing programme. Data collected included information about the types of clinical settings where students were exposed to cancer patients, perceptions of their experiences with cancer patients and aspects of educational and clinical inputs perceived as helpful in preparing them to care for cancer patients. Additional insight into the students' experience was further obtained from semi-structured interviews conducted from a total of nine students drawn from the three categories of experiences they identified: positive, non-positive and mixed. The findings and implications for the preparation of pre-registration nursing students in caring for cancer patients were discussed in relation to the theoretical input, clinical support and the use of reflection in practice.     

A student-centered clinical educational unit--description of a reflective learning model

This article describes a model of a student-centered Clinical Education Unit (CEU) within an undergraduate nursing education programme. The model comprises three various levels of learning in the nursing education programme at School of Health Sciences, University College of Bor?s, Sweden. The three levels of learning correspond to the first, second and third programme years of the nursing education. Each level of learning is represented by clinical training in three different hospital care settings. The educational model was developed through a co-operation between hospital representatives and nurse educators at the university college. The model is built on a human caring science perspective and knowledge that focuses on patients' lived experience of their care and illness. The model emphasises collaboration in communion between students, hospital and faculty members as an alternative to bridge the gap between theory and practice in nursing. Reflection and critical thinking are the vital components in a clinical learning environment.     

Student nurses' experiences of caring for infectious patients in source isolation. A hermeneutic phenomenological study

Aim. To illuminate issues central to general student nurses’ experiences of caring for isolated patients within the hospital environment, which may assist facilitators of learning to prepare students for caring roles. Background. Because of the development of hospital‐resistant micro‐organisms, caring for patients in source isolation is a frequent occurrence for supernumerary students on the general nursing programme. Despite this, students’ perceptions of caring for this client group remain under researched. Design and methods. Through methods grounded in hermeneutic phenomenology, eight students in the second year of the three‐year undergraduate programme in general nursing were interviewed using an un‐structured, open‐ended and face‐to‐face interview approach. Data analysis was approached through thematic analysis. Results. Four themes emerged: The organization: caring in context, Barriers and breaking the barriers, Theory and practice, Only a student. The imposed physical, psychological, social and emotional barriers of isolation dramatically alter the caring experience. Balancing the care of isolated patients to meet their individual needs while preventing the spread of infection has significance for students. Applying infection control theory to the care of patients in source isolation is vital for students’ personal and professional development. Perceptions of supernumerary status influence students’ experiences of caring for these patients. Relevance to clinical practice. Designating equipment for the sole use of isolated patients assists students in maintaining infection control standards. Balancing the art and science of caring for patients in source isolation is important to reduce barriers to the student–patient relationship and to promote delivery of holistic care. Staff nurses should consider using available opportunities to impart recommended isolation practices to students thereby linking the theory of infection control to patient care. Providing structured, continuing education for all grades of staff would acknowledge the interdependence of all healthcare workers in controlling hospital‐acquired infection.     

Faculty-student interactions and the student-perceived climate for caring.

The identification of caring as a core value for nursing practice elaborates the need to investigate the educational processes through which caring can be learned by those who will assume primary caregiver roles. Using qualitative inquiry, this study was conducted to describe a climate for caring as perceived by 10 junior nursing students and to identify faculty behaviors and faculty-student interactional episodes through which these students experience a climate for caring. Consistent with one researcher's conceptualization of the components of a moral education, the findings from this study suggest that modeling, dialogue, practice, and confirmation are the faculty-student interactional processes through which these students experienced a climate for caring.     

The caring concept,its behaviours and obstacles: perceptions from a qualitative study of undergraduate nursing students

Developing caring competences is considered to be one of the most important aims of undergraduate nursing education and the role of clinical placement is recognised as special in this regard. Students' reflection on caring, their experience and obstacles in being caring is recommended as a key strategy in the process of teaching and studying the nursing discipline. Therefore, the aim of this study was to describe the concept of caring, its manifestations and possible obstacles while caring, as perceived by first‐year nursing students before and after their first clinical placement. Qualitative content analysis of 15 Polish students' narratives written before and after their clinical experience in the form of text‐diaries was undertaken. The findings revealed that students entered their nursing education with a deep humanistic vision of caring both on theoretical and practical levels and the first clinical placement has enriched this vision. Expressive caring was more appreciated by students than the instrumental one and their concept of caring was coherent with the caring behaviours as described in their narratives. Several internal and external obstacles for caring have been reported by students, indicating a specific tension between their ideal of caring and their practical experience of caring in the clinical reality.     

Nursing students' perceptions of the importance of caring behaviors

Title. Nursing students’ perceptions of the importance of caring behaviours Aim. This paper is a report of a study to determine the nursing students’ perceptions of the importance of caring behaviours. Background. Caring has been considered as the essence of nursing. It is believed that caring enhances patients’ health and well‐being and facilitates health promotion. Nursing education has an important role in educating the nurses with adequate caring abilities. Method. Ninety nursing students (response rate 75%) responded to a questionnaire consisting of 55 caring behaviours adapted from items on Caring Assessment Questionnaire (Care‐Q). Behaviours were ranked on a 5‐point Likert‐type scale. The caring behaviours were categorized in seven subscales: ‘accessibles’, ‘monitors and follows through’, ‘explains and facilitates’, ‘comforts’, ‘anticipates’, ‘trusting relationship’ and ‘spiritual care’. Data were collected in Iran in 2003. Findings. The students perceived ‘monitors and follows through’ (mean = 4·33, SD = 0·60) as the most and ‘trusting relationship’ (mean = 3·70, SD = 0·62) as the least important subscales. ‘To give patient’s treatments and medications on time’ and ‘to do voluntarily little things…’ were the most and least important caring behaviours, respectively. ‘Explains and facilitates’ statistically and significantly correlated with age (r = 0·31, P = 0·003) and programme year (r = 0·28, P = 0·025). Gender had no statistically significant influence on students’ perceptions of caring behaviours. Conclusion. Further research is needed, using longitudinal designs, to explore nursing students’ perceptions of caring behaviours in different cultures, as well as evaluation studies of innovations in curriculum and teaching methods to improve learning in relation to cultural competence and caring concepts.     

实习中期护生人文关怀能力与同理心的相关性研究

[目的]探讨实习中期护生人文关怀能力与同理心水平,明确两者之间的关系及影响人文关怀能力的因素,为改进临床教学方法,进一步提高实习护生人文关怀能力提供参考资料。[方法]采用实习护生人文关怀能力评价量表（HCANU）、Jefferson同理心量表一中文版（JSE—CV）对98名实习中期护生进行问卷调查。[结果]实习中期护生的人文关怀能力及同理心总体处于中上等水平,得分分别为（70．17±8．04）分和（105．86±13．41）分;其中,同理心与人文关怀能力总分及灌输信念和希望、人道及利他价值观、提供良好环境、促进情感交流4个维度呈正相关（P〈0．01）,且表现出较强的预测能力（P〈0．05）。[结论]提高实习护生的同理心、改善实习环境、培养职业价值感等可有效提高其人文关怀能力,为建立人文关怀能力的临床培养路径提供了参考依据。     

Nursing students’ evolving professional values: Capturing their journey through co-operative inquiry

Aim/objective and BackgroundDespite a worldwide emphasis in nursing codes of practice that state nurses must uphold professional values to be caring and compassionate, evidence continues to emerge of poor-quality care standards. Existing literature attests to a tendency to deteriorating caring values as students’ progress through their nursing programme. In response, one university in England exposed pre-registration nursing students to a values-based curriculum which embedded Todres et al.’s (2009) Humanising Values Framework.Design and MethodsThis paper describes the later stages of a co-operative inquiry, where students as participants explore their evolving values around person-centred approaches to care as they engaged with clinical practice. Data were collected between 2013 and 2016.Results and ConclusionFindings reveal how students developed their confidence and resilience in the face of situations that challenged their value base by internalising a humanised approach to care. They demonstrated this in practice by using problem-based coping strategies, peer and mentor support. Engagement with a curriculum based on humanistic philosophy encouraged students as participants to feel confident in the practice of person-centred care.     

Being with the carer: a dimension of the caring process

This study presents one of the dimensions of the caring process in nursing, under the nurses' view, in a hospital reality. It was brought to understanding through a qualitative study with a phenomenological-hermeneutical approach. One of the dimensions revealed was to be with the carer in the world of the cared patient which revealed the following constructs: the being-there of the nursing carer; sharing decision making processes; sharing knowledge; building up a caring relationship. The caring process in nursing manifests itself by meeting caring among carers, where the way of being of its existence happens in an authentic way, promoting an exchange of lived experiences, feelings and emotions, building up a caring relationship.     

Predicting factors of positive orientation and attitudes towards nursing: A quantitative cross-sectional study

BackgroundPrevious studies have identified various reasons for students to choose a career in nursing. Students at the start of their programme hold a great variety of images and perceptions of nursing which can affect their orientation and attitudes towards their future profession.ObjectivesThis paper aims to examine nursing students' orientation and attitudes towards nursing at the beginning of their educational programme, and to explore predictors of positive orientation and attitudes.DesignThe study used a quantitative cross-sectional design.SettingsA survey was conducted among first-year nursing students at four nursing universities of applied sciences in the Netherlands.ParticipantsQuestionnaires were administered to all students enrolled in a bachelor of nursing programme (n = 1414) at these universities.MethodsRespondents completed a survey consisting of: 1) Nursing Orientation Tool, 2) Nursing Attitude Questionnaire, and 3) demographic data such as gender, living status, nursing experience, preliminary training, first-choice programme, and career choice. Kruskal Wallis tests, with post hoc Mann Whitney U tests, were used to compare group scores. Multiple regression was performed to investigate predictors of positive orientation and attitudes towards nursing.ResultsStudents in this study sample (n = 1244) strongly agreed with statements related to caring, nursing expertise, professional nursing knowledge and the application of this knowledge. Predictors of positive orientation and attitudes towards nursing include having nursing/caring experience, indicating nursing as the first choice for study, preliminary vocational training, and a desire to make a career in nursing.ConclusionsData from this survey suggest a link between personal and environmental characteristics and motivations to select nursing as a career. Understanding which factors predict positive orientation and attitudes towards nursing could offer educators a tool in the recruitment and selection assessment of new students.     

关怀性触摸对失能老年人抑郁症状的干预效果

目的探索关怀性触摸对失能老年人抑郁症状的干预效果。方法由接受过培训的36名护生对某养老院36名失能老人(其中22名为重度抑郁患者、14名为轻度抑郁患者)进行连续6个月的关怀性触摸。干预前后,对失能老人和护生分别采用老年抑郁量表(geriatric depression scale,GDS)和护士人文关怀品质量表(护生版)进行测量。结果干预后失能老人的GDS得分低于干预前,护生的人文关怀品质评价量表得分优于干预前,差异均有统计学意义(均P0.05)。结论关怀性触摸不仅有助于改善失能老人的抑郁状况,同时能有效提高护生人文关怀品质。     

Reflections on caring narratives: enhancing patterns of knowing

The purpose of this study was to provide graduate students with the opportunity to enrich their esthetic knowing and acquire the meaning of caring in their practice by reflecting on their caring narratives. Content analysis examining for context, process, and fulfillment was used to analyze 68 caring encounters written by five classes of graduate nursing students over five semesters of course work. This article focuses on the value of reflection in knowing and the fulfillment identified by the students through the reflective process. Student fulfillment included reflecting on the need to care for self, knowing that emotional attachment can be dangerous, recognizing caring as a moral responsibility, attending to caring teaches one about caring, and reflecting on caring encounters engages one in defining caring. It is concluded that graduate nursing students can enhance multiple ways of knowing and their understanding of caring through the process of reflecting on caring encounters.     

《关怀与照护》课程后对学生人文关怀认知行为的调查分析

目的:了解学习《关怀与照护》课程后,学生的关怀知识、态度、行为情况,分析其相关影响因素,使《关怀与照护》课程的教学目标和方法更具针对性和有效性。方法:在《关怀与照护》课程结束后1周,采用问卷调查法对本学期参加本门课程学习的105名本科生进行调查。结果:学生关怀知识、关怀态度、关怀行为得分较高;男女学生、不同年级学生、不同民族学生、是否独生子女学生在关怀知识总分、态度总分和行为总分的评分差异无统计学意义,护理学专业和非护理专业学生在态度维度、知识总分的评分无明显差异,在总分、行为总分方面,护理学专业的评分低于非护理专业;学生知识总分、态度总分、行为总分、总分之间存在着相关性。结论:开设《关怀与照护》课程对本科生树立关怀意识、培养关怀态度和践行关怀行为有积极意义。     

基础护理操作训练中提升护生人文关怀能力的研究

目的：探索基础护理操作训练中渗透人文关怀能力要素对提高护生人文关怀能力的效果。方法选择护理本科二年级护生86名,按学生选课分为干预组与对照组,干预组45人,对照组41人,干预前两组护生在一般社会学资料及人文关怀能力基线水平方面无明显差别( P﹥0.05)。对照组护生接受传统的护理技能训练,教师采用讲解、演示-模仿练习-回复示教的模式进行授课。干预组采用引导-行动-反思的模式将人文关怀要素融入护理操作训练中,干预时间为5个月。干预后采用护理专业大学生人文关怀能力量表进行效果评价。结果干预前低年级护生人文关怀能力的水平较低,总均分为(109.90±48.8)分,得分指标为48.8％。干预后干预组护生人文关怀能力较干预前有所提高,而对照组人文关怀能力得分下降,两组间人文关怀能力的变化有明显差别(P<0.05),特别是“灌输信念和希望”“健康教育”“科学解决健康问题”维度。结论采用引导-行动-反思的模式将人文关怀要素融入护理操作训练中能明显提升护生人文关怀能力。     

护理本科学生人文关怀能力现状调查

目的 调查护理本科学生人文关怀能力,并分析不同性别和不同年级学生人文关怀能力的差异.方法 采用Nkongho关怀能力量表,对421名护理本科学生进行横断面问卷调查.结果 护理本科学生关怀能力各维度得分低于国际护理关怀能力评分标准(P＜0.001).女生的关怀能力高于男生(P＜0.001),低年级学生的关怀能力高于高年级学生(P＜0.05).结论 护理专业学生整体关怀能力偏低.护理院系应建立学生早期接触临床的机制,进一步改善护理人文课程教学,将人文关怀教育融入到护理专业课教学中,以提升学生的关怀能力.