Supportive counselling programme for nursing students experiencing academic failure: randomized controlled trial

Title.  Supportive counselling programme for nursing students experiencing academic failure: randomized controlled trial.
Aim.  This paper is a report of a study examining the effects of a supportive counselling programme on the academic performance of Iranian nursing students experiencing academic failure.
Background.  In order to using limited educational resources effectively, nursing students experiencing academic failure should be immediately identified in order that appropriate intervention can take place.
Method.  Data were collected over a 12-month period in 2006–2007, with 42 Bachelor of Science nursing students who displayed poor academic performance. They were randomly allocated to receive either supportive or ordinary counselling. The mean grades in basic theoretical courses, special courses, and also the combination of both basic and special courses was compared between the two groups.
Findings.  Over the study period, there were improvements in the mean grades of special courses and also in both basic and special courses of male students in the experimental group, compared with those of male students in the control group (0·27 against −1·43, P  = 0·014; and 1·87 against −0·40, P  = 0·009; respectively).
Conclusion.  A supportive counselling programme can improve the academic performance of male nursing students. Replication of the current study with larger samples and longer duration is recommended.     

Positive psychotherapy for depression and self‐efficacy in undergraduate nursing students: A randomized,controlled trial

Nursing students across the globe experience depressive symptoms, and many interventions have been used to alleviate their depression. However, few interventions focus on students' personal strengths and advantages. The aim of the present study was to explore the effects of an 8‐week group positive psychotherapy (PPT) programme on depression and self‐efficacy in full‐time undergraduate nursing students. A randomized, controlled trial was conducted for 76 nursing students (34 in the experimental group, 42 in the control group). The Beck Depression Inventory‐II and the General Self‐Efficacy Scale were used to collect data prior to, immediately after PPT, 3 months', and 6 months' post‐PPT. Repeated‐measures analysis of variance indicated that the intervention significantly alleviated depression and improved self‐efficacy (each P < 0.05); the effect of time and time–group interaction was also significant (each P < 0.05). The findings suggest that PPT could significantly relieve depressive symptoms and improve self‐efficacy. We recommend that PPT is effective in alleviating depression and improving self‐efficacy in undergraduate nursing students. Academic mental health nurses should appreciate the value of PPT and consider incorporating it in psychological support methods in order to facilitate nursing students' mental health.     

Autogenic training to reduce anxiety in nursing students: randomized controlled trial

AIM: This paper reports a study to determine the effectiveness of autogenic training in reducing anxiety in nursing students. BACKGROUND: Nursing is stressful, and nursing students also have the additional pressures and uncertainties shared with all academic students. Autogenic training is a relaxation technique consisting of six mental exercises and is aimed at relieving tension, anger and stress. Meta-analysis has found large effect sizes for autogenic trainings intervention comparisons, medium effect sizes against control groups, and no effects when compared with other psychological therapies. A controlled trial with 50 nursing students found that the number of certified days off sick was reduced by autogenic training compared with no treatment, and a second trial with only 18 students reported greater improvement in Trait Anxiety, but not State Anxiety, compared with untreated controls. METHODS: A randomized controlled trial with three parallel arms was completed in 1998 with 93 nursing students aged 19-49 years. The setting was a university college in the United Kingdom. The treatment group received eight weekly sessions of autogenic training, the attention control group received eight weekly sessions of laughter therapy, and the time control group received no intervention. The outcome measures were the State-Trait Anxiety Inventory, the Maslach Burnout Inventory, blood pressure and pulse rate completed at baseline, 2 months (end of treatment), and 5, 8, and 11 months from randomization. RESULTS: There was a statistically significantly greater reduction of State (P<0.001) and Trait (P<0.001) Anxiety in the autogenic training group than in both other groups immediately after treatment. There were no differences between the groups for the Maslach Burnout Inventory. The autogenic training group also showed statistically significantly greater reduction immediately after treatment in systolic (P<0.01) and diastolic (P<0.05) blood pressure, and pulse rate (P<0.002), than the other two groups. CONCLUSION. Autogenic training has at least a short-term effect in alleviating stress in nursing students.     

The learning effectiveness of nursing students using online testing as an assistant tool: a cluster randomized controlled trial

With the rapid development of the Internet, online testing is becoming more widely-used in education. The purpose of this study is to explore the learning effectiveness of nursing students using online testing as an assistant tool. The participants were 146 junior college nursing students aged 19 to 20 taking the community health nursing course. With a class as the unit, three classes were randomized and allocated to one experimental group and two control groups. Two structured questionnaires were used to obtain the basic data, and the groups' examination results were also collected. The results of this study showed that before the intervention, there were no significant differences between the experimental and two control groups. After the intervention and adjusting for potential confounders, the score of midterm test in the experimental group was significantly better than those of the control groups. Over half of the students felt that answering 21 to 30 questions in 31 to 60 min for one unit of testing were appropriate. The results of this study showed that online testing is feasible for use as an assistant tool for learning. However, the positive effects of this approach appeared to be short- rather than long-term, and thus more studies are required in future.     

A tailored educational intervention improves doctor's performance in managing depression: a randomized controlled trial

Rational and objectives To assess the effects of a tailored and activating educational intervention, based on a three‐stage modified Prochaska model of readiness‐to‐change, on the performance of general physicians in primary care (GPs) regarding management of depressive disorders. Methods Parallel group, randomized control trial. Primary hypothesis was that performance would improve by 20 percentage units in the intervention arm. The setting was primary care in southern Tehran. The participants were 192 GPs stratified on stage of readiness‐to‐change, sex, age and work experience. The intervention was a 2‐day interactive workshop for a small group of GPs' at a higher stage of readiness‐to‐change (‘intention’) and a 2‐day interactive large group meeting for those with lower propensity to change (‘attitude’) at the pre‐assessment. GPs in the control arm participated in a standard educational programme on the same topic. The main outcome measures were validated tools to assess GPs' performance by unannounced standardized patients, regarding diagnosis and treatment of depressive disorders. The assessments were made 2 months before and 2 months after the intervention. Results GPs in the intervention arm significantly improved their overall mean scores for performance regarding both diagnosis, with an intervention effect of 14 percentage units (P = 0.007), and treatment and referral, with an intervention effect of 20 percentage units (P < 0.0001). The largest improvement after the intervention appeared in the small group: 30 percentage units for diagnosis (P = 0.027) and 29 percentage units for treatment and referral (P < 0.0001). Conclusions Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development.     

Effect of performance feedback on tracheal suctioning knowledge and skills: randomized controlled trial

Title. Effect of performance feedback on tracheal suctioning knowledge and skills: randomized controlled trial. Aim. This paper is a report of a study to determine whether individualized performance feedback improved nurses’ and physiotherapists’ knowledge and practice of tracheal suctioning. Background. Nurses’ knowledge and practice of tracheal suctioning is often deficient. Whilst teaching has been shown to improve suctioning knowledge and practice, this is not sustained over time. Method. Ninety‐five qualified healthcare professionals (nurses and physiotherapists) in two acute hospitals were randomly allocated to receive either individualized performance feedback or no additional feedback after a standardized lecture and practical demonstration of tracheal suctioning. Randomization was stratified by profession, seniority and site. Data were collected in 2005 in a clinical setting involving patients and a simulation setting. The outcome measures were knowledge and practice of tracheal suctioning, assessed by self‐completion questionnaire and structured observation. Results. In both settings, intervention groups performed statistically significantly better in terms of knowledge (P = 0·014) and practice (P = 0·037) at final follow‐up. Those who received performance feedback had statistically significantly higher knowledge (P = 0·004) and practice (P < 0·01) scores than the control group. For practice, there was also a relationship between professions (P < 0·01), with physiotherapists performing better than nurses overall, and an interaction between group and setting (P < 0·01), with performance feedback showing a stronger positive effect in the simulation setting. Conclusion. Retention of knowledge and tracheal suctioning practice is improved when training is followed up by tailored feedback on performance. Further research would shed light on how long such improvements are sustained, and whether the improvements seen in a simulated setting can be generalized to clinical settings.     

Effects of combination oral care on oral health,dry mouth and salivary pH of intubated patients: A randomized controlled trial

Intubated patients are at risk of oral health problems. Although a variety of oral care regimens for intubated patients have been studied, there is a lack of research on the effects of combination oral care that includes tooth brushing, chlorhexidine and cold water. This open‐labelled, randomized, controlled trial aimed to evaluate the effects of combination oral care on oral health status. Participants aged 20 years and older were recruited on the first day after intubation through convenience sampling in a medical intensive care unit. Random assignment was performed using an internet randomization service. The primary outcome was oral health status. Data were collected during May and June 2013. Participants were randomized to one of two groups (23 intervention and 21 control). The final analysis included 18 patients with combination oral care and 17 in the control group. The intervention group had better oral health (effect size = 1.56), less dry mouth and higher salivary pH than the control group. Any additional burden of providing combination oral care to patients who are mechanically ventilated is worthwhile in terms of clinical outcomes.     

Effects of the Phramongkutklao model on alcohol-dependent patient: a randomized controlled trial

This study was conducted to investigate the effects of Phramongkutklao (PMK) model at Department of Psychiatry and Neurology, Phramongkutklao Hospital. A randomized trial, assigned into the usual care (n = 53) or PMK model (n = 47) group. One hundred alcohol-dependent patients were assessed by using the 4th Diagnostic and Statistic Manual of Mental Disorder (DSM-IV) to diagnose alcohol dependence and Alcohol Use Disorders Identification Test (AUDIT) to determine the level of alcohol addiction. There were significant differences between usual care and PMK model groups on reducing or abstaining from alcohol consumption at 6-month follow-ups (p < 0.01). The participants in the PMK model group showed a total moderate quality of life, which was better than those in the usual care group after 6 months. According to the comparison of readiness to change outcome, the results showed a change to reduce or abstain from alcohol consumption in the PMK model group; in contrast, in the usual care group there was no change. The three situations positive, negative and craving drinking demonstrated significant in self-efficacy in the PMK model group. To conclude, the intensive inpatient rehabilitation (PMK model) intervention was more effective than usual care. Accordingly, this study was done in the setting at an inpatient psychiatric department; therefore, it could be generalized to any other similar areas.     

Rofecoxib in the acute treatment of migraine: a randomized controlled clinical trial

OBJECTIVE: To investigate the efficacy, tolerability, and safety of rofecoxib and ibuprofen for acute migraine treatment. BACKGROUND: Rofecoxib was effective and well tolerated in a previous study of treatment of a single migraine attack. We sought to replicate these findings for a single attack and also study the clinical profile of rofecoxib in the acute treatment of multiple migraine attacks. Ibuprofen was included as a reference nonselective NSAID. METHODS: Adult migraineurs (n = 783) treated one migraine attack with either rofecoxib (25 or 50 mg), ibuprofen 400 mg, or placebo in a randomized, double-blind study. Patients could elect to enroll in a 3-month double-blind extension phase. RESULTS: In the single-attack phase, headache relief at 2 hours postdose was reported by 59.4%, 62.2%, and 57.7% of patients who took rofecoxib 25 mg, rofecoxib 50 mg, and ibuprofen 400 mg, respectively, versus 30.5% for placebo (all P < .001 vs placebo). The active drugs were statistically superior to placebo on a variety of additional measures. In the extension phase, the mean percentage of patients' attacks with headache relief at 2 hours postdose was 61.8% for rofecoxib 25 mg, 65.4% for rofecoxib 50 mg, and 59.3% for ibuprofen 400 mg. The mean percentage of patients' attacks with 24-hour sustained headache relief was greater for rofecoxib 50 mg (52.0%) than for rofecoxib 25 mg (47.8%, P < .050) or ibuprofen (39.0%, P < .010). In the single-attack phase, the adverse event rate was higher for rofecoxib 50 mg (37.8%) than placebo (27.8%, P < .050); rates were similar to placebo for rofecoxib 25 mg (32.0%, n.s.) and ibuprofen 400 mg (28.1%, n.s.). In the extension phase, treatment groups had similar adverse event rates. CONCLUSIONS: Rofecoxib 25 and 50 mg and ibuprofen 400 mg were effective and generally well tolerated in the acute treatment of migraine.     

Evaluation of a bibliotherapy manual for reducing psychological distress in people with depression: a randomized controlled trial

Aim. This article reports a study to evaluate the efficacy of a self‐help manual in reducing psychological distress in individuals with moderate depression. Background. The prevalence of depression in Thailand is increasing markedly (e.g. from 56–197 per 100,000 population between 1997–2007). Design. We conducted a randomized controlled trial with 54 outpatients with depression in Chiang Mai Province in Thailand. Method. Participants were assigned randomly to an intervention or control group. The intervention group participants were given a self‐help manual in addition to standard care and treatment while the control group received standard care and treatment. Psychological distress was measured with the Kessler Psychological Distress Scale. Data were collected between October 2007–April 2008. Results. The findings showed statistically significant differences between both groups in their levels of psychological distress (e.g. tiredness, hopelessness, restlessness). At post‐test, the distress scores of the intervention group were lower than those in the control group. Between post‐test and 1‐month follow‐up, distress scores continued to decrease steadily in the intervention group but only decreased slightly in the control group. Conclusion. The findings affirm the benefits of bibliotherapy or self‐help therapy in book form in helping to reduce psychological distress in people with moderate depression. The approach is easy to use and can be incorporated as an adjunct to standard care and treatment. Bibliotherapy can be used by community mental health nurses and other clinicians to reduce psychological distress and promote recovery in people with moderate depression.     

Evaluation of a cognitive behavioural self-help manual for reducing depression: a randomized controlled trial

The prevalence of depression is increasing in Thailand. We used a randomized controlled trial to examine the effectiveness of a self-help programme in reducing depression in people with depression in Chiang Mai Province in Thailand. Fifty-six individuals diagnosed with moderate depression participated. They were assigned randomly to an intervention (n= 27) or control (n= 29) group. The intervention group were given a self-help manual along with standard care and treatment, while the control group continued to receive standard care and treatment. Both groups were also given a short weekly telephone call. The findings showed statistically significant differences between the groups, and within the intervention group, in their depression levels. Between baseline and post-test, a sharp decrease in depression was evident in the intervention group, whereas the level of depression increased in the control group. Between post-test and follow-up, a decrease was apparent in depression in both groups. However, the intervention group showed a much lower level of depression than the control group. The results support the use of bibliotherapy as an adjunct to mental health nurses' and other professionals' work in caring for people with moderate depression in the community. Trial Registration: http://www.ANZCTR.org.au/ACTRN12611000905965.aspx.