Effects of bloom’s mastery learning model based on CBRN preparedness program on learning skills of nursing students: A randomized controlled trial

BackgroundExposure to chemical, biological, radiological and nuclear (CBRN) threats and hazards can have fatal or disabling consequences. One of the most risky groups in terms of secondary contamination in CBRN exposure is healthcare workers. Nurses need to have several competencies to be able to respond correctly to people exposed to CBRN agents and to protect themselves from secondary contamination.AimThis study aimed to investigate the effectiveness of a Bloom’s Mastery Learning Model-based Chemical, Biological, Radiological, Nuclear Threat and Hazards Preparedness Program for nursing students (MLM-CBRN Preparedness Program) as a means for improving knowledge, attitudes, self-efficacy and skills.DesignA parallel-group trial design was used.MethodsA total of 104 4th-year nursing students were randomized into intervention and control groups. The data from the participants were collected before the intervention, immediately after the intervention and in the 1st and 3rd months after the intervention.ResultsAfter the intervention, a significant difference was observed between the groups in terms of knowledge, attitude and self-efficacy scores. It was seen that there was a significant difference between the pre-intervention measurement (1st measurement) and the 2nd, 3rd and 4th measurements (Table 2). This was due to the increasing scores of the intervention group (p < 0.05).ConclusionsIt shows that the MLM-CBRN Preparedness Program is effective in increasing the knowledge, attitude, self-efficacy and skill development of student nurses about CBRN threats and dangers.     

Effects of prenatal yoga on women’s stress and immune function across pregnancy: A randomized controlled trial

ObjectiveThe effects of prenatal yoga on biological indicators have not been widely studied. Thus, we compared changes in stress and immunity salivary biomarkers from 16 to 36 weeks’ gestation between women receiving prenatal yoga and those receiving routine prenatal care.DesignFor this longitudinal, prospective, randomized controlled trial, we recruited 94 healthy pregnant women at 16 weeks’ gestation through convenience sampling from a prenatal clinic in Taipei. Participants were randomly assigned to intervention (n = 48) or control (n = 46) groups using Clinstat block randomization.InterventionThe 20-week intervention comprised two weekly 70-min yoga sessions led by a midwife certified as a yoga instructor; the control group received only routine prenatal care.Main outcome measuresIn both groups, participants’ salivary cortisol and immunoglobulin A levels were collected before and after yoga every 4 weeks from 16 to 36 weeks’ gestation.ResultsThe intervention group had lower salivary cortisol (p < 0.001) and higher immunoglobulin A (p < 0.001) levels immediately after yoga than the control group. Specifically, the intervention group had significantly higher long-term salivary immunoglobulin A levels than the control group (p = 0.018), and infants born to women in the intervention group weighed more than those born to the control group (p < 0.001).ConclusionPrenatal yoga significantly reduced pregnant women’s stress and enhanced their immune function. Clinicians should learn the mechanisms of yoga and its effects on pregnant women. Our findings can guide clinicians to help pregnant women alleviate their stress and enhance their immune function.     

Effects of two retraining strategies on nursing students’ acquisition and retention of BLS/AED skills: A cluster randomised trial

AimTo determine and compare the effects of two different retraining strategies on nursing students’ acquisition and retention of BLS/AED skills.MethodsNursing students (N = 177) from two European universities were randomly assigned to either an instructor-directed (IDG) or a student-directed (SDG) 4-h retraining session in BLS/AED. A multiple-choice questionnaire, the Cardiff Test, Laerdal SkillReporter^® software and a self-efficacy scale were used to assess students’ overall competency (knowledge, psychomotor skills and self-efficacy) in BLS/AED at pre-test, post-test and 3-month retention-test. GEE, chi-squared and McNemar tests were performed to examine statistical differences amongst groups across time.ResultsThere was a significant increase in the proportion of students who achieved competency for all variables measuring knowledge, psychomotor skills and self-efficacy between pre-test and post-test in both groups (all p-values < 0.05). However, at post-test, significantly more students in the SDG achieved overall BLS/AED competency when compared to IDG. In terms of retention at 3 months, success rates of students within the IDG deteriorated significantly for all variables except ≥70% of chest compressions with correct hand position (p-value = 0.12). Conversely, the proportion of students who achieved competency within the SDG only decreased significantly in ‘mean no flow-time≤5s’ (p-value = 0.02). Furthermore, differences between groups’ success rates at retention-test also proved to be significantly different for all variables measured (all p-values < 0.05).ConclusionThis study demonstrated that using a student-directed strategy to retrain BLS/AED skills has resulted in a higher proportion of nursing students achieving and retaining competency in BLS/AED at three months when compared to an instructor-directed strategy.     

Comparison of the effectiveness of two styles of case-based learning implemented in lectures for developing nursing students’ critical thinking ability: A randomized controlled trial

PurposeTo explore and compare the effectiveness of two styles of case-based learning methods, unfolding nursing case and usual nursing case, implemented in lectures for developing nursing students’ critical thinking ability.Methods122 undergraduate nursing students in four classes were taught the subject of medical nursing for one year. Two classes were randomly assigned as the experimental group and the other two the control group. The experimental group received the lectures presenting unfolding nursing cases and the control group was taught the usual cases. Nineteen case-based lectures were provided in 8 months in two semesters to each group.ResultsThe two groups started with a similar level of critical thinking ability as tested by the instrument of Critical Thinking Disposition Inventory—Chinese version (CTDI-CV). After receiving 19 case-based learning lectures for 8 months, both groups of students significantly improved their critical thinking ability. The improvement in the experimental group was significantly higher than that in the control group (with the average total score of 303.77 ± 15.24 vs. 288.34 ± 13.94, p < 0.05). The experimental group also had significantly better improvement in six out of seven dimensions whereas the control group showed improvement in only three out of seven dimensions of CTDI-CV.ConclusionsThe study suggests the feasibility of implementing case-based learning in lectures. Unfolding nursing cases appear to be significantly more effective than the usual nursing cases in developing undergraduate nursing students’ critical thinking ability in the subject of medical nursing. Further research can implement the unfolding nursing cases in other nursing subjects.     

The effects of family-centered affective stimulation on brain-injured comatose patients’ level of consciousness: A randomized controlled trial

BackgroundDespite the well-defined effects of sensory stimulation, the knowledge of the pure effects of affective stimulation is scarce.ObjectiveTo evaluate the effects of family-centered affective stimulation on the level of consciousness among comatose patients with brain injuries.DesignThis study was designed as a three-group double-blinded Randomized Controlled Trial.MethodsNinety consecutive patients with traumatic brain injuries and a Glasgow Coma Scale score of 5–8 were selected. Patients were randomly allocated to an experimental, a placebo, and a control group using permuted block randomization. Affective stimulation intervention was provided to patients in the experimental group by their family members twice a day during the first seven days of their hospitalization. In the placebo group, a sensory stimulation program was implemented by a fixed trained person who was not familiar with the patients. Patients in the control group solely received sensory stimulation which was routinely provided to all patients. The level of consciousness among the patients using the Glasgow Coma Scale and Coma Recovery Scale-Revised were measured both before and after a family visit. The SPSS software (version 17.0) was used to analyze the data through running the one-way and the repeated measure analyses of variance.ResultsDespite an insignificant difference among the groups regarding baseline level of consciousness, the results of the one-way analysis of variance revealed at the seventh day of this study, however, the level of consciousness in the experimental group was significantly higher (9.1 ± 2.1) than the placebo (7.2 ± 1.1), the control groups (6.6 ± 1.7) (P < 0.001), subsequently. Moreover, at the seventh day of the study, the Coma Recovery Scale score in the experimental group (11.9 ± 3.7) was significantly greater than the placebo (9.0 ± 2.0) and the control (6.6 ± 1.6) groups (P < 0.001). Recovery rate and effect size values also confirmed the greater effectiveness of affective stimulation compared with pure sensory stimulation.ConclusionOur findings in this study indicate that early family-centered affective stimulation is more effective than sensory stimulation in improving the level of consciousness among comatose patients with brain injuries. Family-centered affective stimulation is recommended to be integrated into the nursing curricula and routine care plans for comatose trauma patients in intensive care units.     

Effect of foot reflexology on neonates’ clinical outcomes with hyperbilirubinemia undergoing phototherapy: A randomized controlled trial

BackgroundNeonatal hyperbilirubinemia is the most common reason for neonatal admissions to the Neonatal Intensive Care Unit that can progress to critical levels. Foot reflexology therapy is one of the complementary alternative therapies that can help to upgrade neonatal clinical outcomes with hyperbilirubinemia.AimThis study aimed to investigate the effect of foot reflexology on neonates’ clinical outcomes with hyperbilirubinemia undergoing phototherapy.DesignA Quasi-experimental two groups research design was used to accomplish this study.MethodsThis study was conducted at Neonatal Intensive Care Unit in Alexandria University Children's Hospital at Smouha, Alexandria on 60 full-term neonates with hyperbilirubinemia undergoing phototherapy, were randomly assigned to two groups Neonates of the control group were received only phototherapy for hyperbilirubinemia, While foot reflexology neonates received intervention on the gastrointestinal system zone for 20 min in the morning before feeding once daily for consecutive five days beside phototherapy.Resultsfoot reflexology neonates exhibited a decrease in total bilirubin level to 7.9000 ± 1.81545 on the fifth day compared to 10.1633 ± 1.77054 for the control group neonates. A decline in the mean duration of undergoing phototherapy for neonates in the foot reflexology group to 4.30 ± 0.466 on the contrary with 5.00 ± 1.017 days for the control group.ConclusionApplication of foot reflexology is effective in improving the full-term neonates’ clinical outcomes with hyperbilirubinemia undergoing phototherapy. Thus, this non-pharmacological method is recommended as a supplement treatment for neonates with hyperbilirubinemia beside phototherapy.     

Examining the impact of virtual clinical on prelicensure nursing students’ pediatric knowledge

BackgroundClinical site closure during a pandemic along with the already limited pediatric clinicalplacements challenged educators to develop virtual pediatric clinical experiences. This paper aims toshare a pediatric virtual clinical innovation and retrospectively evaluate its impact on undergraduatepediatric nursing student knowledge.MethodA quasi-experimental natural design was used to retrospectively evaluate a virtual clinicaleducational innovation at one mid-sized, Midwest university. The first half of a student cohortcompleted traditional face-to-face clinical experiences. Simulation and commercially available productswere used to create a 100% pediatric virtual clinical experience for the other half of a student cohort. Course and standardized exam scores were used to measure student learning across the two groups.ResultsFindings suggest virtual clinical, as a replacement for traditional clinical, did not negatively impact students pediatric nursing knowledge.ConclusionsThe results of this natural experiment can support future discussions about pediatric nursing clinical education.     

The effect of multimedia-based education in e-learning on nursing students’ academic success and motivation: A randomised controlled study

BackgroundStudents who receive e-learning in nursing education state that they cannot learn the lessons effectively. This study aims to evaluate the effect of multimedia teaching materials on students' academic achievement and motivation in e-learning.MethodsThe quasi-experimental study was performed on 70 students. The experimental group students were presented with multimedia materials, and the control group students were taught the e-learning course.ResultsIn this study, regarding the effect of multimedia-based education on students’ Instructional Materials Motivation Survey, the mean score of the control group was 85.25 ± 11.95, and the mean score of the experimental group was 94.44 ± 11.82 after the intervention. A moderately significant positive correlation was found between the experimental group's average academic achievement and total scale scores.ConclusionThe study results show that the participants accepted the important role of multimedia as practical learning compared to traditional learning methods. Given the impact of multimedia-based education on academic achievement, this approach can be used to teach other core subjects to nursing students.     

Exercise on balance and function for knee osteoarthritis: A randomized controlled trial

Objectives

To assess balance and function of symptomatic and asymptomatic subjects with knee osteoarthritis (OA) and investigate the influence of physical exercise.

Undergraduate nursing students’ experiences of online education: A cross-sectional survey

During the coronavirus pandemic, UK Academics were required to adjust their learning and teaching environment and pedagogical approaches, with little guidance or time. Feelings of frustration and uncertainty around student engagement were commonplace across Higher Education Institutions. This was heightened in professionally regulated courses, such as nursing. The shift to online learning created a situation where academics were frequently faced with a ‘sea of black screens’ and unable to ascertain student engagement.This study investigated undergraduate nursing students’ experience of online education during the COVID-19 pandemic. An anonymous survey was distributed to each year of the undergraduate nursing programme and data subsequently analysed. Responses from 54 students revealed that engagement varied between different year groups. There were significant differences between those with pre-COVID (traditional face-to-face) teaching experience (years 2 and 3) and those without (year 1) in regard to self-reported engagement with online learning. The findings from this study revealed some powerful and emotional insights into the experience of online learning amongst UK students undertaking an undergraduate nursing programme during the COVID-19 pandemic.     

The effect of the Mediterranean diet on cognitive function in patients with Parkinson’s disease: A randomized clinical controlled trial

ObjectivesParkinson’s disease (PD) is the second most common neurodegenerative disorder. It is proposed that adherence to the Mediterranean diet might have a beneficial effect on the prevention and treatment of PD and its complications. Thus, the aim of this study was to investigate the effects of the Mediterranean diet on cognitive function in patients with PD.DesignThe study was a single-center, randomized clinical trial. Eighty patients with idiopathic PD were randomly allocated to the Mediterranean diet (n = 40) or control (n = 40) group. Patients in the intervention group received an individualized dietary plan based on Mediterranean diet for 10 weeks. The Persian version of Montreal Cognitive Assessment (MoCA) test was used to assess the cognitive function at baseline and the end of the study.ResultsThirty-five PD patients with a mean age of 59.3 ± 8.3 and 35 patients with a mean age of 58.6 ± 9.3 finished the study in intervention and control groups, respectively. After the intervention, the mean score of the dimensions of executive function, language, attention, concentration, and active memory and the total score of cognitive assessment significantly increased in the intervention compared with the control group (p < 0.05, for all). Nevertheless, the mean of the other scores including spatial-visual ability, memory learning task, and navigation versus time and place did not significantly change in both intervention and control groups.ConclusionsThe findings of this study showed that adherence to the Mediterranean diet remarkably increased the dimensions of executive function, language, attention, concentration, and active memory and finally the total score of cognitive assessment in PD patients.     

The effect of Benson’s relaxation response on sleep quality and anorexia in cancer patients undergoing chemotherapy: A randomized controlled trial

Background and objectivesPatients with cancer experience many side effects due to its nature and usual treatments. Sleep disorders and anorexia are the most commonly reported symptoms in cancer patients undergoing chemotherapy. The present study aimed to investigate the effect of Benson's Relaxation Response (BRR) on sleep quality and anorexia in cancer patients undergoing chemotherapy.Methodology and participantsIn the present clinical trial, a total of 84 patients were enrolled and randomly divided into two groups of experimental and control. Benson's relaxation response was administered to the experimental group twice a day over 5 consecutive days. Data was collected using St. Mary's Hospital Sleep Questionnaire (SMHSQ) and anorexia questionnaire with Visual Analog Scale (VAS).ResultsThe results of our study showed a significant improvement in the sleep quality in the experimental group at 24 (p = 0.02) and 48 (p = 0.001) hours after the intervention compared to the control group. Benson's relaxation response (BRR) also had a significant effect on the anorexia in the experimental group at 24 (7.5 ± 1.6) and 48 (6.9 ± 2.1) hours after the intervention compared to the control group. No side effects were reported during the study and follow-up period.ConclusionBenson's relaxation response as a complementary method may improve sleep quality and anorexia in cancer patients undergoing chemotherapy. Further studies with greater sample size and longer follow-up period are needed to confirm the current findings.     

The efficacy of Tung’s acupuncture for sex hormones in polycystic ovary syndrome: A randomized controlled trial

BackgroundPolycystic ovary syndrome (PCOS) is a common and heterogeneous endocrine disorder in reproductive-age women. Tung's acupuncture, a Traditional Chinese Medicine (TCM) treatment, is widely used for PCOS in East Asia, but evidence on its efficacy is rare. The aim of this RCT study was to examine whether the Tung’s acupuncture could be a complementary treatment method for PCOS.MethodsA total of 60 PCOS patients were randomly assigned to a Tung's acupuncture group (n = 30) or a cyproterone acetate/ethinylestradiol (CPA/EE) group (n = 30). Each participant received treatments for 12 weeks to assess the short-term treatment efficacy and then followed up for another 12 weeks to assess the long-term treatment efficacy. The primary outcome examined was change in the ratio of luteinizing hormone (LH) to follicle-stimulating hormone (FSH); the secondary outcomes examined were changes in body mass index (BMI), LH, FSH, total testosterone (TT), ovarian volume, polycystic ovary number and menstrual frequency.ResultsBoth groups showed significant reductions in the LH/FSH ratio, LH and TT after 12-week treatment (p < 0.001) and 12-week follow-up (p < 0.05). No significant differences existed between the two groups (p > 0.05). Both groups showed significant improvement in BMI, menstrual frequency and polycystic ovary number after 12-week treatment (p < 0.05).ConclusionCompared with CPA/EE, Tung’s acupuncture showed no better improvement on LH/FSH ratio for PCOS although it could reduce the ratio. Tung's acupuncture might have some effect on long-term weight control and menstruation frequency. Further studies addressing this study’s limitations are recommended.