Stress, coping and satisfaction in nursing students

Aim. This article is a report of a study conducted to explore the relationship between sources of stress and psychological well-being and to consider how different sources of stress and coping resources might function as moderators and mediators on well-being.


Background. In most research exploring sources of stress and coping in nursing students, stress has been construed as psychological distress. Sources of stress likely to enhance well-being and, by implication, learning have not been considered.


Method. A questionnaire was administered to 171 final year nursing students in 2008. Questions were asked to measure sources of stress when rated as likely to contribute to distress (a hassle) and rated as likely to help one achieve (an uplift). Support, control, self-efficacy and coping style were also measured, along with their potential moderating and mediating effects on well-being, operationalized using the General Health Questionnaire and measures of course and career satisfaction.


Findings. Sources of stress likely to lead to distress were more often predictors of well-being than were sources of stress likely to lead to positive, eustress states, with the exception of clinical placement demands. Self-efficacy, dispositional control and support were important predictors, and avoidance coping was the strongest predictor of adverse well-being. Approach coping was not a predictor of well-being. The mere presence of support appeared beneficial as well as the utility of that support to help a student cope.


Conclusion. Initiatives to promote support and self-efficacy are likely to have immediate benefits for student well-being. In course reviews, nurse educators need to consider how students’ experiences might contribute not just to potential distress, but to eustress as well.

A Cluster Randomized Controlled Trial of an Adapted U.S. Model of Pharmaceutical Care for Nursing Home Residents in Northern Ireland (Fleetwood Northern Ireland Study): A Cost-Effectiveness Analysis

OBJECTIVES: To evaluate the cost-effectiveness of an adapted U.S. model of pharmaceutical care to improve psychoactive prescribing for nursing home residents in Northern Ireland (Fleetwood NI Study).
DESIGN: Economic evaluation alongside a cluster randomized controlled trial.
SETTING: Nursing homes in NI randomized to intervention (receipt of the adapted model of care; n511) or control (usual care continued; n511).
PARTICIPANTS: Residents aged 65 and older who provided informed consent (N5253; 128 intervention, 125 control) and who had full resource use data at 12 months.
INTERVENTION: Trained pharmacists reviewed intervention home residents’ clinical and prescribing information for 12 months, applied an algorithm that guided them in assessing the appropriateness of psychoactive medication, and worked with prescribers (general practitioners) to make changes. The control homes received usual care in which there was no pharmacist intervention.
MEASUREMENTS: The proportion of residents prescribed one or more inappropriate psychoactive medications (according to standardized protocols), costs, and a cost-effectiveness acceptability curve. The latter two outcomes are the focus for this article.
RESULTS: The proportions of residents receiving inappropriate psychoactive medication at 12 months in the intervention and control group were 19.5% and 50.4%, respectively. The mean cost of healthcare resources used per resident per year was $4,923 (95% con?dence interval.

Why is housing tenure associated with a lower risk of admission to a nursing or residential home? Wealth, health and the incentive to keep 'my home'

Background Previous research has shown that home ownership is associated with a reduced risk of admission to institutional care. The extent to which this reflects associations between wealth and health, between wealth and ability to buy in care or increased motivation to avoid admission related to policies on charging is unclear. Taking account of the value of the home, as well as housing tenure, may provide some clarification as to the relative importance of these factors.
Aims To analyse the probability of admission to residential and nursing home care according to housing tenure and house value.
Methods Cox regression was used to examine the association between home ownership, house value and risk of care home admissions over 6 years of follow-up among a cohort of 51 619 people aged 65 years or older drawn from the Northern Ireland Longitudinal Study, a representative sample of approximate to 28% of the population of Northern Ireland.
Results 4% of the cohort (2138) was admitted during follow-up. Homeowners were less likely than those who rented to be admitted to care homes (HR 0.77, 95% CI 0.70 to 0.85, after adjusting for age, sex, health, living arrangement and urban/rural differences). There was a strong association between house value/tenure and health with those in the highest valued houses having the lowest odds of less than good health or limiting long-term illness. However, there was no difference in probability of admission according to house value; HRs of 0.78 (95% CI 0.67 to 0.90) and 0.81 (95% CI 0.70 to 0.95), respectively, for the lowest and highest value houses compared with renters.
Conclusions The requirement for people in the UK with capital resources to contribute to their care is a significant disincentive to institutional admission. This may place an additional burden on carers.

Development of a multi-media book for clinical supervision training in undergraduate nursing

There is an increased interest in higher education in the use of e-learning resources for students. This can be attributed to many factors including, the availability of advanced technology systems, a growing student population that is technology focused, financial implications and the recruitment of international students. However, the introduction of technology and e-learning into teaching has given rise to issues regarding quality and quantity of educational practice . The challenge now is for educationalists is to deliver an optimal learning experience that is effective and appropriate for students’ learning needs.

Stress, coping and burn-out in nursing students

Aim: To explore the relationship between sources of stress and psychological burn-out and to consider the moderating and mediating role played sources of stress and different coping resources on burn-out.

Background: Most research exploring sources of stress and coping in nursing students construes stress as psychological distress. Little research has considered those sources of stress likely to enhance well-being and, by implication, learning.

Method: A questionnaire was administered to 171 final year nursing students. Questions were asked which measured sources of stress when rated as likely to contribute to distress (a hassle) and rated as likely to help one achieve (an uplift). Support, control, self-efficacy and coping style were also measured, along with their potential moderating and mediating effect on burn-out.

Findings: The sources of stress likely to lead to distress were more often predictors of wellbeing than sources of stress likely to lead to positive, eustress states. However, placement experience was an important source of stress likely to lead to eustress. Self-efficacy, dispositional control and support were other important predictors. Avoidance coping was the strongest predictor of burn-out and, even if used only occasionally, it can have an adverse effect on burn-out. Initiatives to promote support and self-efficacy are likely to have the more immediate benefits in enhancing student well-being.

Conclusion: Nurse educators need to consider how course experiences contribute not just to potential distress but to eustress. How educators interact with their students and how they give feedback offers important opportunities to promote self-efficacy and provide valuable support. Peer support is a critical coping resource and can be bolstered through induction and through learning and teaching initiatives. 

Barriers and Facilitators to Providing Palliative Care in Rural Communities: A Nursing Perspective

Nursing plays a key role in the coordination and delivery of palliative care services in rural settings. The purpose of this study is to identify barriers and enablers to providing palliative care in rural communities from a nursing perspective. This study utilized a qualitative descriptive design. Findings highlighted that the remoteness, limited access to resources and professional practice barriers created challenges for nurses as they tried to provide quality palliative care to their clients. System-related barriers were identified and included: lack of services, funding issues, and poor continuity of care. Despite these barriers, nurses drew from supports to optimize palliative care such as using a team approach to care, centers, utilizing local case managers and informal community members, and using palliative care resources. These results may help inform policy decisions around the needs of nurses who practice in rural settings to provide quality care to individuals who are dying and their families.

Ethical issues experienced by healthcare workers in nursing homes: Literature review

BACKGROUND: Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress.

OBJECTIVES: The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs' experiences of ethical issues.

METHODS: Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home.

FINDINGS: The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work.

CONCLUSIONS: The review highlighted a need for improved ethics education for care-providers.

Exploring resilience in nursing and midwifery students: a literature review

AIM: The aim of this study was to explore the concepts of 'resilience' and 'hardiness' in nursing and midwifery students in educational settings and to identify educational interventions to promote resilience.

BACKGROUND: Resilience in healthcare professionals has gained increasing attention globally, yet to date resilience and resilience education in nursing and midwifery students remain largely under-researched.

DESIGN: An integrative literature review was planned, however, only quantitative evidence was identified therefore, a review of quantitative studies was undertaken using a systematic approach.

DATA SOURCES: A comprehensive search was undertaken using Medline, CINAHL, Embase, PsycINFO and Maternity and Infant Care databases January 1980-February 2015.

REVIEW METHODS: Data were extracted using a specifically designed form and quality assessed using an appropriate checklist. A narrative summary of findings and statistical outcomes was undertaken.

RESULTS: Eight quantitative studies were included. Research relating to resilience and resilience education in nursing and midwifery students is sparse. There is a weak evidence that resilience and hardiness is associated with slightly improved academic performance and decreased burnout. However, studies were heterogeneous in design and limited by poor methodological quality. No study specifically considered student midwives.

CONCLUSION: A greater understanding of the theoretical underpinnings of resilience in nursing and midwifery students is essential for the development of educational resources. It is imperative that future research considers both nursing and midwifery training cohorts and should be of strong methodological quality.

Empowering Nursing Leaders to Facilitate Healthy Work Environments: First Steps

The purpose of this project was to examine the literature for perspectives on healthy work environments (HWE). HWEs have been identified as important factors in the nursing profession to enhance recruitment, retention, job satisfaction, and accountability. This paper identifies that the front line manager is an essential role within organizations, and directly impacts work environments. Within this paper it has been pointed out that professional organizations have provided some general recommendations for improving work environments which include increasing nurses’ accountability and teamwork, providing opportunities for shared decision making, having supportive leadership, providing recognition, educational support, and adequate staffing. However, enacting them all can be difficult due to front line manager capacity, the impending nursing shortage, organizational resources and barriers. Based on the literature, conclusions have been drawn and recommendations for future research have been identified. HWE strategies have been developed with implementation plans for my practice area.

Qualidade de vida do cuidador de enfermagem e sua relação com o cuidar; Quality of life of the nursing caregiver and its relationship with care

Objective:To identify aspects that affect the quality of life of nursing caregivers and their relationship with care in an Intensive Care Unit for Adults (A-ICU). Methods:This was a descriptive study with qualitative approach, taking as subjects 21 professionals who constitute the nursing staff of the A-ICU of a school hospital in Maringá-PR. Unstructured interview was used as a strategy to collect data, conducted between May and June 2009. Data analysis was based on the method of content analysis. The categories identified were: overlooking improvement in quality of life related to the resources in an A-ICU; the quality of life influencing the form of care; interpersonal relationships into the health team reflecting on the quality of life and care. Results:The analysis of caregivers’ speech and the results of the observation showed that there is correlation between the aspects they consider influential in their quality of life and the way of caring for patients in an A-ICU.Conclusion: The findings indicate that, among the influential aspects, the stressful factors overlap the enhancing ones. From this perspective, dealing with caregiver’s suffering might be the starting point for the improvement in quality of care in an A-ICU.

Aplicativo informatizado com o nursing activities score: instrumento para gerenciamento da assistência em unidade de terapia intensiva

A gravidade do paciente ou o número de intervenções nem sempre serão proporcionais à carga de trabalho de enfermagem. Este estudo descritivo teve como objetivo demonstrar a trajetória da construção de um aplicativo (software) com o conteúdo do Nursing Activities Score e suas características operacionais. Foi realizado um teste piloto com 12 pacientes seguindo-se a coleta de dados por 90 dias consecutivos em 123 pacientes. Houve compatibilidade na transmissão de dados do Personal Digital Assistent para o computador de mesa, via wireless. A construção do aplicativo resultou em um sistema com coleta e administração de dados e permitiu realizar a interface gráfica. A utilização do aplicativo possibilita o uso de um sistema tecnológico para aplicação diária, com alimentação de um banco de dados sobre as características dos cuidados requeridos. Conhecendo a evolução destas variáveis durante a internação, o enfermeiro poderá planejar, intervir e avaliar a qualidade do cuidado.

Construção de um aplicativo com o Nursing Activities Score: instrumento para gerenciamento da assistência de enfermagem na UTI

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Meaning of the Systematization of Nursing Care for nurse managers

OBJETIVO:Compreender o significado que os enfermeiros gerentes atribuem à sistematização da assistência de enfermagem, desenvolvido em seu cotidiano de trabalho.MÉTODOS:Método fenomenológico, referencial da estrutura do fenômeno situado. Os sujeitos foram treze enfermeiros, gerentes de um hospital universitário. A análise incluiu transcrição e leituras dos depoimentos visando a essência por meio da tematização, interpretação e a síntese do fenômeno.RESULTADOS:As categorias temáticas foram: recursos humanos na realização da sistematização da assistência de enfermagem; sua relevância para o trabalho do enfermeiro; dificuldades na sua implementação; capacitação para a sua realização.CONCLUSÃO:O significado que os enfermeiros gerentes atribuem à sistematização da assistência de enfermagem relacionam-se aos aspectos legais da prática profissional, ao trabalho em equipe, ao dimensionamento adequado de recursos humanos.

Sitios Assistenciais em Unidade de Terapia Intensiva e Relação do Nursing Activities Score com a Infecção Hospitalar

The Patient Classification System has become essential concerning to the practice in management and care from a nurse. This study analyzed the implementation of Assistance Sites in an intensive care unit for adults as a way of organization and classification of patients, as well as the impact of this process on the quality of care according to the Nursing Activities Score and the relation with the Hospital Infection. This is a quantitative, prospective, descriptive and transversal study. The data collection was realized from July until October 2010. The sample was consisted of 214 patients, mostly male, neurosurgical and with a mid age of 57 years. The NAS was on the average of 71.72%. Regarding the Hospital Infection before and after implantation, there was a reduction in the rates of pneumonia. However, the nursing workload remained the same. Moreover, It was evident the importance of using the Nursing Activities Score and the implementation of new ways for classification of patients to improve the organization of the care.

Indicadores de qualidade assistencial e Nursing Activities Score análise correlacional em um Hospital Especializado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)