Saudi Female Nursing Students’ Sense of Belonging in Clinical Settings: A Mixed-Methods Study

The objectives of this study were to: (a) explore what sense of belonging in clinical settings means to female Saudi nursing students, (b) identify the factors affecting the students’ sense of belonging, (c) identify the consequences of a sense of belonging in clinical settings from the perspectives of female Saudi nursing students, (d) modify, translate, and test the Belongingness Scale–Clinical Placement Experience (BES–CPE) instrument based on the qualitative views of the participants, (e) develop a valid and reliable tool for use in the Saudi context, (f) determine the validity and reliability of the Arab version of the BES–CPE, and (g) measure and compare the extent to which nursing students experience a sense of belonging in clinical settings. This research used an exploratory mixed-methods approach. For the qualitative phase, there were 16 student participants. For the quantitative phase, there were 273 student participants. The study was conducted at three government universities in Riyadh, Saudi Arabia. The qualitative data were collected via semi-structured interviews. The quantitative data were collected using modified and translated versions of the BES–CPE. The results indicated different personal, clinical, and academic factors influenced female Saudi nursing students’ sense of belonging. The participants reported the following influential factors: distinctive characteristics of Saudi cultural values; lack of preparation; limited English language skills; and their relationship with the nursing staff, nurse educators, other health care providers, and clinical peers. The participants also reported positive consequences of a sense of belonging, such as feeling safe, valued and like a real nurse, as well as a motivation to learn. The study found that 75% of participants preferred to work with Saudi nurses who understood their needs, culture, and language. Almost 40% indicated their limited English language skills negatively affected their sense of belonging. The majority (90%) indicated an association of their sense of belonging with their motivation to learn. Only 15% indicated they liked the nurses they worked with in clinical settings; and only 13% reported feeling welcomed and accepted by the nursing staff all the time. More than 30% of participants indicated making an effort to feel accepted by the nursing staff. Therefore, students must be team members and participate in patient care to become competent nurses who can provide quality and safe care. The lack of belonging, as the students described, decreases their opportunities to learn and leads to different psychosocial problems. Saudi society and families must promote the nursing profession because the country needs national nurses who understand the language and culture of Saudi patients

'It's communication between people who are going through the same thing': experiences of informal interactions in hospital cancer treatment settings

PURPOSE: In hospital settings, patients, visitors, and staff engage in many interactions outside formal clinical encounters. Whilst many of these may be inconsequential, others contribute significantly to how patients and their carers experience cancer and its treatment. This article aims to explore the experiences and significance of interactions that occur outside formal clinical encounters in hospital cancer treatment settings. METHODS: Semi-structured interviews were conducted with cancer patients, carers, and staff recruited from two hospital sites and cancer support groups. Hermeneutic phenomenology informed lines of questioning and data analysis. RESULTS: Thirty-one people participated in the study: 18 cancer patients, four carers, and nine staff members. The experiences of informal interactions were grouped into three themes: connecting, making sense, and enacting care. The participants described how these encounters allowed connection with others in the hospital spaces, facilitating a sense of belonging, normality, and self-worth. Through these interactions, individuals participated in making sense of their experiences, to better anticipate the decisions and challenges that might lie ahead. By connecting with other individuals, they cared for others and felt cared for themselves, and were able to learn from, teach, and support each other. CONCLUSIONS: Outside the confines of the clinical discourses participants negotiate terms of engagement, sharing of information, expertise, and their own personal stories that they may employ to contribute to the individuals around them. These interactions occur within a loose and evolving framework of social interactions, an 'informal community', in which cancer patients, carers, and staff members play active and meaningful roles

Constantly Thinking: Virtue in the Reflection of Practising Physiotherapists

Reflection is now a key component of physiotherapy undergraduate education and an expectation for professional practice although little is known about reflection as practised by qualified physiotherapists. Aims of the study: The purpose of this research was to explore reflection as practised by physiotherapists. Initially, the interest was in exploring what benefits reflection might bring to physiotherapists’ practice; however, once the richness of physiotherapists’ reflection was experienced, the focus of the research shifted to the process and nature of their reflections. Study design: The study took a pragmatic, qualitative, three-stage course through a grounded theory approach, where the research interest directed methods and analysis. Data collection used photo-elicitation interviews for stage one, audio diaries for stage two and for the stage of verification of the theory. Analysis: The interpretive analysis used a coding process which included the ‘thinking strategies’ of asking questions of the data, writing memos and making comparisons. The theory was further developed with an evolved theoretical coding family. Participants: 15 physiotherapists took part over the three stages of the research; 13 were female and two were male. Their clinical backgrounds included neurology, cardio-respiratory, musculoskeletal, sports therapy and paediatrics; their places of work included NHS, private, acute hospital, and community settings. Findings: Reflection was used by physiotherapists in order to fulfil a purpose in their practice. The purposes are summarised by the categories of Understanding, Seeking and Being Worthy. Each category had two sub-categories, giving six purposes of reflection: making sense of self, making sense of other, seeking a solution, questing for a novel clinical solution, practising worthily and demonstrating worthiness to others. The outcomes of reflection can be grouped into three types: changes in practice, changes in the practitioner and outcomes which did not create change but which had value to the practitioner, such as ease of mind. The purpose of demonstrating worthiness was the only form of reflection which regularly included writing and which had no direct benefit to practice. In addition, practitioners’ reflections were not bounded by their working hours: they typically reflected in hours of routinized, non-cognitively demanding activities such as walking, cycling, or showering. They also used reflective strategies such as reading and discussion with colleagues. Conclusions: Practitioners used a rich practice of reflection in order to achieve Aristotle’s ‘good life’, which is to say they used reflection for their personal sense of fulfilment and professional satisfaction with their work

You’ll never walk alone: supportive social relations in a football and mental health project

Football can bring people together in acts of solidarity and togetherness. This spirit is most evocatively illustrated in the world renowned football anthem You’ll Never Walk Alone (YNWA). In this paper we argue that this spirit can be effectively harnessed in nursing and mental health care. We draw on data from qualitative interviews undertaken as part of evaluating a football and mental health project to explore the nature of supportive social relations therein. We use some of the lyrics from YNWA as metaphor to frame our thematic analysis. We are especially interested in the interactions between the group facilitators and group members, but also address aspects of peer support within the groups. A contrast is drawn between the flexible interpersonal boundaries and self-disclosure evident in the football initiative and the reported more distant relations with practitioners in mainstream mental health services. Findings suggest scope for utilising more collective, solidarity enhancing initiatives and attention to alliances and boundaries to maximise engagement and therapeutic benefits within routine practice

Experience of Robotic Exoskeleton Use at Four Spinal Cord Injury Model Systems Centers

Background and Purpose: Refinement of robotic exoskeletons for overground walking is progressing rapidly. We describe clinicians\u27 experiences, evaluations, and training strategies using robotic exoskeletons in spinal cord injury rehabilitation and wellness settings and describe clinicians\u27 perceptions of exoskeleton benefits and risks and developments that would enhance utility. Methods: We convened focus groups at 4 spinal cord injury model system centers. A court reporter took verbatim notes and provided a transcript. Research staff used a thematic coding approach to summarize discussions. Results: Thirty clinicians participated in focus groups. They reported using exoskeletons primarily in outpatient and wellness settings; 1 center used exoskeletons during inpatient rehabilitation. A typical episode of outpatient exoskeleton therapy comprises 20 to 30 sessions and at least 2 staff members are involved in each session. Treatment focuses on standing, stepping, and gait training; therapists measure progress with standardized assessments. Beyond improved gait, participants attributed physiological, psychological, and social benefits to exoskeleton use. Potential risks included falls, skin irritation, and disappointed expectations. Participants identified enhancements that would be of value including greater durability and adjustability, lighter weight, 1-hand controls, ability to navigate stairs and uneven surfaces, and ability to balance without upper extremity support. Discussion and Conclusions: Each spinal cord injury model system center had shared and distinct practices in terms of how it integrates robotic exoskeletons into physical therapy services. There is currently little evidence to guide integration of exoskeletons into rehabilitation therapy services and a pressing need to generate evidence to guide practice and to inform patients\u27 expectations as more devices enter the market. Background and Purpose: Refinement of robotic exoskeletons for overground walking is progressing rapidly. We describe clinicians\u27 experiences, evaluations, and training strategies using robotic exoskeletons in spinal cord injury rehabilitation and wellness settings and describe clinicians\u27 perceptions of exoskeleton benefits and risks and developments that would enhance utility. Methods: We convened focus groups at 4 spinal cord injury model system centers. A court reporter took verbatim notes and provided a transcript. Research staff used a thematic coding approach to summarize discussions. Results: Thirty clinicians participated in focus groups. They reported using exoskeletons primarily in outpatient and wellness settings; 1 center used exoskeletons during inpatient rehabilitation. A typical episode of outpatient exoskeleton therapy comprises 20 to 30 sessions and at least 2 staff members are involved in each session. Treatment focuses on standing, stepping, and gait training; therapists measure progress with standardized assessments. Beyond improved gait, participants attributed physiological, psychological, and social benefits to exoskeleton use. Potential risks included falls, skin irritation, and disappointed expectations. Participants identified enhancements that would be of value including greater durability and adjustability, lighter weight, 1-hand controls, ability to navigate stairs and uneven surfaces, and ability to balance without upper extremity support. Discussion and Conclusions: Each spinal cord injury model system center had shared and distinct practices in terms of how it integrates robotic exoskeletons into physical therapy services. There is currently little evidence to guide integration of exoskeletons into rehabilitation therapy services and a pressing need to generate evidence to guide practice and to inform patients\u27 expectations as more devices enter the market

Mentoring Experiences of Women in Graduate Education: Factors that Matter

This exploratory study focused on the mentoring experiences of women faculty members and graduate students within a counseling psychology graduate program. Results from semi-structured interviews and focus groups identified the women’s contextual mentoring experiences in higher education and highlighted several factors that contribute to mentorship experiences unique to women in graduate higher education. Findings demonstrate the importance of relational mentoring relationships and investment by mentors. Implications for building upon mentoring theories for women and future research are discussed