Development of teaching strategies to prepare future nurses\u27 ability in evidence-based practice

Session presented on: Tuesday, July 23, 2013: Purpose: Evidence-based practice has become imperative in clinical practice since it bridges up the gap between conducted research and clinical practice. Promote students\u27 interests and enthusiasm for research is therefore crucial when teaching nursing research. The purpose of the study was to develop innovative teaching strategies for undergraduate nursing research to increase students\u27 interests and engagement in research. Methods: This study was descriptive, pretest and posttest quasi experimental design. One-hundred-three students enrolling in nursing research course in two classes were in the experimental group and 106 students in the other two classes were in the comparison group. The majority of students never took nursing research course or participated in any research before the class. The teaching strategy includes literature search and evaluation, in-class activities of research procedure, and final project using integrated research review method. The Attitudes toward Research, Classroom Engagement Scale, Self-Directed Learning Instrument, Nursing Eight Core Competences Scale, and Value of Teams were applied to evaluate the outcomes of the innovative teaching strategies. Descriptive statistics and repeated ANCOVA were used to analyze the data. Results: Participants in the experimental group exhibited higher score on attitudes toward research, nursing core competence, value of teams, class engagement, and self-directed learning than participants in the comparison group at the end of the course. The research knowledge test score was significantly higher in the experimental group than it in the comparison group. Student in the experimental group perceived lower pressure but higher degree of interest, and enjoyment and acceptance of the research course than students in the comparison group. Conclusion: This study provides important information for nurse educators that using innovative teaching strategies in nursing research course is necessary and useful to enhance students\u27 interest, enthusiasm, and research knowledge about evidence-based practice

Fatigue of Chinese mothers from pregnancy to postpartum

Purpose: Many pregnant women experience fatigue that influences quality of life or pregnancy outcomes. Trend of fatigue from pregnancy to postpartum was not understood. This study aimed to explore changes of fatigue level from pregnancy to postpartum and prediction of prenatal fatigue on infant prematurity. Methods: The study was a longitudinal design with nonprobability sampling. One-hundred-ninety-eight pregnant women with mean age of 29.69 and 27.37 weeks of gestation were followed up monthly (T1 to T3) till 4-6 weeks postpartum (T4). More than half of them were primiparous (56.6%), very happy about the pregnancy (50.5%), employed (63.1%), and had an educational level higher than senior high school (68.2%). The 16-item Multidimensional Assessment of Fatigue (MAFS, alpha=.95 in this study) was used to measure fatigue. Descriptive statistics, Pearson correlation, and repeated measure ANOVA were applied. Results: In general, participants did not score high on the MAFS from T1 to T4. More participants experienced fatigue from T1 to T4 (15.7%, 20.4%, 28.4%, and 29.8%, respectively). Fatigue at all survey time points were strongly intercorrelated (r=.50-.76). Repeated measure ANOVA showed a linear increasing trend of fatigue by time (F=8.57, \u3c .001). Fatigued mothers at T1 had high scores on MAFS and high rate of experiencing fatigue from T2 to T4 (56.7%, 64.5%, and 58.1%, respectively). Fatigue at any time point was not related with age or differed by employment, education, or happy about pregnancy. Multiparous mothers experienced higher level of fatigue during pregnancy but not postpartum than primiparous. Prenatal fatigue from T1 to T3 was not related to infant birthweight but significantly and weakly correlated with baby\u27s gestational age. Fatigue at T3 was significantly but weakly correlated with APGAR scores. Conclusion: Active and early screening for mothers of fatigue can help healthcare professionals to prevent or manage fatigue of pregnant and postpartum women, especially multiparous

Development of an informative and supportive website for fertility support

In this study, we developed a website to provide information and support for women with fertility problems. The website included six domains: introduction about infertility, information center, my story, discussion forum, and resources. The Facebook was used as well for women to share, discuss, obtain information, and release stress

Prenatal fatigue and quality of life of pregnant women over 26 weeks of gestation

Pregnant women have high rate of experiencing fatigue, which may impact women\u27s quality of life (QoL). The purposes of his study were to examine relationship between fatigue and QoL (general, physical, mental, and social health) of women in the third trimester. The study was a cross-sectional design with snowball sampling. Data from 128 pregnant women without pregnancy-related physical/mental complications in Taiwan were analyzed. They were at 32.66 (SD=3.76) gestational weeks and were 40.41 (SD=4.30) years old. About half of them were primiparous (55%) and employed (57%); had an education higher than high school (59%) and planned for the pregnancy (51%). The 16-item Multidimensional Assessment of Fatigue (MAFS, scores 1-50, high score indicates higher level of fatigue) and the 17-item Duke Health Profile (DHP, scores 0-100 on each dimension of health, higher score indicates healthier) were used. Cronbach\u27s alphas for the MAFS and DHP were .96 and .80, respectively. Descriptive statistics, ANOVA, Pearson correlation, and regression were used. Participants did not have very high score on the MAFS (M=20.56) and physical (M=52.97), mental (M=64.61), social (M=63.71), and general (M=60.43) health of the DHP. Fatigue was correlated with physical (r=-.68), mental (r=-.53), social (r=-.45), and general (r=-.70) health. Fatigue could explain 47% of the variance of physical, 28% of mental, 20% of social, and 49% of general health. Fatigue and dimensions of QoL did not differ by gestational groups (\u3c32, 32-36, and \u3e36 weeks), educational level (college or higher and lower than college), or happy about pregnancy (happy, unhappy, and uncertain). Employed pregnant women had better mental (t=2.14, p=0.04) and social (t=2.81, p=0.01) health than unemployed women. Strategies to manage fatigue such as time management, may improve maternal QoL. Helping pregnant women to be employed may increase their QoL. Longitudinal study can help to understand patterns of fatigue and QoL during pregnancy

The Cookie Experiment: A innovative strategy for teaching nursing research in Taiwan

Purpose: To examine the effects of a teaching strategy on nursing students\u27 understanding of research procedures, confidence in participating in research, and attitudes toward research. Methods: The study was a quasi-experimental design. One-hundred nursing students, who were in a two-year RN-to-BSN program and enrolled in the Nursing Research course, completed both pre- and post-test. Thiel\u27s (1987) Cookie Experiment, which allows students to experience research designs and procedure, was applied as a teaching strategy in the class. Two weeks before the Experiment, students filled out a questionnaire measuring their attitudes toward nursing research (pretest). On the day of the Experiment, students were asked to taste cookies by following a standard procedure and complete the 17-item Cookie Assessment Tool. After the Experiment, students shared how they related the Experiment to research procedure in the class and completed the questionnaire they did in pretest (posttest). Descriptive statistics and Wilcoxon Signed test were used to analyze the data. Results: Mean age of the students was 21.23, and majority of them were not taking research course for the first time and never employed for any nursing-related jobs. Before the Cookie Experiment, students felt they were not familiar with research procedure or interested in conducting research, and had low confidence in participating in research. After the Experiment, their familiarity with and understanding of research procedure and acceptance of the course were improved. Majority of the students felt the Experiment helped them in learning especially in research purposes, questions, designs, sampling, ethics, and presenting results. They thought Nursing Research was a course worth taking and the Experiment should be applied in the class. Conclusion: Nursing Research can be an interesting and practical course if appropriate and creative teaching strategies are applied. More teaching strategies and activities like the Cookie Experiment can be developed to improve student learning

New Graduate Nurses’ Clinical Competence, Clinical Stress, and Intention to Leave: A Longitudinal Study in Taiwan

This longitudinal research study aimed to develop a pregraduation clinical training program for nursing students before graduation and evaluate its effect on students’ self-perceived clinical competence, clinical stress, and intention to leave current job. A sample of 198 students returned the questionnaires before and after the program. They were followed up at 3, 6, and 12 months after graduation. Results showed that posttest clinical competence was significantly higher than pretest competence, positively related to clinical competence at 3 and 12 months, and negatively related to clinical stress at 3 months. The clinical competence at 3 months was positively related to clinical competence at 6 and 12 months, and clinical competence at 6 months was related to intention to leave at 12 months. Intention to leave at 6 months was positively related to intention to leave at 3 and 12 months. Clinical stress at 3 months was positively related to clinical stress at 6 and 12 months, but not related to intention to leave at any time points. The training program improved students’ clinical competence. The stressful time that was correlated with new graduate nurses’ intention to leave their job was between the sixth and twelfth months after employment

Development of a performance-based clinical competence tool for hospital nurses in Taiwan

Session presented on Sunday, July 26, 2015: Purpose: Clinical competence is important in patient safety and proving quality care. Cultivate nurses\u27 competence becomes a main issue. The purpose of the study was to develop a performance-based competence tool to both increase and evaluate nurses\u27 clinical competence. Additionally, nurses\u27 perceived competence was measured and the top skills that were unconfident performing were explored as well. Methods: The study was a pretest-posttest descriptive design with convenience sampling. Sixty nurses were recruited from three hospitals in Taiwan. The mean age and work experience of the participants was 28.65 and 7.2 years, respectively. 39.79% of them were in their first employment year. 93.33% had a bachelor degree. 40% worked in teaching hospitals and 90% worked in medical-surgical related units. The Clinical Competence Scale (CCS) developed by the authors was used to evaluate perceived competence. The Cronbach\u27s alpha for the CCS was .81. The content, construct, and concurrent validity of the CCS were supported in the study. Nurses were asked to fill out the CCS before and after they finished the performance-based competence tool. Descriptive statistics and paired t test were applied to analyze data. Results: The performance-based competence tool consisting six case-based scenarios was developed based on eight steps of clinical reasoning proposed in the Clinical Reasoning Model. The developed performance-based competence tool was intended to train nurses\u27 clinical reasoning/critical thinking abilities and examine their performance-based competence. In each scenario, sub-situations with questions, which are sequenced and focus on clinical reasoning/critical thinking abilities, were developed to reflect a patient\u27s changing condition or deterioration. The total score of all scenarios are 510. This tool is designed with a scoring system that nurses can understand their own performance in clinical situational care and they can train clinical reasoning/critical thinking abilities by repeatedly taking the program. The mean score of the CCS decreased significantly from pretest (M=3.55 on a 5-point Likert scale) to posttest (M=3.35, t=2.91, p\u3c.01). The mean score of the performance-based competence tool was 317.76 which was under the requirement score 336 (reaching 70% of the total score is a satisfaction level). The top five unconfident clinical skills of performing for nurses were reading EKG, performing CPR, venipuncture, and performing blood transfusion. Conclusion: Nurses\u27 posttest score of perceived clinical competence, which was taken immediately after finishing the performance-based competence tool, was significantly lower than the pretest score. This result implied that nurses over-estimated their actual performance abilities in the real world. After completing the developed tool, nurses can understand what their lack is in performing competent patient care and therefore can increase their knowledge or skills. Nurse administrators are suggested to train nurses on those skills that nurses are not unconfident performing. Further research in understanding nurses\u27 weakness of abilities is needed to provide information for nursing administrators to design appropriate continuing education/training for nurses

The relationships between collectivist orientation, perception of practice environment, organizational commitment, and intention to leave current job among Asian nurses working in the U.S.

Estimates indicate that Asian nurses have become the majority of international registered nurses (RNs) working in U.S. Studies have shown that differences in values exist between members of collectivistic cultures, such as those in Asian countries, and members of individualistic cultures, such as those in most Western countries. The purpose of this study was to understand factors related to turnover among Asian RNs working in the U.S.: level of collectivist orientation; perception of practice environment; degree of organizational commitment, and intention to leave current job. The research design was cross-sectional, correlational, and descriptive. A temporally ordered model was developed using the research literature and well-established instruments measured Asian RNs' level of collectivist orientation (Collectivist Orientation Scale), perception of practice environment (Practice Environment Scale of the Nursing Work Index), organizational commitment (Organizational Commitment Questionnaire), and intention to leave current job (Anticipated Turnover Scale). A snowball of 120 RNs was obtained. Descriptive, Pearson correlation, hierarchical regression, and the Sobel test were used to analyze data. Results showed that Asian nurses were highly collectivist-oriented. Generally, they had high levels of satisfaction with their practice environment and organizational commitment, but had low intention to leave their current jobs. Collectivist orientation, perception of practice environment, and organizational commitment were significantly and positively correlated to each other, but were significantly and negatively associated with intention to leave. The strongest predictor of intention to leave was organizational commitment. Organizational commitment mediated the relationship between perception of practice environment and intention to leave. It is important for administrators to understand characteristics of members of collectivist cultures and their organizational commitment. This may be crucial for administrators to lower the rate of turnover among Asian RNs. Future research should focus on longitudinal and controlled interventional studies to understand Asian nurses' satisfaction with their practice environment and their organizational commitment.Nursin