The purpose of this DNP project was to improve self-care (SC) awareness among undergraduate nursing students by educating on the use of constructive SC activities. Twenty-two senior level nursing students attended an educational seminar, completed the Mindful Self-Care Scale – Clinical (MSCS-C) pre- and post-survey, and reflective journaling. A paired-samples t test was calculated to compare the mean pretest score to the mean posttest score. The mean on the pretest was 77.68 (sd= 9.33), and the mean on the posttest was 75.27 (sd= 31.59). A significant increase from pretest to posttest was found (t (21) = .307, p \u3c .05). Thematical analysis revealed enhanced awareness and incorporation of constructive SC activities. Educational interventions which seek to improve SC awareness will generate practical and sustainable acts of SC, thus improving students’ overall success and further empowering students in their transition from graduate to licensed nurses

Helms, D\u27Anna

English

Digital Commons @ Gardner-Webb University

Gardner-Webb University Digital Commons @ Gardner-Webb University Doctor of Nursing Practice Projects Hunt School of Nursing Summer 2022 Improving Self-Care Awareness Among Undergraduate Nursing Students D'Anna Helms Gardner-Webb University, dlc1106@gardner-webb.edu Follow this and additional works at: https://digitalcommons.gardner-webb.edu/nursing-dnp  Part of the Nursing Commons Recommended Citation Helms, D'Anna, "Improving Self-Care Awareness Among Undergraduate Nursing Students" (2022). Doctor of Nursing Practice Projects. 59. https://digitalcommons.gardner-webb.edu/nursing-dnp/59 This Project – Manuscript is brought to you for free and open access by the Hunt School of Nursing at Digital Commons @ Gardner-Webb University. It has been accepted for inclusion in Doctor of Nursing Practice Projects by an authorized administrator of Digital Commons @ Gardner-Webb University. For more information, please see Copyright and Publishing Info.    Improving Self-Care Awareness Among Undergraduate Nursing Students   D’Anna Helms A project submitted to the faculty of Gardner-Webb University Hunt School of Nursing in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice  2022     Submitted by:   Approved by:                _________________________  ____________________________ D’Anna Helms, MSN, RN, CNEn  Tracy Arnold, DNP, RN       June 4, 2022_______________  June 4, 2022 ________________ Date      Date    ii  Acknowledgements I am deeply indebted to Dr. Tracy Arnold, my project chair, who has encouraged and helped guide me throughout the duration of my DNP project; she has never ceased to communicate her profound belief in my abilities. Thank you for being one of my biggest supporters! I would like to express my deepest appreciation to my colleagues, Dr. Kristen Barbee, Dr. Michele Pfaff, Dr. Kay Edwards, and Dr. Sharon Walker; thank you for your intellectual contributions and for encouraging me along the way. I am extremely grateful to my husband and proofreader, Michael, as the completion of my DNP Project would not have been possible without his incessant love, unwavering support, and relentless patience. Thank you for being my mainstay and for always believing in me!  I would also like to thank my boys, McKinley and Evan, and my family and friends for their love, patience, encouragement, and understanding throughout my educational journey. I love you all!            iii                         ©D’Anna Helms, 2022 All Rights Reserved1    Improving Self-Care Awareness Among Undergraduate Nursing Students Abstract  The purpose of this DNP project was to improve self-care (SC) awareness among undergraduate nursing students by educating on the use of constructive SC activities. Twenty-two senior level nursing students attended an educational seminar, completed the Mindful Self-Care Scale – Clinical (MSCS-C) pre- and post-survey, and reflective journaling. A paired-samples t test was calculated to compare the mean pretest score to the mean posttest score. The mean on the pretest was 77.68 (sd= 9.33), and the mean on the posttest was 75.27 (sd= 31.59). A significant increase from pretest to posttest was found (t (21) = .307, p < .05). Thematical analysis revealed enhanced awareness and incorporation of constructive SC activities. Educational interventions which seek to improve SC awareness will generate practical and sustainable acts of SC, thus improving students’ overall success and further empowering students in their transition from graduate to licensed nurses.  Key Words: Anxiety, nursing students, mental health, psychological distress, reflective journaling, self-care       2    Purpose The purpose of this DNP project was to improve SC awareness among undergraduate nursing students by educating on the use of constructive SC activities. Educational interventions which seek to improve SC awareness will generate practical and sustainable acts of SC. As a result, student nurses, those who will eventually transition to the role of graduate nurse, will appreciate the importance of sustaining SC actions; thus, advancing graduate nurses’ ability to deliver safe care competently and effectively. Literature Review Studies which explore the mental health of nursing students and the implications of SC practices have been appraised. According to Beanlands et al. (2019) acquiring positive SC coping skills will help to mitigate nursing students’ stress, potentiating a positive impact in the transition from the role of student nurse to graduate nurse. Brouwer et al. (2021) posits that SC practices were considerably and adversely related to psychological distress. Green (2020) affirmed that SC interventions, such as “aromatherapy, exercise, healthy eating,” and the advantages “of sleep and positive affirmations” were valuable in nursing students’ reduction of “stress, anxiety and distraction”, thus positively influencing an ability to manage stress (p. 233). According to Nevins et al. (2019), findings positively supported the concept of enhancing knowledge of SC in an effort to improve health and self-efficacy among nursing students.     3    Research Design An interventional, pre-test/post-test design, including an educational seminar related to mindful SC, accompanied by four-weeks of reflective journaling, was used to enhance nursing students’ awareness of SC behaviors. Sample This project was comprised of 22 senior level students enrolled in a mental health nursing course. Participants were pursuing a Bachelor of Science in nursing (BSN) degree during the fall of 2021, at a private University in the southeastern region of the United States. Research Method All participants enrolled in a Mental Health nursing course participated in a required SC educational seminar during a regularly scheduled class day. Prior to beginning the SC educational seminar, the DNP Project Leader provided participants with information regarding the purpose of the DNP project, informed consent, and stated that participation in the survey was voluntary, including all necessary information regarding opting out of this project. All participants accessed an electronic link via Qualtrics, posted in Canvas to view the informed consent and MSCS-C (pre-survey). Students who desired to opt out of the survey could choose not to access the link or could close the survey link. Completion of the MSCS-C took approximately 10-15 minutes. Personal electronic devices were required per the University Nursing Student Handbook; therefore, students accessed the link via their own electronic device. Following completion of the MSCS-C, the educational seminar was conducted in a classroom by the DNP Project Leader and lasted approximately one hour. Following completion of the SC 4    educational seminar, students were encouraged to participate in SC and were instructed on the use of reflective journaling. Students voluntarily participated in SC and were asked to complete a weekly reflective journal over four weeks. Reflective journal links were posted as an announcement and in a module in Canvas for students to access and complete anonymously on their own time. After four weeks, students were asked to complete the post-survey MSCS-C to compare pre- survey scores. Completion of the MSCS-C (post-survey) took approximately 10-15 minutes in class and was accessed via the link on their own electronic devices. MSCS-C scores were analyzed using SPSS descriptive statistics. Qualitative data from reflective journals was thematically analyzed by identifying, examining, and interpreting any patterns in textual data in response to the reflective journal questions. Results Quantitative Analysis A paired-samples t test was calculated to compare the mean pretest score to the mean posttest score. The mean on the pretest was 77.68 (sd= 9.33), and the mean on the posttest was 75.27 (sd= 31.59). A significant increase from pretest to posttest was found (t (21) = .307, p < .05). Thematic Analysis Qualitative responses from reflective journals revealed enhanced awareness and consistent application of SC practices over four-weeks. The overall participation rate for students’ participation in reflective journaling was 74%. Students' responses were thematically analyzed based on Cook-Cottone’s (2015) 10 domains of SC: Nutrition/Hydration (NH), Exercise (E), Soothing Behaviors (S), Self-5    Awareness/Mindfulness (SA), Rest (R), Relationships (RR), Physical/Medical (PM), Environmental Factors (EF), Self-Compassion, Spiritual Practice (SP), and General (G) topics.  To evaluate students’ willingness to incorporate SC practices, the following questions were asked: During the first week, students were asked, “What is a self-care goal you want to accomplish and why?” During the second week, students were asked, “What is your preferred method of self-care?” and “How do you recharge?”. During the third week, students were asked, “How do you relieve your anxiety in a difficult situation?”. For the fourth and final reflection, students were asked, “What new opportunities have come out of challenges you have faced?” and whether they “found this self-care project and reflective journaling experiences to be beneficial in increasing” their “awareness of self-care”. In addition to each week’s prompt, students were consistently asked the following questions, “If you incorporated self-care into this week's routine” or “If you opted not to incorporate self-care into your routine this week, please explain why.” Each response was evaluated and further categorized based on the appropriate SC domain; the majority of students’ responses revealed an apparent understanding and willingness to participate in SC by means of incorporating E, S, and R. Week One Twenty-one students participated in week one’s reflective journal; results indicated that all (n= 21) opted to incorporate SC activities during this week. Students’ responses revealed an understanding of the importance of incorporating SC goals, many associated SC goals with E, S, R, and SA, attributing SC to getting enough rest, 6    establishing a bedtime routine, taking mental health breaks during study times, and walking or working out; RR, PM, and EF were least utilized during this week. Week Two Fourteen students participated in week two’s reflective journal; results indicated that 11 opted to incorporate SC activities during this week, three opted not to incorporate SC. Students’ responses indicated that the most preferred method of SC was E and S, such as working out, listening to music, participating in yoga and meditation, and relaxing in bed. Similarly, students indicated that they recharged by partaking in R and self-compassion. SA, PM, EF, and G were least utilized during this week. Students who opted not to incorporate SC attributed their reluctance to time constraints, schoolwork, and a lack of self-compassion. One student voiced the need to opt out of participating in SC as they felt selfish for taking time to care for themselves. Their notion was that SC is a luxury; the student affirmed this idea by stating, “it comes naturally to me to put my self [sic] at the bottom of my to do list and prioritize my requirements in school and work over myself.”. Week Three Fifteen students participated in week three’s reflective journal; results indicated that 13 opted to incorporate SC activities during this week, two opted not to incorporate SC. Most students’ responses revealed that in a difficult situation, relief from anxiety was achieved by incorporating E, S, SA, and SP. Students experienced relief of their anxiety by participating in mindful breathing techniques, prayer, listening to music, and exercising. EF and G were not acknowledged. Students who opted not to incorporate SC 7    attributed their reluctance to being “too busy” due to exams, and another stated, “I was feeling unwell and barely had time for myself.”. Week Four Eighteen students participated in week four’s reflective journal; results indicated that 15 opted to incorporate SC activities during this week, three opted not to incorporate SC. When asked “What new opportunities have come out of challenges you have faced?”, most indicated that this was achieved by incorporating SA, S, RR, and self-compassion. Students indicated that incorporating SC enhanced resilience and methods of coping, encouraged self-reflection, and provided time to embrace meaningful relationships. One student stated, “I have learned how resilient and adaptable I can be when I am presented with an obstacle…I think adaptability and resilience are very important factors that nurses should possess in order to be great.” Evaluation of Experience 50% of students strongly agreed that they found this self-care project and reflective journaling experiences to be beneficial in increasing their awareness of SC; 22% agreed, 17% somewhat agreed, and 11% did not answer. Limitations The small sample size obtained though convenience sampling was noted as a limitation. Generalizability of findings was also limitation within this study as all subjects were nursing students from one University. Implications for Practice Research suggests that the integration of SC practices within nursing curricula as well as interventional studies which incorporate SC activities have shown to be an 8    effective means in reducing psychological distress in nursing students. During ambiguous times, such as those during the COVID-19 pandemic, it is imperative for nurse educators to maintain continuity in educational proceedings, communicate effectively and in a timely manner, and provide continued support for nursing students. An ability to effectively adapt to ongoing emotional stress and mental health (MH) burdens will allow students to navigate the perpetual, ever-changing challenges of nursing. Incorporating knowledge of SC into nursing curricula will instill resiliency and foster an ability to cope with the inevitable psychological distress triggered by academic rigor. Likewise, it will improve students’ overall success and empower student nurses in their transition from graduate to licensed nurses. Nurse educators (NEs) are urged to empower student nurses by educating on the significance and application of constructive SC behaviors. Incorporating SC into nursing curricula or a nursing elective is a feasible means to introduce this invaluable concept. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, composition, and or publication of this article. Funding The author(s) received no financial support for the research, production, and or publication of this article. Conclusion Nursing students are faced with immense and overwhelming challenges during their training; equally, nurses encounter numerous challenges during their career. Students voiced that time constraints and feelings of selfishness were contributing factors 9    to their unwillingness or lack of SC. Prior to this experience, students asserted feelings that SC did not take precedence over more pressing concerns, such as work, school, or caring for others. This DNP project reinforced that addressing SC behaviors with nursing students, prior to their transition into practice is vital. Accordingly, students must also realize the significance of utilizing constructive SC behaviors. Likewise, it is imperative for nursing students to recognize the consequences they may endure to due to an avoidance of SC. Engaging in SC enhances effectiveness, adaptability and resilience, skills that are necessary to remain successful in one’s nursing career, and ultimately sustain health, both physically and mentally.   10    References Beanlands, H., McCay, E., Fredericks, S., Newman, K., Rose, D., Santa Mina, E., Schindel Martin, L., Schwind, J., Sidani, S., Aiello, A., & Wang, A. (2019). Decreasing stress and supporting emotional well-being among senior nursing students: A pilot test of an evidence-based intervention. Nurse Education Today, 76, 222-227. https://doi.org/10.1016/j.nedt.2019.02.009 Brouwer, K. R., Walmsley, L. A., Parrish, E. M., McCubbin, A. K., Braido, C. E. C., & Okoli, C. T. C. (2021). Examining the associations between self-care practices and psychological distress among nursing students during the COVID-19 pandemic. Nurse Education Today, 100, 1-6. https://doi.org/10.1016/j.nedt.2021.104864  Cook-Cottone, C. P. (2015). Mindfulness and yoga for embodied self-regulation: A primer for mental health professionals. New York, NY: Springer Publishing. https://www.catherinecookcottone.com/wp-content/uploads/2018/04/MSCS-Clinical-2018-Updatel.pdf Green, C. (2020). Teaching accelerated nursing students’ self‐care: A pilot project. Nursing Open, 7(1), 225-234. https://doi.org/10.1002/nop2.384  Nevins, C. M., Sherman, J., Canchola, K., Ihrig, K., Steinfeld, B., & Wagner, W. E. (2019). Influencing exercise and hydration self-care practices of baccalaureate nursing students. Journal of Holistic Nursing, 37(2), 140-147. https://doi.org/10.1177/0898010118792781 

Improving Self-Care Awareness Among Undergraduate Nursing Students

https://digitalcommons.gardner-webb.edu/cgi/viewcontent.cgi?article=1064&context=nursing-dnp

Improving Self-Care Awareness Among Undergraduate Nursing Students

Abstract

Similar works

Full text

Available Versions

Digital Commons @ Gardner-Webb University