Madridge Journal of Nursing

ISSN: 2638-1605

2nd International Nursing Conference

November 1-3, 2017, Barcelona, Spain
Scientific Session Abstracts
DOI: 10.18689/2638-1605.a2.002

A Mentoring Program for Licensure Success

Deborah Zbegner

Wilkes University, USA

Background: In the United States, successful completion of the licensure exam has become synonymous with the quality of educational preparation received by students in baccalaureate programs. Pass rate serves as a key indicator of the achievement of a programʼs academic goals and it is incorporated into state board approval and the accreditation process of programs. The licensure exam provided in the United States for entry into practice as a registered nurse is the National Council of State Boards of Nursing Licensure Exam (NCLEX-RN).

Program: In order to improve upon the programʼs pass rates, a comprehensive mentorship program was instituted. Mentoring in academia has been reported as an effective way to increase self-confidence and promote professional development. Based on the parent universityʼs mentoring model, the School of Nursing used gaming strategies, content reviews, computerized integrative testing and learning packages, to assist students preparing for the licensure exam. Faculty team leaders were assigned to oversee and coordinate student learning. Groups of eight to nine students were assigned to each team. This program is implemented with senior students who must achieve a specific pass rate on their comprehensive predictor exam and meet a specific masterly level score on their computerized NCLEX style questions before graduation.

Results: The Comprehensive Mentoring Program has been implemented over a three year period of time and modified for improvement annually. A variety of data points were used to assess prediction of NCLEX-RN success as defined by first-time pass rate. Pass rates have improved each year from baseline of 79.17% in 2014, to 83.82% in 2015, and 90.14% in 2016. Logistic regression analysis revealed that overall college grade point average (p = .002) and a comprehensive exam in the NCLEX-RN format (p = .001) were significant predictors of NCLEX-RN success.

Deborah Zbegner was appointed dean of the first independent Passan School of Nursing at Wilkes University in January 2015.. Dr. Zbegner has 21 years of teaching experience on the undergraduate and graduate level acting in various leadership positions.. Dr. Zbegner served as Director of Graduate Programs and has been responsible for strategic planning, overseeing operations and supervising curriculum, faculty loading, and student enrollment and retention for the nurse practitioner concentrations and the Doctor of Nursing Practice program. Deborah Zbegner also has 30+ years of professional experience in nursing which includes obstetrical, gynecological, and infertility nursing, ultrasound, university teaching, and governance. She has 28 years of clinical practice as a nationally board certified womenʼs health nurse practitioner. Dr. Zbegner works in a collaborative physician practice caring for women across the life span and also serves as a clinical preceptor for nurse practitioner students within her practice site. She provides a dynamic learning environment that promotes high quality patient care from a holistic perspective. Dr. Zbegnerʼs academic knowledge, clinical expertise and national board certifications validate her commitment for promoting clinical excellence in all programs of the Passan School of Nursing. She is a member of the PA Coalition of Nurse Practitioners of Northeastern Pa., National Association of Nurse Practitioners in Womenʼs Health (NPWH), the Association of Womenʼs Health, Obstetrics, and Neonatal Nursing (AWHONN), and Sigma Theta Tau International Honor Society of Nursing. She earned her Doctorate at Widener University, Masterʼs in Nursing at University of Pennsylvania, and her undergraduate Bachelor of Science in Nursing from DeSales University.

The Effects of Theory-Based Simulation Design on Clinical Nursing Judgment Development

Joyce Victor

Wilkes University, USA

Developing and evaluating clinical nursing judgment is becoming a common and vital component of simulation. Various factors related to clinical nursing judgment, such as cognition, clinical reasoning, performance in simulation, and reflective debriefing, have been discussed in the simulation literature. There are very few studies examining simulation design and its effects on clinical nursing judgment development. Experiential learning theory is commonly used in designing simulations. For full integration of simulation in nursing curricula, simulation experiences need to be designed to incorporate all elements of experiential learning theory as each contributes to the overall development of clinical nursing judgment in prelicensure nursing students. In this study, a significant increase in clinical nursing judgment was found when full integration of simulation based on experiential learning theory was used. This study has also found a significant positive relationship between clinical nursing development, simulation performance, and clinical performance.

Joyce Victor,Phd, RN-BC, CHSE-A, is a graduate of NPR-Pittston School of nursing. She has a bachelor and MSN, MHA, and MA in Creative Writing from Wilkes University. She earned her PhD from Duquesne University School of Nursing, where her dissertation on a theoretical model for simulation design won the outstanding dissertation award. She is coauthor of the International Standards of Best Practice for Simulation: Design, published by the International Nursing Association for Clinical Simulation and Nursing (INACSL).
Victor-Chmil has been the Director of the Clinical and Simulation-Based Learning at the Passan School of Nursing at Wilkes University for the past thirteen years. She has been active in the American Heart Association on the local and state level. She is Regional Faculty for AHA BCLS, ACLS, and PALS programs and has served as National Faculty for ACLS for two terms. She is board certified in Professional Development through ANCC. She holds advanced certification as a Healthcare Simulation Educator (CHSE-A) through the Society for Simulation in Healthcare (SSH). Her research trajectory focuses on how academic programs prepare pre-licensure nursing students for entry into practice.

Nurse Educators are Faced with Challenges in Carrying out Research in the Global Arena

G. Elaine Patterson

Ramapo College of New Jersey, USA

Abstract Content: Study protocols in some countries often lack the rigors of established standards of ethical research. This paper provides some strategies for nurses intending to carryout research globally where an IRB may or may not be in place. Researchers involved in international research must commit to maintaining rigor and ethics. The international center for nursing ethics, (ICNE) lends guidance to these nurses. Researchers are reminded to always adhere to broad general principles of research including respect for person, beneficence, justice, and contextual caring.

Preparing: Prior to carrying out any study the researcher should (a) ensure that there is an ethical viable reason for carrying out the study, (b) involve the community of interest in the design of the study (c) and identify who in the community will benefit most from the study.

Challenges: Carrying out research in a foreign country is not without challenges. Researchers will do well to anticipate some misunderstanding between the local community and the researcher. There may be limited resources, inability to sustain long term involvement, limited technical capacity, inability to obtain consents, and concerns of the locals about exploitation in the use of the data.

Summary: Engaging nurses from the communitywill garner cooperation from subjects andin gaining overall support for the study being done. It is the community leaders who will identify where the needs are, the uniqueness of the situation, assist in disseminating the information about the study, and obtaining consents. Community workers will also be the ones to help maintain confidentiality during the study and disseminate the findings afterwards.

G. Elaine Patterson is a professor in the Ramapo College of New Jersey, USA. Her research interest is learning styles and critical thinking and Use of Electronic Portfolios. She has published many articled in different journals.

An Analysis of Scores Obtained by Undergraduate Nursing Students using Poster Presentations as the Assessment Method

Johanna McMullan

Queens University Belfast, UK

Background, including underpinning literature and, wherever possible, the international relevance of the research

Poster presentations are being used increasingly as a method of assessment in nursing (Davis, 2000). Although published accounts of their use are scant in this country, there is evidence that the method stimulates a positive attitude to learning (Halligan, 2007), facilitates applying the theory of research and nursing to the practice setting, (Conyers & Ritchie, 2001) and enables the development of transferable skills which will ultimately serve to enhance care delivery (Handron,1994).

The authors module contains a poster presentation summative assessment worth 20%. The group consists of undergraduate first year students who are studying general adult nursing and several “branch” students who in second year will branch into childrenʼs, mental health, learning disability nursing and midwifery. McMullan (2016) found the students enjoyed the poster presentation and found it developed many skills that were beneficial to their development as a nurse such as communication and literature critique However, this study also raised students concerns, the main being that marking was subjective and “it depended on who marked you” as to whether you got a high score or not, a common opinion held by students, the literature would suggest (Falchikov, 2013). Secondly, students revealed they believed that mature students would do better as they had more of the skills necessary for a good presentation from previous life experience, that females would find this an easier task than men and that branch students would get better scores than their general adult nurse colleagues.

Despite employing clear marking criteria (Tisi et al, 2013) support for new markers and a robust internal and external moderation of marks which is regarded as good practice (Bloxham, 2009) we were still faced with uncertain reliability and certainly a lack of faith in the robustness of the marking by students (Bell, 2013). An extensive search found no literature whatsoever that investigated the scores awarded from poster scores except for scant reporting of claims of reliability based on the spread of marks (Jackson, 2000).

Aim(s) and/or research question(s)/research hypothesis (es)

The aim of this paper therefore is to investigate marks awarded following poster presentations through statistical analysis of variables which could influence the reliability of scores as discussed.

1. There is no statistically significant difference between the scores obtained by students in various “branches” compared to other students.
2. There is no statistically significant relationship between the age of the student and the score obtained.
3. There is no statistically significant difference between the scores awarded by various markers.
4. There is no statistically significant relationship between experience of marker and the score awarded.
5. There is no statistically significant difference between the scores obtained by males and females.

Research methodology/research design, any ethical issues, and methods of data collection and analysis

The scores awarded to the September 2016 (n=362) cohort were used for this paper. Permission was sought and approved from Ethics and from the various markers involved. Anonymity was assured by assigning each student and marker with a number, the author is the only individual who would know identities and this information was kept securely. Scores were analyzed using various tests with SPSS:

Ho 2: Spearman.
Ho 4: Pearson correlation
Ho 5: Independent T-test t


  • Poster assessment
  • Reliability
  • Statistical analysis
  • Engagement

Three key points to indicate how your work contributes to knowledge development within the selected theme

  • Dispersing fears regarding unreliability
  • Student confidence in robustness of mark awarded
  • Enhancement of student engagement

Johanna McMullan is a lecturer in the School of Nursing and Midwifery Queens University Belfast. Johanna McMullan is currently a Ph.D. student. They jointly coordinate the life, social science and public health module Health and Well-Being delivered to undergraduate nursing and midwifery students. They both emanate from significant clinical backgrounds with many years in clinical practice as front-line clinicians, ward or unit managers or service managers, before returning to education. They both have an increasing range of joint publications significantly reflecting from their teaching and learning experience.

Service Learning: Expanding Community Partnerships and Student Learning

Emily Havrilla

Wilkes University, USA

Background: Service learning is an educational strategy that integrates service and student learning. Based on a reciprocal relationship between a community partner and an educational institution, it provides a unique opportunity for student learning. Grounded in the Kolb Cycle of Experiential Learning, service learning is comprised of instruction, service, and reflection. This partnership results in positive benefits for both partners.

Program: Service learning was initiated in the School of Nursing as an elective nursing course. Design of the service learning course included planning with the community partners. Existing faculty professional relationships with free health clinics in the community were expanded to include service by students enrolled in the service learning course. Course content included: vulnerability, vulnerable populations, and health disparities, cultural competence, social justice, and health policy. Reflective journaling and assignments were key elements in fostering learning. Students received course credits for both the didactic and clinical components of the course.

Outcomes: Service learning provided alternate practice opportunities and reframed knowledge acquisition through civic engagement. The link between knowledge and service fostered critical thinking and assisted in developing a life-long community perspective.

Emily Havrilla is an assistant professor in the department of nursing at Wilkes university. She has published many articled in reputed journals.

Importance of Nurses Knowledge of Delirium in the Intensive Care Unit

Juliana Mwose

Saint Maryʼs College, USA

Delirium is an acute central nervous system (CNS) dysfunction, with accompanying change in cognition, characterized by a disturbance of consciousness resulting from any number of common insults that intensive care unit (ICU) patientsʼ experience. It is the brainʼs form of “organ dysfunction.”Delirium typically manifests as a constellation of symptoms with an acute onset and a fluctuating course. Delirium is extremely common in the intensive care unit (ICU) especially amongst mechanically ventilated patients. Intensive care nurses must be trained to identify and manage delirium accurately. In the (ICU) patient, delirium occurs due to factors such as comorbidity, critical illness, and iatrogenesis. These complications of hospital stay are extremely hazardous in older persons and is associated with increased length of stay, institutionalization, and death. Neurologic dysfunction compromises patientsʼ ability to be weaned from mechanical ventilation or achieve full recovery and independence. Yet ICU nurses are usually unaware of the presence of different types of delirium and often times, only recognize this disturbance in agitated patients (hyperactive delirium). There are various delirium assessment tools. Although the CAM-ICU is the most widely studied and validated diagnostic instrument, the accuracy of this tool may be less than ideal without adequate training of the nurses applying it. The presentation will review the definition and salient features of delirium, its primary risk factors, and review validated instrumentsfor delirium assessment that have been developed for ICU nurses, and interventions to be used in delirium management in the ICU.

Keywords: Delirium, Critical illness, Coma, Sedatives, Antipsychotics

Dr. Juliana Mwose is a critical care nurse by background. She currently teaches both graduate and undergraduate nursing students at Saint Mary›s College at Notre Dame, Indiana, USA. Dr. Mwose also holds an advanced practice position with a Pulmonary and Critical Care Associates group where she manages patients with pulmonary diseases. From the day Dr. Mwose entered nursing school, she knew critical care was the areas she was interested in working in. She served as a critical care bedside nurse for 13 years both in acute care and in Long Term Acute Care (LTAC), before joining Pulmonary & Critical Care Associates as an advanced practice nurse. Juliana Mwose attained her undergraduate nursing degree from Indiana University of South Bend, Indiana, USA, Masters degree from Indiana University/Purdue University of Indianapolis with a concentration on Adult health. She proceeded to attain a Doctor of Nursing degree from Valparaiso University in Valparaiso, Indiana, US. In the community, Dr. Mwose has presented on the subject of delirium in the ICU, of which she states that “delirium continue to be a major problem especially in the ICU and there remains an opportunity for healthcare providers to improve the care of the ICU patient with regard to delirium.”

Use of Storytelling in Preclinical Nursing Education

Chris Calucci Bacchi

Dominican University of California, USA

Ramping up from pre-requisite admission criteria to undertaking pre-clinical curriculum is a leap for many. Pulling ideas from prior courses and understanding their clinical relevance is a daunting notion particularly when you have little or no direct patient care experiences to draw on. Students in clinical rotations have the advantage of connecting theory and practice. The use storytelling and portraying case scenarios provides a bridge in educating students to begin to think like a clinician.

Health professional students make use of a number of tools to assist in memorizing the vast amount of material that they must master during their training. Pneumonics come to mind. One can easily forget that what seems like a native tongue to a seasoned clinician, medical terminology, is actually yet another demand that novice students need to navigate. Relating this material to patient stories aids in placing material in the appropriate memory folder.

Manual skills, judgement calls, and time constraints play a real role in delivery of everyday care to patients. When students are flooded with trying to remember all their material, and have the pressure of having an instructor watch over them, it is no wonder that students are send into fight or flight mode. Under these circumstances it is easy for them to focus on details and miss the big picture. Thinking under pressure requires practice.

Clinicians know that they can arrive to their daily duties anticipating that something or other will throw their best laid plans into the need for a redesign. This important skill of re-prioritization based on current circumstances is something students are best served practicing in simulation prior to encountering this on their own in clinical settings. The ability to experience curve balls and debriefing with an instructor is a valuable addition to traditional delivery of didactic material.

Chris Carlucci Bacchi brings a wealth of knowledge, skills, and experience to her passion for health care education. Areas of focus include pathophysiology, assessment, and simulation. She received her M.D. from The University of California, San Francisco, M.S. from The University of California, Berkeley, a Certificate in Bioethics from Cambridge University, and her B.S.N. from The Catholic University of America. Dr. Bacchi completed residency at Stanford University. She has spent the last twelve years as an instructor at Dominican University of California. Her expertise in both nursing and medicine offers a unique perspective in communicating new material to novice students.

Intraprofessional Collaborative Care Practice Model in Primary Care

Linda Omondi

Southern Illinois University Edwardsville, USA

Redesigning the primary care system in America has become a national priority as the United States (US) struggles to solve issues of poor access, high cost, and suboptimal quality. The Institute of Medicine (IOM) recently highlighted the critical role that nurses will play in this redesign (IOM, 2011). Increasingly the delivery of primary health care depends on the contributions of various team members that represent different disciplines. It may be assumed that bringing together different health providers will make a team. But an effective team must develop over time.Our practice, a nurse-led Advanced Practice Nurse clinic, is in year two of a three-yearpilot program for an Intraprofessional Collaborative Care Practice (IPCP) /Education Model with the central core of the model being the role of a Nurse Patient Advocate (NPA). The disciplines represented are nursing, pharmacy, dental, and social work--as well as nonclinical staff. The NPA coordinates patient-centered team-based primary care. Based on the experiences in the pilot program; review of the literature; and expert input, challenges were identified. Our experiences revealed team conflict which included: role boundary issues; scope of practice, and a lack of understanding of how the role of the Nurse Patient Advocate could be effective as the core member of the team. Exploration of the role of the NPA in the IPCP, evaluation of the program over the last two years, guided the development of strategies for resolving team conflict and communication barriers to ensure the delivery of a team-based approach to patient centered care. Interprofessional Collaborative Care Practice Models improves care by increasing the coordination of services.

Dr. Linda Omondi is a Clinical Associate Professor at Southern Illinois University-Edwardsville (SIUE), Edwardsville, Illinois. She completed her undergraduate education at The John Hopkins University, Baltimore, Maryland, the MS-FNP at Georgia State University, Atlanta, Georgia, and the Doctor of Nursing Practice at The Medical College of Georgia, Augusta, Georgia. She was the former owner of a nurse-managed clinic for 10 years. As the Clinical Coordinator of the SIUE WE CARE clinic, she oversees the clinical coordination of the Interprofessional Collaborative Care Practice that includes the disciplines of Nursing, Dental, Pharmacy, and Social Work. In 2015, the clinic was funded for a three year-1.3 million dollar Health Resources and Services Administration (HRSA) grant for interprofessional collaborative education and practice.

Tale of Two Cities: East Meets West: Culturally Competent Instruction Beyond Geographical Boundaries in India and USA

Jackie L. Michael

University of Texas at Arlington, USA

Based on “Lessons Learned” and experience from teaching Health Assessment in Bangalore and Delhi (India); and Texas USA, presentation will include:

Purposeful design for “Culturally Diverse Classroom”.

Constructs for cultural competence for effective instruction, tried Globally and they Work!

Along with “Remembering why we wanted to teach” Best Teaching Practices.

Based on “lessons Learned” and experience from teaching Health Assessment in Bangalore and Delhi, India presentation is designed for beginner, intermediate and experienced instructors and faculty who are teaching in clinical and academic settings, and are faced with the challenges of the “Culturally Diverse Classroom” in a rapidly evolving environment and learners with diverse learning needs beyond those of age and learning styles. Innovative instructional considerations from content design to teaching strategies and evaluation methods along with Constructs for Cultural Competence will be discussed. Cultural competence is a journey and a process and not a one-time event. Five essential Constructs of Cultural competence will be discussed to include: cultural awareness, cultural knowledge, cultural skill, cultural encounters, and cultural desire. Intra-ethnic variations will be discussed. The impact of cultural consideration on evaluation methods to include rubric design based on course/program outcomes and essential content examples will be shared with the learners. Strategies for restructuring content to accommodate cultural nuances and resources available which impact learning activities and submissions will be shared with the audience. Inter Rater Reliability exercise, along with the course design process, principles, benefits and limitations and challenges for effective and efficient outcomes will be compared. Diagnostic Reasoning Skills and Scenarios problem focused exams conducted by graduate students and use of Standardized Patients (SP) for objective rubric-based evaluation and OSCE Lab set-up will be discussed to encourage the heart and bring the joy of teaching back in the on-line and in-seat class room as the author believes a “mistake is the price paid for a valuable lesson learned and not a “failure”, and “Remembering why we wanted to teach and revisiting our teaching philosophies from time to time is a good thing. Cultural competence creates effective and efficient learning environments and the ability to learn and adapt to local norms is essential to successful instruction in diverse settings.

4. Learning Objectives:

I. Discuss principles of instructional design including Essential Content considerations, credentialing requirements and expectations of stake holders who hire our students.
II. Discuss principles of instructional design and essential content requirements at programs in Delhi and Bangalore, India and Texas, USA
III. Compare innovative teaching strategies including constructs of cultural competence
IV. Apply constructs of Cultural Competence in culturally diverse classroom
V. Designing methods for evaluation including quality matrix, low stake and high stake graded efforts to measure effectiveness of instruction and learning.
VI. Compare innovative teaching strategies including considerations for technology requirements, timelines and schedules examples

Jackie L. Michael, RN, PhD, APRN, WHNP-BC has been a Registered Nurse for 29 years and a Womenʼs Health Nurse Practitioner for 24 years. She is a Clinical Assistant Professor at the University of Texas at Arlington College of Nursing and Health. She designs online courses. She has practiced as a Nurse Colposcopist and serves as a Legal Nurse Consultant and expert witness. She has many presentations, papers, and posters to her credit. Dr. Michael leadership includes National Association of Indian Nurses of America Executive President, Sigma Theta Tau International Honor Society of Nursing DT-102 Past President, Indian American Nurses Association of North Texas Past President and Advisory Committee Chair, Texas Nurses Association District 4 President Elect, TNA D4 Mock Trial Committee, and Elsevier Foundationʼs Nurse Faculty Leadership Academy Program Mentor.

The Development of Assertion Reason Questions (ARQʼs) for the Assessment of Level 7 Graduate Entry Nurses

Devi Nannen

University of York, United Kingdom

In order to make safe and sound decisions in a fast-changing and unpredictable clinical practice environment, nurses need knowledge that has a solid theoretical foundation, which is situationally relevant and clinically appropriate. Describing this as functioning knowledge, Biggs (2003) argues that it can only be acquired through a deep approach to learning and not a surface one. The need for nursing students to adopt a deep approach is therefore obvious.

Graduate Entry Nursing Programmes pose a challenge at assessing students at Level 7 on their understanding, application and reasoning of theoretical knowledge. Multiple Choice Questions are only able to assess the retention of factual knowledge and therefore not appropriate for post-graduate education. By contrast, Assertion Reason Questions (ARQʼs) allow the student to demonstrate high order thinking and thus a deeper level of understanding.

This session aims to provide attendees with a reflection on the development of ARQʼs that were ‘fit for practiceʼ, addressed university assessment guidelines, and assessed module content in a balanced way.

The session will provide an oral presentation on ‘how toʼ develop an ARQ along with the rationale for their use.

Devi is currently a lecturer in the adult field of nursing at the University of York in the United Kingdom, previously a lecturer at Universityof Nottingham. Devi contributes to the undergraduate, post-graduate and CPD modules. Devi also holds the role of Deputy Chair to the Board of Examiners and Chair of the Equality and Diversity Committee. Having trained in South Africa, Devi has varied experiences in nursing from medical, surgical, A&E, Intensive care and clinical education. Devi has worked nationally and internationally (Saudi Arabia). Deviʼs main clinical experience is in cardiac Intensive Care where she obtained a Specialist Practitioner Qualification (Critical Care) and became an ECMO specialist.

Professıonal Value Orıentatıon and Career Choıce of Turkish and United States Nursing Students

Joyce Simones1 and Sultan Ayaz2

1St. Cloud State University, USA
2Gaza University, Turkey

Career choice is someoneʼs inclination to one of various professions which s/he believes that the job includes activities which s/he is best at and will be the most satisfying one for her/himself (Özpancar and Aydın 2008). A research study inquiring aboutprofessional values and career choice was conducted with nursing students from a midwest USA nursing program and a nursing program in Turkey. In this study, the mean scores of nursing students in the US and nursing students in Turkey obtained on Nursing Career Decision Scalewere compared. Vocational Congruence mean score of USA students (38.5±5.9) was found to be higher than that of Turkey students (29.6±8.9). When comparing the Survival Needs subscale scores, mean score of Turkey students (17,2±4,5) was found to be significantly higher than that of USA students (15,8±3,9). These findings showed that USA students primarily considered suitability of a profession for themselves whereas Turkey students firstly considered living conditions.

Joyce Simones has been a nursing professor for over 25 years of baccalaureate teaching in the areas of Leadership, Medical/Surgical, Ethics, Foundations, and Home Care. Her clinical areas of practice have been critical/cardiac care and home care. Her research and publications have involved student thinking during medication administration, delegation through simulation, professional values, career choice, role of the RN in the emergency trauma unit, and role of the RN in home care after the Prospective Payment System. She has traveled with nursing students to Guatemala and Chile.

An Exploration into the Potential Costs and Benefits to Service Users (Citizen Trainers) of Engaging in a Co-Ordinated Teaching and Learning Initiative

Johanna McMullan, John Power, Gillian Prue and Olinda Statin

Queens University Belfast, UK

Background, including underpinning literature and, wherever possible, the international relevance of the research

Cohen (2015) argues for the importance of holistic nursing and to better achieve studentsʼ need to be educated holistically. (Young and Paterson, 2007) and (Bruce, 2007) suggest that historically there was perhaps a tendency towards an over structured curriculum and categorisation; the current focus would not necessarily negate `fixed informationʼ but with more of an emphasis on integration better reflecting the need to prepare students for social political and clinical situations that are complex, moralistic and unpredictableʼ (p.423). (Billings and Halstead, 2012) discuss some of the barriers to student centred learning which include addressing traditional silos of knowledge and expertise in a teacher led approach. The 2010 Nursing and Midwifery Council Standards for Preregistration Nursing and Midwifery Education focus the need for an integrated model of learning reflective of both the physical but also the psychosocial reality and living environment of patients and clients. As a result, The School of Nursing in Queens University Belfast sought to incorporate service users into curriculum development, assessment and teaching in the undergraduate programme.

The legacy of The Troubles in Northern Ireland has left thousands of injured and traumatised service users accessing the health service more frequently in their advancing years (WAVE, 2014). Globally, this ongoing experience of injury and disability reflects in many areas of civil conflict and civil war. A joint educative initiative between the School of Nursing and WAVE (a cross community voluntary organisation offering care and support to anyone bereaved or suffering trauma or injury as a result of the conflict) was established to inform students of the skills, knowledge and context required to care for such individuals through tutorials and a core lecture directed by Wave members called Citizen Trainers.

A paper which evaluated the Wave teaching initiative from the students perspective found the students rated the teaching extremely highly (McMullan et al, 2016), however there was a plethora of anecdotal evidence reported by the citizen trainers themselves that they enjoyed and reaped benefit from engaging with the students during this initiative. The aim of this research was to capture these benefits and potential costs to the citizen trainers when engaging in the teaching initiative.

Aim: An exploration into the potential costs and benefits to service users (citizen trainers) disabled by civil conflict of engaging in a co-ordinated teaching and learning initiative with nursing and midwifery students.

Research methodology/research design, any ethical issues, and methods of data collection and analysis

Qualitative methodology, involved fieldwork methods of focus groups and one to one interviews as appropriate immediately after completion of teaching. All citizen trainers were invited to participate and were fully informed and consented. All ethical considerations were addressed including confidentiality, data security and anonymity and ethical consent sought and approved. Measures were put in place to provide support for both students and citizen trainers in the event of stress arising after engaging in the activities.

Data was recorded, transcribed and analysed using a coding thematic content analysis framework (Gale et al, 2013) and data was interrogated by other colleagues involved in the initiative but not with the data collection to insure interrater reliability (Barbour, 2001).

Johanna McMullan is a lecturer in the School of Nursing and Midwifery Queens University Belfast. Johanna McMullan is currently a Ph.D. student. They jointly coordinate the life, social science and public health module Health and Well-Being delivered to undergraduate nursing and midwifery students. They both emanate from significant clinical backgrounds with many years in clinical practice as front-line clinicians, ward or unit managers or service managers, before returning to education. They both have an increasing range of joint publications significantly reflecting from their teaching and learning experience.

Experiences of Indigenous Student Nurse in Dealing with Death and Dying in Clinical Area

David Mphuthi

University of South Africa, South Africa

The purpose of this study was to explore first year indigenous student nursesʼ experiences of encounters with death and dying of a patient during clinical practice so as to make recommendations on increase support for first year student nurses. Qualitative research which was explorative, descriptive and contextual was conducted. Data collection was done using in-depth unstructured interview. Nine participants were interviewed and data was analysed following thematic analysis approach. The findings revealed that lack of experience, emotional trauma, low self-esteem and nutritional disorder are the outcomes of dealing with death and dying of patients for first year student nurses. Negative attitudes of clinical professionals, shortage of staff and congested block programme were identified as some aspects worsening the situation. Incidental learning that occurs with negative experience encountered was also identified as one of the experiences of the participants. The findings show the need for review of curriculum for first year student nurses and the need for change of attitudes of clinical professionals nurses so that they are able to mentor students. The above findings can also be attributed to high attrition rate amongst the first year nursing students as they feel overwhelmed by their experience. This can be attributed to the indigenous believe systems about death and dying.

Key Concepts

First year student nurse, indigenous, death, dying, encounter, clinical practice

David Mphuthi Current PhD candidate with North West University (SA) and has completed M.Cur, B.Cur (Adm et Ed), Dip. Nephrology, RN. David is a PhD scholar in Indigenous Knowledge Systems (IKS) also a lecturer in the Department of Health Studies, University of South Africa. David has published an article in the Journal of Renal Nursing in 2013.

Experiences of University of Limpopo Learner Nurses during Experiential Learning in Clinical Setting of Limpopo Province

Lekhuleni Masamo and Magdeline Thopola

Department of Nursing Science, University of Limpopo, South Africa

Background: The goal of undergraduate nursing education is to provide opportunities for learner to become professional nurses who acquired competency in cognitive, affective and psychomotor skills. Teaching in higher education does not solely concern learner nursesʼ ability to recall or reproduce information rather it concerns altering theirʼ understanding regarding the provision of quality patient care. The study aimed to explore the experiences of learner nurses during experiential learning in the clinical setting of Limpopo province.

A qualitative phenomenological research design was used. The population comprised all learner nurses registered for a four-year degree at the University of Limpopo. Purposive sampling was used to select 48 learner nurses who participated in the focus group interviews for data collection. Teschʼs open coding method was used for data analysis. Ethical clearance was obtained from the University Ethics Committee.

Findings: Five themes emerged from data analysis: attitudes of professional nurses in hospital, initial clinical anxiety, opportunities for learning, difficulty in correlation of theory and practice and good versus bad experiences.

Conclusions: Experiences of learner nurses in clinical setting provide opportunity to develop an effective clinical teaching strategy in nursing education. The main objective of this study was to explore the experiences of learner nurses regarding their learning experiences in the clinical settings.

Recommendations: Professional nurses should be encouraged on clinical teaching of learner nurses as part of their teaching function. Quality improvement strategies should be applied in the clinical settingto enhances correlation of theory and practice.

Dr. Lekhuleni Masamo is a professor in the department of Nursing Science at University of Limpopo in South Africa. She has published 43 articles on nursing education and nursing practice, presenter at national and international conferences.

A Model for Facilitating Teaching of Intimate Care to Nursing Students in South Africa

Sheila Mokoboto-Zwane and Simangele Shakwane

University of South Africa, South Africa

Intimacy and intimate care are concepts that are not freely used in nursing education, practice, and literature because of their sexual connotation. Nursing students provide basic nursing care to diverse patients. This care requires exposing and touching body parts considered intimate, private, or sexual in nature. This encounter may bring about feelings of anxiety, embarrassment, and discomfort for both nursing students and patients. The purpose of this study was to develop and describe a model for facilitating teaching of intimate care to nursing students in South Africa. A theory-generating, phenomenological qualitative design which was explorative, descriptive and contextual in nature was utilize to develop a model for facilitating teaching of intimate care to nursing students. A combination of stages of theory-generating by Chinn and Kramer (2011:184-205) and Dickoff, James and Wiedenbach (1968:431-434) were used to identify and define the main concept. A description of the model entailed a visual portrayal, and a description of the structure and process of the model, as well as evaluating it. Guidelines for operationalizing the model were also developed. It is envisaged that the developed model will empower nursing students to implement intimate care competently, comfortably, and confidently. This will enable them to establish nurse-patient intimate relationships, based on trust, respect, and dignity.

Keywords: Intimacy, intimate care, facilitating, teaching, therapeutic nurse-patient relationship, intimate care conflict

Sheila Mokoboto-Zwane is a Senior Lecturer & Researcher at UNISA in South Africa. She has published many articles in different journals.

Factors Contributing to Quality of Life for Individuals Diagnosed with Chronic Diseases

Mary L. White

University of Detroit Mercy, USA

Purpose/Aims: The purpose of this study is to determine factors that can contribute to quality of life for men and women diagnosed with a chronic disease, such as heart failure (HF). The factors that may be impacting HF are heart failure self-care practices, spiritual self-care practices, and depression. The aims are:

  • Does heart failure self-care practices moderate the relationship between depression and quality of life for individuals diagnosed with HF?
  • Does spiritual self-care practices moderate the relationship between depression and quality of life for patients diagnosed with HF?

Design: A correlational research design was used in this study. This research design is appropriate when trying to determine relationship among variables. The data used in this study was part of a previously conducted study on chronic disease and self-care.

Population/sample Studied: The participants included 140 male and female African American outpatients who had previously been diagnosed with heart failure. The participants had to be at least 18 years of age and able to read and understand English.

Methods (include instruments): The participants completed a short demographic survey, Heart Failure Self-Care Behavior Scale, White Spiritual Self-Care Practice Scale (SSCPS); World Health Organization Quality of Life – Bref (1996). The surveys were completed in the clinic using a private office to ensure confidentiality of the patient.

Data Analysis: The data were analyzed using IBM-SPSS ver. 24. The data were analyzed using moderation procedures developed by Baron and Kenny. Multiple linear regression analysis will be used to determine which of the predictor variables can be used to explain variance in quality of life among African American men and women diagnosed with HF.

Findings: Results indicated that depression was a statistically significant predictor of QOL in a negative direction, while heart failure self-care was significant in a positive direction. The interaction between depression and heart failure self-care was added to the analysis, heart failure was no longer a statistically significant predictor and depression became a stronger predictor of QOL. Results of the moderation effect of spiritual self-care practices on the relationship between QOL and depression indicated that the addition of the interaction between spiritual self-care practices and depression reduced the effects of spiritual self-care practices and decreased the relationship between depression and QOL, although the interaction effect was not statistically significant.

Implications: The findings indicated that self-care practices can have a positive effect on decreasing the relationship between depression and QOL. Nurses should provide self-care education to patients with chronic illnesses, specifically HF.

Conclusions/Recommendations: The results of this study indicated that self-care practices can help moderate the relationship between depression and quality of life for patients with chronic illness such as HF. Further research is needed to determine if patients who are practicing self-care have fewer negative episodes associated with their illnesses.

Mary L. White is aa associate professor and teaches across the undergraduate and graduate nursing programs. As a certified family nurse practitioner, she continues to practice in the community. Her research interests involve spirituality and spiritual self-care for chronic illnesses. She earned her BSN and MSN from University of Detroit Mercy and PhD from Wayne State University

A New Strategy in Nursing Education: From Hybrid Simulation to Clinical Practice

Fusun Terzioglu

Istinye University, Turkey

Background: Various instructional methods and environments are used in nursing education to develop studentsʼ psychomotor and communication skills, reduce their anxiety levels, and enhance their satisfaction.

Objectives: To examine the effect of three different instructional environments on the development of the studentsʼ psychomotor and communication skills and their levels of anxiety and satisfaction. Design: A prospective study design was used.

Methods: The sample of the study consisted of 60 nursing students. Before the implementation of the study, the studentsʼ cognitive skills and trait anxiety levels were evaluated. The students were divided into five groups and five nursing activities (Leopoldʼs maneuvers, teaching breastfeeding, family planning education, teaching vulvar self-examination and teaching breast self-examination) were specified for each group. They implemented these nursing activities under the supervision of a faculty member in the nursing skills laboratory, standardized patient laboratory and clinical practice environment respectively. In each instructional environment, the studentsʼ psychomotor and communication skills, state anxiety levels and satisfactions were evaluated.

Results: The median scores for psychomotor skills [Nursing Skills Laboratory=73.1; Standardized Patient Laboratory=81.5; Clinical Practice Environment=88.6] and communication skills [Nursing Skills Laboratory=64.9; Standardized Patient Laboratory=71.6; Clinical Practice Environment=79.0] were found to increase as the students went on practicing in a more complicated environment (p<0.05). Similarly, it was determined that the studentsʼ anxiety levels decreased as they were practicing incrementally [Nursing Skills Laboratory=33.0; Standardized Patient Laboratory=32.0; Clinical Practice Environment=31.0]. As the instructional environments were getting more similar to the reality, the studentsʼ satisfaction levels were found to become higher.

Conclusions: Students who deliberately practice in the instructional environments until they are competent develop their psychomotor skills while reducing their anxiety levels, and enhancing their communication skills and satisfaction. For that reason, the development of studentsʼ competency areas is thought to be effective for the enhancement of patients and healthcare workersʼ safety.

Keywords: Nursing education, clinical practice, nursing skills laboratory, standardized patient, psychomotor skill, communication, anxiety, satisfaction

She graduated in first place from Hacettepe University in 1989. She won the İhsan Dogramacı Superior Merit Award and Science Incentive Award. She earned her pilotʼs license from Republic of Turkey Ministry of Transport. She studied about counseling on assisted reproductive techniques at Liverpool Womenʼs Hospital Reproductive Medicine Unit in United Kingdom on the British Council Research Scholarship. She earned a certificate in management and leadership in nursing. She is an active member of Thematic Network leadership work group. She studied as a research scholar at Kent State University College of Nursing in 2006 for 3 months. In 2007, she worked on a project named “Development of Leadership Skills in Nursing Doctoral Students” at University of Michigan Faculty of Nursing on an international research scholarship which was supported by International Network for Doctoral Education in Nursing (INDEN) and Sigma Theta Tau and provided to only three people around the world every year. She worked as a research assistant at Hacettepe University School of Nursing in the Maternity and Womenʼs Health Nursing Division from 1990 to 1997. She was promoted to assistant professor in 1998, associate professor in 2006 and professor in 2012. She worked as a Co-Head of Nursing Department, Erasmus Department Coordinator, Head of Strategic Planning Group and board member of Hacettepe University Womenʼs Research and Implementation Center (HUWRICH) between 2009 and 2011. Her interest subjects are sexuality and reproductive health and management and leadership. She is member of national and international nurseʼs organizations such as INDEN and Sigma Theta Tau. She has been working as a Director of Nursing Services at Hacettepe University Hospitals between 2012-2016 and Founding Dean of Faculty of Nursing. She has published more than 70 papers, 15 grant projects, eight books as an editor and author, and more than 100 presentation in the national and international congress. She is also invited speaker more than 60 congress and symposium. She has working as a Dean Faculty of Health Science and Director of Nursing of MLPCare in Istinye University.

Impediments of Optimal Midwifery Experiential Learning Environments in Maternity Units of Public Hospitals of Limpopo Province, South Africa

Thopola Magdeline Kefilwe and Masamo Esther Lekhuleni

University of Limpopo, South Africa

The purpose of this study was to ascertain the impediments of optimal midwifery experiential learning based on the numeric information of level four learner midwives in the Nursing education institutions. The objective of the study was to identify the impediments of optimal midwifery experiential learning environment in maternity units of Public hospitals in Limpopo province. A cross-sectional, descriptive quantitative design was adopted. Simple random sampling was used to select a sample of 149 respondents. Data were collected using a pre-tested and validated self-developed questionnaire which was administered to the total population of learner midwives (N=148) and the response rate was 89% (N=133). Informed consent was received from the respondents as was ethical approval from the relevant authorities. Data were analyzed using SPSS version 20 with the aid of a statistician. Descriptive and inferential statistics were used to analyze the data.

The findings revealed that the majority of the respondents were challenged by impeded factors such as inadequate resources, limited equipment, poor mentoring and supervision; poor quality of learning opportunities. Some learner midwives were considered as workforce not learners and were made to do non-midwifery duties. The processes of checking and countersigning of maternity case registers and workbooks were not well planned and addressed as indicated by about 75%respondents. More than 25% also indicated that the learning situations were not sufficient and not meaningful. While 73.98 % indicated that they received constructive feedback from their supervisors, about half of the respondents indicated that the feedback was not given continuously. Recommendations were the need to increase midwifery practitioners and availability of material resources to ensure efficient and effective mentoring and supervision, thus, improve quality of midwifery experiential learning.

Keywords: Impediments; enhancement; optimal midwifery experiential learning environment

Dr Magdeline Kefilwe Thopola, teaches midwifery, supervising research to undergraduates and Masters Dissertations. Qualifications: Doctor of Philosophy (PhD), Mcur, B Cur: Nursing Education, Community Nursing Science, Occupational Health Nursing, Nursing Administration, Registered Midwife and Registered Nurse. Midwifery specialist, initiated advanced midwifery training in Ga-Rankuwa Nursing College. PhD Title “An evidence-based model for enhancing optimal midwifery practice environment in maternity units of public hospitals, Limpopo province. Presented research papers nationally and internationally. Published 13 midwifery articles in accredited journals. Reviewer of articles for publications in accredited journals. Served as faculty advisor of First Africa Cohort of Maternal-Child-Health Care Leadership Academy, 2013-2015.

Emotional Intelligence: Crucial to Quality Nursing Care and Patient Safety

Maria Dolores B. Mangubat

St. Josephʼs College, USA

Description: Emotional intelligence (EI) is one personal characteristic that is increasingly referred to as having an impact in nursing. It is suggested that EI is important for effective practice, particularly with respect to providing quality nursing care.

This systematic review explores what is meant by EI, discusses ways to develop emotional competencies, explores ways in which EI might be usefully applied in enhancing the quality of nursing care, and describes how an emotionally intelligent nurse can effectively improve the work environment which affects provision of quality care to patients.

It is crucial to nurses how they control and manage their emotions. From extensive research conducted by Goleman and his associates, and by The Hay Group of Boston, emotional competence has been found to matter twice as much as intelligence quotient and technical skill combined in producing superior job performance. Also, nursing literature shows widespread support for EI as central to nursing practice. Nurses should be able to regulate their own emotions for the sake of their patients. It is having supportive and positive work environment that help nurses to alleviate their stress in managing their own and othersʼ emotions at the same time. Nurses must know themselves well and will be able to react and respond appropriately in problem situations. Good relationships with others are shown by managing relationship and social awareness commonly called “social radar”.

Conclusion: It is very important to follow the EI framework consisting of the two components: the ability to understand and manage oneself and the ability to connect and react well to others. Having these qualities, nurses may create a healthy, safe, and productive environment which contributes to the delivery of a quality nursing care and safe patient outcome.

Maria Dolores B. Mangubat is a Registered Nurse, Clinical Nurse Specialist licensed and certified in New York State, nationally certified as CCRN and ACNS-BC. Currently, an Associate Professor at St. Josephʼs College, NY. She earned her Doctor of Education degree from Teachers College, Columbia University. She worked as Classroom and Clinical Educator in various schools, colleges, universities, and hospitals in the Philippines, Canada, and the United States. She held several administrative and managerial positions in different specialty units in NY hospitals. She was a former Clinical Preceptor of graduate nursing students in Nursing Informatics, Management and Education.

Self-Administration of Peroral Medicine

Helen Schultz and Niels Qvist

University of Southern Denmark, Denmark

Background and Aim: Recovery after surgery is increasingly taken place in the home of the patients where the patients are in charge of the administration of their medicine. However, incorrect use of medicine after hospital discharge has been described in several studies. The aim of this study was to investigate how self-administration of peroral medicine during hospitalization affected pain scores, use of analgesics and patient experience during and after hospitalization for patients with acute abdominal pain.

Methods: A quasi-experimental study was conducted in a surgical department and an emergency department observation unit in Denmark. Data was collected during December 2014- June 2015 (control group) and January-November 2016 (intervention group). Data was collected from medical file review and questionnaires.

Results: In total, 190 patients were included. Analysis of data is in process.

Conclusions: The study will provide knowledge about how self-administration of peroral analgesics affects pain intensity, use of analgesic and patient experience for patients with acute abdominal pain.

Acknowledgements: The study was funded by Odense University Hospital, University of Southern Denmark, and Novo Nordisk Foundation.

Helen Schultz performs a Ph.D. research study at the University of Southern Denmark of Emergency Departments, Emergency Department Observation Units and Surgical Assessment Units and has published papers on the topic. She is a specialist in critical care nursing and supervision, has 18 years experiences within critical care nursing, 3 years experiences within general surgical nursing and 12 years experiences as supervisor and has published a book on that subject.

Assessment of Nursing Care in Hospitals by Level of Care Dependency of Patients: An Example from Turkey

Esra Özbudak and Ayşegül Oksay Şahin

Karabük University, Turkey.

The quality of nursing care is influenced by many factors, such as the nurse or the patient. It is thought that the level of care dependence of the patients may also be effective in evaluating the care services offered because they can change their needs and expectations.

The study was carried out as a descriptive study to evaluate the level of care dependency and nursing care services of the patients in hospitals located in a province center in Turkey. The sample consisted of 381 patients in a university and a public hospital. Data collection were used “Care Dependency Scale” and “Nursing Care Assessment Inventory”. The data were collected through face-toface interviews with patients who received informed consent following ethics committee and institutional permission. Mann Whitney U, Kurskall Wallis, Spearmanʼs Correlation Coefficient were used in the evaluation of the data.

55,64% of the respondents were female, 54,07% were over 60 years of age, 56,69% were primary school graduates, 69,03% were colleagues and 94,3% were staying with patients all day revealed. According to the average of maintenance dependency scale score, found to be highly dependent on university hospital(66,73±17,23), fully dependent in state hospital (75,74±11,02). On the provincial basis, the average nursing care assessment score was found to be 218,77 ± 28,32 with good care at advanced level. But the total score of the nursing care assessment of patients in the state hospital is significantly lower than that in the university hospital (z:-3,576, p=0,001).

Patients described nursing care as good care at an advanced level in both provinces. No significant relationship was found between the level of care dependence and the assessment point evaluation of nursing care in the study.

Authorʼs Note: This study is under the supervision Yrd. Assoc. Dr. Ayşegül OKSAY ŞAHİN is derived from a master thesis study conducted by Esra ÖZBUDAK in the Department of Nursing Science at the Institute of Health Sciences of Karabük University.

This study was supported by Karabük University Scientific Research Projects Coordination Unit. Project Number: KBÜBAP-17-YL-197

Keywords: Nursing, Care Dependency, Evaluation of Nursing Care

Esra Özbudak. In 1991, the world came to Çorum. She studied at various schools throughout her years of education. Hitit University Nursing Department finished in 2013 as the first.
She worked as a nurse for two years. Later, she started to work as an Instructor at Gaziosmanpaşa University. Sheʼs still on duty. She is also a graduate student at Karabük University Health Sciences Institute Nursing Science Department.

An Evaluation of the Psychoeducation Program for Emotion Identification and Expression in Schizophrenia

Elif Aşik and Gül Unsal Barlas

Nursing Department, Kırıkkale University, Turkey

The inability of patients with schizophrenia to recognize their facial expressions is an important issue that has an impact on social functioning. This study was conducted to determine the effects of a psychoeducation program for emotion identification and expression in schizophrenic patients on their ability to identify and discriminate between emotions and on their social functionality.

The study was of quasi-experimental design (pretest-posttest, with control group). Schizophrenic patients tracked at the Public Mental Health Centers (PMHC) comprised the intervention (21) and control (21) groups. A 10-week psychoeducation program was administered to the intervention group. The psychoeducation program, prepared by the researcher on the basis of the literature, was set up after obtaining the views of 10 experts. Measuring instruments were administered to the groups before the intervention, after the intervention, and 3 months after that. The measuring instruments consisted of a personal information form, the Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT) and Personal and Social Performance Scale (PSP). The data were analyzed with the SPSS 21.0 program, using the “two-way repeated measures analysis of variance.”

In the first measurements taken at the conclusion of the psychoeducation program, a significant difference was found (p<0.001) between the intervention and control groups in terms of their FEIT and PSP mean scores. In the measurements taken 3 months after the conclusion of the psychoeducation program, this difference had disappeared. In the first measurements taken at the conclusion of the psychoeducation program, FEDT mean scores had increased, but there was no statistically significant difference between the two groups. The psychoeducation program implemented in the study is an effective program that makes recognition of facially expressed emotions possible and increases the social functioning of patients. These programs may be used at the PMHCʼs and in rehabilitation programs after discharge. They should, however, be repeated.

After Elif Aşik graduated from Nursing Department of Abant Izzet Baysal University, she red master program about mental health nursing. Then she graduated from doctorate program of Marmara Universityʼs Mental Health Nursing Department. She interested in schizophrenics, disability people and art therapy along the education life. She has reports and articles about these subjects. She worked as a mental health nurse in different hospitals in Turkey. Now she works as a lecturer at Kırıkkale University in Turkey.

Moments of Birth and Death – A Personal Journey

Janette O Sullivan

Kingsborough Community College, USA

The care that nurses and midwives render to those who are dying and those who are laboring towards giving birth has many similarities. As an oncology nurse, I have assisted women (and men) when they were at the end of their lives. As a nurse-midwife, I have taken care of many women and attended their births. Being present at the beginning and the end of life is an honor beyond words. My work as a nurse-midwife prepared me well for caring for my mother at the end of her life. One of the hallmarks of midwifery care is non-intervention – to honor and support the process as long as there is normalcy. Support at the end of life includes honoring the wishes of the dying person and offering support and palliative care.

Janette O Sullivan became a registered nurse in 1984 and worked for five years in oncology. She had a strong interest in maternity and completed her nurse-midwifery training at Columbia University in 1992. She has worked in hospitals in NYC and in an out-of-hospital birth center. For ten years she had a private practice with a midwife in Brooklyn, NY. I teach Nursing at Kingsborough Community College.

An Evidence - Based Model for Enhancing Optimal Midwifery Practice Environment in Limpopo Province, South Africa

Thopola Magdeline Kefilwe and Masamo Esther Lekhuleni

University of Limpopo, South Africa

A sequential explanatory mixed method research design was adopted in order to develop an evidence-based model for enhancing optimal midwifery practice environment. The design was utilized in four phases: quantitative, qualitative, model development and validation of the model. Population comprised of midwifery practitioners and learner midwives. Simple random sampling was used to select 174 midwifery practitioners and 173 learner midwives. Ten midwifery practioners and ten learner midwives participated only in the pilot study. Self-developed 4-point Likert scale questionnaires were administered. Statistical Package for Social Science version 22 was used for data were analysis using descriptive and inferential statistics. Phenomenological semi-structured interviews were conducted for midwifery practitioners (n=20), 3 Focus group discussions of learner midwives (n=18) and 3 focus groups of puerperal mothers (n=18) were held until data reached saturation. Interview guides were used for individual interviews and focus group discussions to explore the quantitative findings in more depths through qualitative data analysis. Data were analysed qualitatively using Teschʼs open-coding methods. Themes and sub-themes were coded manually. An interpretive integration of quantitative and qualitative designs was used for data collection and data analysis.

The results that emerged from the corroboration, comparison and integration of numeric and narratives revealed: the existence of sub-optimal midwifery practice environment, sub-optimal midwifery experiential learning environment and provision of suboptimal midwifery interventions. An evidence-based model for enhancing optimal midwifery practice environment was developed from using reasoning strategies and the process of concept analysis. The components of the structure of the evidence-based model were: context, goal, existing environment, dynamics, sub-optimal midwifery practice environment, arrows and circles, bridge the gap and ideal situation. The evidence-based information from the existing situation as seen from the world of participants brought about a gap of optimal midwifery practice environment. Protocols were designed for quality improvement pertaining to human and material resources. Guidelines for utilizing evidence-based model were formulated.

Dr. Thopola Magdeline Kefilwe, teaches midwifery, supervising research to undergraduates and Masters Dissertations. Qualifications: Doctor of Philosophy (PhD), Mcur, B Cur:Nursing Education, Community Nursing Science, Occupational Health Nursing, Nursing Administration, Registered Midwife and Registered Nurse.
Midwifery specialist, initiated advanced midwifery training in Ga-Rankuwa Nursing College. PhD Title “An evidence-based model for enhancing optimal midwifery practice environment in maternity units of public hospitals, Limpopo province.
Presented research papers nationally and internationally. Published 13 midwifery articles in accredited journals. Reviewer of articles for publications in accredited journals. Served as faculty advisor of First Africa Cohort of Maternal-Child-Health Care Leadership Academy, 2013-2015.

Introducing the Relationship-Based Care Model in Undergraduate Nursing Education

Kimberly Garcia

Drexel University, Philadelphia, PA

Relationship-Based Nursing Care is a care delivery model that strives to transition nursing care from task-focused to relationship-based. In Relationship-Based Care (RBC), the goal is to provide care that is perceived by patients as personal and caring. Holistic, individualized, person-centered, and culturally competent care all begin with the need to initially recognize the person, not the disorder. This delivery model has been associated with improvement in patient safety, increased patient satisfaction, decreased readmissions, and the perception of improved teamwork among nurses. As patient satisfaction scores are increasingly included in hospital outcome measures, the focus on the nurse-patient relationship has intensified. While the patient has been the primary focus of RBC, this delivery model is actually founded on three core relationships, including the nurse with the patient, the nurse with colleagues, and the nurse with self. Nurse-colleague relationships are instrumental in providing a milieu that is conducive to satisfactory patient care. Negative interpersonal relationships among nurses have a significant impact on the retention of nurses. Research suggests that up to half of all newly registered nurses will leave their positions, often due to collegial aggression and bullying in the workplace. Negative peer relationships are associated with physical and emotional exhaustion and burn out. Despite these destructive challenges, nurses are expected to provide stellar patient-centered care. At Drexel University, RBC is introduced in the studentsʼ introductory nursing course. Students are provided with course content that specifically addresses communication techniques and legal and ethical principles that guide their relations with others. By preparing students for the reality of work place challenges, not only clinically but interpersonally, quality of life and job retention can improve for future nurses.

Dr. Kimberly Garcia, DNP, CRNP, FNP-BC, GNP-BC, PMHNP-BC, NP-C is an Assistant Clinical Professor at Drexel University College of Nursing and Health Professionals. She obtained her BSN, MSN in nursing education, and post-masterʼs certificates in Transcultural and International Nursing and Family Nurse Practitioner from Duquesne University. She is a student in Duquesneʼs DNP-to-PhD program. She received her Doctor of Nursing Practice degree from Columbia University. She received a post-masterʼs certificate in psychiatric mental health nurse practitioner studies from the University of Virginia. Dr. Garcia has more than 18 years of nursing experience, including 10 years as a nurse practitioner. Clinically, she maintains an active clinical practice, working in both acute care and community mental health settings. Her research interest focuses on the experience of individuals with opiate use disorder.

Assessment of Chronic Disease Patients Views of their Care and Treatment

Hediye Arslan Özkan and Sevim Şen

Yeditepe University, Turkey

Introduction: According to the World Health Organization, chronic diseases are defined as slow progressing, incurable by medical interventions, long-term, require periodic follow-ups and support care in order to reduce the severity of the disease andenhanceoneʼs physical functions and autonomyfortheir care management. Chronic diseases cause major changes andchallenges in patientsʼ daily life as a result ofcontinuousobservations, long-term follow-ups and care requirements, irreversible pathologies, persistent inadequacies or limitations of movement. In addition, chronically ill individuals become a financial burden to their family and society. For this reason, it is of utmost importance that chronic disease management is strengthened not only for the treatment of the disease but also for patients gaining self-management skills.

Objective:This study was conducted to evaluate the perception ofpatients with chronic diseases regarding the treatment and care services they receivedand to identify the factors that impeded this careprocess.

Methods: The sample of the study consisted of 191 volunteers with chronic illnesses who were treated in public and private hospitals in February, March and April 2017. “The Patient Assessment of Chronic Illness Care -Patient Form” and “Patient Information Form” were filled with face-to-face interview method. The data were evaluated by Cronbach alpha, mean, percent and Pearson correlation analyzes using the SPSS 24 packet program.

Results: In the study, the mean age of the sample group was 66.02 ± 15.57 (min: 21, max: 95 years), 52.4% were male, 47.6% were female, 74.9% were married, 43.5% were primary school graduates, 47.1% received care support and 99% had health insurance. 49.7% of the participants had diabetes mellitus, 17.8% had hypertension and 12% had heart disease. The examination in this study revealed that the 3 most common problems in continuity of treatment and care for chronic diseases; 36.6% were unable to manage the sypmtoms and complications, 12% were regular follow-up incompetencies and lack of self-care, and 10.5% were the stress of living with thediseases for life. The participants were asked what would reduce the burden of their treatment and care, 36.1% of the responses were reduced complications, 20.9% full recovery from the illness and 11.5% adequate information and education. The Patient Assessment of Chronic Illness Care scale, subscale means weredetermined as following: Patient Participation (Items 1-3) 3.89 ± 1.23, Decision Making (Items 4-6) 3.86 ± 1.03, Objective Determination (Items 7-11) 3.54 ± 1.31, Problem Solving (Items 12-15) 3.80 ± 1.14, Monitoring / Coordination (Items 16-20) 3.40 ± 1.23. The overall scale mean was (1-20 items) 3.65 ± 1.44. Cronbach alpha of the scale was analysed which was .93. The determination of higher subscale scores in patient participation, decision making and problem solving reflects that the participants were more satisfiedin chronic disease care.

Conclusion: In recent years, the increasing prevalence of chronic diseases has revealed the importance of chronic disease management which requires planning of treatment and follow-up, improvement of care results and quality, and patient satisfaction. The services provided to individuals with chronic illnesses should be assessed regularlyso that the quality is maintained and improved. When the health care services provided to participants were evaluatedin the survey, it was observed that the results were above the average scale score. Non the less, it was also appeared that individuals with chronic disease should be strengthened byeducating them regularly for management of regular follow-upsandcomplications.

Keywords: Chronic Care, Health Management, Self Care, Nursing

Hediye Arslan Özkan is a professor in the Yeditepe University, Turkey. She has copleted her PhD at İstanbul Üniversitesi in 1985.

Using Prayer and Yoga to Reduce Stress among Hispanics with Chronic Conditions

Sandra Benavides-Vaello

Montana State University, USA

The purpose of this pilot and formative study was to explore the receptivity of using prayer and yoga to reduce stress among Montana (MT) Hispanics with diabetes and/or hypertension. Stress is a known contributor to poorer diabetes and cardiovascular management. Yet, daily stress is one of the most common complaints among Hispanics with chronic conditions, including diabetes and/or hypertension. Evidence supports that meditation and/or meditative type activities such as yoga are effective in reducing stress biomarkers and positively impact metabolic and cardiovascular health. Evidence also supports that Hispanics are responsive to parish-linked services. This is not surprising since religion and health are tightly connected in most Hispanic cultures and nearly 70% Hispanics identify as being Roman Catholic, with the majority being actively involved in religious services. Thus anchoring a self-management health intervention (prayer/yoga for reducing stress) within a faith-based institution has great potential for success.

In a review of the literature, no studies could be identified that combined prayer and yoga as an activity to reduce stress among Hispanics with chronic disease. The purpose of the pilot study was to specifically evaluate if using prayer and yoga could reduce stress and if the population of focus was receptive to such an approach. The pilot study involved the targeted/ recruitment of n=30 Hispanic men and women, residing in MT, with hypertension and/or diabetes. Criteria for participation in the study were: self-Identified Latino/Hispanic; adult persons 21 years and older that have diabetes or hypertension; able to speak Spanish or English languages; reside in MT; open to prayer, in the Catholic form, as part of the activity (participants were not required to be Catholic to take part, but had to be comfortable with using Catholic doctrine during the yoga activity and yoga sessions as these were held in the Catholic parishes across rural Montana; self-identified as being able to independently engage in yoga – level activity.

The specific aims of the study were to: 1) Evaluate the receptivity of using a prayer/yoga session as a venue for reducing stress among Hispanics with diabetes or hypertension that reside in MT participatory action based –approach; 2) Employ the results from the pilot study to inform and aid in the design of an intervention study. The pilot study employed an exploratory descriptive (formative) methodology that used Participatory Action Research (PAR) as the guiding approach. Multi-methods were used for the gathering of data and to address the aims of this investigation. An interpretive descriptive methodology was used for the qualitative arm of the study. Data from debriefing groups (post yoga), participant observation, and field notes were the methods for collecting qualitative data. The quantifiable (quantitative) arm of the study used a descriptive approach and data sources were the pre/post stress surveys [Stress scale and Perceived Stress Scale (PSS-4)] and demographic information collected from all participants. To characterize the study group, demographic characteristics and key variables for all participants were summarized for the group. These attributes included age, gender, acculturation (primary language spoken), and stress experience.

Dr. Benavides-Vaello is an associate professor in the College of Nursing at Montana State University-Bozeman, and Director (Department Chairperson) for the Missoula Nursing Campus. The focus of her research is the sociocultural experiences (food practices, health status monitoring, cultural values and norms, behavioral health concerns), social determinants, and self-care of low income Hispanics with chronic conditions. She is an international scholar, researcher and the author of numerous peer reviewed scholarly publications and co-authored chapters in two books: U.S.-Mexico Border Health: Issues For Regional And Migrant Populations, and AIDS Crossing Borders, The Spread Of HIV Among Migrant Latinos. Dr. Benavides-Vaello holds a bachelorʼs in nursing and doctorate in nursing from The University of Texas, School of Nursing, Austin, Texas, and a Master of Public Affairs (focus on health policy) also from The University of Texas, LBJ School of Public Affairs, Austin, Texas.

Appropriateness and Timeliness of Care Seeking for Complications of Pregnancy and Childbirth in Rural Ethiopia: A Case Study of the Maternal and Newborn Health in Ethiopia Partnership

Lynn M. Sibley1, Yared Amare2, Solomon Tesfaye Abebe3, Mulusew Lijalem Belew4 and Kemeredin Shiffra5

1Emory University, USA
2,3Consultancy for Social Development, Ethiopia
4Amhara Regional Health Bureau, Ethiopia
5KemeredinShiffra, Oromia Regional Health Bureau, Ethiopia

Background: The USAID/University Research Co., L.L.C. Translating Research into Action Projectʼs Systematic Documentation of Illness Recognition and Appropriate Care Seeking for Maternal and Newborn Complications launched in 2014. The project used a common protocol involving descriptive mixed-methods case studies of community projects in five low- and middle-income countries, including Ethiopia. In this paper we present the Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) case study.

Methods: Methods included secondary analysis of data from MaNHEPʼs 2010 baseline and 2012 end line surveys, health program inventory and facility mapping to contextualize care seeking; and illness narratives to identify factors influencing illness recognition and care seeking. Analyses used descriptive statistics, bivariate tests, multivariate logistic regression and thematic content analysis.

Results: Maternal illness awareness increased between 2010 and 2012 for major obstetric complications. After 2012, the Ministry of Health introduced nationwide initiatives to improve the supply and demand for maternal and newborn health care. By 2014, care seeking for perceived maternal illness increased by 26% and occurred more often compared with care seeking for newborn illness (64% vs. 38%)--a difference notable in cases of culminating death (100% vs. 31%). Most families sought care < 1 day of illness recognition. Facilitating factors were health extension worker advice and ability to refer upward, and health facility proximity; impeding factors were time of day, weather, road conditions, distance, poor communications, lack of transportation or money, perceived spiritual or physical vulnerability of the mother and newborn, postnatal restrictions on movement, and preference for traditional care. Some families sought care despite disrespectful, poor quality care.

Conclusions: Improvements in illness recognition and care seeking observed during MaNHEP and reinforced through new government initiatives can be expected to continue if concerted efforts are made to reduce identified barriers and improve quality of care.

Lynn Sibley is Professor in the Nell Hodgson Woodruff School of Nursing at Emory University and holds a joint appointment in the Rollins School of Public Healthʼs Department of Global Health and affiliate appointment in the Department of Anthropology. Her career has been devoted to reducing maternal and newborn mortality across low resource settings by focusing on community-level formative and implementation research and programming. Other professional activities include advisor/consultant on community-level maternal and newborn health to well-respected global organizations including the World Health Organization, UNICEF, International Confederation of Midwives, United States Agency for International Development and National Institutes of Health.

Effect of Family Empowerment on the Quality of life of School-Aged Children with Asthma Attending Pediatric Outpatient Clinics of Tanta University and El-Mehalla El- Koubra Chest Hospital

Latiefa Fouda, Amaal Mohamed Ahmed El-Zeftawy and Amiera Sad

Tanta University, Egypt

Abstract: Asthma affects a childʼs quality of life and overall health. Although children with asthma should be able to achieve good asthma control.

Aim of the study: To evaluate effect of family empowerment on the quality of life of school-aged children with asthma attending pediatric outpatient clinics of Tanta University and El-Mehalla El- Koubra chest hospital

Materials and Methods: The study design was quasi -experimental study. This study was conducted at the Pediatric Outpatient Clinic of Tanta University and Outpatient Clinic of El-Mehalla El- Koubra Chest Hospital. A convenient sample of 47 asthmatic children and their parents in the selected settings who were willing to participate in the study then randomly divided into two groups of intervention (case) (23 children) and control (24 children). Three tools were used by the researchers to obtain the necessary data, the structured interview questionnaire sheet and tool II:- Measures Child quality of life and tool III: - Measures Parent/caregiverʼs quality of life.

Results: The mean of the age of the children in the family empowerment group was (Mean ±SD: 8.91 ± 2.52) while it was (Mean ±SD: 8.66± 2.18) in the control group. More than half of children (56.5% and 58.3%) were male in the family empowerment group and control group respectively. There was statistical significantly different between both groups in the total and subscale scores of quality of life of children before and after the intervention of family empowerment group (p<0.05).

Conclusion and Recommendations: There was significantly different between both groups in the total and subscale scores of quality of life of children and caregivers before and after the intervention of family empowerment group and before after two weeks of control group (p<0.05). Educational programs about asthma are recommended to be performed on asthmatic patients in all age groups.

Keywords: Family Empowerment, Asthma, School-aged children, Quality of life

Latifa Mahmoud Fouda is a professor, of community health nursing Nursing departments and head of department of community health nursing in the university of Tanta in Egypt. She has published about 18 articled at international Journals.

School Nurses and Health Visitors Perceptions of Oral Health Promotion: A Qualitative Study

Anne Marie Coll

University of South Wales, UK

Objectives: The study aimed to explore the views of health professionals with regard to their role in oral health promotion and their understanding of the issues surrounding the delivery of effective oral health promotion within their daily practice.

Method: A focus group was conducted with school nurses (n=6) and health visitors (n=3) who had recently completed the ‘Evidence Based Public Healthʼ core module as part of their higher degree Specialist Community Public Health Nurse (SCPHN) programme of study (May 2014). A 12-item focus group interview schedule was devised in which face and content validity were established. A thematic analysis was then undertaken in which themes and sub-themes were identified.

Results: Three over-arching themes were identified: the ‘responsibilityʼ the participants felt they had towards their clients, the responsibility the parents should have towards their childrenʼs oral health and the responsibility of the state and its policies; the main ‘barriersʼ encountered in the participantsʼ practice; and the need for a ‘cohesive approachʼ in promoting the communication of key messages on oral health.

Conclusions: Although school nurses and health visitors are best placed to take the lead on oral health promotion in children and young people, several barriers were identified, which prevented them from performing this role effectively and confidently. The participantsʼ belief that the consequences of poor oral health is incentive enough for behaviour change may well have been a main contributory factor to their perceived ineffectiveness and frustration. A recommendation is made for more training, which focused on behaviour change principles of concordance and setting realistic targets tailored to the needs of those children and young people who need it most.

Dr. Anne Marie Coll is a senior lecturer at the University of South Wales in United Kingdom. She completed her PhD in 2001. She has published many articles in reputed journals.

Colorectal Cancer Screening and Preventive Health Behaviors among Thai Immigrants in America

Bulaporn Natipagon-Shah, Eunice Lee and Samantha Sangsanoi-Terkchareon

California State University San Marcos, USA

Background: In the past decade, the Thai American (TA) population in the United States (US) has increased by 58.08%, while colorectal cancer (CRC) death rates have gradually increased. However, very little is known about CRC screening among the TA population.

Purpose/Objectives: The purpose of this cross-sectional quantitative study was to (1) explore TAsʼ CRC screening beliefs, and behaviors, and (2) examine the relationship among socioeconomic status (age, religion, years of education), access to health care, spousal support, preventive behaviors, and CRC screening behaviors in the TA population.

Methodology: This study was driven by the health belief model supplemented by a cultural explanatory model. A purposive, convenient sample of self-identified TAs who were 50 years of age or older and resided in Southern California participated in the survey. The participants were recruited from Thai Buddhist temples, community agencies, and community events. Eligible participants who agreed to participate gave consent and answered questions to measure demographic variables and their knowledge, beliefs and behaviors related to CRC screening.

Results: A total of 138 TAs (49 male and 89 female) participated in the survey. The mean age of participants was 61. The majority of them were immigrants (98%) and Buddhist (98%), had lived in US more than 15 years (86%), and had health insurance (93%). About half of the sample had more than a high school education (47%). About three fourths of the participants (68%) had had CRC screening of some type (fecal occult blood test, colonoscopy, or sigmoidoscopy) and 54% of the participants were up to date on CRC screenings. Those with a primary physician and those who had had a screening without symptoms in the previous 2 years were more likely to have had a CRC screening ( p = 0.01). Having CRC-related knowledge and a higher level of perceived susceptibility, benefits, spousal support, and lower level of perceived barriers were also more likely to have had a CRC screening (p = 0.05). Having CRC screening was positively related with measured blood pressure, blood sugar, and cholesterol within the previous year. TAs who lived in the US longer than 15 years (AOR = 26.7; CI = 1.3–532.6), who had greater perceived susceptibility of CRC (AOR = 2.2; CI = 1.0–4.7) and who had greater perceived self-efficacy to obtain CRC screening (OR = 1.2; CI = 1.0– 1.4) were more likely to have had CRC.

Implications for Nursing: Culture-specific health interventions targeting TAs who have lived in the US less than 15 years and who have less desirable CRC-related health beliefs and who are less likely to be getting preventive health services could be helpful in decreasing cancer disparities in the TA population.

Dr. Natipagon-Shah is a health researcher whose overarching goal is to promote culturally sensitive and competent care. Her research emphasizes on cancer prevention and awareness among the Thai-American population. She received a CBCRP grant for her research to study the knowledge and screening of breast cancer in Thai immigrant women where she published her research findings in peer-reviewed journals and presented the findings at both national and regional conferences. Her most recent research was to examine colorectal, cervical, and breast cancer screening behaviors and the influence of spouse in supporting the screenings among Thais. Dr. Natipagon-Shah is a fellow at Western Institute of Nursing Research and Sigma Theta Tau International. She also has over twenty years of teaching experience in generic BSN, accelerated BSN to MSN, and MSN programs. She currently works as an Assistant Professor at California State University at San Marcos, USA.

Cultural Variations in End-of-Life Simulation

Victoria R. Hammer, Susan M. Herm and Katherine A. Koepke

St. Cloud State University, USA

The Cultural Variations in End-of-Life Simulations were created Fall 2012 for a second semester baccalaureate nursing course entitled Nursing Care of Older Adults. End-of-life (EOL) content was included in the classroom course, but there were no end-of-life simulations. Some students cared for a person at EOLor cared for a person of a different culture. End-of-life simulations were developed revolving around the time of 15 minutes before and after death for the three cultures of Christian Caucasian, Native American, and Islam Somali. These were chosen as they were predominate cultures where the nursing students had clinical experiences. Individuals from each culture and health professionals participated in developing the scenarios. Research data focusing on the studentsʼ perspective was collected immediately following the full day enactment of the three simulations (Phase I), at the time of graduation (Phase II), and approximately one year after graduation (Phase III). The data collection included thoughts and feelings or experiences; what went well; what to change; and what was learned. Phase I data has been collected from ten cohorts (N=350). Phase II data has been collected from seven cohorts (N=232). Phase III data has been collected from five cohorts (N=31). Themes from the Phase I data: students learned EOL care for patients/families and cultural and spiritual implications of care and felt more comfortable and prepared for performing EOL cares including communicating with families. Phase II data:129 out of 232 (56%) had experienced EOL situations during the nursing program, felt prepared to care for those at EOL, and were more aware of cultural/spiritual needs for all patients/families. Phase III: the new graduate nurses felt comfortable and confident providing care for a dying patient and their family in a variety of settings and were more cultural sensitive to needs of a patient/family from other cultures.

Victoria is an Associate Professor in the Department of Nursing, St. Cloud State University, St. Cloud, MN. She currently teaches courses in Nursing Care of the Older Adult, Nursing Law and Ethics, Nursing Leadership and Management, and Nursing Capstone Seminar. She received her BS in Nursing from St. Olaf College, Northfield, MN, her Masterʼs in Nursing from the University of Washington, Seattle, and her Doctorate of Education in Adult and Higher Education from the University of South Dakota, Vermillion. She is a member of Sigma Theta Tau International and the National League of Nursing.

Quality of Chest Compressions and Compliance by Healthcare Professionals with Real-Time Audiovisual Feedback during in-Hospital Cardiopulmonary Resuscitation

Kristina Schildmeijer1, Birgitta Semark2, Kristofer Årestedt3, Johan Israelsson4, Jörg Carlsson5 and Burkard von Wangenheim6

1,2,3Department of Health and Caring Sciences, Linneaus University, Sweden
4,5,6Department of Internal Medicine, Division of Cardiology, Kalmar County Hospital, Sweden

Introduction: A high quality of chest compressions, e.g. sufficient depth (5-6cm) andrate (100-120 per minute), has been associated with survival. The patientʼs underlay affects chest compression depth. Depth and rate can be assessed by feedback systems to guide rescuers during cardiopulmonary resuscitation (CPR).

Aim: To describe the quality of chest compressions by healthcare professionals using real-time audiovisual feedback during in-hospital CPR.

Method: An observational descriptive study was performed including 63 cardiac arrest events with a resuscitation attempt. Data files were recorded by Zoll AED Pro, and reviewed by RescueNet Code Review software. The events were analyzed according to depth, rate, quality of chest compressions and underlay.

Results: Across events, 12.7% (median) of the compressions had a depth of 5-6 cm. Compression depth of > 6 cm was measured in 70.1% (median). The underlay could be identified from the electronic patient records in 54 events. The median compression depth was 4.5 cm (floor) and 6.7 cm (mattress). Across events, 57.5% (median) of the compressions were performed with a median frequency of 100-120 compressions per minute and the most common problem was a compression rate of < 100 (median = 22.3%).

Conclusions: Chest compression quality was poor according to the feedback system.

However, the distribution of compression depth with regard to underlay points towards overestimation of depth when treating patients on a mattress. The audiovisual feedback devices ought to be further developed. Healthcare professionals need to be aware of the strengths and weaknesses of their devices.

Kristina Schildmeijer, RN, PhD and senior lecturer at the Institution of Health and Caring Sciences, Linnaeus University in Kalmar, Sweden. She has many years of experience working both as a Registered Nurse and as Head of Division. She defended her dissertation in 2013 and the name of the thesis was Retrospective record Review- A Matter of Patient Safety. She is a part of several research teams and is also participating in a national collaboration by the Swedish Association of Local Authorities and Regionsfor the development of a manual for the identification of Adverse Events in Swedish home care settings. At the Linnaeus University Kristina Schildmeijer is working asa senior lecturer and is teaching subjects as Patient Safety, Caring Leadership, Lifestyle- and Health subjects and System Theory.

The Development of Community Care for Enhancing the Quality of Life in Disabled Older People

Tassana Choowattanapakorn, Phuriphong Charoenphaet and Nuntacha Sa-Nguankulchai

Chulalongkorn University, Thailand

Background: Disabilities are a range of impacts from chronic illness that are common in older people. The limited mobility results in declining activity and an increasingdependency. Rehabilitation is then required to increase the independency and quality of life.

Method: Participation action research was used to develop rehabilitation care for the disabled in the community. A sub-district with seven communities in a province nearby to Bangkok was chosen. The population of 6047 people included 1001 people aged 60 years and above. From the screening of the health center, 15 people were categorizedas disabled, while 97 had limited mobility. Questionnaire-based interviews of their daily activity, symptoms of depression, nutrition (Mini-Nutrition Assessment, section 1), risk of falling (Thai FRAT), risk of getting pressure sores (Braden Scale) and their self-perceived health status were taken to confirm their level of ability. Focus-groups were conducted to gather information from family members.

Results: More than half (61.9%) of the subjects were female, with an average age of 73.4 years. Most people were independent (86.6%), with only three people being shown to be highly dependent. Nonetheless, they perceived themselves as having a good (67%) or moderate (33%) health status. The focus groups revealed that family members and village health volunteers mainly took care of the disabled, and they expressed a lack of confidencein the rehabilitation care provision. The teaching of chronic diseases and rehabilitation strategies was developed, where caregivers were educated and trained by researchers. Most of the trainees had more confidence and satisfaction with their improved rehabilitation skills.

Conclusion: Continual rehabilitation training is essential to sustain the required knowledge and skills for caregivers of the disabledelderly in the community, and is also a critical requirement to keep disabled people in their family and community.

Keywords: Disability, rehabilitation, care

Tassana Choowattanapakorn is an assistant professor at Chulalongkorn University. She has completed her PhD in Gerontological Nursing at La Trobe University, Australia. Her research interest is Gerontological Nursing. She has published many articles in different journals.

New Modalities in Nursing Education Inter-Collaborative Education

Maryann Godshall

Drexel University, USA

New methods of delivering nursing education are needed in todayʼs complex healthcare environment. Traditional methods of teaching facts, student memorization, and testing to determine learning are not adequately preparing nursing students for the practice environment. A major obstacle new graduate nurseʼs face is communicating, working with, and collaborating with other disciplines. One method to bridge this gap is developing inter-collaborative experiences for medical residents, nurses, and other disciplines while in school. An inter-collaborative simulation experience delivering “bad news” and discussing palliative care options to live standardized or simulated patients (SPʼs) will be discussed. Conclusions found were that all participants felt this experience enhances their ability to interact with patients, families, and work with other disciplines collaboratively. This experience created life-long experience and skills new nursing professionals can utilize in the practice environment.

Dr. Maryann Godshall, PhD, RN, CNE, CCRN, CPN is an Assistant Clinical Professor at Drexel University College of Nursing and Health Professions. She obtained her BSN from Allentown College of St. Francis DeSales and her MSN from DeSales University. She has a post-masterʼs degree in Nursing Education from Duquesne University, Pittsburgh, PA. Dr. Godshall completed her PhD at Duquesne University. Her research topic was “Exploring Learning of Pediatric Burn Patients through Storytelling.” Dr. Godshall has worked in Adult Medical-Surgical Telemetry and comprehensively in pediatrics. She continues working in Pediatric Critical Care and Pediatric In-patient Rehabilitation nursing. She has been a nurse for over 25 years. She holds certifications in Pediatrics, Pediatric Critical Care, and as a Nurse Educator. She has been teaching for over 15 years in both the university and hospital settings. Dr. Godshall is co-editor of The Certified Nurse Examination (CNE) Review Manual (2016), and wrote Fast Facts of Evidence Based Practice, 3nd Ed (2016); Springer Publishing Company.” She has numerous publications and speaks both nationally and internationally on a variety of topics including nursing education, pediatrics, and her research with pediatric burn patients.

Physical Assault, Perceived Stress, Coping and Attitudes toward Assault Experienced by Psychiatric Nurses and their Intent to Leave

Carolyn Hanohano1 and Vivien Dee2

Azusa Pacific University, USA

Background: Physical assault on nurses is a major occupational hazard especially for psychiatric nurses working in inpatient psychiatric settings. Physical assault impacts nursesʼ health and well-being and causespsychological and emotional stress.

Objective: The purpose of this study was to examine and explore the relationships between perceived stress, coping, attitudes toward patient assault and their intent to leave.

Design: A descriptive, cross-sectional study using the convenience sampling method.

Setting: United States of America

Participants: One hundred thirty one (n=131) psychiatric nurses who had experienced patient physical assault in an acute psychiatric setting within the last 10 years completed online surveys. Age range at the time of assault was 20-65 years, with an average age of 40. Eighty four percent were female nurses.

Instruments: Demographic Questionnaire, Attitudes Toward Patient Physical Assault (ATPPA), Perceived Stress Scale (PSS)-10 and the Brief COPE Scale (BCS) were used.

Data Analysis and Findings: Participants experienced patient assault one to five or more times. The PSS mean and standard deviation was 22.94 (11.06), indicated participants experienced moderately high stress. Over half (68.7%) of the psychiatric nurses felt that they can expect to be physically assaulted by a mentally ill patient sometime during their career. Most felt that they were not equipped or staffed to treat those patients admitted to their units safely. A t-test and chi-square analysis revealed no significant differences between the demographic characteristics and the intent to leave in the past six and 12 months, t = 0.47, p >.05. The mean for BCS subscale active coping was not significant at 4.35 (2.02) and mean was significant for denial at 5.36 (3.21). The BCS subscale denial was significantly related to intent to leave at six months, t(129) = 2.02 p = 0.04. Stress was related to intent to leave at six months, t (129) = 2.58, p = 0.011. ATPPA subscale legal score was significant t (129) = -2.28, p = 0.02 at six months. The 12 monthsʼ intent to leave ATPPA subscale staff performance was significant, t (129) = 2.57, p = 0.11. Independent t-test was significant for PSS and intent to leave at six months; and significant for ATPPA subscale staff performance and the intent to leave at 12 months. Logistic regression equation for the past 6 months was significant at .000, chi-square = 19.36, p = .004; and significant for the past 12 months at .000, chi-square = 15.38, p = .017. The ATPPA subscale staff performance was identified as a predictor for the intent to leave at 12 months.

Discussion and Conclusion: The findings of this study support previous studies and provides new empirical knowledge. This studyʼs findings found that psychiatric nurses used denial copings strategies significantly more than active coping strategies. These psychiatric nurses experienced moderately high stress. There was a significant correlation between PSS and their intent to leave related to physical assault. Moreover, PSS was identified as a predictor for the intent to leave the job at six months. Staff performance and legal issues were also identified as predictors for intent to leave. A key implication for nurse intention is the well-being of the psychiatric nurses. Nurse supervisors and nurse managers must collaborate to focus in providing an emotionally healthy environment with stress management interventions designed to help psychiatric nurses modify appraisal of stressful situations to effectively cope with stressful events.

Carolyn Hanohano began her nursing career in the United States Navy as a hospital corpsman. She holds a Bachelor of Science in Nursing from California State University Dominguez Hills (CSUDH), Carson, CA, Master of Science in Nursing Administration from CSUDH, and PhD in Nursing from Azusa Pacific University, Azusa, CA. Carolyn is a psychiatric nursing supervisor at Ventura County Medical Center in Ventura, CA.
She has served as part-time nursing clinical instructor at Ventura College and California State University Channel Islands, Camarillo, CA. Research includes physical assault, perceived stress, coping, and attitudes toward assault experienced by psychiatric nurses and their intent to leave.

Analysis of Depression Levels in Hemodialysis Patients by Assessing the Effect of Dialysis on Quality of Life

Ozlem Yazici, Dogan F, Gulhan Y.B. and Yurugen B

Okan University, Turkey

Chronic diseases are irreversible pathological changes that cannot be cured completely, are continuously progressive and often lead to permanent failure and disability, while at the same time causing pain and limitations in the physical, psychological, social, and economic life of patients. These disorders also require long-term follow-ups, care and control. Chronic renal failure, which is a disease that significantly affects the lives of patients, is one example of chronic disease. Hemodialysis is a widespread treatment modality in this disease. The aim of this study was to determine the stress levels of hemodialysis patients by assessing the effect of dialysis on Quality of Life. The study was performed with 573 patients undergoing hemodialysis treatment in the dialysis units of Izmir Katip Celebi University (Atatürk Training and Research Hospital), Izmir Bozyaka Training and Research Hospital, Ege University Training and Research Hospital, and other private dialysis centers in Izmir (FMC Ege, FMC Nasır, FMC Karşıyaka, FMC Hatay, FMC Buca, FMC Sevgi and FMC Gaziemir). Data were obtained from the “Introductory Questionnaire,” the “Short Form-36 Health Survey (SF-36)” and “Beck Depression Inventory.” The data were then analyzed using SPSS 22.0 and AMOS software. The study revealed a negative correlation between “physical function,” “physical component summary scale scores” and age. Having a higher level of education was associated with higher scores of physical function, general health, vitality, mental health, as well as with higher scores on the physical component summary scale. The Quality of Life Scale scores decreased as Beck Depression Inventory scores fell. In terms of patient safety and patient satisfaction, it might be recommended that training programs on the adverse effects of hemodialysis on quality of life be set up and psycho-therapeutic assistance be made a requirement in an effort to prevent the psychological impact of these adversities on patients.

Keywords: Hemodialysis, Chronic Kidney Disease, Quality of Life, Chronic Renal Failure, Depression

Ozlem Yazici is working as a faculty in the Okan University. She completed her PhD in Medical education in 2008 at Istanbul University Health Science Institute. She is the member of the Intensive Care Nurses Society and Admiral Bristol Graduates and Members Society. She has published many articled in reputed journals.

Factors Leading to Re-Admission of Mental Health Care Users at Thabamoopo Psychiatric Hospital of Limpopo Province, South Africa

Jermina Kgole, M.E. Lekhuleni and L.S. Takalo

Department of Nursing Science, University of Limpopo, South Africa

The purpose of this study was to explore the factors leading to re-admission of mental health care users at Thabamoopo Psychiatric Hospital, Limpopo Province. A qualitative, descriptive and exploratory research method was used. The population of the study included all mental health care users who are discharged and re-admitted in Thabamoopo Hospital and the relatives taking care of the mental health care users. Non-probability purposive sampling was used to select the twelve participants. A phenomenological research design was applied; and semi-structured interviews were used for collection of data. One-on-one interviews were conducted, of which ten were conducted with mental health care users and two with the relatives of mental health care users. The data was analysed by using Teschʼs method of analysis. The results of the study proved that re-admission of mental health care users occurred due to abuse of alcohol and cannabis and the mental health care users did not adhere to the prescribed psychotropic medications. Social problems such as family disorganisation and lack of psychological support from families proved to be factors that can lead to re-admission of mental health users to the hospital. Based on the results of the study mental health professionals should provide mental health care users and relatives with psycho-education on substance abuse and cannabis and on the importance of taking psychotropic medications as prescribed.

Keywords: Readmission, mental health care user.

Jermina Kgole is a senior lecturer in the department of Nursing science at the University of Limpopo, South Africa. She has published 29 articles in accredited journals. She was Attended conferences and presented papers provincially, nationally and internationally.

Using Peers Directly during in vivo Homework of Prolonged Exposure Treatment for PTSD

Melba A. Hernandez-Tejada1,2,3, Ron Acierno2,3 and David Sanchez-Carracedo1

1Universitat Autonoma de Barcelona, Spain
2VAMC Charleston, USA
3Medical University of South Carolina, USA

Background: Prolonged Exposure (PE) for PTSD is a highly effective evidence-based treatment. However, the dropout rate of 25-35% is a major concern. In our study of about 70 dropouts from two large trials of exposure therapy with combat veterans, we found that a large percentage reported difficulty during in vivo exposure homework (Hernandez-Tejada et al., 2014). Qualitative interviews with this sample also indicated that the limited availability of a peer “workout buddy” who offered support during in vivo exposure trials would be likely to enhance treatment retention. We developed such a peer support program, where peers accompanied veterans during exposure homework 3-4 times per week, for 3-4 weeks and hypothesized that dropouts who decided to re-engage in treatment with a peer would evince improvement in depression and anxiety scores.

Methods: Participants were veterans of OIF/OEF/OND who dropped out of PE and continued to meet criteria for PTSD. A repeated measures single arm design (pre-, post-treatment) was used to derive within subject evaluations of PTSD (PCL-M) and depression (PHQ-9) over time (follow-up pilot data are currently being collected at 3&6 months). Data were analyzed with SPSS-22. Multiple imputation was applied to missing data.

Results: 28 veterans (34% of those approached) re-entered treatment when offered peer support during exposure. Considering outcomes: the PCL-M was reduced from a x‾=65.32 (SD=10.447) to x‾=49.57 (SD=4.90) at posttreatment. PHQ-9 was reduced from x‾=15.80 (SD=5.0529) to x‾=11.48 (SD=0.464) at postreatment.

Conclusion: Peers are routinely consigned to tertiary roles in PTSD treatment, such as offering testimony toward the usefulness of treatment, facilitating referrals or participating in support groups. However, peers have rarely been directly involved in exposure components of care. Our findings indicate that peers who offered support during in vivo exposure homework were effective in returning combat veterans with PTSD back to treatment, which was subsequently effective in reducing symptoms of PTSD and depression.

Dr. Melba A. Hernandez-Tejada is a Research Associate Professor at the College of Nursing and a Research Scientist at the Ralph H. Johnson Veterans Affairs Medical Center. Dr. Hernandez-Tejada holds degrees in Health Administration and Clinical Psychology, and completed a postdoctoral fellowship in Health Disparities at MUSC. Her research experience and interest are concentrated in the following areas: Improving access and increased health care utilization and engagement in treatment for both physical and mental health conditions through innovative use of social support and telehealth, particularly among minority groups. She has also applied this focus to work with veterans, most specifically those with a mental health condition such as depression, and PTSD. Finally, she has engaged in practice level efforts involving raising awareness among providers regarding adequate screening, identification, diagnosis and referral of elder mistreatment survivors, and treatment options for elder abuse victims.

Formulation, the Essence of Competent Person Centred Mental Health Nursing Care Planning

Colin Hughes and Fiona Martin

Queens University Belfast, UK

The ability to be at ease with a variety of paradigms for example the cognitive, interpersonal, psychodynamic, and biopsychosocial is strength of Mental Health Nursing, and provides the ability to truly implement a person centred approach, not simply to pay vague lip service to the concept (Hughes et al, 2014). We argue what can be accomplished through the use of a Formulation approach. The use of Formulation differs from a biomedical modelʼs diagnosis in that it is not simply focused upon a limited range of standardised terms designed to serve a statistical function, eg, Major Depressive Disorder (MDD) (Crowe et al, 2008). The Formulation approach is a much broader framework and indeed is not necessarily exclusive of the biological approach. Formulation, can be considered as both longitudinal and cross sectional, and is not concerned with categorisation, rather examines collaboratively what situational, cognitive, affective, physiological, behavioural and indeed social processes create, and perpetuate the service users distress (MacNeil, 2012). This then allows for the creation of value directed goals from which the most appropriate intervention can be implemented in collaboration with the service userʼs and carers participation (Hughes et al, 2014). This process of Formulation is at its heart strengths based, while talking cognisance of the service users vulnerabilities. In short the use of person centred Formulation as the keystone for care planning is worthwhile as it gives the Mental Health Nurse and service user a deeper understanding of the problem, resulting in a personalised treatment potentially offering better clinical outcomes (MacNeil et al, 2012).

Colin Hughes is an NMC registrant as well as a BABCP accredited Cognitive Behavioural Psychotherapist. He has been involved in education for over ten years, is Professional Lead for Mental Health within the School of nursing and Midwifery at Queens, and is involved in both undergraduate and postgraduate Education. Mr Hughes has presented at several conferences and is also a published author. Fiona Martin is an NMC registrant as well as a prominent accredited member of THORN. She has been involved in education for many years and is a senor practitioner and educator at the School of Nursing and Midwifery at Queens University. She is a publish author and winner of the Florence Nightingale Travel scholarship.

Mental Health Outcomes: 8 Year Follow-Up of the National Elder Mistreatment Study

Ron Acierno1,2, Melba A. Hernandez-Tejada1,2,3 and Wendy Muzzy1

1Medical University of South Carolina, USA
2VAMC Charleston, USA
3Universitat Autònoma de Barcelona, Spain

Background: The National Elder Mistreatment Study (NEMS), conducted in 2008 with 5,777 community residing older adults, represented the largest epidemiological study of elder abuse conducted in this country. The original study assessed psychological, physical, sexual, and neglectful mistreatment using behaviorally-specific queries and documented unexpectedly high rates of abuse (i.e., approximately 10%). However, mental health correlates of abuse were understudied. The purpose of this study was to explore the current mental health status of those elderly people who identified themselves as victims of elder abuse through NEMS 2008.

Methods: We attempted to re-contact the entire original sample of elder abuse victims (now age 68 and over) and a reference sample of non-victims at about a 1:3 ratio, producing a follow-up sample of 172 abuse victims (of the original 684) and a reference sample of 602 non-victims. Computer assisted telephone survey methodology was used to standardize data collection while measuring new episodes of abuse since the last survey, and to determine presence of DSM-V diagnoses of major depression (MD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD).

Results: Reports of past-year abuse in 2008 strongly predicted current MD, PTSD, and GAD. Specifically, odds ratios (OR) for MD (16.7% victims vs. 5.8% non-victims; OR: 3.3, CI: 1.7-6.3), PTSD (13.1% vs. 1.6%; OR: 9.3, CI: 3.9-22.1), and GAD (10.7% vs. 2.0%; OR: 5.8, CI: 2.4-13.8) demonstrate dramatically increased risk of these disorders in the abused group. Of even greater interest and potential import was the finding that high social support in 2008 was extremely protective against psychopathology at follow-up 8 years later, such that rates of MD, PTSD, and GAD in the abused group with high social support mirrored those in the non-abused group.

Conclusion: Elder abuse is a prevalent problem in the US, and the present study demonstrates that its outcomes are lasting and negative. However, perceived social support appears to be highly protective against the negative effects of abuse, and interventions to enhance social connectedness of older adults may prevent depression and anxiety disorders in elder abuse victims.

Ron Acierno is a Professor and Associate Dean for Research in the College of Nursing and a Senior Clinical Research Scientist at the Ralph H. Johnson Veterans Affairs Medical Center, MUSCʼs Consortium VA partner. Finally, he is the Clinical Training Director and Board Member of the nonprofit Veterans on Deck, an organization he founded that uses sailing to impart socialization, teambuilding and personal growth in veterans recovering from PTSD, substance use, and who have been victims of Military Sexual Trauma.

Wanting to Feel Normal: An Exploration of Mentally Disordered Offenderʼs Perspectives Following Psychoeducation

Helen Walker1 and Steve Trenoweth2

1University of West of Scotland, UK
2Bournemouth University, UK

The recovery approach has been increasingly influential amongst mental health nurses in the UK (Trenoweth, Tingle and Clark 2016). The approach stresses the importance of developing a collaborative partnership with service usersbased onunderstanding the personʼs subjective experience. The Repertory Grid Technique (Kelly 1955/1991) is a structured interview technique which allows the nurse tounderstand the individualʼs personal frame of reference and capture how service users make sense of their world and the world around them. This also allows the nurse and service user to understand and evaluate particular health care interventions in supporting the individual on their personal recovery journey.

This study explored the personal impact of a psychoeducational programme for a group of mentally disordered offenders. A purposive sample of 20 participants were selected from two secure units in a high secure hospital. Structured interviews were completed using the Repertory Grid Technique. Significant differences were apparent in three areas: have confidence to engage in groups, (z = -2.203, N = 18, p < .05);understand my own illness and how it affects me, (z = -2.203, N = 18, p < .05) and wanting to feel normal, (z = -1.997, N = 18, p < .05). Feeling normal was also associated with feeling valued, having hope, feeling confident, understanding your illness and realising others have the same problems. This study has highlighted that, following a psychoeducational programme, service users placed importance on understanding themselves and their personal world, and of feeling normal as part of their own recovery journey.

This study has implications for mental health nursing practice and suggests a mechanism by which mutual understandings can be developed between the nurse and service user, revealing meaningful information for discussion and reflection and understanding the personal pathwaysfor recovery for those who have complex needs.

Helen Walker is a senior lecturer in the University of West of Scotland, UK. Steve Trenoweth qualified as a mental health nurse in 1991 and has worked in a variety of services before entering higher education in 2003. He is currently senior academic at Bournemouth University.

Examining the Attitudes of University Students in the Health Sciences toward Disability

Elif Aşik, Erdem Y, Elibol F, Çakmak A, Akoğlu G and Albayrak S

Kırıkkale University, Turkey

Aim: The aim of this study, conducted under the sponsorship of the Turkish Ministry of Family and Social Policies within the scope of the “Program for Supporting the Disabled” and titled “The Butterfly effect: Add a touch of your own,” was to improve the attitudes toward the disabled of Faculty of Health Sciences students who have a high potential of working with the disabled after graduation. Descriptive data for the study are presented here.

Materials and Method: The study encompassed 906 students enrolled in our Faculty in the 2015-2016 academic year. Our measurement instruments were the “Sociodemographic Data Form” and the “Attitudes Toward Disabled Persons” (ATDP) developed by Kaner et al. (2009) The ATDP consists of the subscales of educational environment, interpersonal relations, work life, family life, personal characteristics and competence-independent living. Each subscale domain measures the studentʼs desires to interact with disabled persons. The higher scores represent a positive attitude.

Results: Of the students, 75.9% (688) were females, 24.1% (218) were males. It was found that the female studentsʼ ATDP mean scores were higher than the male studentsʼ scores (p<0.01). Statistically significant differences were found in the ATDP scores in terms of the studentsʼ departments (p<0.01) and their classes (p<.05). It was observed that these differences stemmed from the scores of the students in their 1st and 4th years and 2nd and 3rd years. In the subscales, it was seen that there were significant differences in the mean scores of the students in the domains of educational environment, interpersonal relations, work life, personal characteristics and competence-independent living (p<0.01). The differences stemmed from the mean scores of the students in the Child Development and Physiotherapy and Rehabilitation Departments.

Conclusions: Studies may be carried out to improve the attitudes of students whose ATDP mean scores are low, namely, male students and students studying nursing, health management, nutrition and dietetics. It may be appropriate to schedule lessons aimed for this purpose so that they are made available over the entire course of the educational program.

Keywords: Disability, Attitudes toward the Disabled, University Students

Dr. Elif AŞIK is a lectuerer in the Kırıkkale University, Turkey. She graduated from doctorate program of Marmara Universityʼs Mental Health Nursing Department. She interested in schizophrenics, disability people and art therapy along the education life. She has reports and articles about these subjects.

Psychosocial Hazards Faced by Health Care Workers in Selected Public Hospitals in Gauteng, South Africa

Odilia Mm Sehume

Vaal University of Technology, South Africa

Health care workers face risks of exposure to psychosocial hazards during their provision of patient care. This is a global phenomenon that requires measures to protect them against adverse psychosocial conditions. However, there is a dearth of information on these hazards among health care workers in South African public hospitals.

The study reported here is part of a larger investigation which used a quantitative cross-sectional survey to investigate on a large scale the occupational hazards experienced by 926 nurses at 8 public hospitals in the Tshwane healthcare district.

Above 40% of health care workers experienced increased workload. Findings on participantsʼ experiences regarding long working hours, insufficient rest, poorly structured shifts and poor managerial practices are stated. Violence against nurses was perpetrated by patients, patientsʼ relatives and colleagues. Developed guidelines are recommended to enhance good work practices and psychosocial well-being.

Keywords: Health care worker, psychosocial hazards, public hospitals.

Dr Odilia MM Sehume obtained her PhD from the University of South Africa in June 2017, where she also obtained an Honours degree in Industrial Psychology in 2000. She developed a passion for the well-being of health care workers, and developed guidelines (unpublished) for their occupational well-being, from her PhD. From 1998 to 2008 she worked in the corporate sector as a health trainer, and resumed her lecturing duties at a Nursing College in 2008. In 2013, she assumed full-time employment at the Vaal University of Technology, and now serves as a Nursing Programme Coordinator for under- and post-graduates.

Resilience in Nurses Providing Mental Health Care to Involuntary Mental Health Care Users

Rudo Ramalisa

Vaal University of Technology, South Africa

There is a paucity of information addressing strengths, assets, competence or resilience that enable nurses to remain committed to their profession despite the adversities they face in their working environment. The purpose of this research was to explore the resilience of nurses, using the Connor- Davidson Resilience Scale (CD-RISC) (2003) and to explore and describe how to strengthen the resilience of nurses in a work environment with involuntary mental healthcare users. A multi-method approach, in an exploratory and descriptive design was used. The CD-RISC indicated that nurses are resilient. Narrative responses to two open-ended question - how do you cope to provide mental health care to an involuntary admitted mental healthcare users? and how can your resilience be strengthened to provide mental health care to involuntary mental healthcare users? - yielded coping mechanisms and resilience strengthening strategies. In conclusion, nurses caring for involuntary mental healthcare users are faced with challenging situations while they themselves experience internal conflict and have limited choices available to be assertive. They take pride in their achievements and have passion for their work; they find it difficult making unpopular decisions which affect others and handling unpleasant feelings. To strengthen their resilience, the following factors should be taken into account: support, trained staff, security measures and safety, teamwork and in-service training and education.

Rudo Ramalisa is a lecturer in the Vaal University of technology, South Africa. She has completed Masters in Nursing Science and Psychatric nursing.

Do Personal Characteristics of the Pregnant Affect the Fear of Child Birth?

Menekşe Nazlı Aker*1, İlknur M. Gönenç2, Huriye Güven3 and Özlem Moraloğlu4

1,2Ankara University, Turkey
3Ankara Etlik Zübeyde Hanım Womenʼs Health Training and Research Hospital, Turkey
4Zekai Tahir Burak Womenʼs Health Training and Research Hospital, Turkey

This study was carried out in descriptive and cross-sectional type to determine the effect of personal characteristics of the pregnant on the fear of childbirth. A total of 422 pregnant women were included in the study. The data were collected between 01 May, 2016 and 01 August, 2016. A Pregnancy Information Form, Big Five Personality Test, and the Wijma Delivery Expectancy Questionnaire (W-DEQ) Version A were used in data collection process. The mean age of the participants was 24.73 + 4.48 (Min: 18, Max: 45). 58.8 % of them had secondary or high school education, while 31.3 % were found to have higher education or over. 64.4 % of the participantsʼ longest settlement was a province and 68.2% had nuclear family type. The study found that as the score for agreeableness and conscientiousness, two of the personal characteristics, increased, the state of planning pregnancy increased as well (p= .000). A negative statistically significant relationship was found between W-DEQ A median and agreeableness, extraversion, conscientiousness and emotional stability personality characteristics (r = .190, r = -. 203, r = -. 186, r=-.315, p = .000 respectively). These findings have important practical implications concerning the planning of antenatal care for the pregnant. Defining the personal characteristics of the pregnant can make a contribution to handling the care of the individuals with personal characteristics related to the fear of childbirth primarily in the antenatal period.

Keywords: personality, fear of childbirth, childbirth

Menekşe Nazlı AKER received her B.S. degree in Nursing from Selcuk University (2007), M.Sc. degree in Obstetrics and Gynecological Nursing from Selcuk University (2010). Currently, she is continuing her Ph.D. education in Nursing. She worked as a lecturer at Selcuk University Akşehir School of Health Department of Nursing (2010-2015), then moved to Department of Midwifery at Ankara University Faculty of Health Science (2015-). She is interested in childbirth preparation training, complementary medicine applications, obstetric nursing, sexual health, nursing informatics.