Purpose: To develop and test the validity and reliability of the Life Sustaining Treatment Attitude Questionnaire (LSTAQ), a survey instrument to elicit family member decision-maker attitudes toward life sustaining treatments for the critically ill at end of life. Background: Attitudes toward life sustaining treatments (LST) have been shown to influence decision-making at end of life (EOL). A reliable and valid tool to elicit attitudes specifically from family member decision-makers may help healthcare professionals facilitate decision-making during serious illness at end of life. Methods: A 33-item LSTAQ instrument was tested in 170 adults. Construct validity was evaluated by exploratory factor analysis. Correlations established convergent and discriminant validity. Reliability testing for internal consistency was assessed by Cronbach's alpha and corrected split half reliability coefficients. All procedures were done with Statistical Package for Social Sciences (SPSS version 18) software (SPSS Inc., Chicago, 111). Results: A 30-item final LSTAQ tool was derived from this study. Principal components factor analysis extracted six factors explaining 62.7% of variance. Correlations with a similar tool supported convergence (r = .72, ? <.01). Discriminant validity was confirmed by the absence of significant correlation with the dissimilar tool. LSTAQ internal consistency was good (Cronbach's alpha = .92). A preliminary exploration of differences in LSTAQ scores by ethnicity revealed a sampling size and distribution that was not optimally responsive to detection of ethnic differences. Conclusion: The LSTAQ is a reliable and valid tool to elicit LST attitudes specifically from family member decision-makers. The knowledge gained may help healthcare professionals promote interventions that facilitate family decision-making on life support for the ill relative at end of life. This might help reduce decision difficulties that cause preventable discomfort, unnecessary treatment and prolonged suffering for the terminally ill patient, as well as avoidable distress among family members involved in decisions for the sick relative.

Faculty members in many schools of nursing have been urged to include critical thinking in all aspects of the nursing curriculum. The faculty at the Institutes of Nursing in the United Arab Emirates, have adopted in the academic year I998 a case-based curriculum that teaches nursing courses by using case studies, which represent a terrific and non-threatening method to use to teach and learn either critical thinking skills or clinical decision-making (Robinson, 1998; Glendon and Ulrich, 1992, 1997). The development of critical thinking skills in a case-based curriculum was investigated. A randomly selected, cross-sectional sample of nursing students at the Abu Dhabi Institute of Nursing (N= 88) was studied. Three groups (n=30) from each level of a three-level-diploma nursing program were measured for development of critical thinking skills using the Test of Everyday Reasoning (TER). Relationships were investigated between TER scores, the level of the program and other socio-demographic and academic achievement determinants. Critical thinking ability did not change significantly among the three levels during the educational experience in a case-based curriculum; however, the participants in the highest level of the program were able to get a higher mean TER scores from the other two levels. One of the conclusions that could be drawn from this study was that critical thinking might not change as an associated factor with a case-based curriculum at this premature phase of its implementation until some time after the graduates of this program become practicing nurses where clinical decision-making would be in action. The other conclusions focused on the necessity of unfolding the utilized cases in the curriculum and on determining whether the construct of critical thinking has been incorporated in them. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

The Institutes of Nursing in the United Arab Emirates adopted a new approach for educating and training the Diploma Nursing students in 1997. This approach emphasized the use of case-based learning, which was characterized by self-directed and cooperative learning. As the students were experiencing changes in the educational setting and teaching practices it was important to determine the impact of the teaching and learning approaches on students' learning, and to describe suggestions needed for improvement. The purposes of this study were to determine the learning styles and stages of self-direction in learning for students at Abu Dhabi Institute of Nursing, and to investigate whether there was a relationship between learning style, stage of self-direction and academic performance in courses taught by the case-based method. This study was guided by Kolb's theory of Experiential Learning, and Grow's theory of the Staged Self-Directed Learning Model. Kolb's learning style inventory and a self designed tool to measure stages of self-direction were administered to 186 students, who agreed to participate in the study. The design was a descriptive correlational one, and data was analyzed by descriptive, correlation, and inferential statistics methods. The assimilator learning style was the most predominant learning style (35.5%) followed by the converger (29.6%). Accommodators and divergers had equal percentage (17%) for each. As for the stages in self-direction, most of the students rated themselves in the moderate stages of self-direction (67.2%), however, Diploma III had the higest percentage of high self-directed learners (57%). Significant relationship was found between learning styles and academic performance, where convergers and divergers scored higher than assimilators and accommodators. Also a significant relationship was found between the stage of self-direction in learning and academic performance, where students in higher stages of self-direction had higher mean scores compared to students in low and moderate stages of self-direction. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

D.Cur. (Psychiatric Nursing Science) / Please refer to full text to view abstract

Community based service-learning is one of the fastest growing reforms in higher education, especially in the field of health care. The increased interest in this phenomenon is based on the demands by government and society that higher education institutions should be more responsive to the needs of the community. Literature, however, reflects that service learning lacks a sound theoretical base to guide teaching and learning due to limited research in this area. This study was, therefore, aimed at exploring the phenomenon knowledge construction in basic nursing programmes in selected South African nursing schools with the intention to generate a middle range theory that may be used to guide the process of knowledge construction in community-based service-learning programmes. This study adopted a qualitative approach and a grounded theory research design by Strauss and Corbin. Two university-based schools of nursing were purposively selected to participate in the study. There were a total number of 16 participants. The collection of data was intensified by the use of multiple sources of data (participant observation, documents analysis and in-depth structured interviews). The data analysis process entailed three phases; open, axial and selective coding. The results of the study revealed that the phenomenon “knowledge construction” is conceptualised as having specific core characteristics, which include the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue and communities of learners. The findings showed that there are a number of antecedent conditions and contextual circumstances contributing to how knowledge is constructed in a community based service learning programme. The process of knowledge construction emerged as cyclical in nature, with students, facilitators and community members having specific roles to play in the process. A number of intervening variables were identified that had an influence on the expected outcomes on knowledge construction in community based service learning programmes. These findings led to the generation of a conceptual model. Knowledge construction according to this model takes place in an environment which is characterised by interactive learning, collaborative learning, actively learning and inquiry-based learning through continuous reflective learning processes. The main concepts in this conceptual model include concrete learning experiences, continuous reflection, problem posing, problem analysis, knowledge deconstruction and knowledge generation, knowledge verification, knowledge generation, testing of generated knowledge and evaluation of generated knowledge. The sub-concepts include learning through senses, an initial situation, health-related triggers, social interaction, reflection-in action, reflection-on action, hypotheses generation, conceptualisation of learning experiences, information validation and community interventions. Recommendations were categorised into education and training of academic staff, application of the model and further research with regard to quality assurance in CBSL programmes as well as the use of other research designs for similar studies. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.