This thesis has explored the characteristics, in terms of masculine traits on the Bem Inventory that student nurses in a diploma nursing program believed their role models in nursing possessed. In the study, student nurses nearing the end of their basic nursing education selected a greater number of masculine traits for their role models than did student nurses beginning their basic nursing education.The thesis also explored the position of the students' role model. Student nurses nearing the end of their basic nursing education more frequently identified staff nurses as their role models, followed in frequency by supervisors and nursing faculty. Student nurses beginning their basic nursing education more frequently identified nursing faculty as role models, followed in frequency by staff' nurses.Ball State UniversityMuncie, IN 57406

In the United States nearly 1 million annual new and recurrent myocardial infarctions (MI) occur with 10% of patients hospitalized with MI having unrecognized ischemic symptoms. Inexperienced nurses are expected to accurately interpret cardiac symptom cues, possibly without ever having experienced care of patients with MI, yet have been shown to be less able to classify symptom cues and reach accurate conclusions than experienced nurses. The purpose of this study was to test an educational intervention using theories of pattern recognition to develop CT in MI and improve nursing students’ clinical decision-making and clinical judgment using high fidelity patient simulation. This study used a quasi-experimental three group pre-/post-test design and qualitative data to triangulate information on critical thinking, clinical decision-making, and clinical judgment in MI. A sample of junior baccalaureate in nursing students (N = 54) from a large metropolitan university were divided in pairs and randomized to one of two control groups. Data were collected with instruments which measured pattern recognition in MI, critical thinking in MI, and self-perception of clinical decision-making. In addition, diagnostic efficiency and accuracy were measured. Triangulation on clinical decision making with semi-structured interviews using ‘thinking aloud’ technique was conducted. Data were analyzed as qualitative data and compared among groups. Students who were given prototypes for MI using simulation significantly improved critical thinking as measured by pattern recognition in MI (t(3.153(2), p = .038) compared with the non-simulation control group. Qualitative findings showed that students receiving the experimental simulation with a non-MI scenario and feedback-based debriefing had greatest gains in clinical reasoning which included development of clinical decision-making using analytic hypothetico-deductive and Bayesian reasoning processes and learned avoidance of heuristics. Students receiving the experimental simulation learned to identify salient symptom cues, analyzed data more complexly, and reflected on their simulation experience in a way which students reported improved learning. Students who were given MI only simulation scenarios developed deleterious heuristics and showed fewer gains in clinical reasoning, though both simulation groups demonstrated greater critical thinking ability than the non-simulation control group. Findings support the use of simulation to improve clinical reasoning including pattern recognition and clinical decision-making, and emphasize the significance of simulation scenario construction and debriefing to achieving learning outcomes. The findings could be used to guide further research to improve critical thinking, clinical decision-making, and clinical judgment in nursing students using simulation. Funding for this study was provided by the American Association of Critical Care Nurses and Philips Medical Systems and a testing grant from Elsevier, Assessment.

Introduktion: Humant Immunbrist Virus (HIV) är en obotlig sjukdom som smittat omkring 34 miljoner personer världen över och sjukdomen konfronteras därför kontinuerligt inom sjukvården. Syfte: Att identifiera och sammanställa sjuksköterskors och sjuksköterskestudenters attityder till att vårda personer med HIV samt bakomliggande faktorer till dessa attityder. Metod: Litteraturstudie med deskriptiv design. De inkluderade artiklarna (n=17) har funnits via databaserna CINAHL och MEDLINE. Resultat: Sjuksköterskor och sjuksköterskestudenters attityder till att vårda personer med HIV påverkades av olika faktorer. Sjuksköterskor och sjuksköterskestudenter som hade mer positiv attityd till att vårda personer med HIV var yngre, singel, hade inga barn, hade tidigare erfarenheter av att vårda personer med HIV, närstående/anhöriga med HIV, utökad utbildning om sjukdomen samt bodde i länder där det var större förekomst av sjukdomen och därmed oftare stötte på personer med HIV i vården. De som var äldre, gifta, hade barn, mindre utbildning, bodde i länder där HIV var ovanligt och inte stötte på dessa personer ofta, hade mer negativ attityd till att vårda dessa personer. Slutsats: Den generella orsaken till sjuksköterskors och sjuksköterskestudenters negativa attityder till att vårda personer med HIV grundar sig i okunskap. Därför är mer information och kunskap om HIV, smittvägar och hur personer med HIV upplever sin sjukdom nödvändig. / Introduction: Human Immunodeficiency Virus (HIV) is an incurable disease that has been contracted by approximately 34 million people worldwide and thus presents a quotidian challenge to healthcare. Aim: To identify and compile nurses’ and nursing students’ attitudes towards caring for people with HIV and the factors underlying these attitudes. Method: Literature study with a descriptive design. The articles included (n = 17) have been obtained from the databases CINAHL and MEDLINE. Results: Attitudes held by nurses and nursing students towards caring for people with HIV were affected by various factors. Those who had a more positive attitude towards caring for these people were younger, single, had no children, better educated about HIV, had previous experience of caring for people with HIV, had relatives/family members with HIV and lived in countries where there was a greater incidence of HIV - and thus often encountered caring for people with the disease. Those found to have unfavorable, negative attitudes were older, married, had children, less educated and lived in countries with less exposure to HIV and therefore didn’t encounter caring for these people on a regular basis. Conclusion: Lack of knowledge on the part of nurses and nursing students has been established as the principal factor contributing to their negative attitudes towards caring for HIV sufferers. Therefore, increased information and understanding regarding HIV, its transmission routes and how people with HIV perceive their disease is of paramount importance.

ABSTRACT Insufficient pain management continues to be problematic for hospitalized patients throughout the country. It significantly interferes with a person's quality of life making it an issue of great concern to nurses in any setting. However, nurses do not do a good job of managing pain. The purpose of this evaluation was to assess graduate nursing students' knowledge and attitudes toward pain management. Forty (n=40) graduate nursing students were asked to participate in the evaluation. All students agreed and completed the Demographic Data Form, Nurses Attitude Survey and the Pain Management and Principles Assessment. Thirty-eight females and two males participated in this study. The mean age was 35 years old (SD=9.77) with a range between 24 and 62. The majority of the participants were Non-Hispanic white (70%), followed by African American (10%), Hispanic (10%), Asian and others. The mean years of nursing experience was 10 years with a standard deviation 7.31. The data showed that nursing students demonstrated inadequate knowledge regarding pain management. The mean score on the PMPAT was 66% (SD= 3.61). The mean score on the Nurse Attitude Survey was 77 (SD=5.8) on a survey with scores that could range from 25 to 100. The higher the score the more favorable that nurse is towards pain management. The scores ranged from 69 to 91. Knowledge and attitude scores had room for improvement, suggesting that the curriculum of the college could be improved. In addition, continuing education courses could be developed to support nurses' knowledge of pain management.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Övervikt och fetma är ett växande problem i stora delar av världen, även i Sverige där ungefär 10% av den vuxna befolkningen räknas som feta. Detta leder till olika hälsoproblem av både fysisk, psykisk och social art. Övervikt och fetma leder ofta till kontakt med sjukvården där sjuksköterskor har en roll i att stödja patienter i arbetet i att ändra sin livsstil i syfte att gå ner i vikt. Undersökningen är en kvantitativ studie i form av en enkät till studenter i sjuksköterske- och pedagogutbildning på Högskolan i Borås. Deltagarna bestod av tre olika grupper, två sjuksköterskeklasser som gick i termin ett (VHB-T1) respektive termin tre (VHB-T3) samt en grupp pedagogikstuderande som gick sin första termin (PED-T1). Syftet med undersökningen var att dels ta reda på om kunskaper och attityder hos sjuksköterskestudenter skiljer sig från andra studenters i frågor om övervikt och fetma, dels se om det fanns skillnader som kunde ha samband med var sjuksköterskestudenterna befann sig i sin utbildning och som då kunde bero på vilka studiemoment med koppling till livsstilsfrågor som hunnit genomföras inom ramen för denna utbildning. Resultatet av undersökningen visade att de sjuksköterskestudenter som kommit längst i sin utbildning också hade mer faktisk mätbar kunskap om övervikt och fetma. De (VHB-T3) såg sig också som mer kunniga och medvetna om livsstilsfrågor än studenter i termin ett, oavsett inriktning (VHB-T1, PED-T1). Studenter i termin tre (VHB-T3) kände sig också bättre rustade att möta patienter med viktproblem i sin kommande profession än studenter inom samma utbildning men som befann sig i termin ett (VHB-T1). / Overweight and obesity is a growing problem in large parts of the world, including Sweden where approximately 10% of the adult population is considered obese. This leads to various health problems of physical, mental and social nature. Overweight and obesity often lead to contact with the health and care services where nurses have a role in supporting patients in changing their lifestyle in order to lose weight. This survey is a quantitative study in the form of a questionnaire directed at students in the nursing and the teacher educations at the University of Borås. The participants consisted of three groups: two nurse student groups - one with semester one students (VHB T1) and one with second year students, in semester three (VHB-T3) and one group of teacher students in their first semester (PED-T1). The primary purpose of the study was to investigate whether knowledge and conceptions of overweight and obesity differed between the nursing students and the teacher students. The seconsary purpose was to find out whether there were differences that could be related to which level the students were in their studies due to study elements related to lifestyle issues. The results of the survey show that the nursing students who had made the most progress in their education had the most measurable knowledge in overweight and obesity. These students (VHB T3) also regarded themselves as more knowledgeable and aware of lifestyle issues than semester one students, regardless of orientation (VHB-T1, PED-T1). The nursing students in semester three (VHB T3) felt better prepared for meeting patients with weight issues in their future profession than semester one students in the same education (VHB-T1).

Bakgrund: Sjuksköterskeyrket har sedan 1800-talet ansetts vara passande för endast kvinnor. Så sent som på 1900-talets mitt blev det accepterat för män att utöva yrket. Forskning visar att sjuksköterskeyrket fortfarande domineras av kvinnor och präglas av fördomar och stereotypa bilder med förutfattade meningar om vem sjuksköterskan är och hur en sjuksköterska ska vara. Syfte: Syftet med denna studie var att undersöka vilken subjektsform sjuksköterskestudenter vid Uppsala Universitet använder vid benämning av sjuksköterskan i godkända examensarbeten, att analysera detta ur ett genusperspektiv samt att se om det har förändrats över tid. Metod: Deskriptiv, kvantitativ och kvalitativ metod. Resultat: I den kvantitativa analysen benämndes sjuksköterskan neutralt med yrkestitel i samtliga granskade examensarbeten. I åtta av 60 granskade examensarbeten användes benämningen “han/hon” och en neutral benämning med yrkestitel. I totalt 9 granskade examensarbeten gjorda 2009 benämndes sjuksköterskan som ”hon” och genom neutral benämning med yrkestitel, medan benämningen ”hon” aldrig användes i examensarbeten gjorda 2012. Benämningen ”han” och/eller ”hen” användes aldrig vid syftning på sjuksköterskan. I den kvalitativa analysen framkom att sjuksköterskan beskrevs som en ödmjuk, empatisk, förstående och vägledande person med kommunikativa förmågor. Slutsats: En mer könsneutral benämning på sjuksköterskan har utvecklats under de senaste åren men stereotypa bilder om vem sjuksköterskan är och hur en sjuksköterska ska vara lever omotiverat kvar. / Background: The nursing profession has since the nineteenth-century been considered suitable for women only. As late as the mid 20th -century, it became accepted for men to practice the profession. Research shows that the nursing profession still is dominated by women and characterized by prejudices and stereotypes with preconceptions of whom and what a nurse should be. Purpose: The aim of this study was to investigate which subject nursing students at Uppsala University uses in their mention of the nurse in approved candidate theses, to analyze this from a gender perspective, and to see if it has changed over time. Method: Descriptive, qualitative and quantitative method. Results: In the quantitative analysis the nurse was referred to in neutral terms and / or through title in all audited candidate theses. In eight of 60 candidate theses the term “he/she” and a neutral appellation with the title was used. In a total of nine candidate theses from 2009, the nurse was called “she” and a neutral appellation with the title, while the same appellation of “she” never was used in candidate theses made in 2012. The term “he” or/and the Swedish neutral word “hen” were never used in allusion to the nurse. The qualitative analysis showed that the nurse was described as a humble, empathetic, understanding and guiding person with communicative skills. Conclusion: A more gender-neutral term for the nurse has developed over time, but the image of the nurse lives on, unmotivated, with stereotypical notions of who and how the nurse should be.

Det föreligger ett ökat behov av placeringar inom sjuksköterskeutbildningens verksamhetsförlagda utbildning. Syftet med den här interventionsstudien är att kartlägga sjuksköterskestudenters tillfredsställelse med lärandemiljön och handledningen i två olika handledningsmodeller. Interventionsgruppen (IG) handleds i par av en handledare i en studentsal, s.k. peer learning och kontrollgruppen (KG) enligt traditionell handledningsmodell. För datainsamlingen har en validerad enkät, CLES + T (Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale) använts. Data (N = 247) har samlats in från sjuksköterskestudenter i termin 3 och 4 på Ersta Sköndal högskola under tre terminer (VT 2011-Vt 2012). Resultatet visar att båda grupperna generellt är tillfredsställda med lärandemiljön och handledningen. IG upplever en större tillfredsställelse med lärandemiljön än KG. KG upplever generellt en större tillfredsställelse i relationen med handledaren och har fått individuell handledning i större utsträckning än IG. / There is an increasing need for placements in the clinical education of the nursing education. The purpose of this intervention study is to identify nursing students’ satisfaction with the learning environment and the supervision in two different supervision models. The intervention group (IG) is supervised in pairs by a tutor in a student ward, so called peer learning, and the control group (KG) is supervised according to a traditional supervision model. A validated questionnaire, CLES + T (Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale) was used for data collection. Data (N = 247) were collected from nursing students in term 3 and 4 attending Ersta Sköndal högskola during three terms (spring 2011-spring 2012). The results show that both groups are generally satisfied with the learning environment and the supervision. IG is experiencing a greater satisfaction with the learning environment than KG. KG generally experience greater satisfaction in the relationship with the supervisor and received individual supervision to a greater extent than IG.

Introduktion: HIV-infektion medför en kronisk och progressiv sjukdom som, i obehandlad form, leder till en successiv försämring av immunförsvaret och utvecklandet av AIDS. Syfte: Att vid två lärosäten undersöka sjuksköterskestudenters kunskaper om HIV och inställningen till behovet av HIV-testning. Metod: En empirisk tvärsnittsstudie med deskriptiv och komparativ design med kvantitativ ansats. Genomförd som enkätstudie bland studenter vid Högskolan i Gävle och Uppsala Universitet (N=95), som studerade på sjuksköterskeprogrammets tredje år. Resultat: Majoriteten (88,4 %) angav korrekt att samlag med fler än en partner ökar risken att smittas med HIV. Tre studenter (3,2 %) angav felaktigt att det finns ett vaccin mot HIV-infektion. Nästan hälften (42,1 %) saknade kunskap om att glidmedel, tillsammans med kondom, inte minskar risken för HIV-smitta. En majoritet (78,9 %) rekommenderade ett HIV-test till en kvinna som haft oskyddat sex med en man. I studenternas motiveringar till behovet av ett HIV-test, framkom fyra kategorier; ”risk”, ”sexualvanor”, ”patientens oro” och ”ovisshet”. Konklusion: Sjuksköterskestudenterna hade relativt goda kunskaper om HIV. Däremot fanns betydande brister i vissa frågor. Sjuksköterskestudenternas inställning till HIV-testning överensstämmer relativt väl med gällande riktlinjer. Däremot finns ett behov att förändra ett förlegat riskgruppstänkande för att kunna ge patienter rådgivning i enlighet med den senaste kunskapen. / Introduction: HIV-infection is a chronic and progressive disease that, left untreated, leads to a deterioration of the immune system and the development of AIDS.  Aim: To examine nursing students´, at two universities, knowledge about HIV and their attitude towards assessing the need for a HIV-test. Method: An empirical cross-sectional study using descriptive and comparative design with a quantitative approach. Data was collected by a questionnaire among third year nursing students at the University of Gavle and Uppsala University (N=95). Result: A majority (88,4 %) answered correctly that intercourse with more than one partner increases the risk for contracting HIV. Three students (3,2 %) answered incorrectly that there is a vaccine for HIV. Nearly half of the students did not know that lubricant, combined with a condom, does not reduce the risk for contracting HIV. A majority (78,9 %) recommended a HIV-test to a woman who have had unprotected sex with a man. In analyzing the students´ explanatory statements for the need for a HIV-test, four categories emerged; “risk”, “sexual behavior”, “patients´ concern” and “not knowing”.   Conclusion: The nursing students had relatively good knowledge about HIV. However, there was a significant lack of knowledge in some questions. The nursing students´ attitudes towards HIV-testing conforms relatively well with current guidelines. However, there is a need to change an outdated way of assessing the risk for HIV-infection to be able to provide counseling to patients based on current knowledge.