Orientador: Maria Cristina Pereira Lima / Resumo: Introdução: O sofrimento psíquico atinge grande parte da população, e pode ser caracterizado por um acentuado e duradouro desconforto emocional, angústia, tristeza, falta de expressão afetiva, esgotamento emocional, isolamento social, dentre outros sintomas. Os estudantes universitários, especialmente da área da saúde, carregam expectativas diversas em relação ao futuro profissional e no decorrer de sua formação são expostos às mais variadas situações que mobilizam seu sofrimento psíquico, podendo vir a comprometer tal formação. Objetivo: Estimar a prevalência e identificar os fatores associados a Transtorno Mental Comum (TMC), entre os estudantes universitários da área da saúde, dos cursos de Enfermagem e Medicina da Faculdade de Medicina de Botucatu e de Nutrição do Instituto de Biociências. Método: Este é um estudo transversal que se insere na pesquisa “Condições de vida e saúde de estudantes de Enfermagem, Medicina e Nutrição do campus de Botucatu”, cujos dados foram colhidos em 2013. Trata-se assim, de uma análise parcial do referido banco de dados. A variável dependente é TMC, investigada a partir do Self Report Questionnaire, considerando-se caso mulheres com 8 pontos ou mais e homens com 6 pontos ou mais. As variáveis independentes são as características sociodemográficas e rede de apoio avaliada pela Escala de Apoio Social (EAS). Inicialmente foi feita análise descritiva, seguida de análise bivariada e posteriormente foram construídos modelos de regressão logística... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

An increase in reports of undesirable professional behaviour in the nursing profession has prompted the question: How could the internalisation of skills, knowledge, values and beliefs be guided in student nurses to help them become effectively socialised as professional nurses? Using a sequential exploratory mixed-methods approach, the study addressed the above question. The researcher used focus-group interviews and field notes to explore and describe the perceptions of professional nurses and experiences of student nurses regarding the professional socialisation of students. The data generated from these findings were further used to determine and describe educators’ (N=128) perceptions on their teaching and facilitation of professional socialisation of students, using a self-administered questionnaire. The findings of both the qualitative and quantitative data were integrated to develop and validate guidelines to support educators and professional nurses in the professional socialisation of students. To establish rigour, the researcher applied measures of trustworthiness and performed validity and reliability tests. The qualitative data were analysed by utilising Tesch’s method of data analysis. The themes that emerged as influential in the professional socialisation of students were related to the professional nurse as role model, clinical supervisor, the educator, clinical learning environment, values and beliefs of the nursing profession and cultural and gender orientations. The quantitative data were analysed using descriptive and inferential statistics. Educators’ teaching and facilitation strategies revealed that the educator as a role model, the clinical environment, teaching approaches and cultural awareness were important social determinants in the professional socialisation of students. The qualitative and quantitative data were integrated to develop guidelines that were validated by field and guideline experts. The guidelines for educators and professional nurses addressed issues such as the professional nurse as role model and clinical supervisor, the creation of a positive clinical learning environment, the educator as role model, the teaching and support of students, the work ethic of the professional nurse and educator, the students’ behaviour and cultural awareness. These guidelines propose recommendations for educators and professional nurses to support the professional socialisation of students. / Health Studies / D. Litt. et Phil. (Health Studies)

Background: The Institute of Medicine and numerous other healthcare organizations have identified the severe shortage of underrepresented minority healthcare professionals graduating into the workforce, and have called for a radical transformation of healthcare educational programs to make them more welcoming and supportive of underrepresented minority students. Purpose: The purpose of the study was to develop a reliable and valid measure of faculty response patterns to the needs of underrepresented minority nursing students. Theory: Yoder’s patterns of faculty interaction formed the conceptual basis for the development of this instrument. Methods: A mixed-method approach was used to develop this instrument. The first phase (item development phase) consisted of work with underrepresented minority nurse and faculty focus groups, individual interviews, and content experts to develop items. During the second phase of this study, psychometric evaluation of 134 survey responses from nursing faculty in the Northeast was conducted. Results: A 10-item scale was developed that measured faculty engagement with underrepresented minority nursing students. The Cronbach alpha for the EFURMS scale was .81. Principle component factor analysis with varimax rotation revealed a 3 factor solution that explained 66% of the variance in engagement with underrepresented minority students. The Cronbach alpha for the 3 factors ranged from .72-.78. The EFURM scale did not demonstrate ceiling or floor effects, or social desirability bias. More positive scores (higher EFURMS Scores) were associated with older faculty who had been teaching longer and had more experience teaching underrepresented minority students. Conclusion and Implications: The results of this study provide preliminary evidence for the reliability (internal consistency) and validity (content, criterion-related, and construct validity) of the 10-item EFURMS Scale. Further testing is needed to test the usefulness of this scale with wider samples of nursing faculty. With further development, the EFURMS Scale could be used to evaluate faculty readiness to engage with underrepresented minority students, and with studies to test the efficacy of interventions designed to improve faculty engagement with underrepresented minority students. A major finding of this study was the significance of age, years teaching, and experience teaching underrepresented minority students with EFURMS Scores suggesting that younger or less experienced faculty could benefit from mentoring by more seasoned faculty who have greater experience teaching underrepresented minority students.

Background: The society is rapidly changing in a demographic matter. As a result of this nurses are required to be equipped with the right skills and knowledge to approach a more diverse patient group. Hence, the health care is dependent on cultural competent nurses, without them the health care is vulnerable. Previous studies show that nurses are faced with great challenges when it comes to encounters with patients from different cultural backgrounds and that they lack the essential cultural knowledge which effects the quality and standard of care. This means high demands on the nursing curricula to integrate guidelines for cultural competence and educate future nurses in order to make them more prepared for their future profession. Aim: To explore nursing students experiences of practicing cultural competence in care of patients from diverse cultural backgrounds, a qualitative study in Gauteng province, South Africa.  Method: The chosen method was qualitative. Eight individual semi-structured interviews were conducted and analyzed with inspiration from Burnard’s (1996) four-step content analysis. Findings: The findings showed the main-category: beneficial components in cultural competent care, with three sub-categories: positive attitudes and adapting of care, gaining knowledge from cultural encounters with patients and existing contextual insights of own culture and other cultures. The beneficial components included the positive attitudes of the participants and their ability to adapt the care around cultural challenges. Gaining knowledge from cultural encounters with patients and having existing contextual insights of own culture facilitated the encounters with patients. Findings also showed the main-category: barriers in providing a cultural competent care with three sub-categories: disrupted communication, limited levels of cultural knowledge and lack of trust. Disrupted communication was mostly due to the language barrier, a huge problem as important information was left out and the system of getting interpreters faulted. The limited levels of cultural knowledge were based on limited knowledge about different cultures. Lack of trust originated from patients’ strong cultural belief while disbelieving in the westernized health care which resulted in a non-trusting relationship between health care personnel and patients.  Conclusion: There were several barriers as well as facilitators, though the barriers were more dominating in character. Therefore, more education is needed so nursing students feel empowered and more secure when encountering patients from different cultures. Continuing education is also needed for registered nurses as well as prospective and further research is required in order to obtain the best resources for implementation of cultural competence.

One of the major challenges associated with nursing education in this 21st century is the practice preparation of student nurses in this complex healthcare environment to ensure their fitness to practice. Practice training relies largely on mentoring which is central to the professional development of student nurses. In the local context of Mauritius, the clinical mentoring of students is service-led rather than education-driven. In the context of the current debate, it is becoming evident that the clinical mentoring system in Mauritius needs rethinking in order to respond to the emerging training and education needs of nurses. The aim of the study was to develop a contextually relevant clinical mentoring framework for student nurses in Mauritius in order to enhance the standard of student nurses’ training during clinical placements. A descriptive exploratory sequential mixed method with a cross-sectional design was used in this study. The sample for the qualitative phase consisted of eight nurses, while there were 255 nurses and 115 students in the quantitative phase. Data were collected through face-to-face semi-structured interviews and a self-administered questionnaire, respectively. The findings were synthesised using Dickoff et al’s (1968) survey list to develop the clinical mentoring framework for student nurses. The findings of the qualitative phase indicated that the current learning support system for students in the clinical settings did not reflect what mentoring should be about. Mentoring per se was not practiced, but rather a form of clinical accompaniment resulting in the practice being less effective for its purpose. A variety of activities/roles were described that nurses fulfil in everyday clinical practice that included some aspects of a mentoring approach. Participants provided a number of pre-requisites needed for the mentoring process. The results of the quantitative phase revealed that both students and nurses recognised that the mentoring system was informal. They also shared the same views regarding barriers to mentoring, such as staff shortage, lack of resources, and inadequate support from management and the Central School of Nursing (CSN). Along with mentoring competencies, teaching, assessing, communication, managerial and leadership skills, were identified as core competencies for mentors. Effective clinical mentoring requires an understanding of the mentoring process from a broader perspective. Mentors should be equipped with core competencies. Successful mentoring outcomes are dependent on a conducive clinical learning environment (CLE) and the approach used to mentor. The framework on mentoring could guide and provide a holistic approach to mentoring students in CLEs. However, emphasis must be placed on the collaboration between the management, the clinical setting and the CSN. The clinical framework developed from this study can be tested for its effectiveness. / Health Studies / Ph. D. (Nursing)

The incidence and prevalence of body piercing health complications among students is a public health matter that has not been researched in Puerto Rico. College students are the most consistent participants in body piercing activities and have reported health complications resulting in visits to medical offices and emergency rooms. Based on the health belief model, which is used to explain and predict health attitudes, the purpose of this quantitative nonexperimental study was to analyze the health risks and possible complications occurring after body piercing and to investigate the association between sex and age and medical complications. Data were collected from 64 nursing students from Puerto Rico who completed the Body Piercing Experience survey. Results of descriptive analyses and logistic regression analyses indicated no significant associations between sex and age and medical complications. Most participants reported they would repeat a body piercing after having knowledge of the health risks and complications of this activity. Results may be used in various ways: to change attitudes of health professionals and the general population regarding health implications related to body piercing; to develop educational programs for children, because results of this study revealed that piercing began in many participants at age 11; and to develop education through promotion and prevention programs with college students and others who engage in body piercing.

Indiana University-Purdue University Indianapolis (IUPUI) / Despite outstanding employment opportunities and high demand to address the global nursing shortage, men who consider becoming nurses are less likely to enroll in and to graduate from nursing programs. Many barriers that men commonly encounter during nursing education have been found in the literature; however, there is a lack of theoretically based research that examines factors that help men succeed as they study nursing. Based on a conceptual model derived from O’Lynn’s construct of male friendliness in nursing education and Frankl’s theory of will to meaning and purpose in life, this study examined facilitators for men during nursing education. This was accomplished through the development and psychometric testing of the Survey of Facilitators for Men (SFM) in a sample of 145 men in nursing. Strong evidence of reliability and validity was provided for the SFM consisting of three subscales (Internal facilitators, External Connections facilitators, and Institutional facilitators). Internal facilitators consist of intrapersonal strengths, experiences, and motivators. External Connections facilitators are interpersonal connections that emerge from relationships that men develop. Institutional facilitators involve structural or organizational aspects of institutions that ease barriers. Testing provided satisfactory evidence of internal consistency (α = .85) and test-retest reliability (intraclass coefficient = .72; confidence interval = 0.57–0.83). Dimensionality of three facilitator subscales was supported by Principle Axis Factoring with Varimax rotation and satisfactory factor loadings (.49–.72). Support for the conceptual model was provided using multiple regressions explaining 17% of the variance in purpose in life [F(4, 140) = 6.99, p < .001], 13% of the variance in GPA [F(6, 114) = 2.88, p < .01], and 49% of the variance in perception of nursing success [F(9, 128) = 13.42, p < .001]. Purpose in life was associated with Internal facilitators and comfortable income, GPA was associated with External Connections facilitators and age at BSN, while perception of nursing success was associated with purpose in life, holding an MSN, having a comfortable income, and having children. Future research is warranted to determine the usefulness of the SFM in designing strategies to recruit and retain men in nursing programs.

Indiana University-Purdue University Indianapolis (IUPUI) / Clinical nursing faculty members often work with students who underperform in the clinical area. Underperforming students are those who exhibit deficits in nursing knowledge, the application of nursing knowledge, psychomotor skills, motivation, and/or interpersonal skills. The outcomes of faculty work with underperforming students have implications for patient safety and the nursing workforce, yet little is known about how faculty work with underperforming students. The purpose of this project was to develop a theoretical framework that describes how clinical faculty work with underperforming students in the clinical area. Twenty-eight nursing faculty who had worked with underperforming nursing students during clinical rotations were interviewed and invited to tell stories about working with these students. Their narratives were analyzed using constant comparison analysis, and a theoretical framework was developed. The framework included three stages that unfolded as faculty worked with underperforming students over time. The first stage, Being Present, was the process by which faculty came to know students were underperforming. They did this by noticing red flags, taking extra time with students, working side-by-side with students, and connecting with students "where they were at." The second stage, Setting a New Course, was the process by which faculty attempted to provide remedial experiences to improve the performance of those students determined to be underperforming. The participants did this by beginning a new course of instruction for the students, bringing in new people to help the students, and creating new learning experiences for them. This process could result in students turning it [their performance] around, making it through [the clinical rotation], or not making it. The final stage, Being Objective, was the process by which participants made negative progression decisions. They did this by relying on objective indices, documenting problematic student behaviors, and obtaining validation for their decisions.

Denna studie syftade att öka kunskap om självstigma och attityder till att söka psykologisk hjälp bland svenska sjuksköterskestudenter, med anledningen av de höga sjukskrivningstalen bland sjuksköterskor samt den pågående COVID-19 pandemin och dess medföljande negativa konsekvenser på psykisk hälsa. Studien fokuserade på sambandet mellan självstigma och attityder, samt hur de påverkas av ålder, tidigare erfarenheter av psykologisk hjälp och utbildningen. Data insamlades med självskattningsformulären Self-Stigma of Seeking Psychological Help Scale och Mental Help Seeking Attitudes Scale, som besvarades av 171 sjuksköterskestudenter vid Linnéuniversitet, Växjö. Studien visade att personer med lägre självstigma hade mer positiv attityd till hjälpsökande beteende, samt att tidigare erfarenhet av psykologisk hjälp varierade signifikant med nivå av självstigma, men inte med attityd till hjälpsökande beteende. Varken ålder eller utbildningsnivå var signifikant. Studiens resultat poängterade självstigmas betydelse i utformning av stödjande insatser för att främja hjälpsökande beteende, och behovet av fler studier inom området. / This study aimed to increase knowledge about self-stigma and attitudes to seeking psychological help among Swedish nursing students, due to the high sick leave rates among nurses and the ongoing COVID-19 pandemic and its accompanying negative consequences on mental health. The study focused on the relationship between self-stigma and attitudes, as well as how they are influenced by age, previous experiences of psychological help and education. Data were collected with the self-assessment forms Self-Stigma of Seeking Psychological Help Scale and Mental Help Seeking Attitudes Scale, which were answered by 171 nursing students at Linnaeus University, Växjö. The study showed that people with lower self-stigma had a more positive attitude towards help-seeking behavior, and that previous experience of psychological help varied significantly with the level of self-stigma, but not with an attitude towards help-seeking behavior. Neither age nor level of education were significant. The results of the study emphasized the importance of self-stigma in the design of supportive efforts to promote help-seeking behavior, and the need for more studies in the field.

The problem with which this study is concerned is the inclusion of actual critical care experience in generic nursing curricula in the United States. A survey instrument was sent to faculty representatives selected by the dean of each of 312 generic baccalaureate nursing programs.