<p> <b>Background:</b> Implementation of evidence-based knowledge in healthcare is challenging with success rates less than optimal at times. This is particularly true in the area of pressure ulcer prevention. Attention to use of the affective domain in educational interventions to implement best practices may be part of the solution. </p><p> <b>Purpose:</b> The ultimate purpose of this study was to compare the use of two different educational interventions on medical-surgical nurses' behavioral intent to use evidence-based practice in preventing pressure ulcers. </p><p> <b>Theoretical Framework:</b> The theoretical framework for this study was the theory of planned behavior. </p><p> <b>Methods:</b> This study proceeded in three phases and collected both qualitative and quantitative data for instrument development and instrument testing. The resultant instrument was used to collect data for hypothesis testing in a cluster randomized experiment. </p><p> <b>Results:</b> The theory of planned behavior was not fully supported in this study. Attitudes toward pressure ulcers were predictive of behavioral intent. Nurses who experienced the affective domain educational intervention showed significant improvements over the control group on attitude and perceived behavioral control. Behavioral intent and subjective norm were not impacted. </p><p> <b>Conclusions:</b> A reliable and valid theory of planned behavior derived instrument was created. The theory of planned behavior was partially supported. An affective domain intervention has the potential to favorably impact nurses in valuing pressure ulcer prevention, despite any barriers.</p>

<p> The purpose of this quantitative ex-post facto study was to determine if the level of satisfaction is increased over hospitals that do not incorporate PCC services. The study involved the use of archival data from HCAHPS (n.d.) satisfaction surveys analyzed during the first quarter of 2013. The respondents of the study included using archival patient satisfaction survey data from 113 hospitals within the State of Michigan. Fifty-two of these hospitals were identified as providing some level of PCC services to patients, and 61 of the hospitals were identified as not providing PCC services to patients. For each of the research questions, a two-sample t-test was used to compare the mean percentages between hospitals that have implemented PCC services and hospitals that have not implemented PCC services. The use of a two-sample test with all of the research variables did not reject any of the hypotheses for this study. This outcome could indicate that HCAHPS (n.d.) patient satisfactions scores may not be directly linked to PCC services. Although the results for this study did not demonstrate a favorable outcome regarding HCAHPS (n.d.) satisfaction scores and PCC services, the literature review for this study validates the importance for leaders within the health care community who have established PCC services to find other measurements to assess the effectiveness of PCC services, and those who do not to consider the implementation of Patient-Centered Care (PCC) services within their hospitals.</p>

<p> The purpose of this project is to create fun and educational lesson plans for before and after school childcare providers of children in kindergarten through fifth grade. The lesson plan will incorporate aspects of physical activity and nutrition into the basic curriculum for this age group. The nutrition and physical activity curriculum contains four themed weekly lessons. Each lesson incorporates a nutrition discussion, an activity related to the discussion, and one group game. The lessons and activities were designed to incorporate minimal materials so that any facility could easily incorporate them. A committee of nutrition professionals and educators reviewed the curriculum and improvements were made based on their recommendations.</p>

<p> Childhood obesity is a disease that affects 17% of children aged 2-19. This disease, best described by a social ecological perspective, is multifactorial in nature and includes individual, familial, community, and societal contributors. As the causes are multifactorial, so too should be prevention and treatment. Healthcare providers, specifically physicians, can play an important role in the diagnosis, prevention, and treatment of childhood obesity, especially if they appropriately utilize nutrition behavior change counseling to facilitate lifestyle changes. Behavior change falls within the realm of the social and behavioral sciences, disciplines that will receive greater emphasis on the newly designed MCAT 2015^&reg;; therefore, premedical and medical programs may need to alter their approaches to disseminating this discipline-specific knowledge. Nutrition education is currently limited in medical education; and thus, just as premedical programs seek to increase the social and behavioral sciences, so too should they increase nutrition education. In light of these recommended curricular changes, researchers sought to investigate the current state of premedical and medical students. views of childhood obesity. This dissertation describes three studies conducted for that purpose. In study 1, researchers investigated 30 pre-healthcare undergraduate seniors. views of childhood obesity and their sources of knowledge through in-depth qualitative interviews. Investigators found that students with specialized coursework and significant volunteer and/or internship experience had a deeper understanding of childhood obesity; however, as a whole, students failed to see the role of healthcare providers in prevention and treatment. These findings provide justification for premedical programs to guide students to see their role in prevention and treatment through educating them on the social ecological model and providing them with relevant service-learning opportunities and guided reflection. In study 2, researchers conducted a similar nationwide qualitative investigation in 78 third and fourth year medical students. These students described student-, patient- and healthcare system-centered barriers, including their lack of knowledge, patients. lack of access, and their lack of time in practice. Students also requested more applicable information and counseling training in order to equip them to prevent and treat childhood obesity. Much like the pre-healthcare seniors, these medical students failed to discuss their role in prevention and treatment. Therefore, medical schools need to help their students overcome barriers by providing them knowledge and skills and helping them understand their role in prevention and treatment. In study 3, researchers built on the knowledge gained from study 1 and study 2 and developed a valid and reliable computerized tool, the Childhood Obesity Prevention Self-efficacy (COP-SE) survey. Factor analysis of 444 completed surveys from students at 53 medical schools revealed a two factor structure with a correlation of 0.637 between factors. Factor 1 assesses self-efficacy in nutrition counseling while Factor 2 measures self-efficacy to assess readiness to change and initiate nutrition lifestyle changes. There was high reliability within factors (Factor 1 = 0.946; Factor 2 = 0.927), and the correlation (0.648) between the COP-SE survey and a general self-efficacy survey confirmed that the COP-SE measures domain-specific self-efficacy. This valid and reliable survey can be used by medical schools as a formative or summative assessment of students. self-efficacy in childhood obesity prevention and treatment. Further research should include confirming the factor structure and exploring the significance of response trends seen in this sample. The findings of all three studies can be used by premedical and medical programs to maximize the effectiveness of their preparatory programs to provide students with the necessary skills for prevention and treatment of childhood obesity. With the appropriate preparation, future healthcare providers can build their self-efficacy in disease prevention and treatment, hopefully resulting in improved patient outcomes.</p>

<p> Low health literacy impacts an individual's ability to comprehend communication from healthcare providers, reduces access to healthcare, and contributes to increased mortality. The purpose of this study was to evaluate the impact of learning style on adult health literacy education. The health belief model, protection motivation theory, the transtheoretical model, and social cognitive theory were used to analyze the data in this study, and to further develop effective health literacy education. The research questions addressed the effectiveness of educational intervention adjusted to their appropriate learning style in comparison to a standardized health literacy intervention and potential difference, according to type of learning style, in the amount of changed performance between pretest and posttest. A sample of 80 adults in an urban community was recruited through organizations serving low-income individuals. The participants were assessed for baseline health literacy level, followed by identification of learning style, educational intervention, and posttest assessment, which led to determination by <i>t</i> test that changes between pretest and posttest scores were statistically significant between the control group and the study groups. This finding suggests that health education should be delivered to patients according to individual learning style in order for patients to comprehend and retain information provided. Social change implications include healthcare professionals appropriately addressing health literacy so that patients may participate more actively in their personal healthcare decisions to improve healthcare quality outcomes, decrease long-term costs of delivering healthcare services, and improve the general health of the community.</p>

<p> Intercultural competence through study abroad is widely recognized as a preferred teaching approach for the development of globally competent health care practitioners. Colleges and universities are looking for multiple ways to encourage students to study abroad because of the noteworthy effects that these experiential opportunities have on students. Sparse research has been conducted to determine if short-term study abroad trips of less than two weeks are achieving these same outcomes. </p><p> The purpose of this basic interpretative qualitative study was to describe the nature and meanings of a short-term international cultural experience for nursing students, and whether or how their understanding of the role of the professional nurse was changed. A group of baccalaureate nursing students traveled to Tanzania and took part in professional and social opportunities over an 8-day period. All participants were required to complete a nursing course with global objectives prior to the trip and pre-immersion seminars. Data were collected from reflective journals during the study abroad experience, focus group discussions one month after returning home, and personal interviews 6 months later. The results indicated that the participants experienced culture shock, but they also gained in self-awareness, cultural empathy, leadership skills, a desire to learn more, and a new perspective of the role of the professional nurse. Langer's theory of Mindfulness, Bennett's Developmental Model of Sensitivity and Campinha-Bacote's Process of Cultural Competence provided the theoretical framework for this study.</p>

<p> The recent impetus to increase the number of baccalaureate-prepared nurses comes from within and outside the profession, prompting increased numbers of registered nurses (RN-BSN) to return to college. Yet little is known about what these adult, non-traditional students do to prepare for the challenges ahead. Therefore, the purpose of this mixed-methods case study was to learn how RN-BSNs prepare for their return to college, why they go about doing so, and what resources they utilize. Secondly, what are the gaps, how do they overcome them, and what is their advice to potential RN-BSN students so they could be better prepared. The Transtheoretical Model and the Epidemiological Model were used to guide the study. The eight participants interviewed ranged in age (32-57). Each had contemplated the return to school since their initial nursing program. Six were enrolled at a rural satellite site at their place of employment. While participants prepared in a variety of ways, findings showed they also did not know what to expect and thus felt unprepared in many respects. The most common type of preparation was mental; whereas the most frequent gap in preparation was academic, including writing papers, presentation skills, computer literacy, citations, obtaining books, information literacy, and study skills. Overall, five themes summarized their advice to future students: (a) obtain academic skills early on, (b) find balance, (c) make connections, (d) embrace the difference, and (e) don't wait; make the decision. Based on the findings, examples of recommendations that are both practical and affordable are outlined.</p>

<p>Death is perhaps the most paramount loss an individual can experience. Many faculty, administrators, and students do not anticipate the sudden death of a student or classmate; however it is estimated that approximately 30 to 40 percent of college students experience the death of a family member or friend within two years on campus. Despite these astounding statistics, the topics of student death, grief, and bereavement are rarely discussed in faculty development workshops or addressed in nursing education journals. Much research has been devoted to end of life care among practicing nurses. Conversely, there is scant nursing research pertaining to the personal experiences and grief reactions following the loss of a friend or nursing classmate. </p><p> The aim of this qualitative phenomenological study was to explore the grief experiences, coping strategies, and reactions of traditional college age baccalaureate nursing students following the unanticipated, sudden death of a classmate. Purposive sampling yielded nine participants from four universities who experienced the death of their classmate within the previous nine months. The source of qualitative data included a demographic questionnaire and in-depth interviews with each participant. Interviews were digitally recorded, and verbatim transcriptions were analyzed utilizing the seven-step Colaizzi&rsquo;s (1978) method. Nine major themes emerged: 1) emotional pain of grief, 2) struggling with the reality of death, 3) void in life &ldquo;empty desk&rdquo;, 4) university and departmental responsiveness, 5) connecting with the deceased, 6) bond of comfort and unity, 7) coping and support structures, 8) linger/dwell versus moving on, and 9) grief as a nurse. </p><p> Findings of this study support contemporary models of grief and bereavement and previous research related to peer grief. However, unique aspects of grief emerged for the nursing student. The participants reflected on their emotional struggle with grief amidst the walls of academia, acknowledging they are in a helping profession and &ldquo;we cannot even help one of our own.&rdquo; This study yielded a rich understanding of the grief experience of nursing students, while providing insights for policy development and supportive interventions for nursing faculty and college administrators. </p><p> <i>Keywords</i>: nursing education, grief and loss, bereavement, nursing student, peer grief, sudden death </p>

<p>It is estimated that over 30,000 applicants to registered nursing (RN) programs are turned away each year following a rigorous selection process for the limited available program admissions. An alarming number of those students who are accepted and enter upper division programs and depart prior to completion do so because of increased stress and anxiety experienced during clinical activities. Attrition occurs when students repeatedly experience levels of stress and anxiety and feel they have reached a breaking point. Self-efficacy impacts the amount of stress and anxiety an individual can tolerate before encountering negative outcome expectations. The theoretical framework for this study was underpinned by Bandura's (1995) theory of self-efficacy. A multi-case study approach and cross-case analysis was utilized to identify if a link existed between simulation and self-efficacy. Beginning nursing students engaged in a simulated clinical experience prior to the initial acute care clinical experience. Nursing students discoursed about physical and sociostructual influences on agency and environment related to self-efficacy and negative affective behaviors. Based upon students' discourse, this study supports a link does exist between simulation and self-efficacy for beginning nursing students.

<p> <b>Context</b>: Entry-level athletic trainers enter the workforce with the skills taught to them by athletic training programs (ATPs) using the Competencies developed by our accrediting body. </p><p> <b>Objective</b>: These competencies are developed using data collected from athletic trainers in the field with no input from the consumers of athletic training services. </p><p> <b>Design</b>: This study used a 3-round Delphi questionnaire. </p><p> <b>Setting</b>: Secondary schools located South Louisiana. </p><p> <b>Participants</b>: Six experts in the field of athletic training. </p><p> <b>Data Collection and Analysis</b>: In round 1, participants were first asked to identify individual skills within predetermined skill categories created from the Competencies and existing research. In rounds 2 and 3, participants ranked and rated their responses from round 1. Using Delphi methodology with qualitative and quantitative analysis, a Duty-Task List (DTL) was created from the data, which identified the essential skills for entry-level athletic trainers. </p><p> <b>Results</b>: Ranking of the skill categories produced four tiers, the top tier consisting of skill categories developed from the Competencies. The bottom tier consisted of two items, both from the Competencies: use of evidence-based medicine in practice and therapeutic interventions. Data further revealed communication, its many different forms, was the most important individual skill for entry-level athletic trainers. </p><p> <b>Conclusions</b>: The Delphi methodology used in this study was once again shown to be as effective as DACUM in producing an industry-supported DTL. In doing so, the participants gave a clear conceptualization of the essential skills needed as an entry-level athletic trainer, while also identifying some skills missing from the Competencies. Consideration should be given to the consumers of athletic training services when the next version of the Competencies is created. The athletic trainers on the panel consistently ranked higher skill categories from the Competencies, while the administrators on the panel ranked the non-competency skill categories higher. Additionally, there is still some resistance to increased use evidence in practice, which may be further proof of the chasm between what is considered desirable by clinical setting athletic trainers and academic setting athletic trainers.</p>