Class of 2009 Abstract / OBJECTIVES: The purpose of this study is to evaluate and compare the DDI knowledge of pharmacy, medical, and nurse practitioner students who are beginning clinical clerkships. METHODS: This study utilized a prospective evaluation of DDI knowledge among healthcare professional students who were currently enrolled in their final didactic year at the University of Arizona College of Medicine, College of Pharmacy, or College of Nursing’s nurse practitioner course. Students were provided with 15 possible DDI pairs, and asked to select an appropriate management strategy for each pair. Management options included: “Avoid Combination,” “Usually Avoid Combination,” “Take Precaution,” “No Special Precaution,” and “Not Sure.” The primary outcome measure was the ability to correctly categorize each DDI pair into one of the five management responses. The secondary outcome measure was the number of clinically significant DDIs recognized. Analysis of variance was used to evaluate differences between groups. An alpha of 0.05 was set a-priori. RESULTS: Response rates were 61% for medical students (72 of 119), 82% for pharmacy students (64 of 78) and 100% for nurse practitioner students (29 of 29). The mean number correct for management strategies was comparable in the medical students (2.5, SD= 1.9) and nurse practitioner students (3.0, SD= 1.9), while the pharmacy students had a mean score of 6.1 (SD= 2.2) correct answers. There was a significant difference between the groups in correct responses (p< 0.001). In regards to student ability to identify interactions, the mean number correct was 10.1 (SD= 2.6), 5.0 (SD= 3.3), and 4.4 (SD= 3.0) for pharmacy, medicine, and nursing respectively (F= 60.6; p< 0.001). Post hoc analysis demonstrated that pharmacy students performed significantly better than medical and nurse practitioner students in regards to their ability to: 1) select management strategies for DDI pairs; and 2) identify a DDI interaction. No significant differences were found between the medical and nurse practitioner students. CONCLUSIONS: Pharmacy students demonstrated better knowledge than medical and nurse practitioner students with respect to identifying and selecting management strategies for possible DDIs. However, there is much room for improvement for all groups.

Female genital mutilation (FGM) has been illegal in Tanzania since 1998; nonetheless this procedure is still being performed in some regions of the country. Since the prohibition of this practice it has become harder to detect the practitioners. Nurses are one of the professions who can identify the women who have been exposed to FGM, which creates an opportunity to provide care for these women and educate them about the practice. The aim of this study is to describe Tanzanian nursing students’ views on FGM. Data was collected with focus group interviews with second and third year students at a nursing school in northwest Tanzania. Data was analysed inductively by content analysis. The results, the students’ views on FGM, were categorised into four themes; ‘FGM creates suffering’, ‘the right to sexual integrity’, ‘the role of nurses’ and ‘educating the patient and the community’. The findings clearly demonstrate that the students’ negative attitudes toward the practice are based on their knowledge of its harmful implications on health. For further research, it may be of interest to study nursing students’ views of the practice in more FGM-prevalent regions of Tanzania. / <p>Röda Korsets sjuksköterskeförening stipendium 2017</p>

Clinical practice is a major component of nursing education wherein significant learning takes place. It is also a place where nursing students can experience stress which can have a negative impact on their learning. The purpose of this study was to explore nursing students’ perceptions of and experiences with their coping efforts as they face stress associated with clinical practice. Lazarus and Folkmans’ theory of stress and coping guided this study. Semi-structured interviews were conducted with 10 undergraduate nursing students. Qualitative thematic analysis was used to analyze the data. Four major themes emerged upon analysis: Learning about self, Social Support, Self-Care, and Clinical Instructors. Nursing students need clinical environments which let them face challenges and meet the responsibilities of nursing practice with support from clinical instructors (Emerson, 2007; Parker & Myrick, 2010). A non-punitive and respectful environment is essential for a student to learn and cope effectively with stressful situations. Clinical instructors play a significant role in the clinical practice of nursing students. Clinical instructors facilitate learning by helping students to overcome situational, knowledge-related or emotional stressors. Negative relationships with them can increase the amount of stress in students in their clinical practice. Whereas positive relationships with the instructors and the staff on the unit increase students’ comfort, decrease stress, and enhance learning. This study yielded qualitative data on nursing students’ views about and experiences with coping with the stress from their clinical practice. This study also provided valuable information regarding the clinical instructor’s role in the coping process. The findings have implications for improving the clinical instructor’s role in enhancing coping among nursing students with the stress that arises from clinical practice. / May 2016

Magister Curationis - MCur / Studies have indicated that the global population of older people will reach 1.53 billion by 2050. The ageing population is a large consumer of health-care services and this remains a global concern due to the impact on existing health care systems. To have an adequately prepared workforce, nurses must have enough knowledge and skills to care for older people and positive attitudes toward them. This is because nurses’ attitudes towards older people might influence the quality of care they provide. Studies have documented nurses’ reluctance to care to work with older people, but little is known about the attitudes and knowledge of nursing students towards caring for older people in South Africa. The aim of this study was to examine undergraduate nursing students’ knowledge about ageing and their attitudes towards caring for older people. A quantitative descriptive survey, utilizing a self-administered questionnaire was used. A pre-tested self-report questionnaire was used to collect the data from a stratified sample of 240 nursing students across 5 levels of Bachelor of Nursing programme, from the foundation year to the 4th year.. Data were analyzed using SPSS version 25. The response rate was 100%. The findings showed that the first- and second-year students had minimal clinical exposure to older people while the third and fourth year had extensive contact with patients in clinical and other health settings. The students had an average level of knowledge with a generally positive attitude towards older people, though significant differences were found between the year levels. Just over half of the respondents reported that they intend to work with older people after graduation. The study recommended the improved training of nursing students in caring for older people.

Philosophiae Doctor - PhD / Academic success, which is measured by continuous assessment and examination results, is one of the major goals of higher education. However, Higher Education institutions worldwide are faced with a challenge on how to improve the academic performance, success and ultimately the retention of students during their studies. Aim: The aim of this study was to develop an intervention towards the improvement of academic performance, success and retention among undergraduate nursing students at a university in the Western Cape, South Africa. Methods: A multi-method research approach was employed to meet the study aim and objectives. The study was conducted in three phases that were guided by the adapted phases of the Design and Development (D&D) model by Rothman and Thomas (2013). Phase one (Study 1– 4) was the problem analysis and information gathering phase. Phase two was the design and early development during which designing observational elements and specifying procedural elements were applied. Phase three (Study 5) was the validation phase. Results: This thesis comprised of five interdependent studies. Study 1: A systematic review of literature was conducted encompassing previous literature from 2006 to 2016 regarding the predictors of academic performance and success among undergraduate nursing students. It was found that satisfactory academic performance among nursing students is associated with older age, female gender, English language proficiency, majority ethnic status, pre-admission academic achievements, selecting nursing as first choice for study, participating in organised music programmes, active academic engagement, as well as psychological and emotional factors. Study 2: Undergraduate nursing students’ (n =232) perceptions regarding their educational environment were explored. This study showed that generally the nursing students were positive about their educational environment. However, the findings indicated that enhancements are required to improve the conditions of the educational environment. Study 3: The study explored the challenges experienced by undergraduate nursing students (6 - focus group discussions) regarding their academic performance and success and the measures implemented to overcome these challenges. The findings revealed that students’ academic performance is influenced by the students’ economic background, place of residence, inadequate theoretical and clinical support and the unfavorable educational environment. However, the findings also indicated that students employ a surface approach to learning, maintain a positive attitude and remain academically engaged in response to these challenges. Study 4: The study explored the challenges experienced by nurse educators (n = 8) regarding the academic performance, success and retention of undergraduate nursing students and the measures implemented to overcome these challenges. The findings revealed that students’ academic performance is influenced by poor class attendance, lack of academic readiness, socioeconomic backgrounds, English language proficiency, structure of the programme, the educational environment and the working conditions for nurse educators. Study 5: A three round Delphi study was conducted to validate an intervention towards improving the academic performance, success and retention among nursing students. The intervention was structured into eleven categories that emerged from phase 2: (1) Select high quality prospective nursing students; (2) Provide English language support; (3) Promote class attendance; 4) providing financial support to deserving students; (5) Provide university residence to undergraduate nursing students; (6) Encourage family support and involvement; (7) Make the undergraduate nursing programme student-friendly; (8) Ensure a conducive teaching and learning environment; (9) Enhance theoretical and clinical support to undergraduate nursing students at all times; (10) Ensure uniformity and consistency in the process of teaching and learning as well as; (11) Provide support to nurse educators and clinical supervisors. Conclusion: The findings of this study have several implications for the education of nursing students. The developed intervention may help promote better understanding of the academic performance, success and retention of nursing students.

Introdução: Durante a trajetória acadêmica diferentes situações são vivenciadas pelos estudantes de enfermagem. Algumas são descritas como sendo de maior impacto e podem repercutir negativamente nas esferas física e emocional nestes estudantes. Conhecer o perfil destes indivíduos e os fatores de estresse, a presença de sintomas depressivos e a qualidade do sono torna-se fundamental para que estratégias de melhoria da qualidade de vida acadêmica sejam desenvolvidas. Objetivo: Verificar se existe correlação entre as características sociodemográficas, acadêmicas e estilo de vida com as variáveis fatores de estresse, sintomas depressivos e qualidade do sono de estudantes de enfermagem. Método: Trata-se de uma pesquisa observacional, transversal, quantitativa, realizada com 110 estudantes de enfermagem de uma instituição de ensino superior na cidade de Santo André, São Paulo. Para coleta de dados foi utilizado um questionário, contendo dados sociodemográficos, acadêmicos e estilo de vida, a Escala de Avaliação de Estresse em Estudantes de Enfermagem (AEEE), a Escala de Sintomatologia Depressiva do Center for Epidemiologic Studies Depression (CES-D) e a Escala de Índice de Qualidade do Sono de Pittsburgh (PSQI). Para análise dos dados, utilizou-se o coeficiente de correlação de Pearson, a Análise de variância (ANOVA) e o Modelo de Regressão linear Múltipla. Resultados: Para 68,18% dos estudantes, a Formação Profissional representou alto nível de estresse, enquanto Atividades Práticas e Teóricas representaram médio nível de estresse. 78,18% da amostra estavam com sintomas depressivos, cuja média de escore de sintomatologia depressiva foi de 25,82, acima do ponto de corte 16, e os fatores Depressão e Somática/iniciativa obtiveram maior escore. Os acadêmicos foram considerados maus dormidores, por apresentarem média do escore de qualidade do sono de 8,89, acima do ponto de corte 5. Somado a isto, 83,5% dos acadêmicos dormem menos de 7 horas por noite. As variáveis sociodemográficas que correlacionaram-se significativamente com os fatores de estresse, sintomas depressivos e qualidade do sono foram idade, sexo, turno de trabalho, os estudantes com dependentes, os solteiros e os que moram sozinhos. Quanto às variáveis acadêmicas, evidenciou-se que o tempo utilizado pelo estudante para chegar à faculdade e ser estudante da terceira e da quarta séries correlacionam-se de forma significativa com os fatores de estresse e os sintomas depressivos. O tempo de tabagismo foi a variável referente ao estilo de vida que correlacionou-se significativamente com os fatores de estresse e sintomas depressivos. Na análise entre os instrumentos utilizados; verificou-se importante correlação entre os fatores de estresse, sintomas depressivos e qualidade do sono. Conclusão: Os fatores de estresse, a sintomatologia depressiva e a qualidade do sono ruim foram vivenciados na trajetória acadêmica dos estudantes de enfermagem investigados. E algumas variáveis presentes entre os dados sociodemográficos, acadêmicos e estilo de vida interferiram na existência desses fenômenos (fatores de estresse, sintomas depressivos e qualidade do sono). / Introduction: During the academic trajectory different situations are experienced by nursing students. Some of them are described as being of greater impact and may have negative repercussions in the physical and emotional spheres for these students. Knowing the profile of these individuals and the stress factors, the presence of depressive symptoms and the quality of sleep becomes fundamental for strategies to improve the quality of the academic life to be developed. Objective: To verify if there is correlation between the sociodemographic, academic and lifestyle characteristics with the variables stressors, depressive symptoms and sleep quality of nursing students. Method: This is an observational, cross-sectional, quantitative study of 110 nursing students from a higher education institution in the city of Santo André, São Paulo. For data collection, a questionnaire has been used, containing sociodemographic, academic and lifestyle data, the Nursing Student Stress Assessment Scale (NSSAS), the Depressive Symptomatology Scale of the Center for Epidemiologic Studies - Depression (CES-D) and The Pittsburgh Sleep Quality Index (PSQI). For data analysis, we have used the Pearson correlation coefficient, the Analysis of Variance (ANOVA) and the Multiple Linear Regression Model. Results: For 68.18% of the students, \"Professional Training\" represented a high level of stress, while \"Practical and Theoretical Activities\" represented a medium level of stress. 78.18% of the sample had depressive symptoms, whose average of depressive symptomatology score was 25.82, above the cut-off point 16, and the \"Depression\" and \"Somatic/initiative\" factors obtained a higher score. Academics have been considered \"bad sleepers\" because they had an average sleep quality score of 8.89, above the cut-off point 5. In addition, 83.5% of the students slept less than 7 hours a night. The sociodemographic variables that correlated significantly with the stress factors, depressive symptoms and sleep quality were age, gender, work shift, students with dependents, single people and those living alone. Regarding the academic variables, it was evidenced that the time spent by the student to arrive at the university and to be a student of the third and fourth grades correlate significantly with the stress factors and depressive symptoms. Smoking time was the variable related to lifestyle that correlated significantly with the stress factors and depressive symptoms. In the analysis of the instruments used, there was an important correlation between stress factors, depressive symptoms and sleep quality. Conclusion: The stress factors, the depressive symptomatology and the poor sleep quality have been experienced in the academic trajectory of the nursing students investigated. In addition, some variables present between sociodemographic, academic and lifestyle data interfered in the existence of these phenomena (stress factors, depressive symptoms and sleep quality).

O ensino de enfermagem em ressuscitação cardiopulmonar (RCP) deve refletir a prática baseada em evidências, as diretrizes da American Heart Assossiation (AHA) e basear-se nos cenários de prática clínica incluindo o reconhecimento da parada cardiorrespiratória, em qualquer ambiente de atenção à saúde. Este estudo trata-se de uma revisão integrativa da literatura e tem como referencial teórico a prática baseada em evidência. Buscou-se identificar e analisar na literatura as evidências oriundas dos estudos primários que abordassem as estratégias de ensino e aprendizagem da RCP em adultos, para os estudantes de graduação em enfermagem. A busca foi realizada nas bases de dados PUBMED, EMBASE, CINAHL e LILACS, no período de 2000 a 2011. Das 591 referências encontradas, 18 estudos primários fizeram parte desta amostra. Foi realizada a extração e análise dos dados, por dois revisores. Foram encontradas as seguintes evidências nos estudos primários: sete de nível II, dois de nível III, dois nível IV e sete estudos de nível VI. Instrução por pares, aprendizagem assistida por computador, aprendizagem baseada em problemas, simulações de alta e baixa finalidade, autoinstrução por leitura de manuais do BLS, autoinstrução por vídeo e a estratégia tradicional têm sido explorados pelos pesquisadores para ensinar e avaliar o nível de aquisição e da retenção dos conhecimentos e das habilidades dos estudantes de enfermagem em RCP. Os estudos de evidência II apresentam comparações entre a estratégia de simulação com o padrão da AHA, com os menequins de média e alta fidelidade, com os estudantes de diferentes níveis de formação; dois estudos comparam estratégias Instrução por pares com a estratégia de ensino tradicional e outro estudo comparando a autoinstrução com a tradicional e com a web-based. O uso da estratégia de simulação com cenários estruturados e com manequins de alta fidelidade mostrou-se, em relação as demais estratégias, a que melhor apresentou subsído para a retenção do conhecimento e aquisição de habilidades na realização da RCP, de acordo com as recomendações das diretrizes da AHA. Os estudos primários mostraram que a retenção do conhecimento e das habilidades apresenta declínio com o passar do tempo, independente da estratégia utilizada pelo professor, sendo necessárias sessões de repetição para que as habilidades não se deteriorem. / Nursing teaching of cardiopulmonary resuscitation (CPR) should reflect the evidence-based practice, the guidelines of the American Heart Association (AHA), and be based on clinical practice scenarios, including the recognition of cardiopulmonary arrest in any environment of health care. This study is an integrative literature review and has the evidence-based practice as the theoretical referential. It aimed to identify and analyze in the literature the evidences from the primary studies that addressed teaching and learning strategies of CPR in adults for undergraduate nursing students. The search was conducted in the PUBMED, EMBASE, CINAHL and LILACS databases in the period from 2000 to 2011. Of the 591 found references, 18 primary studies were part of this sample. Data extraction and analysis were performed by two reviewers. The following evidence in the primary studies were found: seven of level II, three of level III, two of level IV, and six studies of level VI. Peer instruction, computer-assisted learning, problem based learning, high and low-fidelity simulations, self education by reading BLS manual, self education by video and traditional strategy have been explored by researchers to teach and evaluate the level of acquisition and retention of knowledge and skills of nursing students in CPR. Studies of evidence II show comparisons among the simulation strategy with the AHA standard, with the medium and high-fidelity mannequins, and with students of different levels of training; two studies comparing peer instruction strategy with traditional teaching strategy, and another study comparing self education with traditional and web-based strategies. The use of simulation strategy with structured scenarios and high-fidelity mannequins was that showed, in relation to other strategies, better subsidy for the retention of knowledge and skill acquisition in CPR, according to the recommendations and guidelines of the AHA. The primary studies showed that the retention of knowledge and skills declined over time, regardless of the strategy used by the professor, requiring repeated sessions so that skills do not deteriorate.

O presente estudo teve como objetivo avaliar o desempenho da versão traduzida e adaptada para o português do Short Alcohol and Alcohol Problems Perception Questionnarie - SAAPPQ. O desenho metodológico do estudo é do tipo descritivoexploratório. O instrumento foi aplicado a 235 (92,5%) estudantes de enfermagem de uma faculdade privada da cidade de Fátima do Sul-MS. Os alunos apresentaram atitudes predominantemente negativas em relação ao alcoolista e na satisfação e motivação em trabalhar com alcoolista. No entanto, os graduandos apresentaram atitudes positivas no que diz respeito, a saber, que investigar o consumo de bebida alcoólica dos pacientes faz parte do papel do enfermeiro. Na sub-escala segurança profissional os estudantes apresentaram atitude neutra e na sub-escala compromisso terapêutico atitude negativa. O SAAPPQ apresentou bom índice de confiabilidade com alfa global de 0,8764, variando de 0,7079 a 0,8386. A estrutura fatorial da escala na versão brasileira constitui-se por dois fatores, diferentes da versão original. Concluí-se que a escala SAAPPQ pode ser usada em outros estudos e que a graduação de enfermagem deve reavaliar as práticas de ensino sobre álcool e seus problemas correlatos. / This study aimed to evaluate the performance of translated and adapted into Portuguese of the Short Alcohol and Alcohol Problems Perception Questionnaire - SAAPPQ. The methodological design of the study is descriptive and exploratory. It was administered to 235 (92.5%) nursing students from a private college in the city of Fátima do Sul-MS. The students had predominantly negative attitudes towards alcoholics and satisfaction and motivation in working with addicts. However, the graduates had positive attitudes with to regard, namely, to investigate the alcohol consumption of patients is part of the nurse´s role. In sub-scale security professional students had neutral attitude and in the sub-scale therapeutic commitment they had negative attitude. The SAAPPQ showed good reliability index with alpha of 0.8764, ranging from 0.7079 to 0.8386. The factorial structure of the Brazilian version is constituted by two factors, different from the original version. We concluded that the scale SAAPPQ can be used in other studies and graduate nursing should reconsider the practice of education about alcohol and its related problems.

Trata-se de um estudo descritivo, exploratório, com abordagem de análise quantitativa, cujo objetivo foi verificar os acidentes com material biológico potencialmente contaminado, ocorridos entre acadêmicos de enfermagem de três instituições de ensino de um município do interior paulista. Para a coleta de dados aplicou-se um questionário com questões abertas e fechadas, após a observação dos aspectos ético-legais. Participaram do estudo 355 alunos que estavam presentes em sala de aula por ocasião da coleta de dados e que já realizavam atividades de ensino-aprendizagem. Os dados foram analisados em Epi Info versão 3.4.3. Verificou-se que, 44 (12,4%) estudantes referiram ter sofrido exposição acidental a material biológico. A maioria era do sexo feminino (93,1%), tinha entre 22 a 25 anos (56,8%), cursava o quarto ano do curso de enfermagem (68,1%), em período integral (75%). O número de acidentes mencionados pelos alunos totalizou 55. Quanto ao tipo de exposição, a de pele íntegra foi a mais freqüente (70,9%), seguida de acidente percutâneo (25,5%), exposição em mucosa (1,8%) e pele lesada (1,8%). As topografias mais afetadas nesses acidentes foram os dedos e as mãos (74,6%). As agulhas foram citadas como o objeto causador de 64,3% dos acidentes percutâneos e o sangue foi o material biológico envolvido em 72,7% do total de acidentes. O maior número de acidentes ocorreu na retirada da punção venosa/soro (18,2%), ao puncionar ou coletar sangue (16,4%) e ao aspirar paciente (12,7%). Os alunos não utilizavam Equipamento de Proteção Individual em 49,1 % dos acidentes, embora em mais de 80% das atividades seria recomendado ao menos o uso das luvas de procedimento. Os alunos lavaram o local do acidente em 92,7% dos casos e dois alunos espremeram a área lesada após acidente percutâneo. Em 40% dos acidentes, os estudantes não notificaram a ocorrência aos docentes supervisores; em 38,2% das exposições os alunos não tomaram nenhuma conduta, não notificaram e não procuraram atendimento médico. A maioria dos docentes, quando notificados, orientou seus alunos quanto às condutas corretas e os encaminharam para avaliação médica; um docente, apesar de notificado, ignorou o fato. As situações mais apontadas pelos alunos como as que favoreceram a exposição acidental foram não utilizar Equipamento de Proteção Individual (49,1%) e a desatenção (45,5%). Como sugestões para prevenir e controlar acidentes com material biológico entre alunos, 21,4% referiu a educação permanente/continuada e 19,7% a utilização de Equipamento de Proteção Individual e a conscientização quanto ao uso. Para minimização de acidentes com material biológico potencialmente contaminado, entre alunos de enfermagem, nota-se a necessidade de envolver não apenas os alunos, mas também docentes e profissionais dos campos de ensino-aprendizagem, num programa efetivo de prevenção e controle dos acidentes. / This is a descriptive and exploratory study with a quantitative analytic approach. The aim was to verify the occurrence of accidents involving potentially contaminated biological material among nursing students from three teaching institutions in an interior city of São Paulo State, Brazil. After observing ethical-legal aspects, a questionnaire with open and closed questions was applied for data collection. Study participants were 355 students present in the classroom at the moment of data collection and who had already been involved in practical teachinglearning activities. Data were analyzed in Epi Info version 3.4.3. Forty-four (12.4%) students indicated accidental exposure to biological material. Most of them were female (93.1%), between 22 and 25 years old (56.8%), taking the forth year of the nursing course (68.1%) and studying full-time (75%). The students mentioned 55 accidents. As to the type of exposure, intact skin exposure was the most frequent (70.9%), followed by percutaneous accident (25.5%), mucous membrane exposure (1.8%) and injured skin (1.8%). The most affected topographic areas during these accidents were fingers and hands (74.6%). Needles were mentioned as the causal object in 64.3% of percutaneous accidents and blood was the biological material involved in 72.7% of all accidents. The largest number of accidents occurred when removing venipuncture/serum (18.2%), while puncturing or collecting blood (16.4%) and while aspirating a patient (12.7%). The students were not using Individual Protection Equipment in 49.1% of the accidents, although at least the use of procedure gloves would be recommended in more than 80% of activities. The students washed the accident site in 92.7% of cases and two students squeezed the injured area after a percutaneous accident. In 40% of the accidents, the students did not notify the occurrence to the supervising faculty members; in 38.2% of the exposures, the students did not take any action and neither notified nor looked for medical help. When notified, most faculty members advised their students about correct conducts and referred them for medical evaluation; despite the notification, one faculty member ignored the fact. The situations students most indicated as favoring accidental exposure were not using Individual Protection Equipment (49.1%) and lack of attention (45.5%). As suggestions to prevent and control accidents involving biological material among students, 21.4% mentioned permanent/continuing education and 19.7% the use of Individual Protection Equipment and creating awareness about the use. To minimize accidents with potentially contaminated biological material among nursing students, the need to involve not only students is observed, but also faculty members and professionals from teaching-learning areas, as part of an effective accident prevention and control program.

Thesis (M.S.)--Boston University