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Stress and Health in Nursing Students: The Nurse Engagement and Wellness Study.

ABSTRACT: BACKGROUND:Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals. OBJECTIVES:The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline. METHODS:A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline. RESULTS:Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions. DISCUSSION:These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.

SUBMITTER: Olvera Alvarez HA

PROVIDER: S-EPMC7004871 | biostudies-literature | 2019 Nov/Dec

REPOSITORIES: biostudies-literature

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Stress and Health in Nursing Students: The Nurse Engagement and Wellness Study.

Olvera Alvarez Hector A HA Provencio-Vasquez Elias E Slavich George M GM Laurent Jose Guillermo Cedeño JGC Browning Matthew M McKee-Lopez Gloria G Robbins Leslie L Spengler John D JD

Nursing research 20191101 6

<h4>Background</h4>Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals.<h4>Objectives</h4>The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort ...[more]

PMID: 31693551

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Project description:Background:The development and transformation of nursing within professional tertiary education have exerted a great pressure and challenge upon nursing students. Stress experienced by nursing students is a common precursor of psychological distress and attrition. However, no scale is specifically used to evaluate the sources of stress experienced by nursing students in Mainland China. Aims and Objective. This study is aimed at testing and comparing the reliability and validity including sensitivity and specificity of two nursing students' stress instruments, the Chinese version of Student Nurse Stress Index Scale (SNSI-CHI), and the Stressors in Student Nursing Scale (SINS-CN) in Chinese nursing students, and describing the stress status of nursing students in China. Methods:A cross-sectional survey was conducted in two nursing schools in Henan Province from August 2017 to January 2018. Data were collected by using a questionnaire comprising the Chinese version of SNSI (SNSI-CHI), the Chinese version of SINS (SINS-CN), and the Chinese Perceived Stress Scale (CPSS). Homogeneity and stability, content, construct and concurrent validity, and sensitivity and specificity were assessed. Results:The Cronbach's alpha (?) of SNSI-CHI was 0.90, and the item-to-total correlations ranged from 0.35 to 0.66. The Cronbach's ? of SINS-CN was 0.93, and the item-to-total correlations ranged from 0.19 to 0.61. The findings of exploratory factor analysis (EFA) confirmed a good construct validity of SNSI-CHI and SINS-CN. The Pearson's rank correlation coefficients, between total scores of SNSI-CHI and CPSS and SINS-CN and CPSS, were assessed to 0.38 (P < 0.01) and 0.39 (P < 0.01), respectively. Regarding the CPSS, as the criterion, the cut-points of SNSI-CHI and SINS-CN for the area under the receiver operator characteristic (ROC) curve were 0.77and 0.66, respectively. Conclusion:Both scales are valid and reliable for evaluating the source of stress of student nurses in China. Each has its own characteristics, but the SNSI-CHI demonstrated marginal advantage over the SINS-CN. The SNSI-CHI is short, is easily understood, and with clear dimension for the nursing students, and the SNSI-CHI is more acceptable for the users in China.

Project description:BackgroundDuring education it is essential for nursing students to develop professionalism in nursing. Nurses are placed in situations based on trust, and it is crucial that their patients have confidence in them to provide professional and safe care. A key period in nursing students' development of a professionalism occurs during training when students gain knowledge and skills that separate nurses as professional healthcare workers from laypeople. The purpose of this study was to investigate nursing students' experiences of professional competence development during education.MethodsA longitudinal study was carried out using qualitative content analysis with a manifest inductive approach. Thirty-four students enrolled in a Swedish three-year nursing program, from August 2015 to January 2017 were interviewed on four occasions.ResultsThe results revealed that students' professional role developed gradually. The students' started their education with dreams and a naive understanding of the profession, but their understanding of the complexity of the nursing profession gradually evolved. Students became theoretically equipped at the university and developed clinical skills through practice. Students' focus went from mastering medical technology to a more holistic approach. Before graduating, students felt ready but not fully trained.ConclusionsOur findings indicate a discrepancy between the content of the theoretical education and the clinical settings since students identified a lack of evidence-based practice. A solid theoretical education before entering clinical training offered students possibilities for reflecting on evidence-based practice and the clinical settings. The realization that there is always potential for professional improvement can be interpreted as an emerging awareness, and development of professionalism. It is clear that students could benefit from increased collaborative work between clinical supervisors and faculty staff at the university.

Project description:ObjectiveTo estimate and contrast the relationships between nurse staffing and health outcomes in nursing homes with low and high dementia census, to understand the association of staffing hours with dementia care quality.Data sources and study settingA national sample of nursing homes during 2017-2019 (pre-COVID). Data included the Payroll-Based Journal, Medicare Claims, Nursing Home Care Compare, and Long-Term Care Focus.Study designRetrospective, regression analyses. We estimated separate linear models predicting six long-term facility-level outcomes. Independent variables included staffing hours per resident-day (HPRD) interacted with the facility percentage of dementia residents, controlling for other resident and facility characteristics.Data collection/extraction methodsHospital-based nursing homes, those with fewer than 30% dementia residents, and missing data were excluded.Principal findingsWe found that registered nurses and certified nurse assistants HPRDs were likely to exhibit positive returns in terms of outcomes throughout most of the range of HPRD for both high and low-census dementia facilities, although, high- and low-dementia facilities differed in most outcome rates at all staffing levels. Average predicted antipsychotics and activities of daily living as functions of HPRD were worse in higher dementia facilities, independent movement, and hospitalizations did not differ significantly, and Emergency Rooms and pressure sores were worse in lower dementia facilities. Average marginal effects were not statistically different [CI included zero] between the high and low dementia facilities for any outcome.ConclusionsThese findings suggest that increasing staffing will improve outcomes by similar increments in both low- and high-dementia facilities for all outcomes. However, at any given level of staffing, absolute differences in outcomes between low- and high-dementia facilities remain, suggesting that additional staffing alone will not suffice to close these gaps. Further studies are required to identify opportunities for improvement in performance for both low- and high-dementia census facilities.

Project description:Cardiac misconceptions are common among healthcare professionals. The development of professional knowledge is considered an essential component of nursing education. Nurses, regardless of their grade, skills, and experience, should be updated with information so as to be able to rectify their misconceptions, as these could affect patient health outcomes. As the literature evaluating the cardiac knowledge and misconceptions of nursing students is sparse, a study of the subject seems warranted.A cross-sectional sample survey was used to study the cardiac knowledge and cardiac misconceptions of nursing students in Hong Kong. The study sample included 385 senior nursing students from three universities. Their level of knowledge of cardiac disease was assessed using the modified Coronary Heart Disease Knowledge Test. The York Cardiac Beliefs Questionnaire (YCBQv1) was used to examine cardiac misconceptions.The scores for the nursing students' level of knowledge were diverse. Their mean score in the Cardiac Knowledge Test was 12.27 out of 18 (SD 2.38), with a range of 2-17. For cardiac misconceptions, their mean score in the YCBQv1 was 6.98 out of 20 (SD 2.84), with a range of 0-14. A negative correlation, r = -0.33 was found among students with more knowledge and fewer misconceptions. (p < 0.001). The Chi-square tests found some associations between the students' experiences of caring for cardiac patients and misconceptions about stress and physiology.The results of our analyses indicate a diversity in levels of knowledge among the nursing students. Students with higher scores in cardiac knowledge did not necessarily have fewer misconceptions. There were associations between the students' misbeliefs and their caregiving experiences with cardiac patients. This study presents a framework for designing the contents of cardiac nursing programmes and is a starting point for promoting research on misconceptions held by undergraduate nursing students. A new paradigm of teaching should include inputs from both perspectives to help students to make critical use of theoretical knowledge to rectify their misconceptions and pursue excellence in the working world.

Project description:BACKGROUND:The insulin resistance syndrome is one of the major contributors of metabolic syndrome, diabetes Type 2 and atherosclerotic cardiovascular disease. A common mutation (677C to T; Ala to Val) in the methylenetetrahydrofolate reductase (MTHFR) gene is associated with decreased specific MTHFR activity and elevation of the homocysteine. The aim of this study is investigation of association between MTHFR 677C > T polymorphism with insulin resistance by using HOMA (Homeostasis Model Assessment) index in nurses who are potentially prone to develop insulin resistance because of unfavorable effects of shift work. METHOD:Nursing Unacquainted Related Stress Etiologies Study (Nurse Study) was conducted in five different educational hospitals of Tehran University of Medical Science (TUMS). The nurses aged 22-57 who have been referred by the matron were recruited. A self-administered questionnaire was completed. Anthropometric measurements including weight, height, waist and hip circumference in addition to blood pressure were measured. Insulin resistance and Insulin sensitivity were measured using the homeostatic model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) respectively. The detection of MTHFR C677T polymorphism in exon four of MTHFR gene was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis using HINFI restriction enzyme digestion. RESULT:A total of 273 subjects were recruited in the study. CT genotype were detected in 51.6% (129) subjects and CC and TT genotype were seen in 9.2% (25) and 35.2% (96) subjects respectively. Participants with TT genotype (9.65 ± 4.00) have significantly lower insulin level than participants with CT genotype (14.12 ± 15.34) (p-value: 0.01). The same significant difference was observed for HOMA index (p-value: 0.03). Result showed that HOMA is lower in subjects who are taking supplements. CONCLUSION:Result of this study showed subjects with TT genotype had significantly lower HOMA compare to CT genotype and the same pattern was seen for insulin level. We also found subjects taking supplement have lower HOMA compared to others regardless of their genotype.

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Stress and Health in Nursing Students: The Nurse Engagement and Wellness Study.

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Stress and Health in Nursing Students: The Nurse Engagement and Wellness Study.

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