Nursing Forum

As modern nursing advances at an astounding rate, existential advocacy (EA) is vital for delivering patient care in line with wellness goals and personal values. This concept analysis aims to define EA within the context of nursing and align the concept with Jean Watson’s Unitary Caring Science (UCS) and her 10 Caritas Processes. A comprehensive literature search identified 12 relevant publications from the following databases: PubMed, PsycINFO, Google Scholar, and CINAHL. Subsequently, utilizing Walker and Avant’s method for concept analysis, a standardized structure to identify EA’s defining attributes, antecedents, consequences, and empirical referents emerged. Antecedents for EA are patient vulnerability, nurse-patient rapport, nurse autonomy to act as an advocate, and patient request for advocacy. Defining attributes of EA include the following: supporting patient self-determination, caring-trusting nurse-patient relationship, promoting individualized meaning of health and wellness, and encouraging values-based problem-solving. The optimal consequence of EA is patients’ awareness of their current health status, leading to individualized care and decision-making based on a patient’s values. EA is a nurse’s effort to support and promote their patients’ right to self-determination by helping them discern their holistic health and wellness situation and then clarify their values within that reality. Watson’s UCS and 10 Caritas Processes align with EA to facilitate nurse-patient transpersonal caring occasions. EA explicates the care and advocacy nurses provide into a defined concept while highlighting nurses’ essential role in patients’ physical, emotional, and spiritual well-being. With EA better defined, the concept can be assessed, measured, and implemented within the discipline of nursing.

Background. The mnemonic learning method is a systematic approach that helps nursing students memorize new information more effectively, productively, and easily by connecting new information with existing information and exploring unfamiliar information through visual images or combinations of letters and words. While mnemonics can help students remember specific information, it is essential to examine how well they facilitate the transfer of learning to real-world nursing practice. Aim. To investigate the effect of the mnemonic learning strategy on critical care nursing students’ tracheal suction skill acquisition and learning satisfaction. Methods. A quasi-experimental research design was used. A total of 280 second-year nursing students enrolled in critical care and emergency nursing courses were recruited. These students were assigned to study and control groups. The study group used a mnemonic learning strategy to recall the steps involved in the tracheal suction procedure, while the control group used the traditional learning strategy. Two tools were used for data collection: the tracheal suction procedure checklist and learning satisfaction scale. Comparisons between both groups regarding their performance and satisfaction scores were done. Results. Performance scores regarding the tracheal suction procedure were significantly higher in the study group than in the control group in the 5^th, 6^th, and 10^th weeks (, <0.001, and <0.001). A total of 70.6% of the participants in the study group reported high satisfaction using the mnemonic learning experience. Conclusion. Using a mnemonic learning strategy with critical care nursing students was effective. Participants in the study group exhibited improvement in their tracheal suction procedure scores over time. Critical care nursing students reported higher levels of learning satisfaction with the mnemonic learning method than with the traditional method.

Aim. To examine and clarify the concept financial health literacy (FHL) within the context of aging and healthcare. Background. Older adults have a high chronic disease burden and low financial and health literacy levels which often leads to high healthcare costs and poor self-management. Clarification of the concept FHL is necessary to better support nursing care and successful self-management. Design. Concept analysis using literary synthesis. Data Sources. Electronic databases were used to find scientific literature (i.e., PubMed, CINAHL, and Business Source Complete), and online dictionaries were used to find basic definitions. Review Methods. Walker and Avant’s eight-step method was used as a guide to construct a concept analysis of FHL. Clinical, aging, financial, and economic studies were reviewed to determine defining attributes, antecedents, and consequences of FHL on the older adult’s health. Results. FHL is defined as the knowledge, skills, and ability to make decisions that allow an individual to manage finances to optimally meet healthcare-related and household expenses, including resources to self-manage health, and plan for short-term, long-term, and end-of-life healthcare. Personal context, opportunity, and access are antecedents to FHL. There are 3 defining attributes: knowledge about health and financial-related concepts, skills in health and financial planning, and healthcare and financial-related decision-making behaviors. The 4 consequences of FHL include effective healthcare utilization, effective cost management, effective self-management, and positive health outcomes. Conclusions. FHL is a complex, multidimensional concept. A better understanding of this concept has significant nursing implications for research, clinical, practice, education, and policy development. Older adults have unique health and financial needs due to the complexity of retirement, living on a fixed income, and self-management of chronic diseases. Development of a FHL assessment tool and intervention is needed and may be supported based on the results of this concept analysis.

Students’ academic performance is substantially influenced by their learning approaches, which reflect their intentions when confronted with a learning situation and the corresponding strategies they employ to fulfil these intentions. Since there was no validated questionnaire that aimed to assess students’ learning approaches in the context of Vietnam, the purpose of this study is to validate a Vietnamese short version of the approaches and study skills inventory for students (ASSIST). A cross-sectional study involved translation and validation with a group of Vietnamese undergraduate nursing students. This questionnaire was translated by two independent bilingual experts and reviewed by a team of two other experts. To test the internal reliability, Cronbach’s alpha was used with 102 nursing students in a nursing school. Regarding construct validity, the study checked whether the original three subscales fit the data by using confirmatory factor analysis in a group of 1340 nursing students from ten nursing schools across Vietnam. The result indicated that the internal consistency of the Vietnamese ASSIST short version was good; Cronbach’s alpha of the total scale was 0.89. Cronbach’s alphas for deep, strategic, and surface approaches were 0.82, 0.89, and 0.70, respectively. By using confirmatory factor analysis, the model of three subscales showed a moderate fit (X²/df = 7.097, , CFI = 0.927, TLI = 0.886, and RMSEA = 0.067). As such, this finding supported the proposed three-factor structure of the short version of ASSIST in the context of Vietnam, which will be a useful tool for educators and educational institutions to assess students’ learning approaches initially.

Introduction. Falls among hospitalized patients continue to pose a serious threat to patient safety worldwide. Effective fall-prevention education is considered vital for fall prevention. Nurses’ resilience and proactivity may improve the fall-prevention education nurses provide to patients, but how to motivate nurses’ proactivity remains unsolved. This study aimed to examine whether (1) nurse’s resilience and social capital are jointly associated with nurse proactivity and (2) adherence to procedures further moderates the relationships between nurse proactivity and the fall prevention education provided to patients by the nurse. Methods. A nested (∼3 patients per nurse) cross-sectional observational design has been employed in this study. 101 bedside registered nurses were recruited from fourteen internal and surgical wards at a medium-size hospital. For each nurse, ∼3 of their newly admitted patients were recruited (total of 271 patients). Nurses completed validated questionnaires on personal resilience, social capital, following procedures, and sociodemographic data. Fall-prevention education was assessed via a short-structured interview with patients. Hypotheses were analyzed using the Hayes PROCESS macro. Results. Social capital, nurse resilience, and their interaction were associated with proactive behavior. Proactive behavior, adherence to procedures, and their interaction (β = −0.57, ) were associated with patient education for fall prevention given by nurses. The moderated-mediation model was significant under medium and high levels of social capital and low levels of adherence to procedures. Conclusion. The study highlights the importance of nurse proactivity in educating patients about fall prevention, especially when adherence to procedures in the ward is perceived as low. Furthermore, nurses’ proactivity can be promoted by nurturing both their resilience and their social capital. Nursing managers should nurture proactivity at the work environment of the 21-century, by fostering resilience and enculturing social capital. Concomitantly, employees should be educated at ways to promote personal resilience and engage in wise proactivity.

Background. Simulation-based education has been incorporated into nursing curricula as an educational strategy. However, its implementation has not yet been standardized in different regions. Purpose. The aim of this study is to describe simulation-based education in the nursing curricula in Catalonia and Andorra. Methods. An exploratory cross-sectional study was conducted in 2019 in which 16 universities participated. Results. The median dedication to clinical simulation in the nursing studies was 287.5 hours, with variations between universities (ranging from 24 to 516 hours). The dedication for the low-medium fidelity simulation was 89.4 hours (SD ± 58.3) and 26 hours (SD ± 17) for the high-fidelity simulation. All the universities had qualified teaching staff and facilities. Conclusions. There is variability in the implementation and use of simulation-based education among universities. However, there is consensus on its usefulness in nursing curricula. To integrate simulation training into the nursing curriculum, it is necessary to establish convergent simulation standards in higher education.