Tesis sobre el tema "Psychology of nursing"

Patients diagnosed with cancer often require interventions for the accompanying mental health distress of their diagnosis; patients’ mental distress can lead to hopelessness and noncompliance. Improvements for assessment and interventions are needed. This project provides recommendations for improving oncological nursing knowledge by implementing competencies for nurses through educational modules, focusing on nursing approach, confidence, and interventions necessary for understanding methods of treatment and the measurement of distress in oncology and oncological treatment. Using established standards and competencies will improve knowledge and skill in inpatient settings. Current established nursing standards from the American Nursing Association, Institute Of Medicine/National Comprehensive Cancer Network, C-Change, and Public Mental Health Essentials were explored in order to identify gaps and create a list of recommended competencies for oncology nursing. Six associated adaptable educational modules were developed based on the adult education framework of Knowles, and participant training entailed proper use and comprehension of the Distress Thermometer for measurement of distress. The C-Change observation displayed participant (n = 102) results of approximately 119% improvement, which was observed in knowledge, communication, and confidence. Participants used the resources to reduce distress levels by initiating the selected established interventions for management, all of which was made evident in patient self-reported outcomes, using resources from published, established, standardized competencies. Having such training will allow for improved care for patients with cancer, thus having an influence on positive social change.

Incivility, also known as bullying or horizontal violence, can take many forms from derogatory statements to physical harm. Incivility can create physical, emotional, and psychological symptoms leading to job dissatisfaction and increased turnover. Incivility can impact patient care and patient safety. Organizational impacts include increased turnover and decreased productivity. Regulatory and professional agencies have issued recommendations for leaders of organizations to address incivility in the workplace. The purpose of the study was to determine if an educational program for nurse leaders can improve the perceived ability of the leaders to act with moral courage to address uncivil behavior. Two theories identified as relevant to incivility in the workplace, Freire’s Oppression Theory and Kanter’s Structural Theory of Power. A quasi experimental design, one group pretest-posttest, was used. The study took place in a 363-bed tertiary care facility. A convenience sample of nurse leaders completed a pre-survey, education, and post-survey. Analysis was conducted on 37 matched pairs of surveys. The tool, the Professional Moral Courage (PMC) Scale, is comprised of fifteen statements divided into five themes; three statements per theme. Three areas of statistical significance were found using a paired t-test comparing the pre-survey to the post-survey scores. The results indicated improvement in two out of five themes, acting morally and proactive approach, and the overall score. Leaders need to utilize moral and address incivility. By witnessing the leaders’ role modeling civil behaviors and taking action in the face of incivility, staff should also demonstrate the same behaviors.

Nursing students often harbor negative stereotypes and feel unknowledgeable and unprepared to work with mentally ill people. In addition, nursing students rarely choose the psychiatric specialty as a career option. A quantitative quasi-experimental study was conducted to examine nursing student feelings about engaging those with behavioral health problems. Over 300 nursing students in eight Bachelor of Science in Nursing professional nursing programs were surveyed on the first and last day of their program’s psychiatric mental health nursing course (the independent variable). A valid and reliable survey instrument was used to collect nursing student responses characterizing attitudes, impressions of knowledge and preparedness, and career interests relative to psychiatric nursing. This work was supported by the theoretical tenants of Labeling Theory, Benner’s Model, and Peplau’s Theory on Interpersonal Relations. Statistical Package for Social Sciences software was used for exploration of the data. Data examination included descriptive analysis and paired t tests of four component subscales identified by the survey tool authors which were associated with the research questions and research hypotheses in this study. The results indicated nursing students manifest negative attitudes and a moderate sense of knowledge of and preparedness for interacting with the mentally ill. In addition, nursing students had a low interest in behavioral health as a career path. However, significant improvements in all of these factors except the latter were observed at the end of the psychiatric mental health nursing course. Nurse educators may use the information generated from this project to modify psychiatric nursing courses for fostering improvement in student feelings about the mental health specialty.

The purpose of this project was to translate evidence-based literature into policy and practice guidelines in order to improve leadership standards and skills among nurse managers and improve patient outcomes and the quality of care. Guided by the American Nurses Credentialing Center Magnet Model and Lewin's change theory, which sets the framework for creating exceptional nursing leaders, a literature search was conducted from studies ranging from 2010 to 2012 from several databases. Inclusion criteria were based on the presence of one or more leadership styles discussed in the articles and the impact of leadership style on nursing satisfaction. A total of 25 articles were found during the electronic search, but only 7 articles met the inclusion criteria for analysis. The results of this review revealed that transformational leadership enhanced nursing satisfaction rates, while transactional leadership and situational leadership contributed to low levels of nursing satisfaction rates. This project contributes to positive social change for nurse managers because there is limited research available that focuses on leadership styles and its implication for practice. This project will inform the work of nurse managers by illuminating the importance of leadership styles on nursing satisfaction and work environment conditions.

The purpose of this study was to explore the relationship between nurses' use of intuition, years of worked nursing experience, and nurses' perceived ethical decision making ability. Additionally, recognizing the relationship between the intuitive/experiential and the analytic/rational systems, this research extended beyond the intuitive/experiential system capturing analytic/rational thought. A sample of 182 nurses from the Emergency Nurses Association (ENA) was recruited for this investigation. A nonexperimental, correlational research design was used to examine the relationship between the variables. Intuition was measured using the Experiential scale of the Rational-Experiential Inventory (REI) and analytic/rational was measured using Rationality scale of the REI. Perceived ethical decision making ability was measured with the Clinical Decision Making in Nursing Scale (CDMNS) applied to an ethical dilemma within the participants own practice. Cognitive-Experiential Self-Theory (CEST) provided the theoretical framework for this study. According to CEST, information is processed by two independent, interactive conceptual systems; a preconscious intuitive/experiential system and a conscious analytic/rational system. These are thought to function parallel from yet interactively with each other. One-way ANOVAs, independent sample t-tests, Pearson's r correlation, and multiple regressions analysis provided the statistical methods used to answer nine research questions. A significant relationship was found between intuition and perceived ethical decision making (r = .252, p = .001). This contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions.

Although there is a growing body of knowledge concerning service-learning in professional nursing education, nursing research reports minimal studies that sufficiently address the effects of service-learning strategies on baccalaureate nursing alumni in promoting self-efficacy toward long-term civic engagement or development of professional practice. The purpose of this predictive, correlational study was to determine if a relationship existed between participation in the service-learning experience and self-efficacy toward civic engagement as a long-term outcome of professional nursing education and the development of professional practice in nursing alumni. Spearman's Rho was used to correlate the independent variable of service-learning with the dependent variables of civic engagement and professional practice. Multiple regression analysis indicated that service-learning had less than a 4% effect on civic engagement attitudes and a 6% effect on community service hours (behavior). The Social Cognitive Theory, specifically self-efficacy coupled with the construct of practical reasoning provided framework for the study. Results concluded that service-learning had a low to moderate relationship with both long-term civic engagement and the development of professional nursing practice.

The purpose of this research study was to examine the difference between three levels of nursing students (sophomore, junior, senior) and their assessed emotional intelligence (EI) scores. A quantitative, quasi-experimental study was conducted with a population of nursing students from five separate campuses at Montana State University, and a control group of education students at the University of Montana. The following research question was explored in this study: What difference, if any, does nursing education have on the emotional intelligence scores of sophomore, junior, and senior Bachelor of Science in Nursing (BSN) students? Students voluntarily completed the online EQ-i 2.0 assessment resulting in composite standard scores with a mean of 100 and a standard deviation of 15 calculated for the total, scale and subscale EI scores. Mean total standard EI scores were 103.59 (nursing students, n = 51) and 94.43 (education students, n = 7). A one-way analysis of variance (ANOVA), analysis of covariance (ANCOVA), and correlational statistical analyses were conducted. No statistically significant difference was found between the sophomore, junior, and senior students and their assessed EI scores. However, further analysis showed that a moderately strong positive correlation existed between participants’ ages and EI scores: (r = .34, n = 51, p =. 02) with R ² = 0.11.

The purpose of this study was to assess the relationship between emotional intelligence and work engagement in the context of frontline nurses in acute care settings. The relationship between age, gender, years of experience, educational attainment, and specialization was investigated in relation to frontline nurses’ emotional intelligence and work engagement. This quantitative nonexperimental study was conceptualized to bridge a knowledge gap regarding the extent to which emotional intelligence and demographic factors are associated with work engagement in nursing. This study was based on theories concerning emotional intelligence and work engagement constructs. Participants included 142 frontline nurses working in an acute care setting within the United States. All data were gathered quantitatively using an online survey. The survey instrument included a compilation of two measurement scales (the Assessing Emotions Scale [AES] and the Utrecht Work Engagement Scale [UWES]) and a demographic questionnaire. The data analysis procedures included one-way analysis of variance, Spearman’s rho correlations, independent t-tests, and multiple regression analysis. The results of the study revealed that there is no statistically significant correlation between age, gender, years of experience, educational attainment, and specialty with emotional intelligence. Moreover, the findings revealed that there was a statistically significant positive correlation between emotional intelligence and age with work engagement level among frontline nursing. There was no statistically significant correlation found between gender, years of experience, educational attainment, and specialty with work engagement. The study results provide a pathway for researchers to better understand nurse emotional intelligence and work engagement in relation to demographic variables.

Compassion fatigue is of significant concern in critical care settings. Nurses experiencing compassion fatigue suffer physical, emotional, and behavioral symptoms that impact them professionally and personally. When nurses suffer from compassion fatigue, patient care is negatively impacted as nurses lose their sense of caring, compassion and ability to relate to patients or meet their needs resulting in reduced patient outcomes and satisfaction scores. Compassion fatigue prevention programs must be implemented to educate nurses and nurse leaders regarding risk factors, symptoms, and interventions to prevent and treat compassion fatigue.

Development of a compassion fatigue training (CFT) module occurred to address these concerns at a local healthcare organization. Great care was taken to develop an effective training module. Partnerships were formed. The education department director, staff, and unit managers were valuable resources, assisting with the development and implementation of the CFT module. The plan consisted of:

• Administration of a Professional Quality of Life (ProQOL) Scale to critical care and highrisk area nurses • Data analysis to determine specific education needs and address deficits • Creation of a CFT Module based on the ProQOL Scale results • Assignment of CFT and deployment of the module in the HealthStream system • Nurse completion of CFT • Post training evaluation of learning • Analysis of evaluation data and summary of learning

After completion of the CFT module, nurses concluded with a post quiz. Passing scores of 80% were required for successful accomplishment of CFT. All participants achieved the required score and demonstrated meaningful understanding of compassion fatigue, risk factors and interventions through successful completion of a post training quiz. A learning evaluation was available to the nurses to appraise effectiveness of the training and achievement of module objectives. Nurses reported knowledge acquisition regarding compassion fatigue, symptom recognition, coping, and resources. Nurses were able to enumerate coping mechanisms and resources for assistance. They responded that CFT provided valuable information and reported they would use the knowledge and skills gained to secure work-life balance. CFT promoted improvements in career satisfaction, burnout, and secondary traumatic stress levels. CFT must become part of an ongoing measure to ensure staff are receiving instruction necessary to manage the effects of compassion fatigue.

Autism spectrum disorder (ASD), once thought to be rare, is now considered prevalent, with 1 of every 68 children diagnosed nationwide (Salley, 2016). There is no treatment for ASD, but early therapeutic interventions can help children with ASD live a higher quality of life and achieve major developmental milestones such as language development (Dreyer, 2016). Because ASD can challenge all members of a family, early identification and intervention is vital. This process improvement project was created to enable higher rates of detection for ASD and other developmental delays. The major process improvement intervention was implementing universal screening for ASD during all well-child exams between 18 and 24 months. A guideline was created to help providers know when to screen, what screening tool to use, and how to respond if the screening is abnormal. An educational seminar for all staff involved in the care of pediatric patients also occurred. A chart audit of the guideline and algorithm’s clinical use was done to evaluate the successes of the project. To further evaluate outcomes, a staff and provider basic ASD knowledge survey was conducted before and after the education was provided. Finally, steps were taken to work with IT from the electronic health record (EHR) to integrate documentation prompts for providers to ease the use of ASD screening and appropriate billing. With the conclusion of this project, all data acquired indicated the clinical guideline, algorithm, and educational platform were a success. Screening for ASD increased after the implementation. Furthermore, provider and staff knowledge regarding ASD and ASD screening was enhanced. Further work with this type of process improvement project should be conducted, as indicated with the findings of this study.

Abstract Background: End-of-life care has become the focus of most health care organizations due to the increasing number of patients who are living longer with chronic and terminal diseases. Today, patients are more involved in the discussion towards end-of-life care, and nurses are the ones who provide this care. Most studies that explore the experiences of nurses providing end-of-life care focused mostly on nurses working in oncology and pediatrics. These studies suggested that nurses caring for patients at the end of life lack formal training in end-of-life care. This lack of knowledge and training was perceived to have a negative impact on patients' care. These studies, however, lack generalization, as nurses in varies clinical settings other than oncology and pediatric will likely care for a dying patient at some point in their nursing career. Purpose: The purpose of this study explored the lived experiences of nurses who provide care to patients at the end of life. Exploring the nurses' experiences in various clinical settings, such as an acute care and long-term care facilities will bring more knowledge and a deeper understanding about the essence of the experience of nurses who provide end-of-life care to dying patients. This study has the potential to provide information on nurses? experiences in order to develop end-of-life care educational programs for nursing students based on nurses? needs. Methods: This study was guided by Moustakas's (1994) Transcendental Phenomenological approach to phenomenology. The target population was registered nurses and licensed practical nurses who experienced caring for dying patients and have had no prior education or training in palliative or hospice care, post nursing school graduation. Results: From the experiences of 16 nurses who provides end of life care in clinical settings, one primary theme and three subthemes were identified. Conclusion: Experiences of nurses? generosity as described in kind acts and empathetic behavior and their commitment to patients who are dying, illustrates the essence of dedication. Daily interactions support their commitment to patients and competence increase their confidence and improve the skills needed to create a balance between daily work challenges and patient's care. The results of this study supports the need for nurse educators and employers to provide more opportunities to end life care educational programs for professional nurses and nursing students.

The death of a loved one is associated with feelings of grief, which is a multifaceted emotional response for individuals’ who are attempting to cope with a loss. The grieving process can have an unpredictable trajectory for each person, even though it may encompass many common and familiar features. Grief after a loss incorporates an expansive range of emotional and physical responses, which frequently consists of feelings of sadness, depression, and loneliness. Few studies have reviewed effective interventions for combating the emotional and physical symptoms of grief after the loss of a loved one. Walking is an affordable bereavement care intervention that may prove beneficial in improving grief responses and the related physical and psychological symptoms. A physical activity, such as walking, is a type of activity that is easily performed that may ultimately reduce the effects of stress, decrease depression, and improve mood in persons who have experienced the death of a loved one. The conceptual framework that guided this study was the Roy Adaptation Model.

The purpose of this study was to decrease the severity of grief related symptoms associated after the death of a loved one using an acute three-week walking regimen and comparing baseline responses to walking completion responses on the Texas Revised Inventory of Grief (TRIG). A convenience sample of 62 persons in southeastern Georgia who had experienced the loss of a loved one participated in the three-week walking regimen. The results showed no statistical improvement in grief scores after a three-week walking program.

Background: Incivility in health care settings was first identified in 1976. Ten years later, a nurse published an article asking colleagues, “Do we eat our young?”. In 2000, the Institute of Medicine (IOM) sent a challenge for a safer health care environment and in 2008 the Joint Commission emphasized that disruptive behavior continued to compromise patient safety. Incivility in nursing is quickly becoming a topic of interest, yet it had not been studied from a qualitative approach by exploring it as a social process.

Purpose: The purpose of this grounded theory study was to adopt an abductive process to acquire an in-depth understanding of the critical factors that trigger the existence and fuel the persistence incivility in nursing and to develop a substantive theory to address the concept of incivility.

Philosophical Underpinnings: The philosophical underpinnings that guided this study were symbolic interactionism and pragmatism. Method: A constructionist grounded theory approach by Charmaz guided the qualitative research method. Individual and focus group face-to-face interviews were conducted to collect data from 29 Registered Nurses. Data analysis involved initial, focused, axial, and theoretical coding alongside memo-writing and reflexive journaling.

Results: The theory that developed from the data grounded in the voices of Registered Nurses was self-positioning. The four main categories that emerged from the gathered data supporting the theory are neglecting, alienating, relinquishing, and finding oneself. These categories represent the critical factors triggering the existence and fueling the persistence of incivility in nursing.

Conclusion: An in-depth understanding of the critical factors triggering the existence and fueling the persistence of incivility in nursing has been acquired by adopting an abductive process through a constructionist grounded theory approach by Charmaz. The theory of self-positioning serve as a guideline to nursing education, nursing practice, nursing research, and health/public policy in implementing specific plans of action to diminish the incidence of incivility, address the health and well-being of Registered Nurses, provide quality care, and ensure patient safety.

The health outcomes of men are significantly worse, when compared to their female counterpart, for the top 15 leading causes of death nationwide. At this time, men are not actively engaged in the healthcare system and didactic and clinical education does not adequately prepare providers to care for men or understand the psychology of masculinity. As of 2016 there were no primary care programs or medical schools that incorporated a specific course in men’s health promotion or the psychology of masculinity within their curriculum. This research study implemented one curricular module on the content of men’s health promotion and the psychology of masculinity. The researcher sought to understand what aspects of men’s primary healthcare and masculinity were taught within Primary Care Providers (PCP) didactic and clinical studies, what PCPs state was lacking from their curriculum, and how that translates to their ability to practice clinically. The research took place at six separate universities throughout the United States. Using a five-point Likert scaled survey, quantitative data was collected from students in six universities after they participated in a single module on men’s health promotion and masculinity. One month after students at the six universities went through the intervention, a second quantitative, five-point Likert Scale survey was collected that sought to determine what information from the module was applicable in their clinical education and settings after going through the intervention. The researcher then conducted six, qualitative, semi-structured, open-ended interviews with students who responded favorably to such an interview in quantitative evaluations through Qualtrics. Data analysis was completed through Wilcoxon Signed Rank Testing. Cohen’s d effect size was utilized to understand the significance of effect size within the data. Students in primary care agree that lack of timely healthcare, on behalf of men, is a stressor on the healthcare system and 100% of students agree they would welcome more content in their didactic education on men’s health promotion and the psychology of masculinity. Similarly, 94.5% of respondent’s state there is a need for primary care students to learn how to engage men in primary preventive care with 77% of respondents requesting more gender specific training. Students that went through the educational endeavor found value in the content delivered with 83.4% of participants stating they planned to make changes in their practice as a result of going through the educational module. Quantitative findings revealed that less than 20% of those surveyed are consistently utilizing evidence based interventions noted in literature to recruit and retain men into primary preventive care. Qualitative interviews noted that participants found themselves unconsciously unaware of their limitations in caring for men in the primary care setting, but fully aware that diverse and holistic care improves patient outcomes. Qualitative respondents also expressed a desire to grow professionally and a willingness to engage in pioneering practices that would equip them to deliver excellence in care.

Through advancements in modern medicine, human beings worldwide are living longer. The increase in life expectancy creates a need for a more qualified and knowledgeable nursing workforce for the delivery of quality geriatric health care. Although nurses are the primary care providers for vulnerable older adults, they are generally not well trained or prepared in geriatric care. Therefore, the purpose of the project was to develop an education program aimed at improving nursing knowledge of geriatric care in the long-term care (LTC) setting. The goal of the project was to answer the research question: What impact would attendance in the program have on improving nursing geriatric knowledge, retention, and job satisfaction by project end? Guided by the advancing research and clinical practice through close collaboration (ARCC) model for evidence-based practice (EBP), the learning needs of nurses in the LTC setting were assessed. The 6-week education program was designed to provide education on the basics of geriatric care, pharmacology and aging, symptom evaluation, dementia care, and geriatric physical assessment. Project participants consisted of 8 nurses who volunteered to take part in the program. The program was evaluated using a pre-test and post-test method to examine nurse’s knowledge before and after the education program. Using a paired t test, the results indicated a significant increase (p < .05) between the mean pre-test (3.75) and mean post-test (4.25) scores of nurse knowledge of geriatric care. The education program improved participant knowledge of geriatric care. Positive social change will be achieved with this scholarly project as nurses with greater knowledge gain confidence, strengthen decision making and clinical skills, and improve patient outcomes in the LTC setting.

The goal of this dissertation was to contribute to research on practical nursing students’ self-efficacy and the sources that build self-efficacy including mastery experience, vicarious learning, social persuasion, and physiological and affective states (Bandura, 1986). Specifically, the focus in this study was on students’ self-efficacy change and development through the measurement of students’ confidence in ability to engage in medical surgical simulations during the last semester of a practical nursing program. The results of this study revealed perceived self-efficacy did not change, but participants indicated an overall strong sense of efficacy to engage in medical surgical simulations. Additionally, students relied on all four sources that build self-efficacy (Bandura, 1986). In other words, students relied on personal perseverance in facing obstacles, sought the nursing faculty’s assistance and encouragement to perform well, observed and modeled their teachers’ behaviors, and successfully managed their physiological and emotional states. Strong self-efficacy was concluded to be a key factor in the success of practical nursing students. Thus, there is a need for future experimental and theory-driven studies that utilize the self-efficacy approach to reduce student attrition and contribute to academic and professional accomplishment of practical nursing students.

Organizations are increasingly examining the potential benefits of integrating insights concerning emotional intelligence (EI) into their employee training and development programs to enhance their mission. Petrides’s EI model of trait emotional self-efficacy (ESE) has been defined as a constellation of emotion-related self-perceptions and dispositions assessed through self-report. This study explored the relationship between the four factors of Petrides’s ESE model (well-being, self-control, emotionality, and sociability) and the well-researched work outcomes of job satisfaction, counter-productive work behavior, and turnover intent. Based on existing research, the study controlled for age, gender, job tenure, and social desirability. The study relied on an archival data set drawn from a similar pilot study, and included a sample population (N = 157) of certified nurse assistants and registered nurses, selected both out of convenience and because this population is known for its affect-laden work. The study employed a 239-item survey. ESE was measured using the TEIQue long form, and psychological instruments were used to measure outcomes. Confirmatory factor analysis found a lack of fit for the four-factor model, and a new, two-factor model was found using an exploratory factor analysis. The first factor, comprised mostly of the facets well-being and self-control, was named emotional constitution. The second factor, comprised mostly of emotionality and sociability, was named emotional awareness. Data analysis included four-step hierarchical regression models to assess unique variance in each of the three outcome variables using emotional awareness and emotional constitution as predictors. Results showed that emotional awareness predicts nurse job satisfaction (β = .21, p < .05), and emotional constitution negatively predicts both nurse CWB (β = –.49,p < .01) and turnover intent (β = –.31,p < .05). No difference between groups (RNs and CNAs) on these factor dynamics was found. Implications of this study are discussed.