Revision and Psychometric Testing of the Intercultural Competence Scale.

Background and Purpose: Given the broad availability of instruments developed to assess cultural competence, there is a need to develop psychometric properties of existing instruments so they might be adapted accordingly. The purpose of this study was to conduct a psychometric evaluation of the Intercultural Competence Scale (ICS) to ensure its validity and reliability of measurement. Methods: The psychometric evaluation included scale selection and construction, psychometric testing, and instrument validation. Data analysis methods included item analysis, internal consistency reliability, and exploratory factor analysis. Results: Participants in this longitudinal study included 215 nursing students from a selected university. The ICS adopted three instruments modified into a 21-item tool. Conclusion: This study provides a foundation for future research to develop a modified instrument for measuring cultural competence.

Nursing students' perceived attitudes toward addressing sexual health in their future profession: A longitudinal quantitative study.

BACKGROUND: Sexual health is a necessary component of human wellbeing. Nurses espouse holistic care but in practice often overlook a person's sexual health. Disparities linked to sexual health persist nationally and globally, including those among gender and sexual minorities. Inconsistent sexual health curriculum in nurse education in the United States has led to gaps in learning. This study aimed to understand nursing students' attitudes toward addressing sexual health issues in their future profession during an Associate of Science in Nursing program in the United States. METHODS: A convenience sample of Associate of Science in Nursing students from a university voluntarily participated in this longitudinal quantitative study. All eligible students enrolled in the first semester completed the Students' Attitudes Toward Addressing Sexual Health instrument. Summary statistics and Pearson r correlation were used to analyze the data. RESULTS: The 159 students were relatively young, female, and White, non-Hispanic. The total score of students' attitudes toward addressing sexual health was 83.48, ranging from 41 to 109. Regarding the positively loaded items of the Students' Attitudes Toward Addressing Sexual Health, the results showed students believed they would have too much to do for handling sexual issues (M = 4.44), need to get basic knowledge about sexual health (M = 4.31), and take time to deal with patients' sexual issues (M = 4.24). CONCLUSION: In this study, nursing students reported positive attitudes toward addressing sexual health in their future profession but acknowledged they would need basic education. Due to the homogeneity of participants' backgrounds, the generalizability of study results might be limited. It is suggested that nurse educators should develop an innovative curriculum for building students' competence and prepare graduates to deliver sexual health care for meeting a person's health needs.

The relationships among alarm fatigue, compassion fatigue, burnout and compassion satisfaction in critical care and step-down nurses.

AIMS AND OBJECTIVES: The study purpose was to investigate if compassion fatigue, burnout, compassion satisfaction and personal characteristics are associated with alarm fatigue and predict alarm fatigue in critical care nurses. BACKGROUND: The phenomena of alarm fatigue, compassion fatigue and burnout place nurses, patients and the healthcare environment in potentially harmful situations and represent the opposite of the foundation of caring and compassion satisfaction in nursing. It has been noted that healthcare organisations should address alarm fatigue as mandated by the Joint Commission based on the higher number of alarms sounding in the critical care environment and based on factors influencing nurses to respond to the alarm. DESIGN: This was a correlational and predictive quantitative study. METHODS: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for research reporting of observational studies was followed in this study. Nurses working in the step-down and intensive care units from three hospitals in a selected healthcare network in Pennsylvania were recruited using convenience sampling (n = 52). Observation, the ProQOL and demographic surveys were used to collect data on alarm fatigue, compassion fatigue, burnout, compassion satisfaction and personal characteristics of critical care nurses. Methods of data analyses included descriptive statistics, chi-square, Spearman's ρ and binary logistic regression. RESULTS: The study results revealed that the participating critical care nurses showed alarm fatigue, were at risk for compassion fatigue and were near risk for burnout. CONCLUSIONS: This study illuminated the significant relationships among alarm fatigue and the characteristics of gender, nursing unit, nurse-to-patient ratio and age in critical care nurses. RELEVANCE TO CLINICAL PRACTICE: The study results can help critical care nurses take the initiative to not only help themselves prevent or overcome alarm fatigue, compassion fatigue and burnout, but also help their coworkers in this area.

Development and psychometric properties of student perceptions of an online course (SPOC) in an RN-to-BSN program.

BACKGROUND AND PURPOSE: Despite the rapid growth in offering online RN-to-BSN programs, limited information is available on student perception of online courses. The aims were to develop and to evaluate Student Perceptions of an Online Course (SPOC) scale. METHODS: A quantitative study using a two-phase methodological design was applied. A convenience sample of 201 RN-to-BSN students was used to establish internal consistency and evidence of validity including exploratory factor analyses. RESULTS: Three factors of student engagement, organization, and resources were verified. The overall SPOC had high reliability with Cronbach's alpha =0.98. CONCLUSIONS: The SPOC is valid and reliable. It can be used in research and quality assurance/improvement work on the delivery of online nursing education.

Differences in Nursing Faculty Satisfaction Teaching Online: A Comparative Descriptive Study.

BACKGROUND: Many students today desire an education that can be completed without attending traditional classroom settings. Nursing administrators are responding by increasing the number of online course offerings, which has resulted in more nursing faculty asked to transition coursework from traditional to online classes, often without support. METHOD: The sample for this quantitative, descriptive, comparative study included nursing faculty from 15 randomly selected states who participated in an online survey, producing 185 completed surveys for analysis. RESULTS: Satisfaction was significantly higher in nursing faculty who taught 20 or more courses online, compared with those who taught five or fewer. Satisfaction was significantly higher for faculty who received mentoring, release time, technical support for software, hardware, the Learning Management System (LMS), and training for the LMS, compared with faculty who did not. CONCLUSION: Results offer valuable evidence that support services are important to increase overall faculty satisfaction teaching online. [J Nurs Educ. 2018;57(9):536-543.].

Factors Influencing the Development of Cultural Competence in Undergraduate Nursing Students.

BACKGROUND: The study purposes were to assess the cultural competence level and to identify factors that influence the development of cultural competence in undergraduate nursing students. METHOD: This quantitative study using a comparative and predictive design was conducted to recruit 106 undergraduate nursing students from a university by sending e-mails to all randomly selected Associate in Science in Nursing and RN-to-Bachelor of Science in Nursing students for participation. Each student participated voluntarily to self-administer a demographic survey and the Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals-Student Version (IAPCC-SV©). RESULTS: The summated score of 20 questions of the IAPCC-SV among the participating students was 61.70, indicating a culturally competent level. Approximately 51% of the variation in the cultural competence level could be attributed to the predictor of cultural encounters. The second strongest predictor was the cultural knowledge. CONCLUSION: Further research should focus on identifying cost-effective teaching and learning strategies using the concept of cultural encounters and cultural knowledge to increase students' exposures to individuals from other cultures. [J Nurs Educ. 2018;57(1):40-43.].

Posttraumatic Psychiatric Disorders and Resilience in Healthcare Providers following a Disastrous Earthquake: An Interventional Study in Taiwan.

BACKGROUND: Posttraumatic psychiatric disorders (PTPDs) are common in disaster workers; however, their incidence and resilience in healthcare providers (HCPs) following a disastrous earthquake are still unclear. Therefore, we conducted an interventional study to clarify this issue. METHODS: After a medical response to the scene of a collapsed huge building, we conducted an assessment of the HCPs using an immediate self-administered questionnaire and a follow-up questionnaire 1 month later. Psychological support after the operation was implemented. We performed analysis of the risk for PTPDs and comparison between immediate and follow-up questionnaires. RESULTS: The mean age (standard deviation) of the HCPs was 32.7 (5.2) years, with 33.5 (5.8) years for nurses and 32.4 (4.4) years for physicians. The proportion of females among the nurses and physicians was 94.3% and 12.5%, respectively. In total, 16.4% (11/67) of HCPs fit the criteria of PTPDs. Nurses had a trend of higher incidence than physicians. Female HCPs had a trend of higher incidence than male HCPs. After intervention, none of the HCPs reported PTPDs in the follow-up questionnaire (p < 0.05). CONCLUSION: This study delineated that PTPDs were common in HCPs following medical response to an earthquake; however, the resilience was good after the early intervention.

Decision-Tree Analysis for Predicting First-Time Pass/Fail Rates for the NCLEX-RN® in Associate Degree Nursing Students.

BACKGROUND: Little evidence shows the use of decision-tree algorithms in identifying predictors and analyzing their associations with pass rates for the NCLEX-RN(®) in associate degree nursing students. This longitudinal and retrospective cohort study investigated whether a decision-tree algorithm could be used to develop an accurate prediction model for the students' passing or failing the NCLEX-RN. METHOD: This study used archived data from 453 associate degree nursing students in a selected program. The chi-squared automatic interaction detection analysis of the decision trees module was used to examine the effect of the collected predictors on passing/failing the NCLEX-RN. RESULTS: The actual percentage scores of Assessment Technologies Institute®'s RN Comprehensive Predictor(®) accurately identified students at risk of failing. The classification model correctly classified 92.7% of the students for passing. CONCLUSION: This study applied the decision-tree model to analyze a sequence database for developing a prediction model for early remediation in preparation for the NCLEXRN. [J Nurs Educ. 2016;55(8):454-457.].

A Customized Workflow-Driven Instant Messaging System Support Team Communication in the Hospital.

Effective communication among the healthcare team is a very important skill to support team resource management (TRM). However, we take too much effort to connect with other team members by using traditional telephone communication. In this study, we developed an instant messaging system embedded in the original hospital information system and evaluated the preliminary outcome and the usage of the system.

Do ePortfolios Contribute to Learners' Reflective Thinking Activities? : A Preliminary Study of Nursing Staff Users.

The purposes of this study are threefold: 1) to find out what characteristics are required for the successful use of ePortfolios; 2) to discover what activities best represent reflective thinking during the use of ePortfolios; and, 3) to investigate the interrelationship between nursing staff users' perceived success levels with ePortfolios and with their reflective thinking activities. Survey methodology was used to gather responses from 78 nurses from a medical center located in southern Taiwan via questionnaires. Factor analysis and canonical correlation analysis were used to analyze the collected data. The results demonstrated that system quality, information quality, and user satisfaction are important variables in successful ePortfolio usage; while habitual action, understanding, reflection, and critical reflection are major variables of reflective thinking. Further, we found a significant relationship exists between the relative success of ePortfolios and reflective thinking activities of ePortfolios users. The subject hospital should pay special attention to important characteristics including system quality, information quality, and user satisfaction when employing ePortfolios to help nursing staff users to achieve their learning goals through this form of reflective thinking.

Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurses.

PURPOSE: The purpose of this study was twofold: (a) to determine the prevalence of compassion satisfaction, compassion fatigue, and burnout in emergency department nurses throughout the United States and (b) to examine which demographic and work-related components affect the development of compassion satisfaction, compassion fatigue, and burnout in this nursing specialty. DESIGN AND METHODS: This was a nonexperimental, descriptive, and predictive study using a self-administered survey. Survey packets including a demographic questionnaire and the Professional Quality of Life Scale version 5 (ProQOL 5) were mailed to 1,000 selected emergency nurses throughout the United States. The ProQOL 5 scale was used to measure the prevalence of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses. Multiple regression using stepwise solution was employed to determine which variables of demographics and work-related characteristics predicted the prevalence of compassion satisfaction, compassion fatigue, and burnout. The α level was set at .05 for statistical significance. FINDINGS: The results revealed overall low to average levels of compassion fatigue and burnout and generally average to high levels of compassion satisfaction among this group of emergency department nurses. The low level of manager support was a significant predictor of higher levels of burnout and compassion fatigue among emergency department nurses, while a high level of manager support contributed to a higher level of compassion satisfaction. CONCLUSIONS: The results may serve to help distinguish elements in emergency department nurses' work and life that are related to compassion satisfaction and may identify factors associated with higher levels of compassion fatigue and burnout. CLINICAL RELEVANCE: Improving recognition and awareness of compassion satisfaction, compassion fatigue, and burnout among emergency department nurses may prevent emotional exhaustion and help identify interventions that will help nurses remain empathetic and compassionate professionals.

Nursing Student Satisfaction with an Associate Nursing Program.

PURPOSE: The purpose of this study was to conduct a nationwide survey to understand the satisfaction of associate of science in nursing (ASN) students with a nursing program as a whole. BACKGROUND: Student satisfaction is viewed as an indicator of program success. Yet, nursing student satisfaction has not been sufficiently studied in the United States. METHOD: The Curriculum, Faculty, Social Interaction, and Environment model was used to support this nationwide study. Stratified random sampling was used to recruit 56 ASN programs from 31 US states for participation. RESULTS: The students rated their satisfaction with the nursing program as close to "satisfied." The faculty, curriculum, and social interaction significantly and positively predicted overall student satisfaction with a nursing program. CONCLUSION: A nursing program can evaluate students' satisfaction periodically to determine the impact of the educational experience on the program's performance.

Development of a prediction model for early diagnosis of not passing the national council of licensure examination for registered associate degree nurses.

Passing the national licensure examination for registered nurses (NCLEX-RN) in the US is a critical outcome of the nursing program. Research has been conducted to identify which nursing students are at risk for not passing the NCLEX-RN test. The purpose of this study was to investigate whether any of several student covariates can be used to accurately identify associate in science in nursing (ASN) students that are at-risk for failing the NCLEX-RN test. Covariates included in the study were demographics, students' pre-admission grade point average (GPA), the scores of test of essential skills (TEAS), and the assessment technologies institute® (ATI)'s comprehensive scores for a pre-RN examination test. Chi-squared automatic interaction detection, or CHAID analysis, was used to develop the model. One covariate, ATI comprehensive test scores, was found to accurately identify all at-risk ASN students. The model explained that students identified as "at-risk" had a failure rate nearly two-and-a-half times as high as the general population.

Development and psychometric testing of the Nursing Student Satisfaction Scale.

AIM: The purpose of this study was to develop an instrument with rigorous psychometric properties to comprehensively measure nursing student satisfaction and to identify areas for nursing program enhancement. BACKGROUND: Measures of program quality are frequently designed to demonstrate to professional groups that the educational program will prepare graduates for success in a rapidly changing world. METHOD: This was a longitudinal methodological study.The Nursing Student Satisfaction Scale (NSSS) was used to gather students' perceptions of satisfaction with a nursing program at a university. RESULTS: In total, 303 nursing students enrolled in the final semester of the associate degree in nursing program participated in the study. Psychometric evaluation of the NSSS included content validity, item analysis for internal consistency reliability, and construct validity. CONCLUSION: The NSSS demonstrated sound psychometric properties through the pilot test and the three-year longitudinal study. It provides a theory-based approach to the measurement of nursing student satisfaction.

The relationship among obesity, menopausal status, and health behavior among middle-aged women in a rural community of southern Taiwan.

In this study we explored the relationship among obesity, menopausal status, and health behavior among middle-aged women in a rural community of southern Taiwan. This was a cross-sectional study using a face-to-face interview to collect data. Sixty middle-aged women from four community centers participated in this study. The results indicated that approximately 23.3% of the women had body mass index (BMI) ≥ 27 kg/m(2), and 38.3% of the women's waist girths were above 80 cm. Both BMI and waist circumference (WC) of the middle-aged women were significantly different between reproductive and postmenopausal status. The variable of nutrition-related health behavior was significantly and negatively associated with the BMI levels and accounted for 12% of the total variance. An understanding of the factors that contribute to obesity is provided among middle-aged women in Taiwan's rural communities.