Exploring the psychological health related profile of nursing students in Singapore: a cluster analysis.

AIM: To determine whether definable profiles exist in a cohort of nursing student with regard to factors associated with nurses' perceived emotional intelligence, social support and stress level. BACKGROUND: There is a need to have a basic understanding of a nursing student's psychological health-related life quality profile will have a direct effect on their study and contribution to nursing educators to develop an appropriate learning environment for nursing students. DESIGN: A descriptive survey. METHODS: Data were collected in January 2009 in one nursing school in Singapore. A sample of 112 full-time baccalaureate nursing students from year 1-3 completed the stress in nursing students, social support rating scale and Trait meta-mood scale. RESULTS: Cluster analysis revealed two profiles in four main factors: demographic, perceived emotional intelligence, social support and stress level. CONCLUSIONS: Findings might help by providing important information for health care professionals to develop interventions that improve students' psychological health during their university life. RELEVANCE TO CLINICAL PRACTICE: The findings will assist nursing educators or health care professionals by creating psychological health-related life quality profiles that they can use to develop interventions to improve the health of nursing students.

Correct placement of blood pressure cuff during blood pressure measurement.

AIM: The aim of this project was to educate staff nurses and enrolled nurses on the correct placement of blood pressure cuff and monitor the compliance of best practice to audit criteria. METHODS: This project adopted a pre- and post-implementation audit approach. It utilised the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. The project utilised three audit criteria that are considered the best practice standards. The audit took place in a 10-bed oncology high-dependency unit that involved 24 nurses. RESULT: The post-implementation audit findings revealed an improvement in all the three criteria. The first criterion scored 100% consistent documentation of blood pressure measurement in the clinical charts by the nurses. The second criterion showed a 50% improvement in the correct placement of blood pressure cuff on the arm circumference. The third criterion achieved a 12% improvement in compliance with maintaining the patient's arm at the heart level. CONCLUSION: This project highlighted some essential strategies that are required to implement evidence in clinical practice. These strategies include planning a systematic process, using Joanna Briggs Institute best practice sheet, involving relevant stakeholders and using multifaceted strategies. Having a committed and enthusiastic team contributed to the positive outcomes. The challenge now is to develop strategies in sustaining the momentum of compliance and embed the new evidence into routine clinical practice.

Anxiety in women with breast cancer undergoing treatment: a systematic review.

BACKGROUND: Breast cancer is one of the most common cancers worldwide, and anxiety is a psychological morbidity that is inevitable. Many researchers have investigated the prevalence and detrimental effects of anxiety in breast cancer treatment, but little is known about differences in anxiety level among women receiving different breast cancer treatments. A systematic review of all available literature was needed to attain better understanding of anxiety in patients undergoing treatment for breast cancer. AIM: This review aimed to determine the best available evidence on the level of anxiety among women with breast cancer who were undergoing cancer treatment(s), and the factor(s) contributing to anxiety in various treatment modalities. METHODS: The search sought to gather data from published and unpublished studies conducted between 1990 and 2010. An initial search on CINAHL and Medline was done to identify relevant search terms. A search strategy was then developed, using MeSH headings and key words. The following databases were searched: CINAHL, PubMed, ScienceDirect, PsycINFO, Cochrane Database of Systematic Review, Scopus, Wiley InterScience and PsycARTICLES. All papers are quantitative papers (randomised controlled trials and descriptive studies) that examined anxiety level in women with breast cancer of stage 0 to stage IIIA, over and equal to 21 and below 65 years of age, who were undergoing/had undergone treatment restricted to chemotherapy, radiotherapy and/or surgery, and these quantitative papers have made correlations between women's anxiety levels and contributing factors. The Hospital Anxiety and Depression Scale and State-Trait Anxiety Inventory were the two tools most frequently used by these papers to quantify the anxiety level. Two reviewers independently assessed the eligibility of the papers for inclusion. Eighteen papers were selected based on relevance, and assessed for methodological quality using MAStARI. Ten research papers that met our methodological standard were included in the review. Both reviewers agreed on the papers to be included and excluded. Due to the methodological heterogeneity of the included papers, a meta-analysis was not possible. The studies were hence presented in narrative summary. RESULTS: Anxiety seems to be ubiquitous, presenting itself in all treatment types for breast cancer. Anxiety level in women who underwent chemotherapy was highest before the first chemotherapy infusion, mediated by age and trait anxiety. Radiotherapy regimes did not affect anxiety level in radiotherapy-treated patients, and most research concluded that anxiety level was higher among women who underwent mastectomy than those who underwent breast conservation therapy. CONCLUSIONS: The prevalence and intensity of anxiety have been shown to be pronounced among breast cancer women who were undergoing/had undergone one or more of the three treatments. Chemotherapy, as compared to other treatments, is shown to be associated with a higher anxiety level. With the prevalence, intensity and correlated factors of anxiety identified through this review, future research may investigate the interventions that could help alleviate anxiety among these patients. Anxiety is prevalent in women with breast cancer undergoing treatment, especially those undergoing chemotherapy. Healthcare professionals should pay greater attention to identify signs of anxiety in patients and design interventions to help alleviate it earlier.