Engaging care partners of persons living with dementia in acceptance and commitment therapy (ACT) programs: a scoping review.

OBJECTIVES: Acceptance and commitment therapy (ACT) is a relatively new type of psychotherapy effective for treating depression and anxiety amongst family care partners of persons living with dementia [PLWD]. However, care partner engagement in mental health services is low and specific guidelines for designing ACT programs for care partners of PLWD do not exist. The purpose of this scoping review was to examine patterns in care partner engagement in ACT programs to identify program factors potentially influencing engagement. METHODS: A comprehensive scoping review according to Arksey and O'Malley's framework was followed. Databases and grey literature were searched for primary studies of ACT programs with care partners of PLWD. Data were charted and synthesized. RESULTS: Ten studies met inclusion criteria and were analyzed. Amongst these, engagement was highest in three ACT programs that were delivered individually, remotely and were therapist-led or supported. Conversely, engagement was the lowest in two ACT programs that were self-directed, web-based and had minimal or no care partner-therapist interaction. Program factors perceived as influencing engagement included tailoring and personalization, mode of delivery and format, therapeutic support and connectedness, program duration and pace. CONCLUSION: Findings from this review suggest that care partners engagement may be promoted by designing ACT programs that focus on the therapeutic client-therapist relationship, are delivered remotely and individually. Future research should focus on evaluation of best implementation practices for engagement and effectiveness.

Clinical Nurse Well-being Improved Through Transcendental Meditation: A Multimethod Randomized Controlled Trial.

OBJECTIVE: To evaluate the impact of Transcendental Meditation® (TM®) practice on the multidimensional well-being of nurse clinicians affected by the COVID-19 pandemic. BACKGROUND: The health of clinical nurses has substantial impact on both the availability of a nursing workforce and the quality and safety of patient care. TM improved health and coping strategies across many populations. METHODS: Clinical nurses were recruited from 3 Magnet®-designated hospitals during the COVID-19 pandemic. Well-being outcomes included flourishing, burnout, anxiety, and posttraumatic stress disorder. Participants were randomized following completion of baseline surveys into immediate (intervention) or delayed (control) TM instruction. Surveys were repeated at 1 and 3 months following baseline survey or TM instruction. Repeated-measures analysis of variance compared differences in groups over time. RESULTS: Across the 3 sites, there were 104 clinical nurse participants. Repeated-measures analysis of variance showed significant medium to large effects in improvement over time in well-being measures for the intervention group. CONCLUSIONS: TM improved multidimensional well-being of clinical nurses by reducing posttraumatic stress disorder, anxiety, and burnout and improving flourishing. TM is easy to practice anywhere. The benefits are immediate and cumulative. Organizations and individual nurses can use TM to support clinical nurses in the difficult and meaningful work of patient care, especially in challenging times. Future studies may consider the feasibility of integrating TM into clinical shifts and evaluating its impact on patient and organizational outcomes.

Differences in critical thinking skills between nursing students on a fast-track versus traditional 4-year programme.

BACKGROUND: The authors were unable to find studies comparing the critical thinking skills of nursing students on advanced standing programmes (ASP) and on traditional 4-year BN programmes in Canada. The ASP is a condensed Bachelor of Nursing (BN) programme, designed for students who already have a university degree or similar qualification. AIM: To measure and compare the critical thinking skills of ASP students and traditional 4-year BN students. METHOD: A cross-sectional study using a self-administered questionnaire used to collect data from 100 nursing students at a university in Canada. Data were analysed using descriptive and inferential statistics. All research ethics were taken into consideration. FINDINGS: All participants scored highly in their critical thinking skills. However, ASP students scored significantly higher than their counterparts on the 4-year programme (M=21.6 vs M=18.9, F=4.75, P=0.035). CONCLUSION: Higher critical thinking skills among ASP nursing students is a promising sign to expand and support this type of programme as a fast and effective method to cover the shortage in nurses.

Transcendental Meditation Enriches Nurses' Authentic Presence Through Caring for Self and Others.

Purpose of Study: Given the enormity of the most recent challenges to clinician well-being, intensified by the pandemic, we decided to explore the influence of Transcendental Meditation® (TM)® on the well-being of clinical nurses. The purpose of our study was to use qualitative analysis to enhance our understanding of the experiences of clinical nurses who practiced TM, as viewed through the lens of our conceptual model and Watson's holistic unitary caring science theory. Design and Method: This qualitative study involved a thematic analysis of clinical nurses' written descriptions following the completion of the TM program during the COVID-19 pandemic. Findings: The nurse participants shared their experiences with the practice of TM as creating present moment focus, leading to enhanced self-care, and development of authentic presence with others. The overall theme uncovered in the analysis is that authentic presence is veritas (truth) in knowing, being, doing, and becoming. Conclusions: The findings were congruent with Watson's unitary caring science theory and provided illumination of the holistic value of TM as a self-care strategy for supporting nurses' well-being with the goal of retaining nurses in practice. When nurses care for themselves, they are more likely and able to care for others, thus helping them to enjoy their nursing careers.

Barriers to Providing Smoking Cessation Intervention by Nursing Students: What is the Solution in Nursing Education?

AIM: This study aimed to explore the barriers that hinder nursing students from providing comprehensive smoking cessation interventions for their clients. METHOD: A mixed method study combining a self-administered questionnaire and one open-ended question were used to collect data from 152 nursing students at the university in Canada. Data were analyzed using descriptive statistics and thematic analysis. The Health Belief Model was the theoretical underpinning for this study. RESULTS: Participants showed positive attitudes toward smoking cessation interventions as being a part of their future work. However, students faced many barriers that hindered them from providing smoking cessation interventions to their clients. The participants identified the following seven themes/barriers: the lack of knowledge, training, resources, and time; the willingness of patients to quit; lack of students' self-confidence; students' level of comfort; smoking cessation being covered by other members of the health care team; patients already being knowledgeable about smoking cessation; and protecting therapeutic relationships with patients. CONCLUSION: There is a need for empowering nursing students and enhancing their self-confidence in smoking cessation interventions by incorporating theory-based educational materials and strategies regarding smoking cessation interventions in their curricula.

A comparison of two nursing theories in practice: Peplau and Parse.

This column illuminates nursing practice through two unique theoretical perspectives: Peplau's theory of interpersonal relations and Parse's theory of humanbecoming. Processes of each practice method will be explicated as each is related to a practice scenario. The key differences between Peplau's and Parse's practice methodologies are identified. Nursing is a unique, evolving, everchanging profession for which theory can be used as a guide for practice. This column demonstrates two of these unique theories. Whether through health promotion or quality of life from the person's perspective, theory provides meaning in nursing practice and in everyday life.

Self-Care Strategies for Professional Development: Transcendental Meditation Reduces Compassion Fatigue and Improves Resilience for Nurses.

The Transcendental Meditation technique was provided to 27 nurses across levels and areas of the organization. Quantitative tools measured the effect on nurses' compassion fatigue and resilience. Paired-sample t test analyses revealed significant improvements in the phenomena studied. Further, resilience showed a large significant, inverse relationship with burnout. This study contributes new knowledge for an innovative self-care strategy to improve resilience and reduce compassion fatigue and burnout among nurses.

Developing a surgeon-patient communication checklist for total knee arthroplasty.

BACKGROUND: Total knee arthroplasty (TKA) is a well-established surgical procedure with high rates of clinical success, yet up to 20% of patients are dissatisfied with their outcomes. Surgeon-patient communication is an important contributor to patient satisfaction, particularly in the area of setting or resetting postoperative expectations that are reasonable and achievable for individual patients. OBJECTIVE: The goal of the present research was to develop a communication checklist for surgeons to use with their patients, to enhance communication in order better to manage postoperative expectations and increase patient satisfaction with TKA. METHODS: Content analysis was used to identify a preliminary list of checklist items from audio-recorded interviews of eight patients who were between 6 weeks and 6 months of their recovery from TKA. Patients identified eight issues for which more information was desired. The proportion of mentions for each topic was calculated, and chi-square tests assessed the distribution and pattern of the categories mentioned across groups of patients. RESULTS: Certain topics were used significantly more often than others. Age and employment status, but not gender, affected which topics were mentioned more often. The final categories for the checklist included pain management, physiotherapy, medication and general outcome information. CONCLUSION: An in-depth analysis of patient experiences of recovering from TKA was the foundation of this research. The result was a checklist that creates a potential new avenue for increasing patient satisfaction by improving surgeon-patient communication. The research described here could extend to any other type of intervention in which understanding patient expectations and increasing patient satisfaction is the goal.

A pilot project for chlamydia screening in adolescent females using self-testing: characteristics of participants and non-participants.

OBJECTIVES: A self-test screening program for genital C. trachomatis infection in female students attending high school in rural Nova Scotia was introduced. The objectives of this pilot study were to determine the extent of uptake, reasons for being/not being screened, and whether students at risk would be more likely to be screened. METHODS: The screening program was carried out between September 2005 and May 2006. Test kits were accessed through the school's health centre without first seeing the school nurse for counselling. Tests were processed non-nominally at the laboratory. A cross-sectional survey was offered to all students in the school to assess factors related to participation or non-participation. Univariate analysis was carried out for young women's sexual activity and risk taking, reasons for being participants or non-participants, risk behaviours, and knowledge about chlamydia. RESULTS: One hundred and sixty-three women (58%) had had vaginal intercourse at least once. Twenty-four of these used the self-test kit. Though 83% of those not using the self-test knew that females with chlamydia are very often asymptomatic, 54% indicated lack of symptoms as a reason for not doing so. Many (49%) gave low probability of infection as a reason for not using the kit, but high-risk sexual activity was frequent in these young DISCUSSION: Uptake of self-testing for C. trachomatis was lower than anticipated. This may be due to lack of counselling meant to encourage testing to overcome a dissonance of knowledge and behaviour. Self-testing should be further explored to better understand its potential to increase chlamydia screening among Canadian adolescents.

The effectiveness of mindfulness meditation for nurses and nursing students: An integrated literature review.

BACKGROUND: A growing body of literature has identified a range of beneficial physiological and psychological outcomes from the regular practice of mindfulness meditation. For healthcare professionals, mindfulness meditation is claimed to reduce stress, anxiety and burnout, and enhance resilience. OBJECTIVE: The objective of this integrative review was to critically appraise the literature that related to the effectiveness of mindfulness meditation programs for nurses and nursing students. DESIGN: This review was conducted using Whittemore and Knafl's framework for integrated reviews. DATA SOURCES: Using the terms mindfulness, mindfulness-based-stress reduction, Vipassana, nurses, and nurse education a comprehensive search of the following electronic databases was conducted: CINAHAL, Medline, PsycINFO, EMBASE. EMCARE, ERIC and SCOPUS. REVIEW METHODS: The initial search located 1703 articles. After screening and checking for eligibility 20 articles were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers and McMaster's Critical appraisal form for quantitative papers. The final number of papers included in the review was 16. RESULTS: The results of this review identified that mindfulness meditation has a positive impact on nurses' and nursing students' stress, anxiety, depression, burnout, sense of well-being and empathy. However, the majority of the papers described small scale localised studies which limits generalisability. CONCLUSION: Contemporary healthcare is challenging and complex. This review indicated that mindfulness meditation is an effective strategy for preventing and managing the workplace stress and burnout, which so often plague nursing staff and students. Further studies with larger sample sizes using rigorous research methods would be useful in extending this work.

The lived experience of women with cancer: phenomenological findings expressed through poetry.

Cancer rates for Canadian women between the ages of 22 and 44 are increasing. Improved survival times and more treatment choices, however create new challenges. Little research has been done to uncover the lived experience of long-term survival. This pilot study describes the meaning of living with cancer for three Canadian women who were diagnosed more than four years ago. The process of inquiry was Giorgi's descriptive phenomenological method for analysis-synthesis of a general structural description (the meaning of the experience). The findings have been interpreted creatively through poetry in an effort to enhance understanding of the experience of living with cancer Each section of the poem is discussed in relation to the literature to encourage nurses and other health professionals to consider the importance of understanding patients' lived experiences and the meanings they ascribe, in order to provide quality, holistic, and individualized care.

Living attentive presence and changing perspectives with a web-based nursing theory course.

Online education can be a wonderful teaching-learning experience for professors and students alike. This column shares excerpts from postings that students and a professor wrote during an online nursing theories course with the intention to illuminate selected essences, paradoxes, and processes of Parse's teaching-learning model and to portray living attentive presence and changing perspectives with online teaching-learning strategies. This reflection was initiated in Pittsburgh, Pennsylvania at the Institute of Human Becoming when two of the authors (Aquino-Russell and Maillard Strüby) were introduced to the human becoming teaching-learning model by nurse theorist Rosemarie Rizzo Parse.

A phenomenological study: the lived experience of persons having a different sense of hearing.

Living with a different sense of hearing, including loss of hearing, is a worldwide phenomenon, known to be a silencing condition that can change persons' patterns of relating and divest effective ways of giving and receiving messages of sound. This research describes the meaning of this experience for 7 participants. The researcher followed Giorgi's descriptive phenomenological method for analysis-synthesis to arrive at a general structural description of the experience. Parse's theory of human becoming framed the researcher's theoretical perspective. Findings build on Parse's theory and may enhance nurses' understanding, in turn altering the way nurses approach persons having a different sense of hearing.

Practice possibilities for nurses choosing true presence with persons who live with a different sense of hearing.

Living with a different sense of hearing is a silencing experience that can change persons'patterns of relating and even deprive them of effective ways to give and receive messages with other human beings. People who live with having a different sense of hearing are often stigmatized, labeled, and judged by nurses, healthcare professionals, and family members alike. This column examines practice possibilities for nurses who choose the human becoming way of being with persons living with a different sense of hearing.

Illuminating person-centered care with parse's teaching-learning model.

Person-centered care is illuminated in this paper through the lens of Parse's teaching-learning model for students who were engaged in patient-centered care during a practicum on an acute care unit. Students' perspectives changed as they tried on strategies for person-centered care and lived true presence with persons, while experiencing the satisfaction of knowing that they made a difference in the quality of life of the persons they were with.

Gender differences in knowledge about chlamydia among rural high school students in Nova Scotia, Canada.

BACKGROUND: Chlamydia is the most prevalent sexually transmissible infection (STI) in Canadian adolescents. STI account for 20% of cases of infertility in Canada and 42% of ectopic pregnancies are attributable to previous chlamydia infection. Despite the importance of this infection, little is understood about young people's knowledge of it. METHODS: A survey was conducted at a rural high school in Nova Scotia, Canada, to assess students' knowledge of chlamydia and associations of knowledge with gender and protective behaviours. Knowledge was assessed using true-false responses to 15 statements about chlamydia. Each statement was examined for differences in the percentage of correct responses by sex. Correct responses were summed, creating a knowledge score. Socioeconomic status variables and age were included in multivariate regression models to determine if they modified associations between knowledge score and protective behaviours seen in simple regression. RESULTS: Eighty-six percent of registered students (n = 538) participated in the survey. Girls responded to 10 of the 15 knowledge statements significantly more often than boys. Respondents were least knowledgeable about their rights to confidential health services for chlamydia infection. Knowledge score was associated with use of both condoms and oral contraception at last intercourse in girls (odds ratio 1.15; 95% confidence interval 1.01-1.31). No association of knowledge score was seen with having had an STI test in the previous year. CONCLUSIONS: School sexual health programs should make special efforts to meet the needs of male students, and programs and health professionals should include information about the confidential nature of sexual health services for adolescents.