Pain experience of the elderly.

Too often, the elderly suffer silently and needlessly with chronic pain. To investigate the pain experience of the elderly living in the community, a descriptive research design was used. The aims of the study were to determine the prevalence of pain in an older population living in the community, to obtain a description of the older adult's pain experience, and to determine strategies used to manage their pain. The results of the study indicated that >90% of the elderly living in the community experienced pain within the past month, with 41% reporting discomforting, distressing, horrible, or excruciating pain. Musculoskeletal pain was found to be the most predominant pain, and inactivity was the most effective strategy used to lessen pain. Pain in the elderly continues to be a challenge which needs to be addressed more effectively by health care providers. Based on the high prevalence of pain experienced by the elderly and the expected demographic shifts in the next two decades, it is imperative to continue research in this area to assure the highest quality of life, as well as maximum functional ability, for the elderly. Health care providers need to understand the multidimensional pain experience that occurs in the daily life of the community-dwelling older adult and the most effective management strategies that can be used to provide pain relief.

Perceptions of the use of reflective learning journals in online graduate nursing education.

The purpose of this study was to examine the perceptions of graduate nursing students and a small sample of faculty regarding learning outcomes associated with reflective learning journals (RLJ) in online education. Reflective journaling is used extensively in nursing curricula, yet few studies have explored perceptions of learning outcomes with online students, specifically those preparing to become nurse educators.An electronic survey was developed utilizing items associated with four learning outcomes of reflective journaling: professional development, personal growth, empowerment, and facilitation of the learning process. Positive outcomes such as the connection between theory and practice, recognition of strengths and weaknesses, and integration of new ideas and concepts were identified. Obstacles included the amount of time needed for reflection and grading, and the development of trust between students and faculty. The results of this study indicate that graduate students and faculty perceive positive learning outcomes with the use of reflective journals in online education.

The use of innovative pedagogies in nursing education: an international perspective.

The purpose of this global study was to explore the types of innovative pedagogies used in nursing education worldwide; transformative learning theory served as the theoretical basis for the study. A descriptive, mixed-method design with a researcher-developed instrument was used to conduct the electronic survey. Respondents were 946 nurse educator members of Sigma Theta Tau International; more than 93 percent were Caucasian women. Respondents indicated that the conventional teacher-centered approach remains the most prevalent pedagogical style (56 percent); fewer than 20 percent of respondents used feminist or postmodern approaches. Ninety percent of respondents reported using instruments to evaluate the effectiveness of their teaching. The majority viewed their faculty role as facilitator (88 percent) or information provider (65 percent). Greater efforts are needed to create an evidence base for nursing education through research that focuses on the effectiveness of innovative pedagogical strategies. This study, by describing the current patterns of teaching/learning strategies and approaches used by nurse educators, provides a beginning research base for improving nursing education.

A review of narrative pedagogy strategies to transform traditional nursing education.

Traditional nursing pedagogies using teacher-centered learning approaches have produced efficient, knowledgeable nursing graduates for many years. However, 21st century learners will require and demand new educational approaches. The information age of computers has challenged all facets of education to keep pace. Nursing education must evolve with ever-changing forms of communication and technology and recognize generational differences in learning. The creation of partnerships in learning, rather than the traditional hierarchy of education, is projected to meet the needs of today's learners more effectively. The National League for Nursing, in its position statements, has challenged nurse educators to develop new research-based pedagogies responsive to the changing health care environment and reflective of new partnerships between and among students, teachers, and clinicians. This article will explore examples of one approach, narrative pedagogy, and its usefulness in nursing education as a way to expand the pedagogical literacy of nurse educators.

Leadership development in geriatric care through the Intergeneration Make a Difference Project.

The Intergeneration Make a Difference Project (MADP) is designed to develop leadership skills in geriatric nursing for seniors in a baccalaureate nursing program. This service-learning project with octogenarians and older individuals is based on theoretical constructs of caring. Stories and journaling are of great importance in the project. Expected outcomes are cognitive, affective, personal, and interpersonal. Students are expected to engage in critical/reflective thinking and develop leadership skills, heightened respect for the elderly, and interest in lifelong learning and a service orientation to society. Empowered to influence their clients, students receive the reciprocal benefits of an intergenerational relationship that, it is hoped, will affect how they care for the elderly in the future.

Improving self-directed learning/intercultural competencies: breaking the silence.

Nurse educators need to develop innovative, technological curricula that foster intercultural competencies as essential components of a university education and break the silence with respect to lesbian, gay, bisexual, transgender, and queer (LGBTQ) health. Goals are to foster using these competencies to make LGBTQ content explicit in nursing curricula and in their professional organizations to promote equality and lessen disparities in this group.

Characteristics of labor pain at two stages of cervical dilation.

This study characterized the pain reported in a selected group of obstetrical patients in labor and compared the pain experienced at 2 stages of dilation, dilation of 2-5 cm and of 6-10 cm. Pain was defined as the perception of an unpleasant sensory and emotional experience with multidimensional factors that evoke behavioral responses. The characteristics of pain were operationalized as responses of 78 laboring women to 3 self-report measures, the Visual Analogue Scale (VAS), Present Pain Intensity (PPI), and the McGill Pain Questionnaire (PRI-R), and 1 observational measure, the nurse-rated Behavioral Index of Pain (BIP). As cervical dilation increased, there were significant increases in self-reported pain and observed pain on all the cited measures. Pain was characterized as 'discomforting' during early dilation and as 'distressing, horrible, excruciating' as dilation progressed. Significant increases in pain with increased dilation occurred on all measures for multigravidas but only on the VAS for primigravidas.

Higher education in nursing: nursing's perfect storm or perfect opportunity?

Many new nursing leaders who assume deanships, or assistant or interim deanships, have limited education, experience, and/or background to prepare them for the job. To assist new deans and those aspiring to be deans, the authors of this department, 2 deans, offer survival tips based on their personal experiences and insights. They address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. The authors welcome counterpoint discussions with readers. This issue's article is by guest author Dr Sylvia Brown, dean, East Carolina University.

Offering an online course: complementary and alternative therapies in nursing practice.

With 30% to 80% of adults in industrialized countries using complementary and alternative therapies, faculty at one university recognized a need for a complementary and alternative therapies course at the graduate level. The course includes concepts for master's students and doctoral students, presents a variety of topics, and allows students to interview a practitioner in a field they are particularly interested in.