Professional quality of life, stress, and trauma in nursing students: Before and during the novel coronavirus pandemic.

OBJECTIVE: The aim of the study was to assess the levels of stress, burnout, primary and secondary trauma, and self-efficacy before and during the novel coronavirus pandemic in a sample of baccalaureate nursing and psychiatric nursing students, a population which has seldom been studied regarding these factors. METHOD: The study used a nonexperimental, cross-sectional methodology at 2 time-points. Nursing and psychiatric nursing students enrolled at 1 western Canadian university were invited to participate in an online, anonymous survey in 2020 prior to the pandemic and in 2021 during Canada's third-wave. Survey measures included the Professional Quality of Life Scale (includes Compassion Satisfaction, Burnout, and Secondary Traumatic Stress), the Perceived Stress Scale, the Life Events Checklist to assess the amount of prior traumatic experiences, and the Core Self-Evaluations Scale. RESULTS: Statistically higher significant differences in prior traumatic experiences measured by the Life Events Checklist were found in the midpandemic cohort in comparison to the prepandemic 2020 student cohort (t(159) = -2.32, p < .05, 95% CI [-2.23, -.18]). Strong correlated relationships were found in many of the study variables (ranging from r = .301 to -.745, p ≤ .001). CONCLUSION: This preliminary study is the first to reveal that students in the nursing field experienced more traumatic events during the pandemic than before. The findings imply that access to greater support for experiences of trauma may be needed to support undergraduate students entering the health care arena amid the novel coronavirus pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"The Message Is You Don't Exist": Exploring Lived Experiences of Rural Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) People Utilizing Health care Services.

BACKGROUND: Lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) people experience significant health inequities with well-documented negative health impacts due to their status as a sexual and gender minority population. Insensitive or discriminatory attitudes toward LGBTQ people within the health care system have negatively impacted access to health services and the overall physical and mental health and well-being of this at risk population. Few studies of LGBTQ populations in rural areas have been conducted, with even fewer in the Canadian context. Rural areas often create greater visibility for LGBTQ persons, contain fewer supports and alternatives in the face of discrimination, and are often are less accepting of LGBTQ populations due to increased stigma and social isolation. OBJECTIVE: The purpose of this study is to examine the lived experiences of LGBTQ people utilizing health care services in rural Manitoba. METHOD: 12 individuals who self-identified as LGBTQ who had accessed health care services in Manitoba were recruited. Using qualitative methodology, interviews were recorded and analyzed for themes. RESULTS: Analysis revealed themes including stigma and discrimination, judgments and assumptions, gender identities, lack of knowledge, limited access/systemic barriers, rural considerations, and recommendations for changes to address the gaps in health care services and barriers to access. CONCLUSIONS: This study of the LGBTQ community provides an expression of their opinions and experiences, but also provides a voice to this underserved population. The findings of this study provide a better understanding of the unique health needs and experiences of LGBTQ people in rural Manitoba, creating opportunities for meaningful change in health care delivery.

Issues postopératoires chez les Autochtones au Canada: revue systématique.

CONTEXTE: Il existe d'importantes iniquités en matière de santé chez les populations autochtones au Canada. La faible densité de la population canadienne et les populations en région éloignée posent un problème particulier à l'accès et à l'utilisation des soins chirurgicaux. Aucune synthèse des données sur les issues chirurgicales chez les Autochtones au Canada n'avait été publiée jusqu'à maintenant. MÉTHODES: Nous avons interrogé 4 bases de données pour recenser les études comparant les issues chirurgicales et les taux d'utilisation chez les adultes des Premières Nations, inuits et métis et chez les adultes non autochtones au Canada. Des évaluateurs indépendants ont réalisé toutes les étapes en parallèle. L'issue primaire était la mortalité; les issues secondaires comprenaient le taux d'utilisation des chirurgies, les complications et la durée du séjour à l'hôpital. Nous avons effectué une méta-analyse pour l'issue primaire à l'aide d'un modèle à effets aléatoires. Nous avons évalué les risques de biais à l'aide de l'outil ROBINS-I. RÉSULTATS: Vingt-huit études ont été analysées, pour un total de 1 976 258 participants (10,2 % d'Autochtones). Aucune étude ne portait précisément sur les populations inuites et métisses. Quatre études portant sur 7 cohortes ont fourni des données corrigées sur la mortalité pour 7135 participants (5,2 % d'Autochtones); les Autochtones présentaient un risque de décès après une intervention chirurgicale 30 % plus élevé que les patients non autochtones (rapport de risque combiné 1,30; IC à 95 % 1,09­1,54; I 2 = 81 %). Les complications étaient aussi plus fréquentes chez le premier groupe, notamment les infections (RC corrigé 1,63; IC à 95 % 1,13­2,34) et les pneumonies (RC 2,24; IC à 95 % 1,58­3,19). Les taux de différentes interventions chirurgicales étaient plus faibles, notamment pour les transplantations rénales, les arthroplasties, les chirurgies cardiaques et les accouchements par césarienne. INTERPRÉTATION: Les données disponibles sur les issues postopératoires et le taux d'utilisation de la chirurgie chez les Autochtones au Canada sont limitées et de faible qualité. Elles suggèrent que les Autochtones ont de plus hauts taux de décès et d'issues négatives postchirurgicales et qu'ils font face à des obstacles dans l'accès aux interventions chirurgicales. Ces conclusions indiquent qu'il y a un besoin de réévaluer en profondeur les soins chirurgicaux prodigués aux Autochtones au Canada pour leur assurer un accès équitable et améliorer les issues. NUMÉRO D'ENREGISTREMENT DU PROTOCOLE: PROSPERO-CRD42018098757.

Postoperative outcomes for Indigenous Peoples in Canada: a systematic review.

BACKGROUND: Substantial health inequities exist for Indigenous Peoples in Canada. The remote and distributed population of Canada presents unique challenges for access to and use of surgery. To date, the surgical outcome data for Indigenous Peoples in Canada have not been synthesized. METHODS: We searched 4 databases to identify studies comparing surgical outcomes and utilization rates of adults of First Nations, Inuit or Métis identity with non-Indigenous people in Canada. Independent reviewers completed all stages in duplicate. Our primary outcome was mortality; secondary outcomes included utilization rates of surgical procedures, complications and hospital length of stay. We performed meta-analysis of the primary outcome using random effects models. We assessed risk of bias using the ROBINS-I tool. RESULTS: Twenty-eight studies were reviewed involving 1 976 258 participants (10.2% Indigenous). No studies specifically addressed Inuit or Métis populations. Four studies, including 7 cohorts, contributed adjusted mortality data for 7135 participants (5.2% Indigenous); Indigenous Peoples had a 30% higher rate of death after surgery than non-Indigenous patients (pooled hazard ratio 1.30, 95% CI 1.09-1.54; I 2 = 81%). Complications were also higher for Indigenous Peoples, including infectious complications (adjusted OR 1.63, 95% CI 1.13-2.34) and pneumonia (OR 2.24, 95% CI 1.58-3.19). Rates of various surgical procedures were lower, including rates of renal transplant, joint replacement, cardiac surgery and cesarean delivery. INTERPRETATION: The currently available data on postoperative outcomes and surgery utilization rates for Indigenous Peoples in Canada are limited and of poor quality. Available data suggest that Indigenous Peoples have higher rates of death and adverse events after surgery, while also encountering barriers accessing surgical procedures. These findings suggest a need for substantial re-evaluation of surgical care for Indigenous Peoples in Canada to ensure equitable access and to improve outcomes. PROTOCOL REGISTRATION: PROSPERO-CRD42018098757.

From coping to building nurse manager resilience in rural workplaces in western Canada.

AIM: To investigate the role stressors, and how coping strategies cultivated nurse managers' resilience in rural workplaces. BACKGROUND: A stressful workplace can impair the mental and physical health of nurse managers leading to poor performance. Building and sustaining manager resilience in complex and stressful practice environments is necessary to attract and maintain competent and skilled managers. METHOD: In this qualitative exploratory inquiry, a purposive sampling method was used to recruit 16 nurse managers in rural western Canada. RESULTS: Coping strategies fostered manager's resilience that made their work meaningful, and included putting out fires, psychologically reframing a situation, serving others and receiving support. CONCLUSIONS: Managers brought expertise, knowledge and skill to make their work meaningful and central to ongoing health service delivery in these rural communities. Nurse manager resilience can be strengthened by using evidence-based strategies in an increasingly complex health care environment. IMPLICATIONS FOR NURSING MANAGEMENT: Managers need to be supported and encouraged to develop awareness of their own protective factors as they cope with challenging situations. Building resilience through formal education, social support and meaningful recognition is an important focus for nurse leaders in establishing a healthy work environment and maintaining a stable nursing workforce.

Rasch analysis of Stamps's Index of Work Satisfaction in nursing population.

AIM: One of the most commonly used tools for measuring job satisfaction in nursing is the Stamps Index of Work Satisfaction. Several studies have reported on the reliability of the Stamps' tool based on traditional statistical model. The aim of this study was to apply the Rasch model to examine the adequacy of Stamps's Index of Work Satisfaction for measuring nurses' job satisfaction cross-culturally and to determine the validity and reliability of the instrument using the Rasch criteria. DESIGN: A secondary data analysis was conducted on a sample of 556 registered nurses from two countries. METHODS: The RUMM 2030 software was used to analyse the psychometric properties of the Index of Work Satisfaction. RESULTS: The persons mean location of -0.018 approximated the items mean of 0.00, suggesting a good alignment of the measure and the traits being measured. However, at the items level, some items were misfiting to the Rasch model.

Perceived training needs of nurses working with mentally ill patients.

Introductio n: In Malaysia, nurses form a significant part of the clinical mental health team, but the current level of training in mental health results in suboptimal nursing care delivery. METHODS: For this study 220 registered nurses and medical assistants working with the mentally ill completed a structured questionnaire. The purpose of this study was to explore perceived competence in mental healthcare and the training needs of nurses working with mentally ill patients in inpatient mental healthcare facilities. RESULTS: The skills perceived as important for practicing in mental health varied among the nurse participants. Post basic training in mental health was significantly related to perceived competence in patient mental state assessment (p=0.036), risk assessment for suicide (p=0.024), violence (p=0.044) and self-harm (p=0.013). CONCLUSION: There is little emphasis on psychosocial skills in current post basic mental health training in Malaysia.

The effect of meeting physical activity guidelines for cancer survivors on quality of life following radical prostatectomy for prostate cancer.

PURPOSE: Recent literature has shown that preoperative physical activity (PA) can positively influence surgical outcomes. It is unknown whether the effect of meeting PA guidelines for cancer survivors can impact quality of life following radical prostatectomy for prostate cancer. METHODS: We reviewed our institutional database of prostate cancer outcomes and included patients that underwent radical prostatectomy and completed the Godin-Shephard Leisure Time Exercise Questionnaire (GLTEQ), the Patient-Oriented Prostate Utility Scale (PORPUS), the International Prostate Symptom Score (IPSS), and the five-item International Index of Erectile Function (IIEF). Participants were categorized as meeting or not meeting the American College of Sports Medicine physical activity guidelines for cancer survivors (150 min of moderate intensity or 75 min of vigorous intensity PA per week). Radical prostatectomy outcomes were measured preoperatively and at 6 and 26-weeks postoperatively. RESULTS: From June 2008 to August 2012, 509 men underwent curative, nerve-sparing radical prostatectomy for prostate cancer and completed the GLTEQ, of whom 46% met the PA guidelines. Prior to surgery, men that met the PA guidelines reported higher quality of life (p < 0.001) and erectile function (p = 0.049) than men that did not meet the guidelines. Quality of life at all postoperative timepoints was higher for men that met the PA guidelines after adjusting for age, preoperative body mass index, and surgical approach (p = 0.02). Men that met the PA guidelines were 19% less likely to be incontinent at 6 weeks postoperatively (p = 0.028). CONCLUSION: PA volume may be a useful marker at predicting postoperative recovery of quality of life and urinary incontinence following radical prostatectomy. IMPLICATIONS FOR CANCER SURVIVORS: Cancer survivors should be encouraged to meet PA guidelines prior to surgery in an effort to attenuate the decline in HRQOL and facilitate recovery.

Breast cancer knowledge and screening behaviour among women with a positive family history: a cross sectional study.

BACKGROUND: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences. OBJECTIVES: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group. MATERIALS AND METHODS: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection. RESULTS: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, R2=0.467, F=12.568, p<0.0001. CONCLUSIONS: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.

Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia.

BACKGROUND: The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence. METHODOLOGY: This study used observational design whereby nursing students' clinical skills were observed and scored in five OSCE stations. Two instruments were used for the data collection - A self-administered questionnaire on the students' bio-demographic data, and a check list on the clinical skills which the examiners rated on a four point scale. RESULTS: The findings revealed that 14% of the nurses had level four competence, which indicated that they could perform the tasks correctly and complete. However, 12% failed the OSCE, even though they had more than 10 years experience in nursing and post basic qualifications. Inter-rater reliability was 0.92 for the five examiners. Factor analysis indicated that five participant factors accounted for 74.1% of the variations in clinical skills performance. CONCLUSION: An OSCE is a necessary assessment tool that should be continuously applied in nursing education, regardless of the mode of the education program, the student's years of experience or his/her clinical placement. This study validates the need for OSCE in both the design of tertiary nursing degree programs and the assessment of nurses' clinical competency level.

Empowerment, job satisfaction and organizational commitment: a comparative analysis of nurses working in Malaysia and England.

AIMS: To examine the relationships between nurses' empowerment, job satisfaction and organizational commitment in culturally and developmentally different societies. BACKGROUND: Employment and retention of sufficient and well-committed nursing staff are essential for providing safe and effective health care. In light of this, nursing leaders have been searching for ways to re-engineer the healthcare system particularly by providing an environment that is conducive to staff empowerment, job satisfaction and commitment. METHODS: This is a descriptive correlational survey of 556 registered nurses (RNs) in two teaching hospitals in England and Malaysia. RESULTS: Although the Malaysian nurses felt more empowered and committed to their organization, the English nurses were more satisfied with their job. CONCLUSION: The differences between these two groups of nurses show that empowerment does not generate the same results in all countries, and reflects empirical evidence from most cross cultural studies on empowerment. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management should always take into consideration cultural differences in empowerment, job satisfaction and commitment of nursing staff while formulating staff policies.