Relationship quality in higher education and the interplay with student engagement and loyalty.

BACKGROUND: To date, studies that have investigated the bonds between students and their institution have emphasized the importance of student-staff relationships. Measuring the quality of those relationships (i.e., relationship quality) appears to help with investigating the relational ties students have with their higher education institutions. Growing interest has arisen in further investigating relationship quality in higher education, as it might predict students' involvement with the institution (e.g., student engagement and student loyalty). So far, most studies have used a cross-sectional design, so that causality could not be determined. AIMS: The aim of this longitudinal study was twofold. First, we investigated the temporal ordering of the relation between the relationship quality dimensions of trust (in benevolence and honesty) and affect (satisfaction, affective commitment, and affective conflict). Second, we examined the ordering of the paths between relationship quality, student engagement, and student loyalty. Our objectives were to gain a deeper understanding of the relationship quality construct in higher education and its later outcomes. SAMPLE: Participants (N = 1649) were students from three Dutch higher education institutions who were studying in a technology economics or social sciences program. METHODS: Longitudinal data from two time points were used to evaluate two types of cross-lagged panel models. In the first analysis, we could not assume measurement invariance for affective conflict over time. Therefore, we tested an alternative model without affective conflict, using the latent variables of trust and affect, the student engagement dimensions and student loyalty. In the second type of model, we investigated the manifest variables of relationship quality, student engagement, and student loyalty. The hypotheses were tested by evaluating simultaneous comparisons between estimates. RESULTS: Results indicated that the relation between relationship quality at Time 1 with student engagement and loyalty at Time 2 was stronger than the reverse ordering in the first model. In the second model, results indicated that cross-lagged relations between trust in benevolence and trust in honesty at Time 1 and affective commitment, affective conflict, and satisfaction at Time 2 were more likely than the reverse ordering. Furthermore, cross-lagged relations from relationship quality at Time 1 to student engagement and student loyalty at Time 2 also supported our hypothesis. CONCLUSIONS: This study contributes to the existing higher education literature, indicating that students' trust in the quality of their relationship with faculty/staff is essential for developing students' affective commitment and satisfaction and for avoiding conflict over time. Second, relationship quality factors positively influence students' engagement in their studies and their loyalty towards the institution. A relational approach to establishing (long-lasting) bonds with students appears to be fruitful as an approach for educational psychologists and for practitioners' guidance and strategies. Recommendations are made for future research to further examine relationship quality in higher education in Europe and beyond.

A conversation approach based on shared goal-setting and shared decision-making for nurses in cancer aftercare: A developmental study.

PURPOSE: This study aimed to develop and pretest a systematic conversation approach for nurses to tailor aftercare to oncology patient's goals, unmet needs and wishes. METHODS: We used an iterative developmental process for complex interventions: 1. Identifying problems 2. Identifying overall objectives 3. Designing the intervention 4. Pretesting and adapting the intervention. RESULTS: The main results of the problem identification were: non-systematic and incomplete screening of potential issues, caveats in providing information, and shared decision-making. The overall objective formulated was: To develop a model for aftercare conversations based on shared goal-setting and decision-making. The conversation approach consists of four phases: 1. Preparation of the consultation including a questionnaire, 2. Shared goal-setting by means of a tool visualizing domains of life, and 3. Shared care planning by means of an overview of possible choices in aftercare, a database with health care professionals and a cancer survivorship care plan. 4. EVALUATION: The results of the pretest revealed that the conversation approach needs to be flexible and tailored to the patient and practice setting, and embedded in the care processes. The conversation approach was perceived as enhancing patient-centeredness and leading to more in-depth consultations. CONCLUSION: The conversation approach was developed in co-creation with stakeholders. The results of the pretest revealed important implications and suggestions for implementation in routine care. The aftercare conversation approach can be used by nurses to provide tailored patient-centered evidence-based aftercare. Tailored aftercare should support oncology patient's goals, unmet needs and wishes. Further tailoring is needed.