The Relationship Between Religious Attitude, Compassion and Spiritual Care in Nursing Students: The Case of Türkiye.

In the present descriptive study, we aimed to examine the relationship between the levels of religious attitude, compassion and spiritual care perception among nursing students. Data were obtained from 135 nursing students using the Socio-Demographic Diagnosis Form, the Ok-Religious Attitude Scale, the Compassion Scale, and the Spiritual Care-Giving Scale. The data were analyzed using the Kruskal-Wallis H test, the Spearman correlation test, and the Mann-Whitney U test. A positive correlation was found between the scores of the Ok-religious attitude scale and cognition sub-dimension, emotion sub-dimension, behavior sub-dimension, god sub-dimension and compassion scale and spiritual care-giving scale scores. Furthermore, we observed that some socio-demographic, and nursing profession and spiritual care characteristics of the students affected their religious attitudes, compassion and spiritual care perception. The sub-dimension scores of compassion and awareness of sharing among female students and the mindfulness scores of students with nuclear families were high. Our data suggest that the course contents for spiritual care, which is an integral part of holistic nursing care, should be included in the nursing curriculum. Moreover, we recommend that efforts be made to maintain a high level of compassion while considering the socio-demographics of the students and their opinions on the nursing profession. Finally, the data presented here has the potential to serve as a valuable resource for the development of novel approaches to the provision of spiritual care within nursing education programs.

The Relationship Between the Sense of Professional Belonging and Perceptions of Spirituality and Spiritual Care Among Turkish Midwifery Students.

This study examined the relationship between the sense of professional belonging and perceptions of spirituality and spiritual care among midwifery students. This cross-sectional study's sample included 194 third- and fourth-year midwifery students associated with the Faculty of Health Sciences at two universities in western Turkey. Data were collected using web-based surveys. The results indicate a positive relationship between total scores on the Midwifery Belonging Scale and scores on the Spirituality and Spiritual Care Rating Scale. As the students' spirituality and spiritual care perceptions increased, their feelings of professional belonging as midwives also increased. Therefore, including the concepts of spirituality and belonging in the midwifery curriculum can increase students' spiritual perceptions and sense of professional belonging, thereby enhancing the quality of the care they ultimately provide.

The mediating effect of academic engagement between psychological capital and academic burnout among nursing students during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Almost all universities have been forced to close and change to online teaching during the COVID-19 pandemic, which has been a big challenge for students. There is little knowledge about the academic burnout among nursing students in these difficult circumstances, especially in traditional Chinese medicine universities, and the relationship between the burnout and their psychological capital and academic engagement. OBJECTIVE: The aim is to describe academic burnout and clarify the relationships between academic burnout, academic engagement, and psychological capital among nursing students in traditional Chinese medicine universities. DESIGN: This is a cross-sectional, descriptive study. SETTING: The study sampled a four-year undergraduate traditional Chinese medicine university in Jian, Shandong Province, China. PARTICIPANTS: A convenience sampling method was used to select 733 nursing students from April to June 2020. METHODS: The Academic Burnout Scale, the Positive Psychological Capital Scale, and the Academic Engagement Scale were used for data collection, in addition to social-demographic data. Path analysis was used to clarify the relationships among academic burnout, academic engagement and psychological capital. RESULTS: Of all the study participants, 39.29% had a certain degree of academic burnout. Academic engagement and psychological capital were negatively correlated with academic burnout among nursing students in traditional Chinese medicine university. Psychological capital was positively correlated with academic engagement. CONCLUSION: Nursing students had a certain degree of academic burnout. Academic engagement played a partial mediated role in the relationship between psychological capital and academic burnout.

Perceptions of student accoucheurs regarding gender inequality in midwifery training at Free State maternal healthcare institutions.

BACKGROUND: Worldwide, gender inequality has been a dominating factor in the training of student accoucheurs in most maternal healthcare institutions. This poses challenges for the maternal healthcare institutions where student accoucheurs are placed for clinical practice as most women become reluctant or refuse to accept their services. Gender inequality has a negative impact on the training of student accoucheurs as most of them become demotivated which could lead to a high attrition rate. OBJECTIVES: This study explored and described the perceptions of student accoucheurs regarding gender inequality in midwifery training at the Free State maternal healthcare institutions. METHOD: An explorative and descriptive qualitative research design was undertaken. There were 40 student accoucheurs that formed 10 focus group discussions. Each focus group discussion had four participants. Tesch's eight-steps of data analysis was used to analyse data. RESULTS: Three major themes emerged during data analysis: meeting the training requirements in midwifery, women's autonomy in a choice of healthcare provider versus student accoucheurs' autonomy to be trained in midwifery and staff establishment to render maternal healthcare. CONCLUSION: The participants perceived prejudice, rejection and resistance by women in maternity units as a contributing factor to gender inequality, which has a negative impact on their training in midwifery. The study recommends that health directorates, nurse managers and training institutions should consider revising maternal healthcare policies regarding the recruitment and placement of willing accoucheurs in maternity units in order to address gender inequality.

A cross sectional study of midwifery students' experiences of COVID-19: Uncertainty and expendability.

The impact of COVID-19 on midwifery students is anticipated to be multi-faceted. Our aim was to explore Australian midwifery students' experiences of providing maternity care during the COVID-19 pandemic. In a cross-sectional study 147 students were recruited through social media. Data were collected through an online survey and semi-structured interviews. Surveys were analysed using descriptive statistics; interviews and open text responses were interpreted through qualitative analysis. Findings revealed students found communication from hospitals and universities to be confusing, inconsistent and they relied on mass media and each other to remain updated. Moving to online learning and being isolated from peers made learning difficult. During clinical placements, students felt expendable in terms of their value and contribution, reflected in essential equipment such as personal protective equipment not always being available to them. Witnessing perceived compromised midwifery care increased students' emotional burden, while personal household responsibilities and financial concerns were problematic. One silver lining witnessed was women's appreciation of an improved 'babymoon', with fewer visitors, allowing uninterrupted time to establish breastfeeding and connection with their baby. Findings may guide management of midwifery education during future pandemics or health crises for universities and hospitals.

Visual Arts in Nursing Education: An Inventive Interprofessional Initiative to Cultivate Metacognitive Awareness in Beginning Nursing Students.

PURPOSE: To test an interdisciplinary art-based educational program for beginning baccalaureate traditional and accelerated nursing students. DESIGN: Longitudinal study (Pretest-Posttest) of nursing students' metacognitive awareness. METHOD: As part of a first-semester foundations nursing course, all students participated in the Art of Nursing program consisting of three 90-minute sessions led by graduate Art Education students in a local fine arts museum. Before and after the program, subcomponents of critical thinking were assessed using the Metacognitive Awareness Inventory (MAI). FINDINGS: A total of 218 students (56 traditional, 162 accelerated) participated. Statistically significant improvement was observed on seven components of the MAI. Although significant increases were observed for Declarative (p < .0001), Planning (p < .0001), and Comprehension Monitoring (p < .0001), the differences pre to post were of different magnitudes between the student groups, characterizing a large change in the traditional versus accelerated group. CONCLUSIONS: Our results suggest that (1) nursing students' metacognitive awareness benefits from the museum-based experience despite demographic and educational differences and (2) overall the accelerated student group has exhibited higher metacognitive awareness at baseline as compared with the traditional student group; however, both groups demonstrate significant growth in this area after experiencing an art-based program.

The experiences of Aboriginal and Torres Strait Islander Bachelor of Midwifery students: An integrative literature review.

ISSUE: There is an underrepresentation of Aboriginal and Torres Strait Islander midwives across Australia and an inadequate number of graduating midwives to redress this. A major pillar for the Birthing on Country Model is maternity care workforce development. AIM: The purpose of this review is to examine the enablers and barriers that Aboriginal students experience while undertaking the Bachelor of Midwifery degree in Australia. METHODS: A search of the literature was undertaken through electronic databases. When only three papers were found looking at the experiences of Aboriginal midwifery students the search was broadened to include Aboriginal undergraduate health students. FINDINGS: The literature review reported a strong need for cultural safety in both the clinical and education systems. Students with access to cultural supports, relationships with Aboriginal mentors and academics and Aboriginal clinical placements felt empowered and were able to navigate the 'two worlds' in a meaningful way. DISCUSSION: This review highlights a significant gap in the literature. Despite the expanded search terms to include Aboriginal health students, a relatively narrow range of papers were found. Interestingly, the combined search revealed similar themes: kinship, personal factors, and cultural issues. CONCLUSION: Empowering and supporting Aboriginal Peoples to become midwives is essential. While systems and societies aim for cultural safety, this review shows there is still a way to go. Further research is essential to decolonise higher education and health care systems, and provide strong, well supported pathways for Aboriginal midwifery students.

Nursing Students' Spiritual Orientations and Their Attitudes Toward the Principles of Dying with Dignity: A Sample from Turkey.

Nurses' attitudes toward spiritual care and death are influenced by their personal belief systems and world-views. The aim of this study is to reveal the attitudes of nursing students toward spiritual orientation and principles of dying with dignity. The study was conducted with the participation of 478 nursing students. As a result of the study, it was found that the average score of the students' spiritual orientation scale was high and the average score of the assessment scale of attitudes toward the principles of dying with dignity was found to be moderate.

Incorporating a Microlearning Wellness Intervention Into Nursing Student Curricula.

BACKGROUND: Cultivating healthy lifestyle beliefs (HLBs) can result in positive health outcomes for students during their nursing program. PURPOSE: The purpose of the study was to determine the effectiveness of short wellness interventions (microlearning) in nursing courses on reducing stress and anxiety and enhancing HLB. METHODS: Microlearning wellness interventions were offered to graduate and undergraduate nursing students in this cluster randomized intervention study. The Perceived Stress Scale 4, Generalized Anxiety Disorder 7, and Healthy Lifestyle Beliefs Scales were administered. Student perceptions were evaluated using a short answer narrative. RESULTS: The intervention group reported higher HLB (P = .15), lower anxiety (P = .06), and lower stress (P = .06) compared with the control group after adjusting for baseline differences. Student comments were favorable and included enjoying the activities, weight loss success, and mindfulness strategies. CONCLUSIONS: Incorporating wellness interventions into nursing curricula demonstrates a positive trend toward reducing anxiety and stress and improving HLB.

The relationship between COVID-19 knowledge levels and anxiety states of midwifery students during the outbreak: A cross-sectional web-based survey.

PURPOSE: To determine the relationship between the anxiety states and knowledge levels of female midwifery students about COVID-19 during the outbreak. DESIGN AND METHODS: This cross-sectional study carried out with online participation of 972 female midwifery students. FINDINGS: The anxiety levels of the female midwifery students were high among those visiting the hospital during the pandemic and having parents or relatives who had chronic diseases. Female midwifery students had a high level of knowledge regarding COVID-19. PRACTICE IMPLICATIONS: Female midwives of the future will take part in primary health care services in the protection and promotion of health as an important occupational group in the public health system. To determine mental health and psychological needs of them during the outbreak will greatly contribute to the pandemic management process.

Teaching Guided Imagery and Relaxation Techniques in Undergraduate Nursing Education.

Guided imagery and relaxation techniques have many documented benefits yet are not traditionally taught in undergraduate nursing education. These techniques can also be used by clinicians and students to manage their own stress. The impact of teaching guided imagery in an experiential skills lab on undergraduate nursing students was examined in this mixed-methods research study. Goals were to evaluate whether students learning these skills would be more likely to use them in clinical practice, to examine whether learning these skills would provide personal benefits, and to compare personal instruction with video instruction. Students completed questionnaires evaluating the experience in terms of satisfaction, personal benefit, and intent to use. Students provided comments and answered open-ended questions regarding personal and professional benefits and ability to apply knowledge and skills. Results were positive, with students reporting satisfaction with the format, personal benefit from the course, and increased likelihood that they will use the techniques with clients in the future. The lowest scores were on confidence in using the technique with clients. A statistically significant finding is that students preferred personal instruction in the areas of satisfaction with the content, satisfaction with the format, and the value of experience in advance of using these skills with patients (p < .05).

Therapy Dog Effects on Nursing Student Stress: A Mixed Methods Study.

BACKGROUND: Nursing students experience stress levels that may interfere with success in rigorous nursing programs. While evidence indicates therapy dogs can decrease stress, no intervention standards exist, and outcomes are usually measured with questionnaires. PURPOSE: The purpose of this research was to enhance empirical evidence supporting a campus therapy dog by explaining the therapy dog's effect on nursing student stress. METHODS: The research used an embedded mixed-methods design. Introductory-level students interacted with a therapy dog on designated days. They measured stress using a smartphone application and Cohen's Perceived Stress Scale. Focus group discussion and program graduate surveys provided qualitative data explaining quantitative results. RESULTS: Results supported use of a campus therapy dog to decrease nursing student stress. CONCLUSIONS: The therapy dog's regular presence on campus may have improved student outcomes by decreasing stress and improving focus.

Willingness to perform induced abortion and associated factors among graduating midwifery, medical, nursing, and public health officer students of University of Gondar, Northwest Ethiopia: institution based cross sectional study.

BACKGROUND: In developing countries, abortion is often unsafe and a significant cause of maternal morbidity and mortality accounting for about 8% (4.7-13.2%) of maternal mortality worldwide. Internationally, safe abortion services are recognized as reducing maternal mortality, and liberalized abortion laws are associated with reduced mortality resulting from unsafe abortion procedures. However, health care providers have moral, social and gender-based reservations that affects their willingness towards providing induced abortion services. The purpose of this study was to assess willingness to perform induced abortion and associated factors among graduating Midwifery, Medical, Nursing, and Public health officer students of University of Gondar. METHODS: Institution based cross sectional study was conducted from March 29 to May 30, 2019. All graduating students available during data collection period were considered as study population. Stratified simple random sampling technique was used to select 424 study participants. Pre tested, semi- structured, self-administered questionnaire was used to collect data. Data analysis was done using SPSS version 20. Ethical clearance was obtained from School of midwifery under the delegation of institutional review board of university of Gondar. RESULTS: Two hundred ninety students out of 424 students were willing to perform induced abortion for indications supported by Ethiopian abortion law, making a proportion of 68.4% (95%Cl: 64.2, 72.9). Sex (Being male (AOR = 4.89, 95%CI: 3.02, 7.89)), religion (being orthodox than protestant (AOR = 10.41, 95%CI: 3.02, 21.57)), being Muslim than protestant (AOR = 5.73, 95%CI: 1.37, 15.92)) and having once or less a week religious attendance (AOR = 2.00, 95% CI: 1.20, 3.34) were factors associated with willingness towards performing induced abortion. CONCLUSIONS: According to this study willingness of students towards providing induced abortion services was good. However female students, protestant followers and those students with more than once a week religious attendance should be encouraged to support women's access to induced abortion services by referring them to other health care professionals willing to provide induced abortion services.

Assessing the preparedness and feasibility of an e-learning pilot project for university level health trainees in Ghana: a cross-sectional descriptive survey.

BACKGROUND: Ghana is challenged with shortage of critical human resources for health particularly nurses and midwives in rural hard-to-reach communities. This shortage potentially hinders efforts towards attaining universal access to basic healthcare. More importantly, poor quality of pre-service training for health trainees has the potential to worsen this predicament. There is therefore the need to leverage emerging digital innovations like e-learning to complement existing efforts. This study was conducted several months before the outbreak of COVID-19 to investigate the preparedness, acceptability and feasibility e-learning innovation for nursing and midwifery trainees. METHODS: The study is a cross-sectional descriptive survey involving nursing and midwifery students (n = 233) in one of Ghana's public universities, located in the Volta region of Ghana. Simple random sampling technique was used to collect responses from eligible respondents using a structured questionnaire. Descriptive statistical analysis was done using STATA software (version 12.0). RESULTS: It was found that nearly 100% of respondents owned smartphones that were used mostly for learning purposes including sharing of academic information. Over 70% of respondents particularly used social media, social networking applications and internet searches for learning purposes. Health trainees were however constrained by low bandwidth and lack of seamless internet connectivity within their learning environments to maximize the full benefits of these e-learning opportunities. CONCLUSION: Respondents were predominantly prepared for an e-learning pilot project. These feability findings suggest e-learning is a huge potential that can be used to augment existing approaches for pre-service training of health trainees in Ghana, when implementation threats are sufficiently addressed. Compelling findings of this study are therefore timely to inform evidence-based policy decisions on innovative digitial solutions for pre-service training of health workforce even as the world adapts to the "new normal" situation induced by COVID-19.

Exploring and developing student midwives' experiences (ESME)-An appreciative inquiry study.

BACKGROUND: There is increased focus on investing in midwifery students as our future workforce. Inquiring into what helps to support an enriched learning experience for student midwives in clinical placements is timely. AIM: To work collaboratively with key stakeholders (student midwives, midwives) in clinical placements to generate an experience-based understanding of what works well in relation to the student midwife experience and from this understanding, co-create ways to enhance students' experiences. DESIGN: An appreciative inquiry approach was used to discover what matters and what works well at present in the student midwife experience from the perspective of student midwives, midwives, and midwifery managers and to use this knowledge to create enhanced experiences in the future. Data were generated across four local health districts in New South Wales, Australia. Data were analysed using immersion crystallisation and then mapped to the 'Senses Framework'. SETTING: Four midwifery units in tertiary teaching public hospitals in NSW. PARTICIPANTS: There were 124 participants in this study: 45 midwifery students and 76 employed midwives. MEASUREMENTS AND FINDINGS: The data culminated in the refinement of the 'Senses Framework' for use in the midwifery learning context. Student midwives and midwives valued experiences that helped them to feel safe, to feel that they belong, to experience continuity in their learning and work, to have a sense of purpose, to have their achievements and their contributions to be recognised and to feel that they matter. Furthermore, the midwives themselves valued the experience of these senses in supporting them to be facilitators of learning in the workplace. The relational framework for learning together in the workplace has the potential to support achievement of the sense of security, belonging, continuity, purpose, achievement and significance for all involved. KEY CONCLUSIONS: There is much to celebrate in what is being achieved currently in promoting excellence in learning experiences in the midwifery context. In particular this study has made conscious the contribution that student midwives and midwives can and do make to enable the positive and reciprocal relationships that develop in the student midwife experience that support the nurturing of enriched learning environments. This study emphasised that learning in the workplace is a relational endeavour, rooted in the day to day engagement between student midwives, midwives and others. By mapping these positive processes to the senses framework these processes are made more explicit and provide guidance for enhancing the learning experience in the midwifery context. IMPLICATIONS FOR PRACTICE: The framework and related inquiry tools developed from the study may be useful in other settings to further test out the impact of this relational approach to learning for student midwives.

Academic caring pedagogy, presence, and Communitas in nursing education during the COVID-19 pandemic.

BACKGROUND: Strong faculty academic human caring presence is paramount during the exponential use of asynchronous, remote learning during the COVID-19 pandemic. PURPOSE: The purpose of this article is to provide a holistic, theoretical foundation for evidence informed-caring pedagogical practices. METHODS: Watson's (2008; 2018) Unitary Caring Science theoretical approach offers one pedagogical caring framework for advancing teaching-learning in the digital age. DISCUSSION: Examples to humanize the virtual classroom and remote or online teaching include narrative, theory-guided pedagogical approaches, such as creation of caring spaces and other modalities to transcend physical distancing and nurture Communitas (caring community) among of faculty and students. CONCLUSION: A theory-guided, holistic caring pedagogical approach supports the needs of both faculty and nursing students.

Exploring the internship experiences of Swedish final term student midwives: A cross-sectional survey.

Today, student midwives in Sweden spend half of their midwifery education at various internships. Practice reality demonstrates that there is an insufficient number of preceptors for the students, and the workload is demanding. Therefore, the present study aimed to explore the experiences of final term Swedish students during their midwifery internship and whether other paedagogical learning experiences beyond the apprenticeship model were included. A cross-sectional survey was distributed to 288 final year midwifery students at all universities offering the midwifery programme in Sweden. This paper focuses on open-ended questions, which were answered by 108 students, and analysed inductively via thematic analysis. Students described an intensive period with pressure during their internship. They expressed a desire for fewer parallel tasks and a better-structured internship. Students revealed that it was both a challenge and stressful to be under constant high performance while practising clinically. Furthermore, students described feelings of competition towards fellow peers in regard to attaining the final number of 50 assisted births. As to the paedagogical methods, the classical preceptorship model with a one-to-one student-preceptor relationship was predominately used. Preceptors were perceived as crucial role models. However, this learning experience was considered suboptimal for learning in the event where preceptors were not engaged or felt insecure regarding their knowledge, or if the preceptor was changed. For the students, the most optimal setting would be if preceptors were selected, trained, and supported in their role to supervise students, instead of being assigned any available preceptor, who was, at times, not a midwife.

Student midwives' knowledge, skills and competency in relation to the active management of the third stage of labour: A correlational study.

BACKGROUND: Lesotho has been experiencing health challenges as indicated by its high maternal mortality ratio of 620 per 100 000 live births for the year 2010, which has been linked to its limited human resources. OBJECTIVES: The knowledge and skills of final-year student nurse-midwives related to the active management of the third stage of labour were determined. METHOD: A quantitative, descriptive survey design was used to conduct this study with 99 final-year midwifery students at four nursing schools in Lesotho using stratified sampling. The structured questionnaire collected data on the knowledge and self-reported competency. Subsequently, the controlled cord traction marks, extracted from the objective structured clinical examination (OSCE), were compared to the self-reported competency of these midwifery students using R software version 3.4.0. RESULTS: The mean score for knowledge and the OSCE was 73.8% (n = 99) and 77.2% (n = 99), respectively. The majority of respondents (95.2%, n = 99) rated themselves highly in terms of the active management of the third stage of labour competency. There was no correlation between the self-reported competency and knowledge (r = 0.08, p = 0.4402), and self-reported competency and OSCE scores (r = -0.004, p = 0.01). CONCLUSION: The high mean scores for the knowledge and the OSCE indicate that the theoretical component of the curriculum on the active management of the third stage of labour was effective in equipping final-year midwifery students with knowledge and skills to carry out this competency.

'The rollercoaster': A qualitative study of midwifery students' experiences affecting their mental wellbeing.

OBJECTIVE: Midwifery student mental wellbeing is an important consideration for the sustainability of the profession, however it has seldom been the subject of empirical research. Previous studies of the lived experience of midwifery students have focused on the impact of transition experiences and student satisfaction, rather than specifically on mental health and students' views on support for their mental wellbeing. DESIGN: A qualitative descriptive study using semi-structured interviews. SETTING: A midwifery undergraduate programme in one university in the South of England. PARTICIPANTS: 20 BSc midwifery students. FINDINGS: Two inductive themes were developed from our analysis. The theme of 'the rollercoaster' encapsulated students' experience over the length of the course, characterised by multiple culture shocks of being in different worlds, from one clinical placement to the next, from university to clinical placement. This experience was emotionally taxing. The theme of 'being noticed, feeling connected' encapsulated midwifery students' views on what could help them enjoy their training. They wanted to be seen as individuals by at least one educator, they wanted opportunities to connect with their peers and they wanted the support available to them to be consistent. CONCLUSIONS: Listening to students' insights into the lived experience of being a midwifery student can enable midwifery educators to improve the way courses are designed and support structures are put in place. The importance of having consistent contact with peers and educators cannot be underestimated. IMPLICATIONS FOR PRACTICE: The emotional demands of midwifery training must be acknowledged. Educators should identify ways in which they can provide students with consistent individualised support and regular opportunities to meet with their peers.