Development and Psychometric Validation of the Perinatal Bereavement Care Competence Scale for Midwives.

PURPOSE: The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties. METHODS: The Perinatal Bereavement Care Competence Scale was developed in four phases. (1) Item generation: 75 items were formulated based on a literature review and interviews with midwives. (2) Delphi expert consultation: 15 experts evaluated whether the items were clear/appropriate/relevant to the questionnaire dimensions, and the items were optimized. (3) Pilot test: The comprehensibility, acceptability, and time required to complete the questionnaire by midwives were assessed. (4) Evaluation of reliability and validity: The scale was validated by initial item analysis, exploratory and confirmatory factor analyses, and internal consistency reliability and test-retest reliability. RESULTS: The final scale consisted of six dimensions and 25 items: maintaining belief (three items), knowing (four items), being with (six items), preserving dignity (four items), enabling (five items), and self-adjustment (three items). Exploratory factor analysis yielded a six-factor structure that was consistent with the theoretical framework and explained 70.8% of the total variance. Confirmatory factor analysis indicated a good fit for the six-factor model. Cronbach's α for the scale was 0.931, and the test-retest reliability coefficient was 0.968. CONCLUSION: The Perinatal Bereavement Care Competence Scale is a valid and reliable instrument for measuring the competence of midwives in caring for bereaved parents who have experienced perinatal loss.

Mindful medical practice: An innovative core course to prepare medical students for clerkship.

BACKGROUND: Medical students show a decline in empathy and ethical reasoning during medical school that is most marked during clerkship. We believe that part of the problem is that students do not have the skills and ways of being and relating necessary to deal effectively with the overwhelming clinical experience of clerkship. APPROACH: At McGill University in Montreal, starting in January 2015, we have taught a course on mindful medical practice that combines a clinical focus on the combination of mindfulness and congruent relating that is aimed at giving students the skills and ways of being to function effectively in clerkship. The course is taught to all medical students in groups of 20, weekly for 7 weeks, in the 6 months immediately prior to clerkship, a time when students are very open to learning the skills they need to take effective care of patients. EVALUATION: The course has been well accepted by students as evidenced by their engagement, their evaluations, and their comments in the essays that they write at the end of the course. In a follow-up session at the simulation centre one year later students remember clearly and enact what they were taught in the course. REFLECTION: The next steps will be to conduct a formal evaluation of the effect of our teaching that will involve a combination of qualitative methods to clarify the nature of the impact on our students and a quantitative assessment of the difference the course makes to students' experience and performance in clerkship.

Perceptions of Spiritual Care Education, Competence, and Barriers in Providing Spiritual Care Among Registered Nurses.

Purpose: The purpose of the study was to explore registered nurses' (RNs) perceptions of their spiritual care competence (SCC), preparedness, and barriers to providing spiritual care and frequency of provision of spiritual care. Additionally, the study aimed to examine associations between spiritual care education, preparedness, competence, and frequency. Method: A descriptive, cross-sectional study included demographic questions, the Spiritual Care Competency scale, the Nurses' Spiritual Care Therapeutics scale, the Spiritual Care Practice questionnaire subscale II, and three open-ended questions. Findings: This online survey was completed by 391 RNs enrolled in postlicensure programs at a public state university in southeastern United States. A majority of participants reported not feeling prepared to provide spiritual care. There were strong associations between receiving spiritual care education in prelicensure programs or at work, and self-reported feelings of preparedness, as well as overall SCC. The level of SCC was positively correlated with spiritual care frequency and number of years working as an RN. Conclusions: The results of this study highlight the need for spiritual care education in prelicensure programs as well as on the job training for RNs.

Community and family nurse: Present keys, future challenges. / Enfermería Familiar y Comunitaria: claves de presente, retos de futuro.

It is the mission of the Community and Family Nurse through an integral and holistic approach to accompany people from cradle to death in developing their health potential, and promote different family, work and social environments to facilitate this development. Throughout history, various international, European and national organizations have regulated the figure of the Community and Family Nurse, and now their functions, powers and professional performance are fully regulated. The Community and Family Nurse can respond to the needs of a changing population and take on new responsibilities in management and research. Their extensive basic and advanced skills gathered under a rigorous training programme, benefit the health system, the nursing profession, citizenry and its communities. Many challenges remain for the Health Departments of each Autonomous Region to make it possible for this specialty to develop its full potential for improving care.

Effectiveness of spiritual care training to enhance spiritual health and spiritual care competency among oncology nurses.

BACKGROUND: Although spiritual care is a basic element of holistic nursing, nurses' spiritual care knowledge and abilities are often unable to satisfy patients' spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care. DESIGN: A nonrandomized controlled trial. OBJECTIVE: To establish a spiritual care training protocol and verify its effectiveness. METHODS: This study recruited 92 nurses at a cancer treatment hospital in a single province via voluntary sign-up. The nurses were divided into two groups-the study group (45 people) and the control (wait-listed) group (47 people)-using a coin-toss method. The study group received one spiritual care group training session every six months based on their routine nursing education; this training chiefly consisted of lectures by experts, group interventions, clinical practice, and case sharing. The control group participated in monthly nursing education sessions organized by the hospital for 12 continuous months. RESULTS: After 12 months of intervention, the nurses in the study group had significantly higher overall spiritual health and spiritual care competency scores as well as significantly higher scores on all individual dimensions compared with those in the control group (P < 0.01). CONCLUSIONS: A spiritual care training protocol for nurses based on the concept of mutual growth with patients enhances nurses' spiritual well-being and spiritual care competencies.

The experiential expertise of primary care midwives in the detection of gender violence during pregnancy. Qualitative study. / El saber experiencial de las matronas de Atención Primaria en la detección de violencia de género durante el embarazo. Estudio cualitativo.

AIM: To use the reflections of primary care midwives to find out the barriers and facilitators for detecting IPV during pregnancy. The second aim is to determine proposals for measures to improve detection of IPV. METHOD: Qualitative methodology with a interpretative phenomenological approach. In-depth interviews were conducted with 12midwives, working in the sexual and reproductive health care centres of Hospitalet de Llobregat (Barcelona). RESULTS: The difficulties in detection relate to the system of visits, the situation of women and barriers of practitioners themselves, such as fear. Follow-up of pregnancy and the relationship of trust with the midwife stand out as facilitators. The proposals for improvement were to increase training and use safe and reliable health care procedures. CONCLUSIONS: The complexity of IPV makes it likely that IPV during pregnancy is undetected. It would be desirable to implement actions such as expanding training and agreeing on an internal work circuit that includes objective instruments to detect IPV, coordination with other services and ethical and legally appropriate way of recording in the clinical record.

"I've Only Just Heard About It": Complementary and Alternative Medicine Knowledge and Educational Needs of Clinical Psychologists in Indonesia.

Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients at risk because clients would then find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, also have the opportunity to provide psychoeducation on the latest scientific CAM research for their clients. The current study aimed to explore knowledge and educational needs regarding CAM among CPs in Indonesia because previous studies on exploring CAM knowledge and educational needs regarding CAM were primarily conducted in Western countries. Materials and Methods: Data were collected through semi-structured face-to-face interviews with 43 CPs in public health centers (PHCs) in Indonesia. Most interviews were conducted at the PHCs where the participants worked and lasted for 55 minutes on average. The interview recordings were transcribed and were analyzed using deductive thematic analysis. Results: Five main themes emerged within participants' responses regarding CAM knowledge and educational needs. First (CAM understanding), participants' responses ranged from those with little or no prior knowledge of CAM treatments and uses, to those with much greater familiarity. Second (source of knowledge), participants' access ranged widely in terms of references, from popular to scientific literature. Third (why is it important?), participants identified CAM as an essential part of Indonesian culture and considered it therefore crucial to have this cultural knowledge. Fourth (the challenges and what is needed?), the challenges for improving participants' knowledge came from personal and institutional levels. Fifth (what and how to learn?), participants advised that only CAM treatments that fit in brief psychotherapy sessions should be introduced in professional training. Conclusions: This qualitative study discovered that CAM was neither well-known nor understood widely. Participants advised that professional associations and health institutions should work together in enhancing knowledge of CAM and incorporating CAM education into psychology education.

A Sequential Mixed-Methods Study of Pre-Professionals' Understanding of the Undergraduate Music Therapy Internship.

Despite the importance of the clinical music therapy internship, little research has been conducted to understand the perspectives, perceived musical, clinical, and personal skills, concerns, challenges, and anxieties of pre-professionals prior to and upon completion of the internship. This sequential mixed-methods study aimed to assess the perspectives and experiences of undergraduate students in the United States at two stages in the internship in music therapy practice. In total, 177 pre-professionals from the United States participated in this two-part study: (1) an online survey and (2) individual interviews with 25% (n = 44) of the participants. Survey results indicate statistically significant increases in clinical, musical, and personal skill development from pre- to post-internship. Six broad categories emerged from the interviews: confidence, anxiety, role clarity, professional suitability, loneliness, and boundaries/ethics. The results are encouraging, showing that the internship is a valued clinical experience that fosters improvement in the clinical, musical, and personal skills needed to work as a music therapist. This paper concludes with recommendations and suggestions for educators and supervisors on preparing and supporting pre-professionals in their skill development prior to and during internship.

Psychometric properties of the Chinese mainland version of the Palliative Care Spiritual Care Competency Scale (PCSCCS-M) in nursing: a cross-sectional study.

BACKGROUND: Spiritual care competencies are among the primary professional skills that enable best practices in nursing. Assessing these competencies and identifying those that are insufficient are important tasks. The traditional Chinese version of the Palliative Care Spiritual Care Competency Scale (PCSCCS) used in Taiwan is a well-validated tool to measure palliative caregivers' competencies in providing spiritual care. However, whether this scale is valid and reliable for use with nurses in other health-care contexts is unknown. The purpose of this study is to determine this version's validity and reliability for use with nurses in mainland China. METHODS: The PCSCCS was first converted into a simplified Chinese version (PCSCCS-M) from the traditional Chinese version used in Taiwan such that mainland nurses could read and understand it easily. Then, the validity and reliability of the PCSCCS-M was evaluated with 400 Chinese nurses recruited using convenience sampling from three university-affiliated comprehensive hospitals, two cancer hospitals, one psychiatric hospital, two traditional Chinese medicine hospitals, one marital and child service care center, and one community health service center. Concurrent validity was assessed using Pearson's correlation coefficients of the PCSCCS-M and the Chinese version of the Spiritual Care-Giving Scale (C-SCGS). Exploratory factor analysis (EFA) was performed to determine the construct validity. Confirmatory factor analysis (CFA) was conducted using another sample of 351 nurses to verify the quality of the factor structures of the PCSCCS-M. An internal consistency test based on Cronbach's alpha coefficient and a stability test based on the Guttman split-half coefficient were also conducted. RESULTS: Useful data were obtained from 356 participants (response rate: 89%). EFA confirmed a three-dimensional structure of the scale after one item was deleted, and the three factors explained 63.839% of the total variance. Cronbach's alpha coefficients of the three subscales were 0.811, 0.889 and 0.896, and the Guttman split-half coefficient for the PCSCCS-M was 0.862. Modified CFA indicated a well-fitting model. The correlation between the PCSCCS-M and C-SCGS was 0.340 (p < 0.01). CONCLUSIONS: The PCSCCS-M is a brief, easy-to-understand, and psychometrically sound measurement tool to evaluate spiritual care competencies in nurses from mainland China.

The Digital Age is Here: Are All Our Physicians Ready?

No Abstract Available.

Complaints about chiropractors, osteopaths, and physiotherapists: a retrospective cohort study of health, performance, and conduct concerns.

Background: Recent media reports have highlighted the risks to patients that may occur when practitioners in the chiropractic, osteopathy and physiotherapy professions provide services in an unethical or unsafe manner. Yet research on complaints about chiropractors, osteopaths, and physiotherapists is limited. Our aim was to understand differences in the frequency and nature of formal complaints about practitioners in these professions in order to inform improvements in professional regulation and education. Methods: This retrospective cohort study analysed all formal complaints about all registered chiropractors, osteopaths, and physiotherapists in Australia lodged with health regulators between 2011 and 2016. Based on initial assessments by regulators, complaints were classified into 11 complaint issues across three domains: performance, professional conduct, and health. Differences in complaint rate were assessed using incidence rate ratios. A multivariate negative binomial regression model was used to identify predictors of complaints among practitioners in these professions. Results: Patients and their relatives were the most common source of complaints about chiropractors, osteopaths and physiotherapists. Concerns about professional conduct accounted for more than half of the complaints about practitioners in these three professions. Regulatory outcome of complaints differed by profession. Male practitioners, those who were older than 65 years, and those who practised in metropolitan areas were at higher risk of complaint. The overall rate of complaints was higher for chiropractors than osteopaths and physiotherapists (29 vs. 10 vs. 5 complaints per 1000 practice years respectively, p < 0.001). Among chiropractors, 1% of practitioners received more than one complaint - they accounted for 36% of the complaints within their profession. Conclusions: Our study demonstrates differences in the frequency of complaints by source, issue and outcome across the chiropractic, osteopathic and physiotherapy professions. Independent of profession, male sex and older age were significant risk factors for complaint in these professions. Chiropractors were at higher risk of being the subject of a complaint to their practitioner board compared with osteopaths and physiotherapists. These findings may assist regulatory boards, professional associations and universities in developing programs that avert patient dissatisfaction and harm and reduce the burden of complaints on practitioners.

Units of Distinction: Creating a Blueprint for Recognition of High-Performing Medical-Surgical Nursing Units.

BACKGROUND: Hospital medical-surgical (M/S) nursing units are responsible for up to 28 million encounters annually, yet receive little attention from professional organizations and national initiatives targeted to improve quality and performance. OBJECTIVE: We sought to develop a framework recognizing high-performing units within our large hospital system. METHODS: This was a retrospective data analysis of M/S units throughout a 168-hospital system. Measures represented patient experience, employee engagement, staff scheduling, nursing-sensitive patient outcomes, professional practices, and clinical process measures. RESULTS: Four hundred ninety units from 129 hospitals contributed information to test the framework. A manual scoring system identified the top 5% and recognized them as a "Unit of Distinction." Secondary analyses with machine learning provided validation of the proposed framework. CONCLUSIONS: Similar to external recognition programs, this framework and process provide a holistic evaluation useful for meaningful recognition and lay the groundwork for benchmarking in improvement efforts.

Defining interdisciplinary competencies for audiological rehabilitation: findings from a modified Delphi study.

OBJECTIVES: The aim of this study is to derive a consensus on an interdisciplinary competency framework regarding a holistic approach for audiological rehabilitation (AR), which includes disciplines from medicine, engineering, social sciences and humanities. DESIGN: We employed a modified Delphi method. In the first round survey, experts were asked to rate an initial list of 28 generic interdisciplinary competencies and to propose specific knowledge areas for AR. In the second round, experts were asked to reconsider their answers in light of the group answers of the first round. STUDY SAMPLE: An international panel of 27 experts from different disciplines in AR completed the first round. Twenty-two of them completed the second round. RESULTS: We developed a competency framework consisting of 21 generic interdisciplinary competencies grouped in five domains and nine specific competencies (knowledge areas) in three clusters. Suggestions for the implementation of the generic competencies in interdisciplinary programmes were identified. CONCLUSIONS: This study reveals insights into the interdisciplinary competencies that are unique for AR. The framework will be useful for educators in developing interdisciplinary programmes as well as for professionals in considering their lifelong training needs in AR.

Exploring global recognition of quality midwifery education: Vision or fiction?

BACKGROUND: Midwifery education is the foundation for preparing competent midwives to provide a high standard of safe, evidence-based care for women and their newborns. Global competencies and standards for midwifery education have been defined as benchmarks for establishing quality midwifery education and practice worldwide. However, wide variations in type and nature of midwifery education programs exist. AIM: To explore and discuss the opportunities and challenges of a global quality assurance process as a strategy to promote quality midwifery education. DISCUSSION: Accreditation and recognition as two examples of quality assurance processes in education are discussed. A global recognition process, with its opportunities and challenges, is explored from the perspective of four illustrative case studies from Ireland, Kosovo, Latin America and Bangladesh. The discussion highlights that the establishment of a global recognition process may assist in promoting quality of midwifery education programs world-wide, but cannot take the place of formal national accreditation. In addition, a recognition process will not be feasible for many institutions without additional resources, such as financial support or competent evaluators. In order to achieve quality midwifery education through a global recognition process the authors present 5 Essential Challenges for Quality Midwifery Education. CONCLUSION: Quality midwifery education is vital for establishing a competent workforce, and improving maternal and newborn health. Defining a global recognition process could be instrumental in moving toward this goal, but dealing with the identified challenges will be essential.

Necesitamos más matronas / No disponible

En España hay actualmente 7073 matronas con un reparto no equitativo en el territorio. Su número se ha mantenido bajo, con un aumento que no ha permitido llegar a las necesidades previstas. La mayoría de las matronas ejercen en el ámbito público. Se accede a la formación como una especialización de enfermería, en régimen de residencia y durante dos años, tras obtener plaza mediante un examen estatal (EIR) en alguna de les 112 unidades docentes públicas de formación repartidas por las diferentes comunidades autónomas. La matrona es una profesional autónoma en la atención al embarazo y el parto fisiológicos y los procesos relacionados con la salud sexual y reproductiva, sobre los que tiene plena responsabilidad en el marco de la interdisciplinariedad (AU)

No disponible

Iranian nurses' professional competence in spiritual care in 2014.

BACKGROUND: The holistic approach views the human as a bio-psycho-socio-spiritual being. Evidence suggests that among these dimensions, the spiritual one is largely ignored in healthcare settings. OBJECTIVES: This study aimed to evaluate Iranian nurses' perceived professional competence in spiritual care, the relationship between perceived competence and nurses' personal characteristics, and barriers to provide spiritual care. RESEARCH DESIGN: A cross-sectional study was conducted in the year 2014. Participants and research context: The study population consisted of nurses working in teaching hospitals in Kashan city. Using a stratified, systematic random method, 250 samples were selected from a total of 1400 nurses. An indigenous instrument was used to assess the nurses' competencies in spiritual care. Ethical considerations: A research ethics committee approved the study. All the participants were briefed on the study aims, were assured of the confidentiality of their personal information, and signed a written informed consent. RESULTS: Among a total of 250 nurses, 239 answered the questionnaire completely, and in total, 23%, 51%, and 26% had poor, moderate, and favorable competence in spiritual care, respectively. No significant differences were found between the mean competence scores of spiritual care in terms of gender, marital status, employment status, and level of qualification. Significant difference was found between nurses' overall score of competence in spiritual care and receiving training on spiritual care, nurses' position, and the ward they worked in. DISCUSSION: Confirming the findings of the international literature, this study puts light on the situation of nurses' perceived competence and barriers to providing spiritual care in Iran as an eastern and Islamic context. CONCLUSION: Three-quarters of the nurses had moderate or unfavorable competence in spiritual care. Due to the crucial role of spiritual care in quality of care and patient satisfaction, nurses should be trained and supported to provide spiritual care.

Hypnosis Training and Education: Distinctive Features of Training Hypnosis Educators.

Much of the field of hypnosis education focuses on what to teach (content) and who to teach (professional identities). A deserving area of focus, and less often addressed, is how to teach basic hypnosis concepts. Worldwide models for teaching hypnosis have mostly included lecture, demonstration, and practice, with little attention paid to the meta-level of educational principles (i.e., what makes an expert trainer). Trainers in hypnosis have been compared to parents: They teach the way they were taught (adults parent the way they were parented). There is a human tendency to repeat what we have experienced. This propensity can be seen while watching the new student use the same induction, in the same way, as his or her first "operator" did when s/he was a subject of his/her first hypnotic experience. Mirroring is a part of all learning, and this article asks what else is needed in faculty education for the trainer to take students beyond mere mimicry to scientifically informed, skilled, and clinically creative uses of hypnosis. This article addresses the unique requirements for teaching hypnosis, reviews a teaching program for clinical hypnosis educators developed by the authors, and looks to future innovations in clinical hypnosis training.

What are the most common domains of the core competencies of disaster nursing? A scoping review.

AIM: Scoping review was conducted to identify the most common domains of the core competencies of disaster nursing. BACKGROUND: Nurses play an essential role in all phases of disaster management. For nurses to respond competently, they must be equipped with the skills to provide comprehensive and holistic care to the populations affected by or at risk of disasters. METHODS: A scoping review was conducted using the Joanna Briggs Institute methodology. The review used information from six databases: the Cumulative Index to Nursing and Allied Health Literature, Ovid MEDLINE, ScienceDirect, ProQuest, Scopus and the Education Resources Information Center. Keywords and inclusion and exclusion criteria were identified as strategies to use in this review. RESULTS: Twelve studies were eligible for result extraction, as they listed domains of the core competencies. These domains varied among studies. However, the most common domains were related to communication, planning, decontamination and safety, the Incident Command System and ethics. CONCLUSION: Knowledge of the domains of the core competencies, such as understanding the content and location of the disaster plan, communication during disaster and ethical issues is fundamental for nurses. Including these domains in the planning and provision of training for nurses, such as disaster drills, will strengthen their preparedness to respond competently to disaster cases. Nurses must be involved in future research in this area to explore and describe their fundamental competencies in each domain.

Fitness to practise will be fit for the future.

The Nursing and Midwifery Council is often in the news, and most coverage relates to outcomes of our fitness to practise (FtP) hearings.