Multiprofessional team perception of a music therapeutic workshop developed by nurses.

OBJECTIVE: To understand the perception of a multiprofessional team regarding the use of music in a therapeutic workshop developed by nurses. METHOD: Qualitative study, of the exploratory type. Data were collected through semi-structured interviews, with the participation of 13 professionals from a Psychosocial Care Center in a municipality of Minas Gerais' Zona da Mata, and analyzed according to Michel Maffesoli's comprehensive sociology approach. RESULTS: The testimonies revealed that the use of music in the nurse's activities in mental health represents a re-signification of nursing care and favors the user's subjectivity. FINAL CONSIDERATIONS: This study allowed us to show that nurses need to listen to the music that comes from the heart, from the soul, and to the truths that are not always stated in the scenarios of therapeutic practices with individuals going through psychic suffering. Therefore, the care offered should be centered on the human history, which wants to be unveiled and understood.

Multiprofessional team perception of a music therapeutic workshop developed by nurses / Percepción del equipo multiprofesional sobre el taller terapéutico de música desarrollado por enfermero / Percepção da equipe multiprofissional sobre oficina terapêutica de música desenvolvida pelo enfermeiro

ABSTRACT Objective: To understand the perception of a multiprofessional team regarding the use of music in a therapeutic workshop developed by nurses. Method: Qualitative study, of the exploratory type. Data were collected through semi-structured interviews, with the participation of 13 professionals from a Psychosocial Care Center in a municipality of Minas Gerais' Zona da Mata, and analyzed according to Michel Maffesoli's comprehensive sociology approach. Results: The testimonies revealed that the use of music in the nurse's activities in mental health represents a re-signification of nursing care and favors the user's subjectivity. Final considerations: This study allowed us to show that nurses need to listen to the music that comes from the heart, from the soul, and to the truths that are not always stated in the scenarios of therapeutic practices with individuals going through psychic suffering. Therefore, the care offered should be centered on the human history, which wants to be unveiled and understood.

RESUMEN Objetivo: Comprender la percepción de los profesionales del equipo multiprofesional sobre el uso de la música en un taller terapéutico desarrollado por enfermero. Método: Estudio cualitativo de tipo exploratorio. Los datos fueron recolectados por medio de entrevistas semiestructuradas, con la participación de 13 profesionales de un Centro de Atención Psicosocial en un municipio de la Zona de la Mata de Minas Gerais, y después analizados desde la sociología comprensiva de Michel Maffesoli. Resultados: Los testimonios demostraron que el uso de la música en las actividades del enfermero en salud mental representa una resignificación de las líneas de cuidados de enfermería y le favorece la subjetividad del usuario. Consideraciones finales: Este estudio señala que el enfermero necesita oír la música que viene del corazón, del alma y de las verdades que ni siempre se dicen en los escenarios de prácticas terapéuticas con individuos en sufrimiento psíquico. Por lo tanto, el cuidado ofrecido debe ser centrado en la historia humana que nos invita a desvelarla y comprenderla.

RESUMO Objetivo: Compreender a percepção dos profissionais da equipe multiprofissional sobre o uso da música em oficina terapêutica desenvolvida pelo enfermeiro. Método: Estudo qualitativo, do tipo exploratório. Os dados foram coletados por meio de entrevistas semiestruturadas, com a participação de 13 profissionais de um Centro de Atenção Psicossocial em um município da Zona da Mata Mineira, e analisados seguindo-se o referencial da sociologia compreensiva, de Michel Maffesoli. Resultados: Os depoimentos revelaram que o uso da música nas atividades do enfermeiro em saúde mental representa uma ressignificação das linhas de cuidados de enfermagem e favorece a subjetividade do usuário. Considerações finais: Este estudo possibilitou evidenciar que o enfermeiro precisa ouvir a música que vem do coração, da alma e das verdades nem sempre proferidas nos cenários de práticas terapêuticas com indivíduos em sofrimento psíquico. Portanto, o cuidado ofertado deve ser centrado na história humana que convida a ser desvelada e compreendida. Descritores: Enfermeiros; Música; Saúde Mental; Serviços de Saúde Mental; Cuidados de Enfermagem.

Survivorship Fellowship: Evaluation and Evolution of a Program for Advanced Practice Providers.

A comprehensive cancer center in the midwestern United States implemented a stakeholder-engaged quality improvement process to extend its existing one-year advanced practice provider (APP) fellowship program consisting of general oncology education and clinical experience to include an additional survivorship clinical rotation. APP fellowship alumni and program stakeholders reported noticeable benefits and greater importance attributed to program participation, validating inclusion of a survivorship clinic rotation as part of the fellowship program.

Developing and evaluating an online learning tool to improve midwives' accuracy of visual estimation of blood loss during waterbirth: An experimental study.

OBJECTIVE: The principal objective was to test the effectiveness of an online learning tool to improve midwives' accuracy of blood loss estimations in a birthing pool environment. The secondary objective was to assess the acceptability of the online learning tool to the midwives using it. DESIGN: A one group pre-test, post-test experiment with immediate and six weeks follow-up to test ability together with an online questionnaire to assess perceived usefulness of an online learning tool. SETTING: A large NHS maternity hospital comprising an acute care obstetric unit, a small district unit labour ward, one alongside midwifery-led unit and three freestanding midwifery-led units. PARTICIPANTS: Volunteer NHS employed midwives who had experience in caring for women labouring and giving birth in water (n = 24). INTERVENTION: An online learning tool comprising six randomly ordered short video simulations of blood loss in a birthing pool in real time, and a tutorial giving verbal and pictorial guidance on making accurate blood loss estimations in water was developed then piloted. Midwives' accuracy scores for estimating blood loss in each of the videos were calculated at three timepoints; pre and immediately post the learning component, and six weeks later. The estimated blood loss volume was subtracted from the actual blood loss volume, to give the difference between estimated and real blood loss in millilitres (ml) which was then converted to percentage difference to standardise comparison across the six volumes. The differences between pre- and post-learning for each of the six blood volumes was analysed using a repeated measures ANOVA. Statistical significance was set at p < 0.05. An online questionnaire incorporated questions using Likert scales to gauge confidence and competence and free text. Free text responses were analysed using a modified form of inductive content analysis. FINDINGS: Twenty-two midwives completed the online learning and immediate post-test, 14 completed a post-test after six weeks, and 15 responded to the online questionnaire. Pre-test results showed under-estimation of all blood loss volumes and particularly for the two largest volumes (1000 and 1100 ml). Across all volumes, accuracy of estimation was significantly improved at post-test 1. Accuracy diminished slightly, but overall improvement remained, at post-test 2. Participants rated the online tool positively and made suggestions for refining it. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This is the first study measuring the accuracy of midwives' blood loss estimations in a birthing pool using real-time simulations and testing the effectiveness of an online learning tool to improve this important skill. Our findings indicate a need to develop interventions to improve midwives' accuracy at visually estimating blood loss in water, and the potential of an online approach. Most women who labour and/or give birth in water do so in midwifery-led settings without immediate access to medical support. Accuracy in blood loss estimations is an essential core skill.

Staff perception of the sustainability of a mature simulation program in nursing and midwifery education: A phenomenological analysis.

BACKGROUND: As an established pedagogy for teaching clinical nursing skills, the use of simulation in nursing and midwifery education continues to increase globally. In Australia, government incentives for staff development, capital equipment and scenario provided initial impetus for introducing simulation into nursing programs. However, a mature simulation program requires ongoing investment in staff and resources. Without appropriate commitment from educators and organisations, a likely decline in the quality of simulation activities may have a direct impact on student learning. PURPOSE: This study sought to explore the views and experiences of nursing and midwifery academics involved in delivering a simulation-based education program in a maturation phase. METHOD: In this qualitative study, interpretative phenomenological analysis was used to inform data collection and analysis. Data were collected through semi-structured audio-recorded interviews with 10 faculty staff in a tertiary school of nursing and midwifery. RESULTS: Four main themes related to simulated learning were abstracted from the data: perceptions and reactions, inconsistent customs, pedagogy of simulation-based education, and collateral opportunities. The findings are located within the context of a maturation, rather than introductory, phase of delivering simulation-based education in a tertiary education setting. CONCLUSIONS: A mature simulation program may be undermined by ageing equipment and scenarios, and facilitators whose skills have not been maintained. Existing simulation activities require ongoing organisational support and investment. The development and introduction of minimum competency levels for facilitators and standardised measures of quality in practice are indicated, to improve simulation practice in the education setting.

Training in diabetes education: meanings attributed by primary care nurses.

OBJECTIVE: seize meanings attributed by primary care nurses to training in diabetes education. METHOD: exploratory and descriptive study, with a qualitative approach, with twenty primary care nurses; semistructured interview script, with interviews processed in the IRaMuTeQ software and analyzed through the Descending Hierarchical Classification. The results were subsidized in the Representational Theory of Meaning. RESULTS: nurse training in diabetes education is insufficient for holistic action, although it allows the community to be instrumentalized in specific issues about the disease, using the limited tools available, especially lectures. Nurses find themselves in a context of challenges, improvisations, weaknesses, and limitations that determine the meaning attributed to diabetes education and subsequent actions. CONCLUSION: the meanings attributed by the nurses revealed an incipient training, which limits the quality of care provided and instigates the search for qualification.

Study circles in hospitals' obstetrics centers as a teaching-learning strategy in midwifery education.

We describe the experience of study circles on the theme 'good obstetrics practices backed by scientific evidence' and argue that they prepared midwifery students to dialogue with hospital staff and empowered them in the process of negotiating the implementation of practices put forward by the International Confederation of Midwives (ICM). We conclude that study circles are an efficient strategy of preparing midwifery students to be active participants in the maternity care team and lead discussions of evidenced-based practice.

The Personal and Professional Experiences of Integrative Nurse Coach Certificate Program Graduates: A Pilot Study.

Integrative Nurse Coaching is a new practice in professional nursing. The purpose of this pilot study is to describe Integrative Nurse Coach Certificate Program graduates' personal and professional experiences. This is a qualitative, pilot study with a convenience sample of Integrative Nurse Coach Certificate Program graduates ( n = 13). Researchers conducted semistructured interviews and identified common themes. The pilot study found four common themes from the participants' experiences as follows: (1) development of self, (2) enriched self-care, (3) a call to action for facilitating the health care paradigm shift, and (4) incorporating Integrative Nurse Coaching into practice. The pilot study's findings and conclusions provide insight into the potential benefits of Integrative Nurse Coaching and the importance of nurse self-care.

Holistic Nursing Simulation: A Concept Analysis.

Simulation as a technology and holistic nursing care as a philosophy are two components within nursing programs that have merged during the process of knowledge and skill acquisition in the care of the patients as whole beings. Simulation provides opportunities to apply knowledge and skill through the use of simulators, standardized patients, and virtual settings. Concerns with simulation have been raised regarding the integration of the nursing process and recognizing the totality of the human being. Though simulation is useful as a technology, the nursing profession places importance on patient care, drawing on knowledge, theories, and expertise to administer patient care. There is a need to promptly and comprehensively define the concept of holistic nursing simulation to provide consistency and a basis for quality application within nursing curricula. This concept analysis uses Walker and Avant's approach to define holistic nursing simulation by defining antecedents, consequences, and empirical referents. The concept of holism and the practice of holistic nursing incorporated into simulation require an analysis of the concept of holistic nursing simulation by developing a language and model to provide direction for educators in design and development of holistic nursing simulation.

Training in diabetes education: meanings attributed by primary care nurses / Formación en educación en diabetes: significados atribuidos por enfermeros de atención primaria / Formação em educação em diabetes: significados atribuídos por enfermeiros da atenção primária

ABSTRACT Objective: seize meanings attributed by primary care nurses to training in diabetes education. Method: exploratory and descriptive study, with a qualitative approach, with twenty primary care nurses; semistructured interview script, with interviews processed in the IRaMuTeQ software and analyzed through the Descending Hierarchical Classification. The results were subsidized in the Representational Theory of Meaning. Results: nurse training in diabetes education is insufficient for holistic action, although it allows the community to be instrumentalized in specific issues about the disease, using the limited tools available, especially lectures. Nurses find themselves in a context of challenges, improvisations, weaknesses, and limitations that determine the meaning attributed to diabetes education and subsequent actions. Conclusion: the meanings attributed by the nurses revealed an incipient training, which limits the quality of care provided and instigates the search for qualification.

RESUMEN Objetivo: aprehender significados atribuidos por enfermeros de atención primaria a la formación en educación en diabetes. Método: estudio exploratorio y descriptivo, de abordaje cualitativo, con veinte enfermeros de atención primaria; guía semi-estructurado de entrevista con testimonios procesados en el software IRaMuTeQ y analizados por medio de la Clasificación Descendente Jerárquica. Los resultados fueron subsidiados en la Teoría Representacional de Significado. Resultados: la formación del enfermero en la educación en diabetes es insuficiente para la actuación holística, aunque permita instrumentalizar a la comunidad en cuestiones puntuales sobre la enfermedad, utilizando las limitadas herramientas disponibles, sobre todo las conferencias. Los enfermeros se ven en un contexto de desafíos, improvisaciones, fragilidades y limitaciones, determinantes para el significado atribuido a la educación en diabetes y para acciones subsiguientes. Conclusión: los significados atribuidos por los enfermeros revelaron una formación incipiente, lo que limita la calidad de la asistencia prestada e instiga la búsqueda por calificación.

RESUMO Objetivo: apreender significados atribuídos por enfermeiros da atenção primária à formação em educação em diabetes. Método: estudo exploratório e descritivo, de abordagem qualitativa, com vinte enfermeiros da atenção primária; roteiro semiestruturado de entrevista, com depoimentos processados no software IRaMuTeQ e analisados por meio da Classificação Hierárquica Descendente. Os resultados foram subsidiados na Teoria Representacional do Significado. Resultados: a formação do enfermeiro na educação em diabetes é insuficiente para atuação holística, embora permita instrumentalizar a comunidade em questões pontuais acerca da doença, utilizando-se das limitadas ferramentas disponíveis, sobretudo palestras. Os enfermeiros se veem num contexto de desafios, improvisações, fragilidades e limitações, determinantes para o significado atribuído à educação em diabetes e para ações subsequentes. Conclusão: os significados atribuídos pelos enfermeiros revelaram uma formação incipiente, o que limita a qualidade da assistência prestada e instiga a busca pela qualificação.

Evaluation of a bespoke training to increase uptake by midwifery teams of NICE Guidance for membrane sweeping to reduce induction of labour: a stepped wedge cluster randomised design.

BACKGROUND: National guidance recommends pregnant women are offered membrane sweeping at term to reduce induction of labour. Local audit suggested this was not being undertaken routinely across two maternity units in the West Midlands, UK between March and November 2012. METHODS: Bespoke training session for midwifery teams (nine community and one antenatal clinic) was developed to address identified barriers to encourage offer of membrane sweeping, together with an information leaflet for women and appointment of a champion within each team. The timing of training session on membrane sweeping to ten midwifery teams was randomly allocated using a stepped wedge cluster randomised design. All women who gave birth in the Trusts after 39 + 3/40 weeks gestation within the study time period were eligible. Relevant anonymised data were extracted from maternity notes for three months before and after training. Data were analysed using a generalised linear mixed model, allowing for clustering and adjusting for temporal effects. Primary outcomes were number of women offered and accepting membrane sweeping and average number of sweeps per woman. Sub-group comparisons were undertaken for adherence to Trust guidance and potential influence of pre-specified maternal characteristics. Data included whether sweeping was offered but declined and no record of membrane sweeping. RESULTS: Training was given to all teams as planned. Analyses included data from 2787 of the 2864 (97%) eligible low-risk women over 39 + 4 weeks pregnant. Characteristics of the women were similar before and after training. No evidence of difference in proportion of women being offered and accepting membrane sweeping (44.4% before training versus 46.8% after training (adjusted relative risk [aRR] = 0.90, 95% confidence interval [CI] = 0.71-1.13), nor in average number of sweeps per woman (0.603 versus 0.627, aRR = 0.83, 95% CI = 0.67-1.01). No differences in any secondary outcomes nor influence of maternal characteristics were demonstrated. The midwives evaluated training positively. CONCLUSIONS: This stepped wedge cluster trial enabled randomised evaluation within a natural roll-out and demonstrates the importance of robust evaluation in circumstances in which it is rarely undertaken. While the midwives evaluated the training positively, it did not appear to change practice. TRIALS REGISTRATION: ISRCTN14300475 . Registered on 23 August 2016.

Effectiveness of an Evidence-Based Practice Nurse Mentor Training Program.

BACKGROUND: Multiple reasons are cited for why nurses do not incorporate evidence into clinical practice, including lack of knowledge and skills, training, time, and organizational support. AIMS: To investigate the effectiveness of a mentor training program on mentors' perceptions of knowledge, attitude, skill, and confidence levels, and organizational readiness related to evidence-based practice (EBP) and research utilization; and to investigate the effectiveness of creating a formalized structure to enculturate EBP in order to prepare nurses to incorporate EBP into clinical practice on nurses' perceptions of knowledge, attitude, skill levels, barriers, nursing leadership, and organizational support related to EBP and research utilization. METHODS: A two-group pretest-posttest quasi-experimental, interventional design was used. A convenience sample of 66 mentors and 367 nurses working at a five hospital integrated healthcare system located in the Southeastern United States participated. FINDINGS: Nurse mentors' knowledge, attitude, skill level, and organizational readiness related to EBP, t = -8.64, p < .001, and confidence, t = -6.36, p < .001, improved after training. Nurses' knowledge, attitude, and skill level related to EBP, t = -19.12, p < .001, and barriers to research utilization, t = 20.86, p < .001, EBP work environment t = -20.18, p < .001, and EBP nurse leadership, t = -16.50, p < .001, improved after a formalized structure was implemented. LINKING EVIDENCE TO ACTION: EBP mentors are effective in educating and supporting nurses in evidence-based care. Leaders should use a multifaceted approach to build and sustain EBP, including developing a critical mass of EBP mentors to work with point of care staff.

Sustaining Nursing and Midwifery Grand Rounds in a Regional Australian Health Service.

This article reports the success, or otherwise, of strategies implemented to sustain nursing grand rounds in a large regional health service in North Queensland, Australia. Nursing grand rounds had been introduced in late 2010 to increase nurses' engagement with research and evidence-based practice. Although the format, topics, and purpose of grand rounds have changed, attendees continue to positively evaluate each presentation. However, after 5 years, the initiative has expanded and somewhat modified its focus. This article describes these changes and proposes options for the future progression of this professional development activity. J Contin Educ Nurs. 2016;47(7):316-320.

Holistic Nursing in the Genetic/Genomic Era.

Holistic nursing practice is an ever-evolving transformative process with core values that require continued growth, professional leadership, and advocacy. Holistic nurses are required to stay current with all new required competencies, such as the Core Competencies in Genetics for Health Professional, and, as such, be adept at translating scientific evidence relating to genetics/genomics in the clinical setting. Knowledge of genetics/genomics in relation to nursing practice, policy, utilization, and research influence nurses' responsibilities. In addition to holistic nursing competencies, the holistic nurse must have basic knowledge and skills to integrate genetics/genomics aspects. It is important for holistic nurses to enhance their overall knowledge foundation, skills, and attitudes about genetics to prepare for the transformation in health care that is already underway. Holistic nurses can provide an important perspective to the application of genetics and genomics, focusing on health promotion, caring, and understanding the relationship between caring and families, community, and society. Yet there may be a lack of genetic and genomic knowledge to fully participate in the current genomic era. This article will explore the required core competencies for all health care professionals, share linkage of holistic nurses in practice with genetic/genomic conditions, and provide resources to further one's knowledge base.

A framework to support the revalidation process.

In January 2016, all registered nurses and midwives will be required to revalidate their practice every three years. This will have implications for individual registrants and line managers. In May 2014 the chief nursing officer for Wales launched a new governance framework for post-registration nurse education in Wales. This article describes the framework, how it underpins a continuous cycle of improvement in care delivery, and how it could be used to support nurses and nurse managers to meet the requirements of the revalidation process.

Needs of labor and delivery nurses caring for women undergoing pregnancy termination.

OBJECTIVE: To explore the psychosocial, educational, and administrative support needs of labor and delivery (L&D) nurses who care for women undergoing pregnancy termination. DESIGN: A qualitative, descriptive design. SETTING: This study was conducted on a L&D unit at a large, university-affiliated hospital in Quebec, Canada. PARTICIPANTS: A convenience sample of 10 L&D nurses participated in this study. Ages of participants ranged from 25 to 55 years, and experience on the unit ranged from 1 to 30 years. METHODS: One-time, face-to-face interviews were conducted with each participant. Audio-recorded interviews were transcribed verbatim and analyzed using inductive content analysis. RESULTS: Participants valued interpersonal support from nurse colleagues and guidance from experienced nurses in managing the emotional aspect of this care. They raised concerns about the effect of nursing workload and patient-to-nurse ratios on patient care. Nurses noted a desire for knowledge and skill-building through access to evidence-based literature, continuing education sessions, and workshops. They also expressed a need for more information regarding the genetic counseling process and community resources available to women undergoing pregnancy termination. CONCLUSION: Ensuring continuity of care through knowledge sharing related to genetic counseling and community resources creates the context for holistic patient care. Increased attention to the particular needs of L&D nurses providing care to women undergoing termination may enhance the quality and safety of care for this unique population.

Web Site de Insuficiencia Cardiaca como propuesta de educación en salud / Web Site de Insuficiência Cardíaca como proposta de educação em saúde / Website of heart failure as a proposal of education for health

Es un estudio que propone como alternativa de intervención de enfermería la creación de un sitio web, con informaciones educativas para pacientes con insuficiencia cardiaca. Tuvo como objetivos específicos describir el proceso de la creación del sitio de web y validar el contenido por profesionales de la salud y pacientes. Para esto, utilizó una metodología descriptiva con abordaje cualitativo dividido en tres fases: definición del contenido, estructuración y validación del sitio web. El resultado general de las evaluaciones de los profesionales del área de la salud demostró la puntuación media de 51,25 (93,18%) y para los pacientes la puntuación media fue de 44,25 (98,33%). Por lo tanto, fue clasificada como bien elaborada y logró los objetivos propuestos. Se puede concluir que el sitio web es una alternativa de intervención para aumentar la adhesión al tratamiento y mejorar la calidad de vida de pacientes con insuficiencia cardiaca. Así, podrán reducirse las hospitalizaciones y posibles complicaciones derivadas de la insuficiencia cardiaca a través de la difusión de las informaciones y en la educación de la población (AU)

Trata-se de uma pesquisa que propôs como alternativa de intervenção de enfermagem a criação de um web site, com informações educativas para pacientes com Insuficiência Cardíaca. Teve como objetivos específicos descrever o processo de criação do web site e validar o conteúdo por profissionais de saúde e pacientes. Para isso, utilizou metodologia descritiva com abordagem qualitativa dividida em 3 fases: definição do conteúdo, estruturação e validação do web site. O resultado geral das avaliações dos profissionais da área de saúde demonstrou o escore médio de 51,25 (93,18%) e para os pacientes o escore médio foi de 44,25 (98,33%). Portanto, foi classificado como bem elaborado e atingiu os objetivos propostos. Conclui-se que o site é uma alternativa de intervenção para aumentar a adesão ao tratamento e melhorar a qualidade de vida de pacientes com insuficiência cardíaca. Assim, poderá reduzir as internações e possíveis complicações decorrentes da insuficiência cardíaca através da difusão das informações e na educação da população

It is a study that proposes as an alternative of intervention of nursing the creation of a website, with educative information to heart failure patients. Objectives: To describe the process of the creation of the website and to validate the content by health professionals and patients. It was carried out a descriptive methodology with qualitative boarding divided in three phases: definition of content, structure and validation of the website. The general result of the evaluation of the professionals in the field of health showed the average score of 51.25 (93.18%), and for the patients the average score was 44.25 (98.33%). Therefore, it was classified as well elaborated and it achieved the proposed objectives. To conclude, it can be said that the website in an alternative of intervention to increase the acceptance of the treatment and to improve the quality of life of heart failure patients. In this way, the hospitalizations and the possible complications from the heart failure could be reduced through the diffusion of the information and the education of the population (AU)

Efficacy of a self-study programme to teach spiritual care.

AIM AND OBJECTIVES: This study investigated the efficacy of a self study programme designed to teach nurses about how to talk with patients about spirituality, and to identify factors predicting this learning. Furthermore, the study investigated whether there were differences in learning between students and practicing clinicians, and between those in a religious or non-religious institution. BACKGROUND: Although USA and UK accrediting bodies mandate nurses learn how to assess and support patient spiritual health, there is a paucity of evidence to guide educators regarding how to teach spiritual care to nurses. Indeed, it is unknown if aspects of spiritual care can be taught using formal approaches. DESIGN: A pretest-posttest pre-experimental design was used to study how attitude toward spiritual care, ability to create empathic verbal responses to expressed spiritual pain, personal spiritual experience, and knowledge about communication for spiritual caregiving changed from before to after programme completion. METHODS: Study participants, 201 nursing students and RNs, independently completed the mailed self-study programme (i.e. workbook with supplemental DVD) and self-report study instruments (i.e. Daily Spiritual Experience Scale, Spiritual Care Perspective Scale-Revised, Response Empathy Scale, Communicating for Spiritual Care Test, and Information about You form). RESULTS: Significant differences were seen between the before and after scores measuring attitude, ability, spiritual experience, and knowledge. An interaction effect of time between students and registered nurses for both spiritual care attitude and personal spiritual experience was observed. CONCLUSIONS: Findings suggest learning occurred for both students and RNs, regardless of whether they were at a religious institution or not. Relevance to clinical practice. These data indicate that this self-study programme was an effective approach to teach nurses about how to converse with patients about spirituality.

Evaluating international clinical education encounters in Lithuania.

BACKGROUND: Since the fall of the Soviet Union in 1991, nurses from various countries have organized clinical education sessions in Lithuania to share expertise. Evaluation of these sessions has not been completed or disseminated. This study provides an evaluation of international continuing nursing education sessions in Lithuania. METHODS: In the late 1990s, a group of nurses and health care professionals from a local college conducted educational symposia for Lithuanian nurses. Those who participated in at least one symposium were asked to complete questionnaires regarding the educational experience. A holistic framework was used to describe the experiences of U.S. and Lithuanian nurses. RESULTS: Descriptive statistics indicated the Lithuanian nurses confirmed or learned new information and adapted it to their practice. The educational material was less challenging in the larger town of Kaunas than in the smaller area of Vilkaviskis. Suggestions for improvement included teaching in smaller groups to encourage discussion and, for the U.S. nurses, acquiring more information about the Lithuanian culture before the teaching trip. CONCLUSIONS: The goals of the symposia, to share knowledge and establish lasting relationships with Lithuanian nurses, were met. In addition, participants provided important advice for future educational trips.