Behavioural sleep problems in children and adults with intellectual disabilities: An integrative literature review.

BACKGROUND: People with intellectual disabilities are more likely to experience sleep problems, which can affect quality of life, physical health, mental health and well-being. METHODS: An integrative literature review was conducted to investigate what is known about behavioural sleep disturbances in people with an intellectual disability. The search used the following databases: Scopus, PsycInfo and Cinahl, to find papers published since 2015. RESULTS: Within intellectual disability research, sleep appears as a common issue due to its high prevalence, negative relationships with an individual's physical and mental health, their quality of life, and impact of sleep problems on family or carers. The growing evidence base appears to support the use of behavioural, lifestyle and pharmacological interventions to improve sleep in people with an intellectual disability. CONCLUSION: A wide array of literature provides evidence that people with intellectual disabilities are affected by and need support with their sleep.

Nutrition knowledge among university students in the UK: a cross-sectional study.

OBJECTIVE: To investigate nutrition knowledge (NK) in university students, potential factors affecting knowledge and predictors of good NK. DESIGN: A cross-sectional study was conducted in 2017-2018. The revised General Nutrition Knowledge Questionnaire was administered online to assess overall NK and subsections of knowledge (dietary recommendations, nutrient sources of foods, healthy food choices and diet-disease relationships). The Kruskal-Wallis test was used to compare overall NK scores according to sex, age, ethnicity, field of study, studying status, living arrangement, being on a special diet and perceived health. Logistic regression was performed to identify which of these factors were associated with a good level of NK (defined as having an overall NK score above the median score of the sample population). SETTING: Two London-based universities. PARTICIPANTS: One hundred and ninety students from various academic disciplines. RESULTS: The highest NK scores were found in the healthy food choices (10 out of 13 points) and the lowest in the nutrient sources of foods section (25 out of 36 points). Overall NK score was 64 out of 88 points, with 46·8 % students reaching a good level of knowledge. Knowledge scores significantly differed according to age, field of study, ethnicity and perceived health. Having good NK was positively associated with age (OR = 1·05, (95 % CI 1·00, 1·1), P < 0·05), White ethnicity (OR = 3·27, (95 % CI 1·68, 6·35), P < 0·001) and health rating as very good or excellent (OR = 4·71, (95 % CI 1·95, 11·4), P < 0·05). CONCLUSIONS: Future health-promoting interventions should focus on increasing knowledge of specific nutrition areas and consider the personal and academic factors affecting NK in university students.

The impact of nutrition on sleep in people with an intellectual disability: An integrative literature review.

BACKGROUND: People with intellectual disabilities are more likely to experience sleep problems. Sleep can impact on health and well-being; therefore, evidence-based interventions are required to improve sleep in this population. METHOD: An integrative literature review was conducted on the impact of nutrition on sleep in people with intellectual disabilities. Following screening of papers (n = 289), 14 papers met the inclusion criteria. RESULTS: Themes related to nutrition and improved overall well-being, use of nutritional supplements, specific foods, links to health comorbidities and food fussiness. CONCLUSION: This is the first comprehensive review completed on nutritional interventions to improve sleep in people with intellectual disabilities. Dietary patterns may be an important factor to improving the quality and quantity of sleep. However, the current literature regarding the benefit of improved nutrition on sleep in people with an intellectual disability needs to be interpreted with caution.

Rationale and Design of an Online Educational Program Using Game-Based Learning to Improve Nutrition and Physical Activity Outcomes Among University Students in the United Kingdom.

OBJECTIVE: To assess the impact of an online game-based educational program on nutrition knowledge and dietary and physical activity habits among university students in the United Kingdom. DESIGN: Randomized controlled trial with pre- and postintervention comparisons. SETTING: Two higher education settings in London, UK. SUBJECTS: Current undergraduate and postgraduate students of two universities (n = 88) aged 18-34 years are randomly allocated to an intervention (n = 44) or a control group (n = 44). INTERVENTION: The intervention group will receive access to an educational website and online quizzes with gamification elements, including information about healthy eating and physical activity. The control group will receive no information. Duration of the intervention will be 10 weeks. MEASURES OF OUTCOME: Primary outcome is nutrition knowledge. Secondary outcomes include dietary and activity habits. Nutrition knowledge and dietary and activity habits will be assessed using questionnaires. Weekly steps will be counted using pedometers. Assessment of anthropometric and metabolic risk factors will take place. ANALYSIS: Quantitative analysis will investigate changes in nutrition knowledge between the two groups of the study population. Linear regression analysis will be used, if the data follow the normal distribution (otherwise binomial regression analysis), to examine whether field of study, residence status, body mass index (BMI), and demographic factors affect nutrition knowledge. Associations between changes in knowledge and dietary and physical activity behavior will be assessed by correlations. CONCLUSIONS/IMPLICATIONS: The study will provide insights with regard to the design and use of online game-playing as a cost-effective approach to improve nutritional knowledge among university students.

Clinical reasoning amongst paramedics using nebulised ß2 agonists to treat acute asthma exacerbations: a qualitative study.

The heterogeneous nature of asthma results in a wide range of presentations during exacerbation. Despite UK pre-hospital management guidelines focusing on ß2 agonists, variables such as cause, severity, underlying health, comorbidities, and drug side effects can often make emergency treatment optimisation difficult. This article examines paramedics' methods of observing, perceiving, interpreting, and treating asthma with ß2 agonists, often acting on limited information in rapidly evolving situations. We recruited paramedics from a single UK National Health Service ambulance Trust for qualitative semi-structured interviews. Responses underwent framework analysis to identify data similarities and differences. Fifteen qualitative interviews with paramedics revealed three main themes affecting patient management: clinician experience of presentation, adaptation of patient management approaches, and severity of side effects. Paramedics felt their ability to manage various asthma presentations was enhanced through guideline adaptation based on their own clinical experience and understanding of ß2 agonist side effects, allowing tailored responses based on a set of reinforcing factors. Inductive analysis revealed additional complexities within these themes, such as anxiety and diabetes, which may influence ß2 agonist administration and result in multiple care pathways being initiated during exacerbation. Paramedic care mirrors asthma's complexity, accounting for a range of characteristics. A dynamic, critically thought approach enables patient management to be based on the presenting conditions rather than strict adherence to a single algorithm. Comprehending the complexities and variables in treatment can be crucial to how paramedics rationalise their treatment and optimise the care provided.

A preceptorship programme for health visitors and school nurses: a pilot study.

This article presents a pilot study that was undertaken into the perceptions of newly qualified health visitors and school nurses of a structured preceptorship programme. The preceptorship programme involved each participant identifying personal goals and objectives linked to their appraisal, and participating in an action learning set over the first year following qualification. As part of the programme, each participant completed a work-related project. A named senior member of the trust acted as a preceptor facilitator. A mixed-method evaluative study was undertaken into this pilot project. Findings of the pilot showed that the majority of the participants were positive about the impact, value, quality and sustainability of preceptorship and also valued the role of the preceptor facilitator, the project and the action learning sets. The health visitors and school nurses also felt they gained in confidence, competence and leadership skills.

Interventions to enhance the research productivity of academic staff in higher education schools of nursing: A systematic review.

AIM: Synthesize and present peer-reviewed evidence of interventions that enhance the research productivity of academics in Schools of Nursing in Higher Education Institutions. BACKGROUND: Pressures on academics in Schools of Nursing worldwide to increase or maintain high research productivity persist and numerous Higher Education Institutions across the world have developed interventions to increase productivity. Given evidence that the COVID-19 pandemic has resulted in a withdrawal from research, understanding which interventions best support and improve research productivity is urgent. Increasing research capacity is crucial but only one element in increasing productivity. No recent attempt has been made to synthesise the knowledge gained from these more wide-ranging initiatives. DESIGN: A mixed-methods systematic review, registered in PROSPERO, searching four academic databases (CINAHL, ERIC, MEDLINE, PsycINFO) from 1/01/2010-20/04/2022. All primary research studies of relevant interventions were included if they described the intervention, reported its outcomes and were published in the English language in peer-reviewed journals. RESULTS: 1637 studies were assessed against eligibility criteria, resulting in 20 included studies. No studies were excluded based on quality. Data pertaining to understandings of 'research productivity', barriers to research productivity, interventions and outcomes of interventions were extracted. The most often used measures were the frequency or staff-output ratio of funding, publications and presentations, while the less commonly used were the number of conference abstracts submitted/accepted and awards. Subjective measures were less commonly used. Barriers to research productivity fell into three broad categories: resource constraints, lack of priority for research and barriers related to the attitudes, knowledge and skills of School of Nursing academics. Interventions covered nine broad areas. Half of the interventions were multi-stranded, including a wide range of components to increase research productivity while the other half comprised one component only, such as writing groups and mentoring. All interventions had a positive impact on research productivity, however, heterogeneity in the measurement of impact, the duration of interventions, sources of comparative data and research design made comparison of interventions challenging. CONCLUSIONS: The review identified a need for future research to explore the barriers among under-represented groups of academics in Schools of Nursing across a broader geographical area; and what works for various sub-groups of academics. It also identified a need for a valid, standardised tool to assess the effectiveness of interventions to increase research productivity of academics in Schools of Nursing.

The PRACTICE framework for organising and delivering a learning event for pharmacists' lifelong learning.

INTRODUCTION: To date, there is no unified model in Great Britain (GB), or globally, that provides consistency in planning, delivering, and evaluating learning events, that can support pharmacists' lifelong learning. This poses ongoing challenges for quality assurance and standardisation. The aim of this study is to present the development and validation of a framework to support the planning, delivery, and evaluation of learning events. METHODS: Development and design of the framework was a result of using triangulating methods capturing data from previous studies. Primary validation included face validation and content validation. Secondary validation involved using a think-aloud systematic process. Finally, the framework was trialed in practice by organising, delivering, and evaluating a learning event, following its guidelines. RESULTS: Initially, the PRACTICE framework included 48 statements. The content validity of the framework was 0.9. Think-aloud interventions resulted in changes to the number and clarity of statements, along with their position in the framework. The final PRACTICE framework consists of 51 statements and was successfully trialed in a face-to-face training event. CONCLUSIONS: The PRACTICE framework is an instrument supported by validation evidence and has been shown to be used effectively. Although the PRACTICE framework was created primarily for pharmacists, validation showed it can also be used for organising training events for other health care professionals. Future organisation and delivery of events according to the framework will continue to provide evidence about use in different settings.

Enhancing knowledge of mental health issues among children's nursing students: evaluation of a service user-led workshop.

BACKGROUND: Over the past 20 years, the number of children and young people with mental health issues has increased. During their clinical placements, children's nursing students often encounter such service users, as well as mothers with mental health issues such as postnatal depression. Many of these students have reported feeling inadequately prepared to meet the needs of these service users. AIM: To evaluate a service user-led workshop to improve the knowledge and confidence of children's nursing students in caring for children and young people with mental health issues. METHOD: One university in the south of England ran an interactive workshop as part of a final-year module for BSc and MSc children's nursing students. The workshop was facilitated by service users who had experienced mental health issues. Questionnaires were administered before and after the workshop to collect data from students who attended, then quantitative and qualitative analyses of the data were conducted. FINDINGS: This study found that children's nursing students gained knowledge and confidence in caring for children and young people with mental health issues after attending the workshop. Four themes were identified from the pre-questionnaire data: fear and anxiety; boundaries; mixed experiences; and learning on the job. The themes of boundaries and learning on the job were identified again in the post-questionnaire data, as well as the additional themes of 'being with, rather than doing' and 'further knowledge'. CONCLUSION: Service user involvement is an essential aspect of nurse education due to its positive and motivating effects on students. Future research could explore the optimal type of service user input required at different stages of nurse education, to ensure that it enhances the development of students' knowledge and confidence.

Enhancing the well-being of front-line healthcare professionals in high pressure clinical environments: A mixed-methods evaluative research project.

BACKGROUND: The last few years have witnessed a growing concern with the well-being of healthcare professionals internationally because of increasing recognition of its impact on patient outcomes and staff retention. The COVID-19 pandemic, which has placed additional and substantial pressure on frontline healthcare professionals, gives added urgency to the topic. While numerous, and successful, interventions have been developed to address compromised well-being among healthcare professionals, they have not always been able to support the needs of frontline staff, specifically those working in high-pressure environments. OBJECTIVE: This paper presents findings of an evaluative research study of an intervention, named the Resilience and Well-being Training Programme, developed and implemented within an Acute Assessment Unit in a hospital in the UK. The 8 week-long programme followed a combined approach (both person-directed and work-directed), with mindfulness training as well as lectures and discussions to deepen participants' understanding of organisational life. The training, delivered from January to July 2018, involved a total of 72 healthcare professionals from a wide range of levels (UK bands 2-8), trained in three cohorts. DESIGN: The research followed a pre-post design to explore participants' experiences of working on the Unit, the programme and its impact on themselves and their working life. SETTING: The study was conducted in a large NHS district general hospital in South London, UK. PARTICIPANTS: Participants included healthcare assistants and nurses who had completed their preceptorship, worked in the hospital's acute assessment unit, and had undertaken the resilience and well-being training programme. METHODS: The study employed mixed methods (online questionnaire, face-to-face focus groups/interviews) to collect data. RESULTS: Findings showed participants' positive experience with the programme, however it had limited positive impacts on aspects of compromised well-being at the personal level and a statistically significant enhancement of the quality of relationships and communication on the Unit, with medium effect size (Cohen's D). The programme had a positive impact on the culture of the Unit. CONCLUSIONS: Results highlight the demand for and value of programmes designed in ways that enable this group of professionals to take part, because these professionals are often not able to participate in such programmes. A strong commitment from the leadership to enable staff attendance in time-protected programmes is one approach that works well in the short-term. However, this may be challenging to accomplish and raises issues of sustainability.

The snapshot pre-registration assessment tool. Part 1: background, literature and research.

This is the first of a two-part article that presents a new assessment tool - the snapshot - for pre-registration nurses in clinical practice, that is being used at Kingston University/St George's University of London during year 3 of the Diploma and BSc programmes. A pilot study of the use of the snapshot in a simulation environment had previously been undertaken and as a result of this, the snapshot was piloted as part of continuous clinical assessment in practice on two cohorts of third-year pre-registration student nurses. An evaluative study was undertaken. This article describes the background to the project, the literature and the research methods used to undertake the evaluative research study. Part 2 will focus on the findings and a discussion of these findings mapped against the literature.

The snapshot pre-registration assessment tool. Part 2: data, discussion and future directions.

This paper is the second of a two-part article presenting a new assessment tool (the snapshot) for pre-registration nurses in clinical practice that is being used at Kingston University/St George's University of London during year 3 of the Diploma and BSc programme. Part 1 of this article presented background to the snapshot tool and the research approach used in the evaluative research study. Part 2 will present the data collection, findings and discussion which show that the snapshot is perceived positively by students in terms of the criteria, documentation and process. However, mentor understanding of these factors varied with some mentors having an inadequate understanding and additional questions of assessment validity also arose and need to be addressed. Both parts of this article make a contribution to the practice assessment agenda and to the continuous clinical assessment methods currently in use that tests students' competence against agreed criteria. The snapshot reflects the reality of practice and assesses skills in a realistic environment.

Supporting people with young onset dementia and their families: An evaluation of a training course for care workers.

This article reports the findings of an evaluation of a training course for care workers who care for people with dementia in the community. Twenty-four care workers participated in the training which took place in London and Surrey, United Kingdom. The training had a significant positive impact on participants' confidence in understanding the experiences and social care needs of people with young onset dementia (YOD) and their families. Participants also perceived that the training would help them improve their working practice by furthering their understanding of practical approaches to supporting and caring for people with dementia in general. Additionally, participants reported many ways in which they perceived being able to specifically support and empower people with YOD. It was concluded that the short training course improved knowledge and confidence for care workers on dementia care, and specifically in understanding how to support people with YOD and their families. Dementia specific training should be considered by service managers as a way of potentially increasing care worker job satisfaction.

Active involvement of learning disabilities service users in the development and delivery of a teaching session to pre-registration nurses: Students' perspectives.

A teaching session about service users' experiences of accessing and receiving health and social care was designed and delivered by service users to first year BSc Nursing students. The aim was to enhance students' knowledge, skills and confidence in caring for people with a learning disability. An evaluation research study was undertaking at one university in London into the perceived effectiveness of the teaching session, including students' perceptions of the extent to which the service users' teaching session was useful, the impact of the session, its benefits and challenges and the sustainability of teaching sessions delivered by service users. Data were collected through an online questionnaire. Quantitative analysis was undertaken of Likert-style questions and qualitative analysis was undertaken using the Framework Method. The session impacted on students' knowledge and understanding of people with a learning disability. Students reported that they felt more comfortable and confident interacting with people with a learning disability. In addition, they reflected on their feelings about caring for people with a learning disability.

The experiences of student nurses on placements with practice nurses: A pilot study.

To prepare the registered nurse of tomorrow in the United Kingdom (UK) to care for patients in general practice (GP)-led services, today's student nurses need to have the opportunity to experience placements with practice nurses to enable them to make positive career choices to become practice nurses in the future. The role of the practice nurse is described in the article. As a pilot project, seventeen students undertook placements with practice nurses in one of seven GP practices selected by the London GP Deanery and the university as having fulfilled the criteria to support student nurses in placements. A mentorship preparation programme was provided to prepare practice nurses for mentoring these students. An evaluation study was undertaken of this pilot project. Findings showed that students were highly positive about the experience; the majority rated this placement as being as good as or better than previous placement experiences. The evaluation also explored the impact on student learning and the value that the placement had. There was a positive impact on students' knowledge and skills in certain clinical areas especially related to health promotion. Students also indicated that they would like to have additional placements with practice nurses and would consider a career as a practice nurse in the future.

Learning about population-health through a community practice learning project: An evaluation study.

Increasing student nurse numbers requiring community placement learning opportunities has led to insufficient numbers of community nurses being available to support student nurses in the community. Although the study presented in the article is based in the UK this issue is reported widely in the literature across the globe. Universities in many countries have had to find innovative ways of providing community health learning opportunities for student nurses. This article reports on how one university in the UK has approached this challenge through students engaging in a population-based study in the community through group work. A research study was undertaken into this innovation which found that the student nurses engaged well with the project and with their groups and undertaking the project had positive value and impact on them and their understanding of population-health. Issues that arose for them largely focused on unequal participation in the group work by some with many participants perceiving that they had done more work on the group project and presentation than others in their group. However, working in this way was perceived to be a good learning experience for the majority of participants.

Student nurse selection and predictability of academic success: The Multiple Mini Interview project.

BACKGROUND: With recent reports of public enquiries into failure to care, universities are under pressure to ensure that candidates selected for undergraduate nursing programmes demonstrate academic potential as well as characteristics and values such as compassion, empathy and integrity. The Multiple Mini Interview (MMI) was used in one university as a way of ensuring that candidates had the appropriate numeracy and literacy skills as well as a range of communication, empathy, decision-making and problem-solving skills as well as ethical insights and integrity, initiative and team-work. OBJECTIVES: To ascertain whether there is evidence of bias in MMIs (gender, age, nationality and location of secondary education) and to determine the extent to which the MMI is predictive of academic success in nursing. DESIGN: A longitudinal retrospective analysis of student demographics, MMI data and the assessment marks for years 1, 2 and 3. SETTINGS: One university in southwest London. PARTICIPANTS: One cohort of students who commenced their programme in September 2011, including students in all four fields of nursing (adult, child, mental health and learning disability). METHODS: Inferential statistics and a Bayesian Multilevel Model. RESULTS: MMI in conjunction with MMI numeracy test and MMI literacy test shows little or no bias in terms of ages, gender, nationality or location of secondary school education. Although MMI in conjunction with numeracy and literacy testing is predictive of academic success, it is only weakly predictive. CONCLUSIONS: The MMI used in conjunction with literacy and numeracy testing appears to be a successful technique for selecting candidates for nursing. However, other selection methods such as psychological profiling or testing of emotional intelligence may add to the extent to which selection methods are predictive of academic success on nursing.

Nursing students' expectations and experiences of mentorship.

BACKGROUND: The literature related to nursing students' mentorship experiences is surprisingly limited and research findings related to students' experiences of mentorship is often integrated with other components of clinical placement experiences. OBJECTIVES: This study aimed to gain a greater understanding of students' expectations and experiences of mentorship and to identify the kind of support provided by the mentor that is most valued by the student, the role of the link lecturer in mentorship and how the university might further enhance the mentorship experience of their students. DESIGN: Mixed-methods exploratory sequential design was used. SETTING: This study was conducted in one university in south west London. PARTICIPANTS: All final year pre-registration nursing students enrolled on a Diploma/BSc in Health Studies course (n=129) were invited to participate. Participation was voluntary resulting in a convenience sample. Fifty-three students completed the questionnaire (response rate=45%). METHODS: The research involved two stages: a semi-structured focus group in the first stage and an online questionnaire in the second. Quantitative analysis was undertaken of Likert-style questions using SPSS version 18 and qualitative analysis was undertaken using the Framework Method. RESULTS: Students' experiences were largely positive. A picture emerged about the most valued mentor activities which included teaching and explaining, support and supervision and encouragement. Students differentiated encouragement from what they labelled as support. Contrary to the literature, the mentor role in practice assessment was not identified as highly important. Support from link lecturers was less well evaluated and students felt that the university needs to support mentors better. CONCLUSION: Students in this university valued the teaching, support and encouragement they received from mentors but the university needs to address ways of strengthening the link lecturer involvement in mentorship which includes the imperative for the university to explore ways of better supporting mentors in their role.

Students' first year experience of a BSc (Hons) in nursing: a pilot study.

BACKGROUND: All new nurses in England from 2013 will be educated at the point of registration to the degree level. A study was undertaken into the first-year experience of one cohort on the new degree programme at one university. OBJECTIVES: The aim of the study was to evaluate nursing students' experience during the first year of the degree programme in terms of their engagement with the programme, its impact and value and their overall satisfaction. DESIGN: A mixed method qualitative and quantitative survey design was used. SETTINGS AND PARTICIPANTS: One cohort of students at one university in south west London was studied. In total 96 out of 256 students completed the online survey questionnaire (response rate=37.5%). METHOD: Data were collected through an online questionnaire survey comprising Likert-style, demographic and open-ended questions. Data were analysed using SPSS version 19 and through the framework method. FINDINGS: Students' responses were largely positive. Areas of concern expressed included assessment timings and juggling personal/family commitments with academic workload. Although some experienced a degree of stress in year 1 the majority indicated that stress was not a problem; some experienced little or no stress at all. Students were positive about the quality of teaching, support received, and their relationships with academic staff. Satisfaction with year 1 was high. A small percentage considered leaving during year 1. Factors that made them stay included personal motivation to succeed, family support and help from academic staff and mentors. Overall attrition rate is low. CONCLUSIONS: As nursing in England moves to an all-graduate profession at the point of registration it is timely to evaluate issues like attrition, the students' engagement with their academic and practice experience, the impact on them of their assignments/assessments, stressors, their perceptions of quality, what makes them stay and their overall satisfaction.

Students' perceptions of practice assessment in the skills laboratory: an evaluation study of OSCAs with immediate feedback.

Assessment of clinical skills is fundamental to undergraduate nursing programmes. However, enabling assessment to be a good learning experience as well is a challenge to nurse educators. The study presented here presents the change from using an objective structured clinical examination (OSCE) for summative assessment (with feedback given to students after results had gone to the examination board--6 weeks after the OSCE) to one with immediate feedback. Because the previous OSCEs were universally disliked by students, for reasons that included absence of immediate feedback, in making this change the university re-branded the OSCE as an objective structured clinical assessment (OSCA) with immediate feedback provided to students. A survey was undertaken to measure student engagement with the OSCA, its value and impact, and its sustainability from the students' perspectives. There is little in the literature about student engagement with OSCEs and sustainability. Findings show that the OSCA with immediate feedback was perceived positively by students, was valued with regard to a number of factors, had a positively impact on student learning and confidence and was felt to be a form of assessment that this university should continue to use.