Knowledge translation resources to support the use of quality of life assessment tools for the care of older adults living at home and their family caregivers.

PURPOSE: To support the use of quality of life (QOL) assessment tools for older adults, we developed knowledge translation (KT) resources tailored for four audiences: (1) older adults and their family caregivers (micro), (2) healthcare providers (micro), (3) healthcare managers and leaders (meso), and (4) government leaders and decision-makers (macro). Our objectives were to (1) describe knowledge gaps and resources and (2) develop corresponding tailored KT resources to support use of QOL assessment tools by each of the micro-, meso-, and macro-audiences. METHODS: Data were collected in two phases through semi-structured interviews/focus groups with the four audiences in Canada. Data were analyzed using qualitative description analysis. KT resources were iteratively refined through formative evaluation. RESULTS: Older adults and family caregivers (N = 12) wanted basic knowledge about what "QOL assessment" meant and how it could improve their care. Healthcare providers (N = 13) needed practical solutions on how to integrate QOL assessment tools in their practice. Healthcare managers and leaders (N = 14) desired information about using patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in healthcare programs and quality improvement. Government leaders and decision-makers (N = 11) needed to know how to access, use, and interpret PROM and PREM information for decision-making purposes. Based on these insights and evidence-based sources, we developed KT resources to introduce QOL assessment through 8 infographic brochures, 1 whiteboard animation, 1 live-action video, and a webpage. CONCLUSION: Our study affirms the need to tailor KT resources on QOL assessment for different audiences. Our KT resources are available: www.healthyqol.com/older-adults .

The systems psychodynamic role identity of nursing students during their preceptorship.

BACKGROUND: Existing research on nursing students' preceptorship experiences focusses mainly on conscious and rational behaviour, evidencing experiences of personal and professional development. This study argues that the exploration of their unconscious experiences could add important information towards an in-depth understanding of their role identity during this experience. OBJECTIVE: The research objective was to describe the unconscious role identity of nursing students during their preceptorship from a systems psychodynamic stance. DESIGN: A qualitative design, a collective case study and hermeneutic phenomenology were utilised as methodologies. SETTING: Set in the School of Nursing of a Canadian University, the research focussed on students in the fourth year Consolidation in Nursing Practice Course. PARTICIPANTS: The sample included 41 nursing students, 37 females, 22-28 years of age. FINDINGS: The manifesting themes were high levels of anxiety, defensive structures, boundary and authority matters, and role dynamics. The nursing students experienced high levels and different kinds of anxiety, which they defended against using introjections, projections and regression to their child ego state. They experienced the preceptorship as being in a middle position between past and future as well as between knowing and not knowing. The discussion was presented in relation to the macro (organisational), meso (group), and micro (individual) levels. CONCLUSIONS: Unconsciously, the nursing students experienced difficulty in effectively taking up their professional role. They defended against their discomfort by splitting their experiences into what they introjected and projected. They introjected incompetence in coping with the emotional demands of the role and projected their anger onto authority figures. Their professional role identity got stuck in a de-authorised position where they could survive but not develop their selves in their new role. These experiences inhibited their authenticity and learning ability.

Nursing Leadership Implications for Clinical Placements in Corrections.

Clinical placements in correctional settings offer nursing students unique opportunities for learning mental health and community health concepts, including social justice, restorative justice and the impact of poverty and marginalization on health and life choices. Although there is some evidence to suggest that a small number of nursing programs use clinical placements in correctional settings, relatively little scholarly literature addresses nursing education in such settings, or the implications for nursing leadership when students do have an opportunity to learn in correctional settings. In this paper, we examine the literature that is available on this topic and present the findings of a secondary analysis of interviews with undergraduate nursing students at our nursing program in relation to their clinical placements in correctional settings. Drawing on the students' perspectives, we have found that these placements, in particular, have fostered learning about caring for marginalized populations; themes of hope and restorative justice featured prominently in their descriptions of their learning. Students also emphasized that they learned a great deal about the expanded role of nurses and about caring for marginalized populations. With strong administrative and faculty support, these settings offer students exposure to expert registered nurse mentors who work with clients in an expanded role to facilitate their achievement and stabilization of a broad range of health challenges. They are also role models for students, by showing students that nurses can be agents of hope when working with a diverse client population and their families. We offer recommendations on how to maximize student learning in correctional settings, including a reflection on how to support students' integration of their learning experiences in their nursing practice, with the long-term view that these transformative student experiences have the potential to shape our future nurse leaders.

The role of spirituality in coping with the demands of the hospital culture amongst fourth-year nursing students.

The aim of this research was to describe the role of spirituality in coping with the demands of the hospital culture amongst fourth-year nursing students. Qualitative, descriptive, hermeneutic interpretive research was done. A case study of 14 female Canadian nursing students was asked to write an essay on their experiences of the demands of the hospital culture. Content analysis was used and positive psychology served as the interpretive lens. Trustworthiness and ethicality were ensured. The findings indicated that although the nursing students expressed themselves in religious and spiritual words, they did not significantly illustrate the theoretically associated intra-, interpersonal and sacred behaviours to be referred to as being spiritual in their experience as a care giver in the hospital culture. They also did not illustrate behaviours linked to other positive psychology constructs such as sense of coherence, resilience, engagement or emotional intelligence. Rather, the nursing students experienced identity crises. Recommendations for the inclusion of mentoring in the curriculum of nursing students were formulated.

Innovation in community clinical placements: a Canadian survey.

Ongoing restructuring within the health care system juxtaposed with mandated increased seats in nursing programs have taxed traditional clinical practice settings beyond their capacity. In the search for suitable clinical placements to meet learning objectives and fulfill required clinical hours, nursing program administrators are turning to various non-traditional settings. Yet limited research exists to describe the prevalence and types of 'innovative' clinical placements (ICPs) or the nature and quality of student learning in such settings. Described in this article are findings from a national survey of Canadian baccalaureate nursing programs completed by nurse educators and clinical placement coordinators regarding nursing student placements within ICPs. Participant survey responses provide a national snap-shot of ICPs, along with perspectives on pedagogy, strengths and weaknesses, capacity and sustainability issues, and ethical, legal and academic considerations associated with student placements in these settings.