Clinical learning environment and graduating nursing students' competence: A multi-country cross-sectional study.

The purpose of this study was to explore nursing students' perceptions of their final clinical learning environment and its association with their self-assessed competence, satisfaction with nursing education, and turnover intentions at graduation in six European countries. A multi-country comparative cross-sectional study was conducted with nursing students (n = 1746) from the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain using the Nurse Competence Scale and the Clinical Learning Environment and Supervision scale. Nursing students' overall perceptions of their final clinical learning environment and supervision were positive in all the countries studied. The correlation between the students' perceptions of their final clinical learning environment and competence was statistically significant and positive. Satisfaction with the nursing program and clinical practicum and no consideration of career change were related to positive perceptions of the final clinical learning environment. Highlighting the importance of the supervisory relationship and pedagogical atmosphere, nursing students' positive perceptions of the final clinical learning environment and supervision contribute to a better level of self-assessed competence and satisfaction with the nursing program and clinical practicum, leading to lower turnover intentions.

[Perception of stress factors among patients admitted to an intensive care unit]. / La percezione dei fattori di stress dei pazienti ricoverati in terapia intensiva.

A descriptive study was conducted to identify stress factors for patients admitted to an Intensive Care Cardiac Surgery Unit of a Northern Italy hospital (Trento). Stress factors were identified according to the opinion of nurses and patients and differences in perceptions were explored. Patients and nurses were asked to rank the main stress factors from a list of 30 and to rate each over a scale of 4 points from 1 to 4 (1 not at all and 4 very stressful). Data were collected from the end of September to the end of October 2001. Patients rate as more stressful the presence of endotracheal tube (as well as the associated point) the impossibility to communicate, suctioning manoeuvres, pain in general. Nurses rate as more stressful for the patients the endotracheal tube, the suctioning manoeuvre, the worries for the outcome of the heart surgery and the impossibility to communicate pain. No statistically significant differences were observed for the more important stress factors, but nurses tend to overestimate the stress related to factors rated as least important by the patients.