Evaluation of the 'Empathic Care of a Vulnerable Older Person' e-simulation.

BACKGROUND: Healthcare reports have identified that the nursing care provided to frail older people is sometimes indifferent, unkind, and lacking in empathy. Compelling research indicates that these types of healthcare interactions can result in both emotional and physiological harm. Thus, there is a need for authentic learning experiences that enhance nursing students' empathy towards older people and that they can reflect upon, learn from and transfer to their real-world practice. e-Simulations provide a pragmatic way of addressing this need. AIM: The aim of this study was to evaluate the impact of an 'Empathic Care of a Vulnerable Older Person' e-simulation on nursing students' empathy levels. SETTING AND PARTICIPANTS: A convenience sample of first year nursing students from one university in the United Kingdom and two Australian universities was recruited for the study. DESIGN AND ANALYSIS: A three-group pre-post study was conducted using the Comprehensive State Empathy Scale to evaluate the impact of the effectiveness of the e-simulation. Sample characteristics were summarised using descriptive statistics. Dependent t-tests and analysis of variance (ANOVA) were used to compare the changes in empathy scores pre post and differences between groups. RESULTS: A total of 684 nursing students participated in the study; their average age was 23 years. Overall, there was a significant increase in empathy scores from pre-test to post-test. Post-hoc comparison of the three groups indicated that the e-simulation had a greater impact on the empathy levels of participants from Universities 2 and 3, compared to those from University 1. CONCLUSION: e-Simulations using narrative methodologies that cater for learners' emotional memory appear to be an effective approach for enhancing empathy towards older people. However, further studies are needed to explore how this learning activity might inform and influence learners' future clinical practice.

RETRACTED: Exploring student nurses' attitudes towards those who are obese and whether these attitudes change following a simulated activity.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief and authors as there was a major error in reporting the results of the "Nurses' attitudes towards obesity and obese patients scale" (NATOOPS). In some places, it was reported that the higher NATOOPS scores indicated a more positive attitude. However, in the original scale, a higher score indicates a more negative attitude. The authors apologize for any inconvenience caused.

Supporting students in practice: An exploration of reflective groups as a means of support.

Evidence suggests that student nurses need to share their personal responses to practice by describing their feelings and experiences. These experiences are often accompanied by a degree of stress. Whilst reflection may enhance students' learning in practice there is little evidence to support the degree of support they may obtain from this process. The study considered the use of reflective groups for adult branch pre-registration students whilst they were undertaking clinical placements. Focus groups were held in which first and third year student nurses were asked to discuss their perceptions of the reflective groups. A thematic analysis of the data revealed that the groups were perceived to be useful on several levels and the students identified different needs depending on their stage of training. They perceived that the sessions helped them to cope with the overwhelming demands of the clinical environment and altered their perspectives on situations. They commented on the skills of the facilitators in enabling them to see issues from a variety of perspectives and guiding them to new insights and the confidential nature of the sessions was valued.

Respiratory assessment.

This article, part of Nursing Standards clinical skills series, discusses the 'look, listen and feel' approach to respiratory assessment. This will assist nurses to carry out a basic respiratory assessment of the patient.

A concept analysis of renal supportive care: the changing world of nephrology.

AIM: This paper is a report of a concept analysis of renal supportive care. BACKGROUND: Approximately 1.5 million people worldwide are kept alive by renal dialysis. As services are required to support patients who decide not to start or to withdraw from dialysis, the term renal supportive care is emerging. Being similar to the terms palliative care, end-of-life care, terminal care and conservative management, there is a need for conceptual clarity. METHOD: Rodgers' evolutionary method was used as the organizing framework for this concept analysis. Data were collected from a review of CINAHL, Medline, PsycINFO, British Nursing Index, International Bibliography of the Social Sciences and ASSIA (1806-2006) using, 'renal' and 'supportive care' as keywords. All articles with an abstract were considered. The World Wide Web was also searched in English utilizing the phrase 'renal supportive care'. RESULTS: Five attributes of renal supportive care were identified: available from diagnosis to death with an emphasis on honesty regarding prognosis and impact of disease; interdisciplinary approach to care; restorative care; family and carer support and effective, lucid communication to ensure informed choice and clear lines of decision-making. CONCLUSION: Renal supportive care is a dynamic and emerging concept relevant, but not limited to, the end phase of life. It suggests a central philosophy underpinning renal service development that allows patients, carers and the multidisciplinary team time to work together to realize complex goals. It has relevance for the renal community and is likely to be integrated increasingly into everyday nephrology practice.

Assessing the cultural and religious needs of older people.

Patients' cultural and religious needs can become particularly important during ill health. This article describes two different frameworks and how they can be used by nurses to assess those needs among older people in their care.

Myocardial infarction and older people.

Nurses have a central role to play in the care of older people who have suffered a myocardial infarction. This article points out that such patients may not present with typical symptoms so it is important to be aware of signs that indicate problems. It suggests that following diagnosis it is vital that older people are offered evidence-based treatment and that secondary prevention and rehabilitation are considered.

Heart failure and older people.

The future care of older patients with heart failure probably lies within specialist teams but many are currently being cared for at home and without access to specialist support. This article aims to improve the skills of nurses in assessing and helping to treat such patients.