Effects of the Perceived Risk of Contracting COVID-19 on Nursing Students' Well-Being.

BACKGROUND: Although mental health symptoms increased during the coronavirus disease 2019 (COVID-19) pandemic, little is known about the associations between nursing students' perceived risk of contracting COVID-19 and their academic and psychological well-being. This study examined associations between perceived COVID-19 risk, likelihood of completing nursing education, and mental health factors of nursing students. METHOD: A total of 979 nursing students completed self-report measures of perceived COVID-19 risk, anticipated academic completion, anxiety and depressive symptoms, stress, coping self-efficacy, hope, and social support. RESULTS: Students with higher perceived COVID-19 risk reported increased anxiety and depression as well as decreased likelihood of graduating, coping self-efficacy, and levels of social support. CONCLUSION: Findings indicate the need for increased mental health support for nursing students for successful completion of their programs. Educators should increase support and proactively strengthen positive psychology factors to mitigate the effects of COVID-19 and other crises on nursing students' well-being. [J Nurs Educ. 2022;61(11):641-645.].

Positive and negative psychosocial factors related to healthy and unhealthy weight control among nursing students.

BACKGROUND: Although nursing students are educated on the importance of exercising regularly and maintaining a well-balanced diet, many do not practice healthy weight management behaviors, and some even use unhealthy weight loss methods. Yet, little research has examined both positive and negative psychosocial variables related to weight control among nursing students. PURPOSE: The present study aimed to identify the most salient psychosocial variables related to healthy and unhealthy weight control among nursing students. METHOD: Using survey data from 241 nursing students, structural equation modeling was conducted to examine the relative contributions of eight interrelated psychosocial variables, including constructs from a strengths perspective (health-specific hope, health self-efficacy, social support, and body satisfaction) and from a deficit perspective (depression, anxiety, weight perception, and barriers to physical activity). RESULTS: Results showed that the degree to which individuals perceive themselves to be overweight was related to both healthy and unhealthy weight control. Aside from weight perception, health self-efficacy produced the strongest association with healthy weight control, and anxiety produced the strongest association with unhealthy weight control. The structural model explained 23 % of the variance in healthy weight control and 29 % of the variance in unhealthy weight control. CONCLUSIONS: These findings emphasize the need for tailored, integrated weight management interventions for nursing students that equip them with effective anxiety management skills and build self-efficacy.

Undergraduate versus graduate nursing students: Differences in nutrition, physical activity, and self-reported body mass index.

ObjectiveThis study compared self-reported nutrition, physical activity, and body mass index (BMI) in undergraduate versus graduate nursing students.ParticipantsRespondents included 233 undergraduate and 230 graduate nursing students in a Southeastern public university.MethodsThe study was an exploratory, descriptive, cross-sectional comparison administered via online questionnaire including self-reported demographics, nutritional intake, physical activity, and BMI.ResultsUndergraduates reported exercising more than graduate students. Graduate students reported consuming significantly more vegetables than undergraduates; however, more graduate students self-reported BMIs in overweight and obese categories than undergraduates.ConclusionsFindings provide a foundational understanding that interventions or educational programs to improve self-care behaviors of nursing students should be tailored depending on the educational level of the students. Educators must establish self-care skills within nursing students at all levels to help them preserve their health in the fast-paced, strenuous, and stressful work of all echelons of nursing upon completion of the educational program.

Weight Bias and Stigma: Impact on Health.

Weight bias and stigma exist in a variety of realms in our society (media, education, employment, and health care), and unfortunately many view it as a socially acceptable form of discrimination. Patients with obesity often avoid scheduling appointments for health promotion visits and routine care due to perceived weight bias and stigma from their health care provider. Within the health care setting, it is important that health care providers strategically focus on reducing obesity bias and provide high-quality obesity management. People-first language should be used and waiting rooms and examination rooms should be accommodating to people of all sizes.

Characteristics of Negative and Positive Mental Health Among Nursing Students in the United States.

BACKGROUND: Researchers have documented significant psychological problems among nursing students, but findings have been inconclusive as to whether nursing students are "at-risk" for mental health problems compared with their non-nursing peers. AIMS: This study examined whether nursing students have unique mental health characteristics compared with students from other professions. METHOD: Undergraduates (N = 18,312; nursing n = 1,399) were selected from the 2016-2017 National Healthy Minds Study. Participants completed the Patient Health Questionnaire-9 (depression), the Generalized Anxiety Disorder-7 (anxiety), and the Flourishing Scale (positive psychology). RESULTS: Nursing students were equally likely to screen positive for depression and anxiety compared with their non-nursing peers. However, when controlling for gender, age, and year in school, multigroup structural equation modeling analyses revealed that female (but not male) nursing students reported significantly higher levels of specific anxiety symptoms and certain psychological strengths than female students from other professions. Nursing students are equally likely to screen positive for depression or anxiety as their non-nursing peers; however, anxiety disorders may reflect symptom profiles unique to nursing students. CONCLUSIONS: Findings suggest a need for tailored screening and interventions to reduce mental health problems and harness psychological strengths unique to nursing students.

Nursing students' resilience, depression, well-being, and academic distress: Testing a moderated mediation model.

AIM: Academic distress is a leading cause of attrition among nursing students. The present study tested a positive psychology-oriented model detailing the potential links between nursing students': (a) psychological resilience; (b) depressive symptoms; (c) intrapersonal well-being; (d) interpersonal well-being; and (e) academic distress. Additionally, we tested whether the academic benefits of resilience were conditional upon nursing students' perceptions of their campus climate as supportive of mental health and well-being. DESIGN: A correlational, cross-sectional design was employed. METHOD: Nursing students (N = 933) were selected from the national 2017-2018 Healthy Minds Study (HMS). Students completed measures of resilience, depressive symptoms, intrapersonal well-being (flourishing), interpersonal well-being (belonging), and academic distress. RESULTS: Conditional process modelling tested depression, belonging, and flourishing as mediators of the associations between resilience and academic distress variables. Furthermore, perceptions of campus climate were included as potential moderators of these mediation effects. Results indicated that the protective academic benefits of resilience were primarily explained by decreases in depression but that this effect was strongest for nursing students with negative perceptions of their campus climate. CONCLUSION: Findings highlight the psychological and academic benefits of greater resilience and the moderated mediation results suggest that such benefits were conditional on the broader campus climate. IMPACT: Nurse educators and policymakers should consider addressing contextual factors, such as campus climate, in addition to resilience training in their efforts to reduce the negative academic impacts of mental health problems and stress in nursing school.

Nurse practitioner students' observations of preceptor engagement in obesity management and weight bias: A mixed-methods approach.

BACKGROUND: Obesity is considered a growing epidemic in the United States. Nurse practitioners (NPs) have the opportunity to serve as leaders in addressing concerns related to disease management, particularly obesity. Currently, we lack an awareness of how NP students are learning obesity management from their preceptors. PURPOSE: Thus, the current study sought to explore how NP students perceive preceptors' behaviors when managing patients with obesity. METHODOLOGICAL ORIENTATION: This study used a mixed-methods design. Participants were asked to report how often they observed their preceptors engage in different strategies when interacting with patients with obesity (e.g., calculate body mass index, identify goals). Students were then asked to respond to the statement: "share observations you made of how patients with obesity were treated in this environment." Students completed 2 clinical rotations during this period and, thus, were asked to answer the questions twice to capture experiences at both clinical sites. SAMPLE: Researchers surveyed 225 NP students completing clinical rotations in 3 settings (Family Practice, Pediatrics, and Obstetrics/Gynecology). CONCLUSIONS: Quantitative results revealed significant differences in the frequency of observed obesity management behaviors by all preceptors. Qualitative results revealed that NP students most often observed preceptors displaying interpersonal warmth without weight bias when working with patients with obesity. Contrary to current literature, this sample of NP students observed their preceptors engaging in positive interactions with individuals with obesity. IMPLICATIONS FOR PRACTICE: Educators must continue to teach students to engage in unbiased behavior toward patients. It is critical to continue to improve obesity management content offered in NP programs.

Food insecurity among nursing students: A mixed methods study.

BACKGROUND: College students are among 48.1 table million Americans who experience food insecurity, affecting aspects of daily living, health, and academic performance. This study sought to assess food security in nursing students to determine the prevalence and significance of this issue. METHODS: A mixed-methods descriptive design was utilized to collect and analyze data through an online survey of junior and senior undergraduate nursing students. Both qualitative and quantitative questions were related to personal experience with food insecurity. RESULTS: Approximately 40% of students responded that they were Sometimes/Often worried that food would run out before the next income arrived. In addition, 52% of the participants Sometimes/Often could not afford an adequate amount of food, and 35% reported having a shortage of food. CONCLUSION: University leadership, College of Nursing administrators, and nursing faculty should be aware of food insecurity among their students and identify strategies to assess and decrease this issue.

Competency in obesity management: An educational intervention study with nurse practitioner students.

BACKGROUND: The National Center for Health Statistics reported that obesity is at epidemic levels in the United States, with an estimated 70.7% of adults affected by overweight and obesity. The disease state of obesity affects all generations and is pervasive among all socioeconomic groups. PURPOSE: This study was designed to examine the impact of implementing educational modules to determine if the intervention improved knowledge and comfort levels for Nurse Practitioner students when managing patients with obesity. METHODS: Nurse Practitioner students completed a survey regarding knowledge and comfort level in managing patients with obesity. Students then completed modules designed to train health care providers on the management of obesity. A postmodule assessment was administered to determine if the obesity management modules improved competency and perceived skills when treating patients with overweight and obesity. RESULTS: Participants' mean score on the knowledge test represented a significant improvement following training. Their comfort level in managing patients with obesity increased. IMPLICATIONS FOR PRACTICE: Implementing these modules in graduate education may be a helpful avenue to improve competency in obesity management. Acknowledging that obesity is a disease and requires a multifaceted approach when helping patients improve their health. This change in perception may lead to better goal-setting with the patient, empathetic understanding, and broader patient involvement in the treatment.

NP student encounters with obesity bias in clinical practice.

This study explores NP students' encounters with obesity stigma and bias in their clinical environment as well as recommendations to decrease obesity stigma and bias. Results indicate a need for continued education on the topic of weight management within NP curricula.

Advanced Practice Nursing student knowledge in obesity management: A mixed methods research study.

BACKGROUND: Obesity, the most prevalent chronic disease affecting multiple systems, is associated with increased mortality and a decreased life expectancy. OBJECTIVES: The purpose of this study was to identify Advanced Practice Nursing (APN) students' confidence of obesity management as well as satisfaction of APN curriculum on and curricular recommendations regarding obesity management. DESIGN: Modified convergent mixed-methods design. SETTING: A university-based college of nursing in the Deep South. PARTICIPANTS: Graduate APN Students. METHODS: An exploratory mixed methods online survey was administered to APN students. The survey included demographics; confidence in obesity management; knowledge of pharmacological treatment; self-reported height and weight; experiences and challenges related to obesity management; and suggestions of curricular content changes for the treatment of obesity that would increase student expertise and confidence. RESULTS: Ninety-nine surveys were completed by 94 female and five male APN students aged 26 to 61 years. The majority (70.7%) were white with BMIs ranging from 19.57 to 51.37 (x̅=27.81). Areas where students were least comfortable were prescribing anti-obesity medications and accurately billing for obesity management. Fourteen percent of APN students reported feeling that their graduate nursing education program did not prepare them well in obesity management, 25.3% reported feeling slightly well prepared, 32% reported feeling moderately well prepared, and 27.8% reported feeling very well or extremely well prepared. Qualitative responses accentuated insecurity in areas such as initiating a discussion on obesity management with patients who have obesity. CONCLUSIONS: Overall, APN students requested that their curriculum incorporate more instruction on how to begin the discussion of weight loss and provide clear evidence-based guidelines that include diet, exercise, and medication options. An efficient way to affect the management and treatment of obesity is to ensure that the next generation of providers is thoroughly prepared to implement the best evidence-based obesity management for patients.

The Family Meal Challenge: A Faith-Based Intervention to Empower Families.

African Americans have increased rates of overweight and obesity and are least likely to participate in family meals compared with other racial groups. A Family Meal Challenge (FMC) was developed with the objective of empowering individuals to eat healthy meals together as a family. The FMC was presented through four classes in three churches, two faith-based ministries, and two community service programs in health disparity zip codes. Surveys (N = 257) indicated a positive response. Engaging participants and teaching the benefits of eating healthy family meals in a faith-based environment are feasible and may increase the frequency of family meals. Information is provided to create and implement an FMC in any faith setting.

Obesity: Risk factors, complications, and strategies for sustainable long-term weight management.

BACKGROUND AND PURPOSE: The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. METHODS: Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention." CONCLUSIONS: Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%-10% range, and above, can significantly improve health-related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal-setting and increased consultation frequency can greatly improve the success of weight-management programs. Nurse practitioners have key roles in establishing weight-loss targets, providing motivation and support, and implementing weight-loss programs. IMPLICATIONS FOR PRACTICE: With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight-management strategies deployed in clinical practice.

Obesity Stigma and Bias.

Overweight and obesity are escalating in epidemic proportions in the United States. Individuals with overweight and obesity are often reluctant to seek medical help, not only for weight reduction but also for any health issue because of perceived provider discrimination. Providers who are biased against individuals with obesity can hinder our nation's effort to effectively fight the obesity epidemic. By addressing weight bias in the provider setting, individuals affected by obesity may be more likely to engage in a meaningful and productive discussion of weight. Providers need to be the go-to source for obesity-focused information on new and emerging treatments.

Pediatric obesity screening and prevention strategies.

Childhood overweight and obesity is a major health concern in the United States. It is recommended that every well-child examination include body mass index measurements and obesity prevention discussions that encourage healthy eating habits, regular physical exercise, and limited television and computer screen time. Providers can make a difference through strategic intervention.

Calorie awareness related to weight control.

Obesity rates are high in all age groups. Individuals are often unaware of the calorie counts of food and the number of calories that they need each day to maintain their weight. Health care providers must promote calorie awareness in terms that are easy for patients to understand and implement. Awareness and understanding of calories can help empower individuals to make healthful food choices.

Guiding patients to safe weight loss.

Many patients have questions about diets, and those adhering to specific diets need patient-tailored monitoring. Nurse practitioners are often called upon to advise, prescribe, and monitor specific weight-reduction and weight-control diets. This article provides guidelines for safe weight reduction and a review of some popular diets.