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.

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.

Understanding Nurse Perception of Leader Empathy.

Patient perception of caregiver empathy has been studied internationally for decades. Although leadership empathy has been described as having a critical influence on staff retention, this subject is less evident in the literature. This article described a study undertaken to gain a baseline understanding of nurses' perceptions of leader empathy from those they identify as their managers. A baseline for nurses' perception of leader empathy has been established that may be used to benchmark future interventions to assess and improve nurses' perception of their leaders' empathy in the work setting.

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.

Prospective Patterns of Help-Seeking Behavior Among Military Veterans With Probable Posttraumatic Stress Disorder and Major Depressive Disorder.

This study examined help-seeking behavior from professional, informal, and religious sources in veterans with a probable need for treatment. In total, 93 veterans who screened positive for posttraumatic stress disorder/major depressive disorder completed assessments of help-seeking at two time points spaced apart by 6 months. Less than half (40%) reached out to a mental health professional or physician; only 1 in 10 engaged with providers who specialize in evidence-based therapies to a minimally adequate degree. Although roughly two thirds pursued help from informal sources, less than 10% similarly sought help nine or more times. Veterans with high willingness to seek help from specific sources at baseline were more likely to report sustained engagement in help-seeking behavior along these same lines at follow-up. Assessing veterans' help-seeking intentions may add prognostic value in predicting engagement in services. Veterans may also benefit from tailoring service delivery models according to preferred sources of help in their families and communities.

A Qualitative Examination of VA Chaplains' Understandings and Interventions Related to Moral Injury in Military Veterans.

This study examines VA chaplains' understandings of moral injury (MI) and preferred intervention strategies. Drawing qualitative responses with a nationally-representative sample, content analyses indicated that chaplains' definitions of MI comprised three higher order clusters: (1) MI events, (2) mechanisms in development of MI, and (3) warning signs of MI. Similarly, chaplains' intervention foci could be grouped into three categories: (1) pastoral/therapeutic presence, (2) implementing specific interventions, and (3) therapeutic processes to promote moral repair. Findings are discussed related to emerging conceptualizations of MI, efforts to adapt existing evidence-based interventions to better address MI, and the potential benefits of better integrating chaplains into VA mental health service delivery.

Do student service members/veterans experience worse mental health stigma than their peers? A comparative study in a national sample.

OBJECTIVES: Examine differences in mental health treatment-related stigma in student service members and veterans (SSM/Vs) and peers from 57 post-secondary institutions across the United States. METHODS: In total, 909 SSM/Vs and 1818 demographically- and institutionally-matched non-SSM/Vs completed assessments of stigma-related barriers to mental health service utilization as part of the Healthy Minds Study between 2011 and 2015. RESULTS: When compared to non-SSM/V peers, SSM/Vs reported more mental health treatment-related stigma toward help-seekers and less confidence in the helpfulness of therapy/counseling and psychotropic medications. However, effect sizes were small in magnitude (ds = .10 to .16), and depressed students in both groups reported greater stigma. CONCLUSIONS: SSM/Vs experience greater treatment-related stigma than non-SSM/V peers, which may deter service use in many cases. However, differences in stigma were small and other under-studied barriers to help-seeking may apply to the substantive subset of SSM/Vs and non-SSM/Vs who may benefit from utilizing available services.

Development and evaluation of the Expressions of Moral Injury Scale-Military Version.

There is consensus that military personnel can encounter a far more diverse set of challenges than researchers and clinicians have historically appreciated. Moral injury (MI) represents an emerging construct to capture behavioural, social, and spiritual suffering that may transcend and overlap with mental health diagnoses (e.g., post-traumatic stress disorder and major depressive disorder). The Expressions of Moral Injury Scale-Military Version (EMIS-M) was developed to provide a reliable and valid means for assessing the warning signs of a MI in military populations. Drawing on independent samples of veterans who had served in a war-zone environment, factor analytic results revealed 2 distinct factors related to MI expressions directed at both self (9 items) and others (8 items). These subscales generated excellent internal consistency and temporal stability over a 6-month period. When compared to measures of post-traumatic stress disorder, major depressive disorder, and other theoretically relevant constructs (e.g., forgiveness, social support, moral emotions, and combat exposure), EMIS-M scores demonstrated strong convergent, divergent, and incremental validity. In addition, although structural equation modelling findings supported a possible general MI factor in Study 2, the patterns of associations for self- and other-directed expressions yielded evidence for differential validity with varying forms of forgiveness and combat exposure. As such, the EMIS-M provides a face valid, psychometrically validated tool for assessing expressions of apparent MI subtypes in research and clinical settings. Looking ahead, the EMIS-M will hopefully advance the scientific understanding of MI while supporting innovation for clinicians to tailor evidence-based treatments and/or develop novel approaches for addressing MI in their work.

Patterns of help-seeking in a national sample of student veterans: a matched control group investigation.

OBJECTIVES: This study examined patterns of professional and nontraditional help-seeking in a national sample of veterans from 57 colleges/universities and demographically matched students from the same institutions who had not served in the US Armed Forces. METHODS: In total, 945 veterans and 2835 demographically matched nonveteran students from the same 4-year institutions completed assessments of help-seeking intentions and behaviors from professional, religious and informal sources in the Healthy Minds Study between 2011 and 2015. RESULTS: Drawing on bivariate and multivariate logistic regression models, equal ratios of these samples (2:1) did not endorse professional help-seeking intentions or behaviors. When compared to nonveteran students, veterans had greater intentions for religious help-seeking but were less likely to seek help from family/friends. Nearly half of depressed veterans who had not utilized services had also not sought help from any religious or informal sources. CONCLUSIONS: Unmet mental health needs might interfere with the success of a sizeable contingent of veterans pursuing new vocational goals. Community-based programs that can educate and/or equip nontraditional sources of support in veterans' naturally occurring relationships might offset these concerns.