Relationship Between the Clinical Learning Environment and Caring Behaviors Among Baccalaureate Nursing Students During the COVID-19 Pandemic.

ABSTRACT: Caring is a fundamental professional nursing value. This study examined the effect of the clinical learning environment (CLE) on nursing students' caring behaviors during the COVID-19 pandemic. Valuing nursing work in the CLE increased the knowledge and skills aspect of caring behavior. Higher CLE scores in affordances and engagement and student centeredness increased the respectful deference of others and positive connectedness aspects of caring behaviors. These results may inform efforts to promote aspects of nursing students' caring behaviors during global health emergencies by enhancing the value of nursing work, engagement, and student-focused qualities of the CLE.

Factors in the clinical learning environment that influence caring behaviors of undergraduate nursing students: An integrative review.

AIM: The aim is to explore literature on the influence of the clinical learning environment on caring behaviors of undergraduate nursing students. BACKGROUND: Caring is a fundamental aspect of nursing practice. However, factors of and in clinical learning environment that help shape the caring behaviors of nursing students as part of their education journey remain understudied. DESIGN: A modified version of Cooper's five-stage integrative review method was used. METHODS: Four databases (Cumulative Index of Nursing and Allied Health, PubMed, Scopus and Embase) were searched for research studies published from 2011 to 2021 in peer reviewed journals, written in English and addressing caring behaviors among nursing students in the clinical learning environment. A combination of keywords with Boolean operators was used including: "nursing students OR nursing undergraduates OR student nurses" and "clinical learning environment" AND "caring behaviors". Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. RESULTS: Empirical evidence was drawn from 11 studies including seven qualitative designs, three quantitative designs and one mixed method design. The results of this review suggest that factors in the clinical learning environment influence nursing students' ability to develop caring behaviors. Specifically, the five themes of: [1] role modeling of clinical faculty and professional nurses, [2] creating a conducive clinical learning environment, [3] effective communication skills, [4] positive effect of simulation and [5] alternative clinical placements may facilitate the development of caring behaviors among nursing students. CONCLUSION: The findings highlight the factors in the clinical learning environment that influence nursing students' caring behaviors. Improving students' clinical learning experiences and implementing more effective role modeling and teaching strategies may advance their caring abilities. The information generated from this review provides evidence on how to enhance the clinical learning environment to develop students' caring behaviors, subsequently leading to more optimal patient outcomes.

Bariatric surgery in the Middle East and North Africa: narrative review with focus on culture-specific considerations.

There is an increasing volume of bariatric surgeries in the Middle East and North Africa (MENA), but the context of bariatric surgery in the region is not fully understood. Incorporating culture-specific considerations in the provision of care to patients who undergo bariatric surgery may help to optimize outcomes after surgery. We conducted a narrative review of published research studies on bariatric surgery in the MENA region, highlighting cultural and contextual aspects relevant to the care of bariatric surgery patients who undergo surgery in this geographic area. The authors searched the following online databases: PubMed, CINAHL, Embase, and Academic Search Elite from 2010-2020 for studies conducted in 18 countries in the MENA region. This narrative review identifies cultural-specific considerations that may affect bariatric care and outcomes in 6 domains: knowledge of bariatric surgery; mental health, body image, and quality of life; influence of family; religion and lifestyle; preoperative practices; and healthcare access. Provision of culturally congruent care may help patients to achieve the best possible outcomes after bariatric surgery. Results may inform efforts to provide safe and culture-specific care in the MENA region, as well as those who migrate or seek care in other countries. More research is warranted on this heterogeneous population to optimize postsurgery weight trajectory and psychosocial adjustment.

A National Survey of Complementary and Alternative Medicine Use for Treatment Among Asian-Americans.

Asian Americans (AAs) are more likely to use complementary and alternative medicine (CAM) compared to other race/ethnicities, yet previous studies have conflicting results. The 2012 National Health Interview Survey data was analyzed to investigate AA's (n = 2214) CAM use for treatment. AAs were divided into four subgroups: Chinese, Asian Indian, Filipino, and Other Asian. Only 9% of AAs reported using CAM for treatment, with 6% indicating CAM use specifically for chronic conditions. This could be a form of medical pluralism, a mixture of Eastern and Western health approaches. The "Other Asian" subgroup reported highest use of CAM for treatment. Significant predictors included age (≥ 65 years) and high educational attainment (≥ college degree). Sociodemographic factors were also significant predictors within Asian subgroups. Further investigation of this and other forms of medical pluralism among AAs are needed to explore potential cofounders and risks like underreporting, CAM schedules/dosages, cultural influences, and CAM's impact on one's health.

Quality of Life and the Predictive Roles of Religiosity and Spiritual Coping Among Nursing Students: A Multi-country Study.

There has been high interest in religious and spirituality practices among college students due to positive benefits to university life. However, no studies have been conducted examining nursing students' religiosity and use of spiritual coping and its impact on their QOL. This cross-sectional, descriptive study measured the QOL and examined the predictive roles of religiosity and spiritual coping among nursing students from four countries. Nursing students reported high overall QOL and health. Significant differences were revealed on the religiosity and spiritual coping of students in terms of demographic characteristics. Findings show frequent attendance to organized and non-organized religious activities lead to better physical and environmental domains, and using non-organized religious activities frequently lead to improved psychological health. More frequent use of non-religious coping strategies was associated with better physical, psychological, and environmental health, and improved social relationships.

Factors Influencing Arab Nursing Students' Attitudes toward Climate Change and Environmental Sustainability and their Inclusion in Nursing Curricula.

OBJECTIVE: To assess the factors influencing the attitudes of Bachelor of Science in Nursing students toward climate change and environmental sustainability and the inclusion of these concepts in the nursing curricula of four Arab countries. METHOD: A convenience sample of 1,059 students from four Arab countries was surveyed using the Environmental Sustainability Attitudes in Nursing Survey-2 (SANS-2) questionnaire in this descriptive-comparative study. RESULTS: The majority of the respondents exhibited positive attitudes toward the five items of SANS-2, with "Environmental sustainability is an important issue for nursing" receiving the lowest mean score and "Issues about climate change should be included in the nursing curriculum" receiving the highest mean score. Saudi students had more positive attitudes toward environmental sustainability in health care compared with students from Iraq, Egypt, and the Palestinian Territories. Country of residence, type of community, and knowledge about environmental issues and their impact on health in any nursing course were significant factors that influenced attitudes toward environmental sustainability. CONCLUSION: The inclusion of climate change and environmental sustainability in nursing curricula in the Arab region was emphasized by the findings. Including environmental sustainability practices in nursing education will help student nurses develop critical thinking and skills in the adaptive delivery of health care, especially when resources are scarce.

Quality of life of nursing students from nine countries: A cross-sectional study.

BACKGROUND: Nursing student life is stressful as a result of the work they exert to learn concepts ranging from basic to complicated issues and health concerns for maintaining overall human health. Hence, assessing the quality of life (QOL) of nursing students is important to determine if they have excellent well-being levels as they go through the learning process. OBJECTIVES: This study measured and compared QOL of respondents by country of residence, and identified the QOL predictors of students. DESIGN: Descriptive, cross-sectional design. SETTINGS: A multi-country study conducted in Chile, Egypt, Greece, Hong Kong, India, Kenya, Oman, Saudi Arabia, and the United States of America. PARTICIPANTS: A convenience sample of 2012 Bachelor of Science in Nursing (BSN) students. METHODS: A self-administered questionnaire containing demographic characteristic items and the World Health Organization QOL-BREF (WHOQOL-BREF) was used to gather data from respondents. RESULTS: The highest overall QOL was recorded in the physical health domain, whereas the lowest was in the social health domain. The perceived highest and lowest QOL dimension varied between countries. Age, country of residence, and monthly family income showed statistically significant multivariate effect on the aspects of QOL. CONCLUSIONS: Considering their stressful lives, the present study underscores the importance of ensuring the highest level of well-being among nursing students. The maintenance of high levels of well-being among nursing students should also be prioritized to maximize their learning and ensure their satisfaction in their student life.

U.S. Filipino Adults' Patterns of CAM Use and Medical Pluralism: Secondary Analysis of 2012 National Health Interview Survey.

The cultural health beliefs of the Filipino population and colonial history of medicine in the Philippines could mean high use of complementary and alternative therapies (CAM) and increased engagement in medical pluralism (i.e., combined use of conventional medicine and CAM) among the U.S. Filipino population, the fourth largest immigrant group in the United States. However, there is limited research regarding U.S. Filipinos' health behaviors related to CAM use and medical pluralism engagement. The purpose of this study was to explore patterns of CAM use and medical pluralism practices of Filipino adults living in the United States. Data from Filipino adult respondents of the 2012 National Health Interview Survey adult CAM supplement were analyzed to determine most common CAM used, most common conditions for which CAM was used as a treatment, reasons for using CAM for treatment of health conditions, and sources of recommendations for CAM as a treatment in this population. Dietary supplements were the most common CAM used by Filipino adults living in the United States. A small number of U.S. Filipino adults reported using CAM to treat pain-related and cardiovascular conditions, with the most common source of recommendations coming from friends and family members. Most common reasons for using CAM for treatment of health condition were: CAM is natural; CAM had a holistic approach, and CAM could be taken/practiced independently. Based on the findings of the study, Filipino adults living in the United States engage in a pluralistic approach to health by using CAM for treatment of health conditions. Analysis of the 2012 NHIS adult CAM supplement provided an overview of Filipino adults' patterns of CAM use and medical pluralism; however, future research is still needed to explain such health behavior patterns.

Knowledge of and attitudes toward climate change and its effects on health among nursing students: A multi-Arab country study.

BACKGROUND: Climate change and its impact on health continues to receive inadequate attention in the nursing literature, especially in the Arab region. This study explored the knowledge of and attitudes toward climate change and its effect on health among nursing students from four Arab countries. METHOD: A cross-sectional study was conducted among a convenience sample of 1,059 baccalaureate nursing students from four Arab countries using the New Ecological Paradigm scale and an adapted questionnaire. RESULTS: The findings indicate an average range of attitude toward the environment, with country of residence, type of community, academic-year level, and climate change related variables as significant factors influencing students' attitudes. A moderate level of knowledge about the potential health related impacts of climate change was revealed. Students from Saudi Arabia and Palestinian Territory reported a significantly higher level of knowledge than Egyptian and Iraqi students. Most of the respondents reported that all identified health related effects of climate change have already increased, while more than two-thirds reported that each of the health-related impacts would increase within the next 20 years. CONCLUSION: The findings underscore the need for more coverage of topics related to climate change and its health-related impacts in nursing education curricula in Arab countries.

Baccalaureate Student Nurses' Study Habits Prior to Admission to Nursing Program: A Descriptive Qualitative Study.

BACKGROUND: Faculty continue to observe students struggling as they adapt their study strategies to learn nursing core content. OBJECTIVES: This study described the study habits of Bachelor of Science in Nursing (BSN) students prior to admission to the program. DESIGN: This study used a descriptive qualitative research design. SETTINGS AND PARTICIPANTS: A purposive sample of 19 BSN students (juniors [n=10] and seniors [n=9]) from a 4-year public Midwestern university were included in this study. METHODS: Two focus group sessions, using a semi-structured interview guide, were conducted in the spring semester of 2013. RESULTS: The four themes which emerged from the analysis of data were: "I just got it," "I had a lot of time then," "I studied alone" mostly, and "…a little struggle with the sciences." CONCLUSIONS: The findings suggest the BSN students did not study much or employed poor study strategies during their years completing general education courses. Academic support is needed by students prior to admission to the nursing program so they can learn effective study skills and modify their study habits for easier adaptation to the rigors of nursing education.

Digestive Enzyme Replacement Therapy: Pancreatic Enzymes and Lactase.

Maldigestion occurs when digestive enzymes are lacking to help break complex food components into absorbable nutrients within the gastrointestinal tract. Education is needed to help patients manage the intricacies of digestive enzyme replacement therapies and ensure their effectiveness in reducing symptoms of maldigestion.

Antithyroid Drugs for Hyperthyroidism.

Hyperthyroidism is a treatable endocrine disorder. Having a working knowledge of the current evidence-based guidelines for treating hyperthyroidism aids in improved patient care.

A Review of Antihypertensive Medications, Part II.

Hypertension requires careful management, including lifestyle mod- ification and drug therapy. Use of angiotensin-receptor blockers, beta blockers, and calcium channel blockers is discussed.

A Review of Antihypertensive Medications, Part I.

Hypertension requires careful management, including lifestyle modification and drug therapy. Use of thiazide diuretics and ACE inhibitors is discussed.

Recognizing Prescription Drug Abuse and Addiction in Patients, Part II .

With health and wellness advocacy as a part of their role, medical-surgical nurses should do their best to address patients' hidden health care concerns such as drug misuse and abuse, and lead them to treatment resources. By gaining knowledge of prescription drug abuse and misuse, nurses will be more prepared to recognize these problems in their patients.

Evaluation of graduate nursing students' information literacy self-efficacy and applied skills.

Maintaining evidence-based nursing practice requires information literacy (IL) skills that should be established prior to completing an undergraduate nursing degree. Based on Bandura's social cognitive theory, this cross-sectional descriptive correlational study assessed the perceived and applied IL skills of graduate nursing students from two family nurse practitioner (FNP) programs in the midwestern United States. Results showed that although the 26 newly admitted FNP students demonstrated a high level of confidence in their IL skills, the students did not perform well in the actual IL skills test. According to Bandura, the students' confidence in their IL knowledge should allow students to be engaged in course activities requiring IL skills. Nurse educators teaching in undergraduate or graduate programs are in key positions to incorporate IL experiences into class activities to allow for skill assessment and further practice. Further research is needed on nursing students' IL self-efficacy and performance.

Reflections of Evidence-Based Practice in Nurse Educators' Teaching Philosophy Statements.

AIM: This article focuses on the nature and importance of evidence-based practice (EBP) as described in the teaching philosophy statements of academic nurse educators (ANEs). BACKGROUND: EBP is a core competency identified by the Institute of Medicine. Its incorporation into teaching philosophies expresses ANEs' ideas, values, and practices. METHOD: A mixed-method design using an online survey was used to collect and analyze demographic data and teaching philosophy statements from 375 ANEs. Coding was done via direct correct analysis. Themes were identified to capture the essence of the coded statements. RESULTS: EBP and its components were mentioned 275 times collectively; 44 ANEs specifically mentioned EBP in their teaching philosophies. other components were mentioned more frequently. three themes emerged: keeping up-to-date, setting up student success with EBP, and EBP as a teaching approach. CONCLUSION: The incorporation of EBP and its components was not widely acknowledged by ANEs.

Types of flu vaccines for yearly immunization.

The best way to prevent influenza and its potentially life-threatening complications is by receiving the annual flu immunization at the earliest opportunity. As patient educators, nurses should help individuals, families, and the community receive the benefits of this important illness prevention strategy.