Enhancing perceived leadership of nursing students through a student-led dedicated education unit in a community setting: A feasibility study.

BACKGROUND: Leadership competence is important to ensure the provision of safe and high-quality care in hospitals. PURPOSE: The aim was to demonstrate the feasibility of enhancing the perceived leadership competence of nursing students through an innovative health education strategy, consisting of a student-led dedicated education unit (DEU) informed by a service-learning approach in a community setting. DESIGN: Feasibility study in a three-phase process: I: Design; II: Acceptability and implementation; III: Expansion to a different setting. In phase II the DEU was piloted with 62 students using a pretest/post-test with control group design. In phase III it was piloted with 20 students in the expansion setting. METHODS: The DEU was implemented and tested in Barcelona (Spain) between 2014 and 2019. To assess acceptability and implementation, students' perceived leadership competence was measured using the Self-Assessment Leadership Instrument. We also obtained satisfaction ratings using an ad hoc questionnaire. RESULTS: Satisfaction was high among students, as well as among service users who received health education. In phase II, students' post-test self-ratings of their leadership competence were higher in both the intervention and control groups, but the increase was significantly greater among students who participated in the DEU (25.84 % vs. 16.72 %, p = .012). Similar results were obtained in the expansion phase, with students in the intervention group once again showing a significant increase in perceived leadership skills (12.89 %, p = .005). CONCLUSIONS: Student-led DEUs appear to be an effective way of enhancing perceived leadership competence among senior nursing students.

Assessing Nursing Students' Self-Perceptions about Safe Medication Management: Design and Validation of a Tool, the NURSPeM.

OBJECTIVE: The objective was to design and validate a tool for assessing nursing students' self-perceptions about safe medication management. METHODS: A descriptive instrumental study was conducted involving construct definition, development of the tool, analysis of the content validity, and psychometric evaluation. Consensus regarding the content was obtained through a two-round Delphi process, and the resulting tool (the NURSPeM) was administered to nursing students to examine its internal consistency, temporal stability, and construct validity, the latter through exploratory factor analysis. RESULTS: Thirteen experts participated in the Delphi process, which yielded a tool comprising two questionnaires: (1) Self-perceptions about safe medication management (27 items) and (2) the frequency and learning of drug-dose calculation (13 items). The tool's psychometric properties were then examined based on responses from 559 nursing students. This analysis led to the elimination of three items from questionnaire 1, leaving a total of 24 items distributed across seven dimensions. All 13 items in questionnaire 2 were retained. Both questionnaires showed good internal consistency (Cronbach's alpha = 0.894 and 0.893, respectively) and temporal stability (ICC = 0.894 and 0.846, respectively). CONCLUSIONS: The NURSPeM is a valid and reliable tool for assessing nursing students' self-perceptions about safe medication management. It may be used to identify areas in which their training needs to be enhanced, and to evaluate the subsequent impact of new teaching initiatives.

Effectiveness of an educational intervention to reduce the burden on home care workers and facilitating factors: A pre-post study.

AIMS: To determine if a training program, aimed at home care workers, for caring for the elderly and for providing their own self-care is effective for reducing workers burden in the short and long terms and to identify the associated variables that can influence burden across 12 months. BACKGROUND: An increasing number of older adults rely on home care workers as a complement to the care received from family caregivers. However, these workers do not usually have any formal training in nursing care and occasionally suffer burden. DESIGN: A pre- and post-intervention study with a follow-up at 12 months including 86 participants. METHODS: An 85-hour training course, which included a practical module lasting 35 h, was offered on five separate occasions between 2014 and 2017 in Barcelona (Spain). The care burden was measured according the Zarit Burden Interview and care knowledge and perceived difficulty performing care tasks were assessed. We also gathered data on the physical and psychological status of the care recipients. RESULTS: The educational intervention was effective after training (-7.45% p = .020) and although the initial burden on caregivers did not worsen significantly despite spending 12 months caring for people with moderate physical and psychological dependence, the decrease in the burden was not maintained over time. Associated variables that can influence the burden over 6 months were the caregivers' baseline perception of lacking knowledge and/or having no difficulty with care tasks. The variable that could influence overburden in caregivers at 12 months was becoming ill before the intervention. CONCLUSIONS: For the first time, the effectiveness of home workers-specific training has been demonstrated: a reduction in the perceived burden was observed immediately following training completion, but this reduction was not sustained at 6/12 months. The practical interpretation is that a remedial/follow-up training course may be needed. Whether difficulty in providing care or having sufficient knowledge and having an illness influence self-care maintenance requires further verification.

Effectiveness of a nurse-led, face-to-face health coaching intervention in enhancing activation and secondary outcomes of primary care users with chronic conditions.

Prevalence of chronic diseases and multimorbidity is rising, and it remains unclear what the best strategy is for activating people with chronic conditions in their self-care. We designed a two-group quasi-experimental time series trial to examine the effectiveness of a nurse-led, face-to-face, individually-tailored health coaching (HC) intervention in improving patient activation and secondary outcomes (self-efficacy, quality of life, anxiety and depression symptoms, medication adherence, hospitalization and emergency visits) among primary care users with chronic conditions. A total of 118 people with chronic conditions were recruited through a primary care center and allocated to either the intervention group (IG) (n = 58) or control group (CG) (n = 60). The IG received a nurse-led individually-tailored HC intervention involving 4-6 face-to-face multicomponent sessions covering six core activation topics. The CG received usual primary care. Data were collected at baseline, after the intervention (6 weeks after baseline for controls) and at 6 and 12 months from baseline. Compared with controls, the IG had significantly higher patient activation scores after the intervention (73.29 vs. 66.51, p = .006). However, this improvement was not maintained at follow-up and there were no significant differences in secondary outcomes across the study period. HC may be an effective strategy for achieving short-term improvements in the activation of primary care users with chronic conditions. Further studies with different methodological approaches are needed to elucidate how HC may improve and sustain changes in patient activation.

Dimensions of leadership in undergraduate nursing students. Validation of a tool.

BACKGROUND: Nurses require leadership skills in order to fulfil their clinical role in an ever-changing healthcare environment. The acquisition of such skills should therefore begin during their professional training. OBJECTIVES: To identify the dimensions of leadership present among nursing undergraduates in the original Self-Assessment Leadership Instrument (SALI). DESIGN: This was a validation study involving the translation and cultural adaptation of the Self-Assessment Leadership Instrument (SALI) for use with nursing undergraduates in the Spanish context. SETTING: Faculty of Medicine and Health Sciences in Spain. PARTICIPANTS AND METHODS: Participants were 280 nursing undergraduates (years 1-4) from a Spanish university. The SALI was adapted following the back-translation procedure, and its psychometric properties (validity and reliability) were analyzed. RESULTS: The Spanish version of the SALI maintains the 40 items of the original scale. Scores on the Spanish SALI were positively and significantly correlated (0.542, p = .000) with scores on the General Self-Efficacy Scale (convergent scale) and negatively and significantly correlated (-0.348, p = .000) with the total score on the Lille Apathy Rating Scale (divergent scale). Factor analysis indicated that scores on the Spanish SALI loaded on four dimensions: Strategic thinking, Emotional intelligence, Impact and influence, and Teamwork skills, which together accounted for 43.42% of the total variance. Cronbach's alpha for the total scale was 0.870 (range 0.688-0.781 for the four dimensions). Test-retest reliability over a 15-day interval was high (ICC = 0.929, p = .000). CONCLUSIONS: The study has identified four key dimensions of leadership that nursing students need to acquire and provides a valid and reliable tool for assessing them. This will enable nurse educators to evaluate the effectiveness of teaching initiatives aimed at developing these competences.

Adaptation to European Spanish and psychometric properties of the Patient Activation Measure 13 in patients with chronic diseases.

Background: The 13-item Patient Activation Measure (PAM-13) is an instrument that assesses people's knowledge, skills and confidence for self-management of their health and health care. Scores on the PAM-13 have been shown to predict adherence to health behaviours, health-related outcomes and health care costs. Objectives: To develop a European Spanish adaptation of the original PAM-13 and to examine its psychometric properties in a sample of chronic patients. Methods: The PAM-13 was forward-backward translated and then completed by chronic patients attending a primary health care centre. Data were analysed with a Rasch model. We assessed the functioning of the rating scale, its reliability, the item goodness-of-fit, differential item functioning (DIF), local dependence, unidimensionality and correlation analysis. Results: A total of 208 patients (80%) completed the questionnaire. Data showed a fit to the Rasch model. More than 50% of patients endorsed all the items. Item rank for the Spanish sample was similar to the original, with few differences. We found significant differences (P < 0.05) in PAM-13 measures according to adherence to prescribed medicines and positive correlations with self-efficacy and physical quality of life. Conclusions: The European Spanish PAM-13 is a reliable and valid instrument for assessing activation in patients with chronic disease in Spain. We suggest adding new items to the instrument so as to examine patients with higher activation levels in the future. Further studies are needed to evaluate the usefulness of this new Spanish PAM-13 in different settings and populations, as well as to examine the relationship between PAM-13 scores and other health-related outcomes.