Inquiry in uncertainty-nursing students' learning experience in challenge-based learning: A qualitative study.

BACKGROUND: Currently, nursing students face a significant lack of preparedness in efficiently addressing complex issues. The use of challenge-based learning, a student-centred situational learning method that utilizes practice scenarios to solve complex problems, can help alleviate the challenges in nurse education. However, there remains to be more extensive exploration on the application of challenge-based learning in nurse practice education. OBJECTIVES: This study aims to explore the learning experiences of nursing students in challenge-based learning to gain a deeper understanding of the ways and mechanisms through which challenge-based learning enhances specific learning abilities. DESIGN/METHODS: This study utilized a hermeneutic phenomenological design, employing semi-structured interviews and thematic analysis. SETTINGS: A university in Hunan, China, hosted the nursing skills competition based on the principles of challenge-based learning, targeting senior students from nursing schools in Hunan province. PARTICIPANTS: A total of 24 fourth-year students from six colleges, including one male and twenty-three female students. RESULTS: Two themes and seven sub-themes emerged from the study. Theme 1 Constructing a knowledge system in complex scenarios with sub-themes: Case-based education centred on comprehensive knowledge promotes knowledge linkage; Reverse reasoning promotes knowledge differentiation; Making mistakes helps finding the correct path of knowledge; Traps inspire identification of potential problems. Theme 2 Inquiry in uncertainty with sub-themes: Unexpected changes promote exploration of general principles; Combining knowledge with diverse case scenarios promotes flexible thinking; The uncertainty of knowledge fosters independent thinking. CONCLUSIONS: The complexity and variability inherent in challenging learning situations promote the construction of students' knowledge systems and the cultivation of an inquisitive spirit. The identification of these mechanisms contributes to the optimization of instructional environment design, the development of a culture of continuous learning and innovation, and effectively tackling complex issues within an ever-evolving global context.

Clinical nurses' compassion fatigue psychological experience process: a constructivist grounded theory study.

BACKGROUND: Clinical nurses are susceptible to compassion fatigue when exposed to various types of traumatic events in patients for extended periods of time. However, the developmental process, staging, and psychological responses distinct to each stage of compassion fatigue in nurses are not fully clarified. This study aimed to explore the processes of compassion fatigue and the psychological experiences specific to each phase of compassion fatigue among clinical nurses. METHODS: Charmaz's Constructivist Grounded Theory methodology was used in this qualitative research. Semi-structured interviews were conducted with 13 clinical nurses with varying degrees of compassion fatigue from December 2020 to January 2021. Interview data were analyzed using grounded theory processes. RESULTS: The data were categorized into five separate categories and 22 sub-categories. This study found that the process of compassion fatigue is dynamic and cumulative, which was classified into five phases: compassion experience period, compassion decrement period, compassion discomfort period, compassion distress period, and compassion fatigue period. CONCLUSION: Clinical nurses who experience compassion fatigue may go through five stages that are stage-specific and predictable. The findings can shed light on local and global applications to better understand the problem of nurses' compassion fatigue. The interventions for addressing compassion fatigue in clinical nurses should be stage-specific, targeted, and individualized.

Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling.

BACKGROUND: Clinical nurses are at high risk for compassion fatigue. Empathy is a prerequisite for compassion fatigue, and social support is an important variable in the process of reducing individual stress. However, the role of social support in the relationship between empathy and compassion fatigue remains unclear. This study explored whether social support mediates the relationship between empathy and compassion fatigue among clinical nurses. METHODS: A total of 992 clinical nurses were recruited through convenience sampling for a cross-sectional study in Central China. They completed the General Information Questionnaire, Perceived Social Support Scale, Professional Quality of Life Scale, and Jefferson Scale of Empathy. SPSS was used to conduct descriptive statistical analyses. Pearson's or Spearman's correlation analyses and AMOS were employed to build a structural equation model (SEM) to verify the mediating effect of social support on the relationship between empathy and compassion fatigue. RESULTS: The results indicated that the standardized direct effect of empathy on compassion fatigue was 0.127, and the standardized indirect effect of empathy on compassion fatigue through social support was 0.136. The mediation effect ratio between empathy and compassion fatigue was 51.7%. CONCLUSIONS: Our findings show that social support mediates the relationship between empathy and compassion fatigue among clinical nurses. This finding suggests that increasing nurses' social support can decrease the prevalence of compassion fatigue. Nursing managers should provide training related to flexibly adjusting empathy and educating nurses to establish effective social networks with family, friends, and colleagues to prevent compassion fatigue.

Autistic children's age difference in affiliate stigma and resilience of their parents in China: A cross-sectional study.

BACKGROUND: Parents of children with Autism Spectrum Disorders (ASD) experience high levels of stigma, especially in China where the culture is shame socialized. Resilience can help overcome stigma; while parent characteristics predict resilience, other factors may also be significant such as the child's age. OBJECTIVE: The study sought to identify the differences in affiliate stigma and resilience among Chinese parents of children with ASD according to the child's age, and to determine whether the levels of resilience and experience of stigma are related. METHODS: A cross-sectional survey of 184 parents of children with ASD was conducted. Affiliate stigma and resilience were measured using the Chinese version of the 22-item Affiliate Stigma Scale and the Chinese version of the Connor-Davidson Resilience Scale. Differences were examined by using regression and correlation analysis. RESULTS: Parents of school-age children experienced more affiliate stigma than parents of preschoolers, but there was no difference in resilience when other factors were controlled. CONCLUSIONS: Considering the child's age is important to understand affiliate stigma and resilience, particularly where resilience is protective and could inform the design of support strategies for preschooler parents.

Visceral Adiposity Index Is a Measure of the Likelihood of Developing Depression Among Adults in the United States.

Background: Depression is a serious mental disorder often accompanied by emotional and physiological disorders. Visceral fat index (VAI) is the current standard method in the evaluation of visceral fat deposition. In this study, we explored the association between VAI and depression in the American population using NHANES data. Methods: A total of 2,577 patients were enrolled for this study. Data were collected through structured questionnaires. Subgroup analysis for the relationship between VAI and depression was evaluated using multivariate regression analysis after adjustment for potential confounding factors. Results: For every 1 unit increase in VAI, the clinical depression increased by 14% (OR = 1.14, 95% CI: 1.04-1.25). High VAI scores (T3) increased the highest risk of developing depression (OR = 2.32, 95% CI: 1.2-4.47). Subgroup analysis demonstrated a strong and stable association between VAI and the development of depression. Conclusion: Our study showed that depressive symptoms are associated with a high ratio of visceral adiposity index after controlling confounding factors.