Barbara Brown

Psychosocial adjustment in women with breast cancer

There is a plethora of studies investigating psychosocial adjustment in women with breast cancer, its correlates, clinical course, and prognosis. These studies have been conducted with varying degrees of methodologic rigor. An assessment has been made of the quality of this existing evidence to identify from the best evidence the factors which predict the adjustment status of women with breast cancer. Studies have been reviewed, using methodologic standards for the critical appraisal of studies on prognosis, developed by Sackett and colleagues in the Department of Clinical Epidemiology and Biostatistics at McMaster University (Hamilton, Ontario, Canada). Few of the studies investigating psychosocial adjustment of women with breast cancer meet all of the criteria for reviewing studies of clinical course and prognosis. This review focuses the direction and methodologic rigor required in future investigations. In particular, studies are needed that employ prospective designs and that deliberately measure or control for the extraneous prognostic variables that may affect adjustment. Future investigations need to incorporate adequate precision in measurement so that measures of the psychosocial variables are objective, reliable, and valid.

A Comparison of Problem-Based and Conventional Curricula in Nursing Education

AbstractThe purpose of this study was to compare graduating baccalaureate students in a problem-based curriculum with those in a conventional nursing program with regard to perceived preparation for clinical practice, clinical functioning, knowledge and satisfaction with their education. Prior tograduation, students completed a self-report questionnaire that consisted of five sections and took about 45 minutes to complete. Following graduation, their pass rates on the National Nursing Registration Examination (RN Exam) were also compared.The findings indicated no significant differences in their perceived preparation for nursing practice, although the conventional students scored higher in all areas. There were also no significant differences between the two groups in their perceived clinical functioning, although there was a trend toward higher function in the areas of communication and self-directed learning in the PBL group. There were no statistically significant differences in RN scores. The PBL students scored significantly higher on perceptions of their nursing knowledge, particularly in the areas of individual, family and community health assessment, communication, teaching/learning, and the health care system. The students undertaking the PBL program were more satisfied with their educational experience than their counterparts in the conventional program, indicating higher satisfaction with tutors, level of independence, assessment and program outcomes, but no difference in relation to workload orclarity of expectationsThis study contributes to our understanding of the relationship between different educational approaches and student outcomes. It suggests that PBL is an effective approach for educating nurses. Furthermore, it indicates that nursing students in the PBL program, like their counterparts in PBL medical programs, report higher levels of satisfaction. Future studies that are longitudinal in design and rely less on self-report measures would contribute further to our understanding of the benefits and limitations of PBL in nursing education.

A cross-sectional study of emotional intelligence in baccalaureate nursing students.

Emotional intelligence (EI) has been identified as a set of competencies necessary for workplace success. EI is deemed essential for effective nursing practice, yet little research has been done in nursing. The purpose of this study was to describe the EI scores of baccalaureate nursing students and to determine if there was a difference among the students across the four years of the program. A cross-sectional design was used to examine the EI scores of 100 female nursing students (25 in each of the four years). Students completed the BarOn Emotional Quotient Inventory Short (EQ-i:S), a 51-item self-report questionnaire that includes scores for a total EQ and 5 subscales. Undergraduate nursing students in each of the four years of the program had EI scores within the emotionally and socially effective functioning capacity, identifying them as being able to establish satisfying interpersonal relationships, and work well under pressure. The difference in total EQ scores between students in Year 1 and Year 4 was statistically significant (p= or <.05) as were the scores in the interpersonal and the stress management subscales (p= or <.05) with students in Year 4 scoring higher than those in Year 1. Implications for nursing education are discussed.

Development of professional confidence by post diploma baccalaureate nursing students

Professional confidence should be nurtured in a caring nursing curriculum, however there is a lack of clarity as to what confidence means, how it is perceived by students, and what educators can do to instill professional confidence in nursing students. A qualitative study using focus groups was conducted to explore the components of professional confidence as perceived by diploma-prepared registered nurses enrolled in a two-year student-centered, problem-based baccalaureate degree program. Students identified professional confidence as developing through a two-phase process. During the first phase, Becoming Informed, students reported acquiring knowledge, theory and critical thinking in the supportive environment of small tutorial groups, which in turn enabled them to examine nursing practice and defend decisions with clarity and confidence. In Finding a Voice of My Own they clearly articulated an evidence-based nursing position in both academic and clinical environments with a sense of ownership and congruence with their own values. Each phase was further composed of four processes: feeling, knowing, doing and reflecting. When supported through these phases, students felt prepared (i.e. confident) to assume broader roles in health care. Post diploma programs should acknowledge and build on the skills and abilities nurses bring to the educational setting, yet challenge learners to develop critical self appraisal.

Adult Psychosocial Adjustment Following Childhood Injury: The Effect of Disfigurement

The literature investigating the psychosocial adjustment of burn survivors is limited and that addressing such adjustment in burned children is contradictory. Forty-two adults, burned in childhood, were assembled into burn severity cohorts and compared as to burn severity, intensity of stress, and extent of disfigurement and disability. The findings substantiated the hypothesis that the biologic variables of years since burn and severity would not explain psychosocial adjustment in adulthood; lower adjustment correlated with visible disfigurement and less peer support rather than with severity of burn.

Analyses of Coping Responses and Adjustment: Stability of Conclusions

This study was conducted to determine the stability of conclusions derived from analyses of different ways of scoring coping responses in relation to the adjustment of subjects who had survived a burn injury. As part of a larger study of adjustment to burn injury, 260 adults who had sustained a burn injury over a 12-year period consented to complete the Billings and Moos Coping Responses Scale (CRS; Moos, Cronkite, Billings, & Finney, 1984) and the Psychosocial Adjustment to Illness Scale (PAIS; Deragotis & Lopez, 1983). A clinician made a global assessment of each subjects adjustment. Three ways of scoring the CRS were used for analyses: (a) Method and Foci of coping (Indices of Coping Responses), as suggested by Moos et al. (1984), (b) new factor analysis, and (c) separate responses. Stepwise multiple regression analysis of each of these with three different outcomes of adjustment (PAIS, global clinical judgment scores, and the PAIS psychological distress component) gave consistent results. The more adjusted burn survivors used more problem-solving coping responses and fewer avoidance responses. The two responses in the individual multiple regression analysis gave a higher correlation than the factor or index descriptors. These two responses correlated well with all three adjustment outcomes, r = .49, .37, and .47. The relationship between coping behavior and adjustment to illness was not sensitive to the different ways of scoring the CRS.

A Comprehensive Faculty Development Model for Nursing Education

Professional nursing education has undergone profound legislative changes requiring a university baccalaureate in nursing as entry to practice as a registered nurse (RN) in Ontario, Canada. Subsequent partnerships between colleges and universities were mandated by the ministry of post secondary education in order to maximize existing resources, such as faculty, and capitalize on the strenghts of both sectors. Faculty, in partnered collaborative undergraduate nursing programs, are challenged by the ever-evolving transition in conceptualization, development, and delivery of nursing education; consequently, the design, dissemination, and evaluation of effective faculty development programs is of paramount importance (Steinert, 2000). This paper focuses on the creation of the Comprehensive Faculty Development Model implemented by a collaborative BScN program partnership in south-western Ontario. It describes the models contextual underpinnings, illustrates the component parts, explains their relationship, and provides an in-depth discussion of foundational concepts. The model was developed under the auspices of a collaborative faculty development committee with representation from all partners. Summaries of four research studies designed and implemented by members of the partnership provide a useful assessment of how faculty members experienced the inaugural BScN program; however, more study is needed in order to understand what approaches to faculty development are most effective and sustainable.

The use of peer evaluation in promoting nursing faculty teaching effectiveness: a review of the literature

Many authors have recommended that peer evaluation should be a key component in evaluating nursing faculty teaching effectiveness. Despite the purported advantages of peer evaluation it remains a controversial method for faculty evaluation. In a review of the literature the success of a peer evaluation depends on faculty involvement, short but objective methods, trained observers, constructive feedback for faculty development as well as open communication and trust.

Methodological problems in studies of burn survivors and their psychosocial prognosis

As the psychological adjustment of burn survivors is a subject of increasing interest, 21 studies on psychosocial adjustment to burns in adults and children are reviewed. These studies are commonly cited as a basis for determining the direction of future research. Eight methodological guidelines are applied to these studies of prognosis. Limitations are identified with the major focus of the paper being to assist in the development of more rigorous methodology in order to promote the optimal rehabilitation for burn survivors.

Wellness education for individuals with chronic mental illness living in the community.

The article reports a wellness education program developed to enhance and promote healthy life-style behaviors for individuals with chronic mental illness living in the community. Theoretical concepts from health promotion, wellness, and social learning were used in the development of this program. The program comprised three components: wellness education sessions, exercise/activity sessions, and a smoking reduction course.