Nurse Education in Practice最新文献

Aim: To evaluate the effects of a trauma-informed care workshop on nurses' knowledge, attitudes and practices, as well as their perceptions of barriers and enablers to trauma-informed care implementation.

Background: Trauma has a widespread impact on survivors. Healthcare providers should deliver trauma-informed care to empower and avoid retraumatization. However, many nurses lack the knowledge and skills to implement trauma-informed care or have negative attitudes toward the practice. Few studies have assessed the effect of trauma-informed care workshops on nurses.

Design: A randomized controlled trial.

Method: Participants included 291 nurses in Saudi Arabia who were randomly assigned to the intervention or control group. The intervention comprised an online workshop based on the Substance Abuse and Mental Health Services Administration 4 Rs framework and six principles of trauma-informed care, followed by 12 weeks of reinforcing educational materials. After 3 months of delivering the online workshop session, posttest data were collected from both groups. An intent-to-treat analysis was considered for all participants lost to follow-up (n = 43). Multilevel linear modeling assessed differences in change from pretest to posttest between the intervention and control groups.

Results: The intervention significantly affected all outcomes (all p<.001). Compared with the controls, the intervention group had greater improvements in knowledge (β = 2.84), attitude (β = 4.25), practice (β = 1.33) and enablers (β = 3.05) and larger reductions in perceived barriers (β = -4.41).

Conclusions: The findings highlight the importance of including trauma-informed care principles in nurses' continuing professional training.

Background: Nurses' trauma-informed care (TIC) competency was a critical factor influencing the integration of TIC into routine practice. However, there is still an absence of culturally tailored and scientific instruments for comprehensive assessment of TIC competency.

Aim: To develop and validate an instrument to measure the TIC competency for nurses.

Design: A methodological study.

Settings: Two comprehensive hospitals in Changsha, Hunan province.

Method: The instrument was developed in 2 stages. In the first stage, items were developed based on the 4 R assumptions of TIC, guided by a scoping-style literature review and qualitative interviews with nurses. The Delphi method was employed to modify and screen the item pool. In the second stage, 600 nurses were recruited to select items and evaluate the psychometric validation. Separate samples were used for the exploratory factor analysis (EFA, n = 300) and confirmatory factor analysis (CFA, n = 300). Test-retest reliability was assessed (n = 52).

Results: The newly developed TIC competency scale for nurses included 33 items categorized into four dimensions: realizing, recognizing, responding and resisting re-traumatization. The Cronbach's α coefficient of the scale is 0.956, with McDonald's ω coefficient of 0.957 and intraclass correlation coefficient of 0.846. The content validity at the scale-level index was 0.965. EFA identified four common factors, accounting for 64.278% of the cumulative variance. CFA demonstrated that the scale has strong structural validity.

Conclusions: The TIC competency scale has strong reliability and validity and could be used to evaluate the TIC competency of nurses.

Aim: To compare effects of stoma care training using standardized patients and low-fidelity mannequins on nurses' meaningful learning self-awareness, perceived learning and stoma care skills.

Background: Stoma creation is a frequent surgical procedure for gastrointestinal and urinary system diseases requiring specialized nursing care. Many nurses feel inadequately prepared. Simulation-based education using standardized patients and mannequins improves clinical competence.

Design: This was a parallel-group, randomized controlled trial.

Methods: The study was conducted between April 1, 2024 and July 1, 2024, at an oncology training hospital in Ankara, Türkiye. Nurses were randomly assigned to standardized patient or low-fidelity mannequin groups. Both active groups received identical theoretical content, but practical simulation components differed. Due to educational interventions, participants were not informed of the study hypothesis and analyses used anonymized group labels. Outcomes were assessed using the Meaningful Learning Self-Awareness Scale, Perceived Learning Scale and Stoma Care Skills Rating Rubric. Analyses included the Mann-Whitney U test, chi-square test, independent-samples t-test, paired-samples t-test, Wilcoxon signed-rank test and ANCOVA.

Results: Both groups improved stoma care skills significantly (p < 0.05), with no between-group differences. Meaningful learning self-awareness did not differ (p > 0.05). The Low-Fidelity Mannequin group scored higher on cognitive subscale (t = 3.567, p = 0.001, r = 0.36) and total perceived learning (t = 2.428, p = 0.017, r = 0.25).

Conclusions: Both simulation methods improved stoma care skills. The findings on perceived learning should be interpreted cautiously due to limited internal consistency. Structured simulation can strengthen stoma care skills and promote quality nursing care.