Search results for: complementing nursing support

Authors: Rose Chapman Rodriguez

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Problem: Evidence-based practice (EBP) attributes are significantly associated with EBP implementation science, which improves patient care outcomes. Nurses influence EBP, yet little is known of the specific EBP attributes of pediatric nurses in their clinical sub-specialties. Aim: This study aims to investigate the relationship between nursing academic degree, years of experience, and clinical specialty, with mean survey scores on EBP belief, organizational culture, and implementation scales across all levels of nursing in a Children’s Hospital. Methods: A convenience sample of nurses (n=185) participated in a descriptive, cross-sectional, correlational study in May 2023. The electronic surveys comprised 11 demographic questions and nine survey items from the short-version EBP Beliefs Scale (Cronbach α = 0.81), Organizational Culture and Readiness Scale for System-wide Integration Scale (Cronbach α = 0.87), and EBP Implementation Scale (Cronbach α = 0.89). Findings: EBP belief scores were notably higher in nurses working in neonatology (m=4.33), critical care (m=4.47), and among nurse leaders (m=4.50). There was a statistically significant difference in EBP organizational culture among nurse leaders (m = 3.95, p=0.039) compared to clinical nurses (m = 3.34) and advanced practice nurses (m = 3.34). EBP implementation was favorable in neonatology (m=4.20), acute care (m=4.05), and nurse leaders (m=4.33). No significant difference or correlation was found in EBP belief, organizational culture, or implementation mean scores related to nurses' age, academic nursing degree, or years of experience in our cohort (EBP beliefs (r = -.06, p = .400), organizational readiness (r = .02, p = .770), and implementation scales (r = .01, p = .867). Conclusions: This study identified nurse’s EBP attributes in a Children’s Hospital using key variables studied in EBP social cognitive theory and learning theory. Magnet status, shared governance structure, specialty certification, and nurse leaders play a significant role in favorable EBP culture and implementation. Nurses’ unit level ‘group culture’ may vary depending on the EBP attributes and collaborative efforts of local teams. Opportunities for mentoring were identified, which may continue to enhance EBP implementation science across all nursing roles in our pediatric organization.

Keywords: evidence-based practice, peditrics, nursing roles, implementation

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Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education

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Authors: Özlem Canbolat, Sevgisun Kapucu

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The aim of this study was to determine the effect of a computer-assisted glycemic surveillance protocol on nursing workload in intensive care unit. The study is completed in an Education and Research Hospital in Ankara with the attendance of volunteered 19 nurse who had been worked in reanimation unit. Nurses used the written protocol and computer-assisted glycemic surveillance protocol for glycemic follow-up approach of the intensive care patients. Nurses used the written protocol first in the glycemic follow-up of the patient, then used the computer-assisted protocol. (Nurses used the written protocol first, then the computer-assisted protocol in the glycemic follow-up of the patient). Less time was spent in glycemic control with computerized protocol than written protocol and this difference is statistically significant (p < 0.001). It was determined that the computerized protocol application was completed in about 10 seconds (25% shorter) than the written protocol implementation. The computer-assisted glycemic surveillance protocol was found to be more easy and appropriate by nurses and the satisfaction level of the users was higher than with written protocol. While 79% of the nurses find it confusing to implement the written protocol, 79% were satisfied with the use of computerized protocol.

Keywords: computer-assisted protocol, glycemic control, insulin infusion protocol, intensive care, nursing workload

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Authors: Alice Khachian, Shoaleh Bigdeli, Azita Shoghie, Leili Borimnejad

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Background and aim: The hidden curriculum is crucial in nursing education and can determine professionalism and professional competence. It has a significant effect on their moral performance in relation to patients. The present study was conducted with the aim of identifying the hidden curriculum components in the nursing and midwifery faculty. Methodology: The ethnographic study was conducted over two years using the Spradley method in one of the nursing schools located in Tehran. In this focused ethnographic research, the approach of Lincoln and Goba, i.e., transferability, confirmability, and dependability, was used. To increase the validity of the data, they were collected from different sources, such as participatory observation, formal and informal interviews, and document review. Two hundred days of participatory observation, fifty informal interviews, and fifteen formal interviews from the maximum opportunities and conditions available to obtain multiple and multilateral information added to the validity of the data. Due to the situation of COVID, some interviews were conducted virtually, and the activity of professors and students in the virtual space was also monitored. Findings: The components of the hidden curriculum of the faculty are: the atmosphere (physical environment, organizational structure, rules and regulations, hospital environment), the interaction between activists, and teaching-learning activities, which ultimately lead to “A disconnection between goals, speech, behavior, and result” had revealed. Conclusion: The mutual effects of the atmosphere and various actors and activities on the process of student development, since the students have the most contact with their peers first, which leads to the most learning, and secondly with the teachers. Clinicians who have close and person-to-person contact with students can have very important effects on students. Students who meet capable and satisfied professors on their way become interested in their field and hope for their future by following the mentor of these professors. On the other hand, weak and dissatisfied professors lead students to feel abandoned, and by forming a colony of peers with different backgrounds, they distort the personality of a group of students and move away from family values, which necessitates a change in some cultural practices at the faculty level.

Keywords: hidden curriculum, nursing education, ethnography, nursing

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Authors: Maho Komura

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The purpose of this study was to determine from a questionnaire survey of teachers the status of implementation of individualized support for the pupils with suspected developmental disabilities in regular elementary school classes in Japan. In inclusive education, the goal is for all pupils to learn in the same place as much as possible by receiving the individualized support they need. However, in the Japanese school culture, strong "homogeneity" sometimes surfaces, and it is pointed out that it is difficult to provide individualized support from the viewpoint of formal equality. Therefore, we decided to conduct this study in order to examine whether there is a difference in the frequency of implementation depending on the content of individualized support and to consider the direction of future individualized support. The subjects of the survey were 196 public elementary school teachers who had been in charge of regular classes within the past five years. In the survey, individualized support was defined as individualized consideration including rational consideration, and did not include support for the entire class or all pupils enrolled in the class (e.g., reducing the amount of homework for pupils who have trouble learning, changing classroom rules, etc.). (e.g., reducing the amount of homework for pupils with learning difficulties, allowing pupils with behavioral concerns to use the library or infirmary when they are unstable). The respondents were asked to choose one answer from four options, ranging from "very much" to "not at all," regarding the degree to which they implemented the nine individual support items that were set up with reference to previous studies. As a result, it became clear that the majority of teachers had pupils with developmental disabilities or pupils who require consideration in terms of learning and behavior, and that the majority of teachers had experience in providing individualized support to these pupils. Investigating the content of the individualized support that had been implemented, it became clear that the frequency with which it was implemented varied depending on the individualized support. Individualized support that allowed pupils to perform the same learning tasks was implemented more frequently, but individualized support that allowed different learning tasks or use of places other than the classroom was implemented less frequently. It was suggested that flexible support methods tailored to each pupil may not have been considered.

Keywords: inclusive education, ndividualized support, regular class, elementary school

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Authors: Mohammad Khatib, Salam Hadid

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Introduction: Developing nurses' cultural competence begins in their basic training and requires them to participate in an array of activities which raise their awareness and stimulate their interest, desire and curiosity about different cultures, by creating opportunities for intercultural meetings promoting the concept of 'culture' and its components, including recognition of cultural diversity and the legitimacy of the other. Importantly, professionals need to acquire specific cultural knowledge and thorough understanding of the values, norms, customs, beliefs and symbols of different cultures. Similarly, they need to be given opportunities to practice the verbal and non-verbal communication skills of other cultures according to their cultural codes. Such a system is being implemented as part of nursing studies at Zefat Academic College in two study frameworks; firstly, a course integrating nursing theory and practice in multicultural nursing; secondly, a course in learning the languages spoken in Israel focusing on medical and nursing terminology. Methods: Students participating in the 'Transcultural Nursing' course come from a variety of backgrounds: Jews, or Arabs, religious, or secular; Muslim, Christian, new immigrants, Ethiopians or from other cultural affiliations. They are required to present and discuss cultural practices that affect health. In addition, as part of the language course, students learn and teach their friends 5 spoken languages (Arabic, Russian, Amharian, Yidish, and Sign language) focusing on therapeutic interaction and communication using the vocabulary and concepts necessary for the therapeutic encounter. An evaluation of the process and the results was done using a structured questionnaire which includes series of questions relating to the contributions of the courses to their cultural knowledge, awareness and skills. 155 students completed the questionnaire. Results: A preliminary assessment of this educational system points an increase in cultural awareness and knowledge among the students as well as in their willingness to recognize the other's difference. A positive atmosphere of multiculturalism is reflected in students' mutual interest and respect was created. Students showed a deep understanding of cultural issues relating to health and care (consanguinity and genetics, food customs; cultural events, reincarnation, traditional treatments etc.). Most of the students were willing to recommend the courses to others and suggest some changes relating learning methods (more simulations, role playing and activities).

Keywords: cultural competence, nursing education, culture, language

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Authors: Ayşegül Bilge, Hacer Demirkol, Merve Uğuryol

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Therapeutic touch is one of the most important methods of complementary and alternative treatments. Therapeutic touch requires the sharing of universal energy. Therapeutic touch (TT) provides the interaction between the patient and the nurse. In addition, nurses can be aware of physical and mental symptoms of patients through therapeutic touch. Therapeutic touch (TT) is short-term provides the advantage for the nurse. For this reason, nurses have to be aware of the importance of therapeutic touch and they can use it from the primary care to tertiary care in nursing practices at in health field.

Keywords: health care services, complementary treatment, nursing, therapeutic touch

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Authors: Toyin Mary Adewumi, Cina Mosito

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Part of enabling learners with special education needs (SEN) to succeed is providing them with adequate support. Support is all activities in a school that enhance its capacity to respond to diversity by making learning contexts and lessons accessible to all learners. The paper reports findings of support provided by teachers to learners with SEN and the pockets of good practice found in the support provided by teachers to these learners in schools in the Amathole West District, Eastern Cape. A purposeful sample, comprising eight teachers, eight principals in eight schools, including one provincial and two district education officials, was selected. Thematic analysis was used for analyzing data gathered through semi-structured interviews. The results established that despite the challenges such as lack of qualifications and training in special education needs, learners with SEN received varied support from teachers which include extra exercises, extra time, special attention during break times or after school hours and homework. The study reveals pockets of good practice in some selected primary schools particularly in the poverty-stricken locations in the Amathole West District. This paper recommends adequate training for teachers for the support of learners with SEN.

Keywords: good practice, learner, special education needs, inclusion, support

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Authors: Margaret S. Wright

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Background/Significance: During many recent public health emergencies/disasters, public health nursing data has been missing or delayed, potentially impacting the decision-making and response. Data used as evidence for decision-making in response, planning, and mitigation has been erratic and slow, decreasing the ability to respond. Methodology: Applying best practices in data management and data use in public health settings, and guided by the concepts outlined in ‘Disaster Standards of Care’ models leads to the development of recommendations for a model of best practices in data management and use in public health disasters/emergencies by public health nurses. As the ‘patient’ in public health disasters/emergencies is the community (local, regional or national), guidelines for patient documentation are incorporated in the recommendations. Findings: Using model public health nurses could better plan how to prepare for, respond to, and mitigate disasters in their communities, and better participate in decision-making in all three phases bringing public health nursing data to the discussion as part of the evidence base for decision-making.

Keywords: data management, decision making, disaster planning documentation, public health nursing

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Authors: Ana Luiza Blanco, Juliana Cordeiro Carvalho, Tábatta Renata Pereira Brito, Ariene Angelini dos Santos Orlandi, Ligiana Pires Corona, Daniella Pires Nunes

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Depressive symptoms are recurrent in older adults and affect the quality of life and well-being of individuals. One of the strategies to reduce depression is social support, but studies are still needed to determine which types of social support are most effective in moderating this effect in certain populations. The objective was to identify the relationship between social support and depressive symptoms in participants of a University of the Third Age. This is a cross-sectional study. Participants were 82 individuals (≥ 50 years) who responded to the Geriatric Depression Scale - GDS and the Medical Outcomes Study - MOS. Data collection was carried out from November 2020 to May 2021. The Chi-Square and Mann Whitney tests were used, at a significance level of 5% for data analysis. Among the participants, 83.4% were female, 57.3% were age between 60 to 69 years, 83.1% studied 12 year or more and 48.1% receive from 4 to 10 minimum wages. The prevalence of depressive symptoms was 12.2%. The type of support with the highest median score was affective (100 points) and the lowest, or emotional (87.5 points). The results showed that participants without depressive symptoms had higher median scores for informational support when compared to those with depressive symptoms (p=0.029). The other types of social support were not statistically significant. The findings suggested that informational support is related to depressive symptoms in older adults. Promote informational support and educational actions in Universities of the Third Age may be an important strategy for preventing depressive symptoms and improve the quality of life of this population.

Keywords: aged, depressive symptoms, social support, university of the third age

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Authors: Komang Rahayu Indrawati, Ni Wayan Sinthia Widiastuti, Ratna Dewi Santosa

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Today the career of Balinese working women has been highly developed where able to work with loyalty and high professionalism. Career for a woman is one conscious choice and a call of conscience, which provides financial support for her family. Career for women can develop their own potencies, intellectually, and socially, so women feel that their role is meaningful and beneficial for herself and others. Emotional support becomes important to understand certainly for women who have multirole like Balinese working women to meet the demands of their role and also enhancing their work motivation and the quality of work life. This research used quantitative research method with questionnaires dissemination to 120 respondents and analyzed using Multiple Regression Analysis. The purpose of this study was to see the role of emotional support for work motivation and quality of work life in working Balinese women. The results of this study showed that emotional support and work motivation give a significant role in the quality of work life on Balinese working women.

Keywords: Balinese working women, emotional support, quality of work life, work motivation

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Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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Authors: C. Catalina Zapata, Z. Claudia Montoya

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Transplant from hematopoietic parents (THP) or medulla (MT) is a procedure used to replace the medulla that does not work as part of a disease or when it is destroyed either by a treatment of high medication doses against cancer or by radiation. The transplant process has three stages, a stage prior to transplant, during and after the transplant. It is held with the help of an interdisciplinary team, including nursing, carrying out mainly educative procedures to warrant the adhesion and the changes in lifestyles needed to whom will undergo this procedure. The aim of the study was to assess the results of an educative procedure by nursing, on adult patients subjected to a transplant from hematopoietic parents at a high complexity institution of Medellin city, Colombia. This study had an observational longitudinal design. According to the rules of protocol, the educative activity must be held on all patients joining the procedure. Four instruments were designed in order to collect all the information. One of them to measure the sociodemographic variables, another one to measure self-care practices, another one to measure transplant knowledge and its cares and the other one to measure the 30-day post-transplant complications. The last three instruments were applied before and after the educative procedure. A univaried analysis was carried out but the bivaried analysis was not carried out since there were not statistically meaningful differences before and after. Within the results, ten patients were evaluated. The average age was 38.2 (13.38 SD – standard deviation), 8/10 were men. Some self-care practices such us having pets and plants and consuming some specific food as well as little use of UV protection are all present in this type of patients and are not modified after the procedure. In measuring the knowledge, something stands out among the answers. It is the fact that some patients do not know what the medulla is, the nature of separating wastes at home and the need to consult about vomit and nausea. The most frequent complications during the first thirty days were: nausea, vomit, fever, and rash. They are considered to be expected within this period. Patients do not exhibit differences in their level of knowledge before and after the educative procedure by nursing. The patients’ self-care practices do not involve all the necessary ones to avoid complications. During the first 30 days, most of the complications are typical of the transplant process from hematopoietic parents.

Keywords: bone marrow transplant, education, family, nursing, patients, Transplantation of hematopoietic progenitors

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Authors: Mahnaz Sanjari, Sedigheh Salemi, Mohammad Mirzabeigi

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Nowadays, the world is facing a crisis of workforce and one of the most striking examples is the shortage of nurses. Nursing workforce productivity is related by various factors such as absenteeism, professional effectiveness and quality care. This cross-sectional study was conducted in 700 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 33 questions and 4 sub categories such as human resource, education and management. The reliability was evaluated by Cronbach's alpha (α=0/85). Statistical analyzes were performed, using SPSS version 16. The result showed that nurses emphasized on "respect to nurse-to-bed ratio" and less importance item was "using less experienced nurse". In addition, another important factor in clinical productivity is "Proper physical structure and amenities","good communication with colleagues" and "having good facilities". Also, "human resources at all levels of standard", "promoting on merit" and "well defined relationship in health system" are another important factors in productivity from nurse` view. The main managerial factor is "justice between employees" and the main educational component of productivity is “updating nursing knowledge”. The results show that more than half of the participants emphasized on the management and educational factors. Productivity as one of the main part of the health care quality leads to appropriate use of human and organizational resources, reduce cost services, and organizational development.

Keywords: productivity, nursing services, workforce, cost services

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Authors: Margareth S. Zanchetta, Kateryna Metersky, Valerie Tan, Charissa Cordon, Stephanie Lucchese, Yana Siganevich, Prasha Sivasundaram, Truong Binh Nguyen, Imran Qureshi

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Due to a new area of practice, Canadian nurses possess knowledge gaps regarding the use of cannabis-based therapies by clients/patients. Education related to medical cannabis (MC) and recreational cannabis (RC) is required to promote nurses’ competency and confidence in supporting clients/patients using MC/RC toward the improvement of health outcomes. A team composed of nursing researchers and undergraduate/graduate students implemented a national survey to explore this theme with the population of undergraduate, graduate (MN and NP), and Post-Diploma (RN Bridging) nursing students enrolled in Canadian Universities Nursing Programs. Upon Research Ethics Board approval, survey recruitment was supported by major nursing stakeholders. The research questions were : (a) Which are the most preferred sources of information on MC/RC for nursing students? (b) Which are the factors and preferred learning modalities that could increase interest in learning about MC/RC, and (c) What are the future career plans among nursing students, and how would they consider the prospective use of cannabis in their practice? The survey was available from Sept. 2022 to Feb. 2023, hosted by a remote platform. An original questionnaire (English-French) was composed of 18 multiple choice questions and 2 open-ended questions. Sociodemographic information and closed-ended responses were compiled as descriptive statistics, while narrative accounts will be analysed through thematic analysis. Respondents (n=153) were from 7 Canadian provinces, national (99%) and international students (1%); the majority of respondents (61%) were in the age range of 21-30 years old. Results indicated that respondents perceive a gap in the undergraduate curriculum on the topics of MC/RC (91%) and that their learning needs include regulations (90%), data on effectiveness (88%), dosing best practices (86%), contraindications (83%), and clinical and medical indications (76%). Respondents reported motivation to learn more about MC/RC through online lectures/videos (65%), e-learning modules or online interactive training (61%), workshops (51%), webinars (36%), and social media (35%). Their primary career-related motivations regarding MC/RC knowledge include enhancing nursing practice (76%), learning about this growing scope of practice (61%), keeping up-to-date responding to scientific curiosity (59%), learning about evidence-based practice (59%), and utilizing alternative forms of medical treatment (37%). Respondents indicated that the integration of topics on cannabis in any course in the undergraduate and/or graduate curriculum would increase their desire to learn about MC/RC as equally as exposure within a clinical setting (75%). The emerging trend in the set of narrative responses (n=130) suggests that respondents believe educational MC/RC content should be integrated into core nursing courses. Respondents also urged educators to be well-informed about evidence-based practice related to MC/RC and to reflect upon stigma and biases surrounding its use. Future knowledge dissemination and translation activities include scholarly products and presentations to stimulate discussion amongst nursing faculty and students, as well as nurses in clinical settings. The goal is to mobilise talents and build collaboration for the development of a socially responsive curriculum on MC/RC competency to address the education-related expectations of all these social actors.

Keywords: Canada, medical cannabis, nursing education, nursing graduate student, nursing undergraduate student, online survey, recreational cannabis

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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Authors: Alexander P. Eremeev, Ivan E. Kurilenko, Pavel R. Varshavskiy

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In this paper, the problem of the application of temporal reasoning and case-based reasoning in intelligent decision support systems is considered. The method of case-based reasoning with temporal dependences for the solution of problems of real-time diagnostics and forecasting in intelligent decision support systems is described. This paper demonstrates how the temporal case-based reasoning system can be used in intelligent decision support systems of the car access control. This work was supported by RFBR.

Keywords: analogous reasoning, case-based reasoning, intelligent decision support systems, temporal reasoning

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Authors: Ridha Abdulla Al Hammam

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Purpose: to measure the extent of perceived structural empowerment and work commitment the intensive care unit in SMC have in their work place. Background: nurses’ access to power structures (information, recourses, opportunity, and support) directly influences their productivity, retention, and job satisfaction. Exploring nurses’ level and sources of work commitment (affective, normative, and continuance) is very essential to guide nursing leaders making decisions to improve work environment to facilitate effective nursing care. Both concepts (Structural Empowerment and Work Commitment) were never investigated in our critical care unit. Methods: a sample of 50 nurses attained from the Intensive Care Unit (Adult). Conditions for Workplace Effectiveness Questionnaire and Three-Component Model Employee Commitment Survey were used to measure the two concepts respectively. The study is quantitative, descriptive, and correlational in design. Results: the participants reported moderate structural empowerment provided by their work place (M=15 out of 20). The sample perceived high access to opportunity mainly through gaining more skills (M=4.45 out of 5) where the rest power structures were perceived with moderate accessibility. The participants’ affective commitment (M=5.6 out of 7) to work in the ICU overweighed their normative and continuance commitment (M=5.1, M=4.9 out of 7) implying a stronger emotional connection with their unit. Strong positive and significant correlations were observed between the participants’ structural empowerment scores and all work commitment sources. Conclusion: these results provided an insight on aspects of work environment that need to be fostered and improved in our intensive care unit which have a direct linkage to nurses’ work commitment and potentially to their quality of care they provide.

Keywords: structural empowerment, commitment, intensive care, nurses

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Authors: Hsing Yuan Liu

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Background: Considerable theoretical and empirical work has identified a relationship between collaboration interactions and creativity in an organizational context. The mechanisms underlying this link, however, are not well understood in healthcare education. Objectives: The aims of this study were to explore the impact of collaboration interactions on team creativity and its underlying mechanism and to verify a moderated mediation model. Design, setting, and participants: This study utilized a cross-sectional, quantitative, descriptive design. The survey data were collected from 177 nursing students who enrolled in 18-week capstone courses of small interdisciplinary groups collaborating to design healthcare products in Taiwan during 2018 and 2019. Methods: Questionnaires assessed the nursing students' perceptions about their teams' swift trust (of cognition- and affect-based), conflicts (of task, process, and relationship), interaction behaviors (constructive controversy, helping behaviors, and spontaneous communication), and creativity. This study used descriptive statistics to compare demographics, swift trust scores, conflict scores, interaction behavior scores, and creativity scores for interdisciplinary teams. Data were analyzed using Pearson’s correlation coefficient and simple and hierarchical multiple regression models. Results: Pearson’s correlation analysis showed the cognition-based team swift trust was positively correlated with team creativity. The mediation model indicated constructive controversy fully mediated the effect of cognition-based team swift trust on student teams’ creativity. The moderated mediation model indicated that task conflict negatively moderates the mediating effect of the constructive controversy on the link between cognition-based team swift trust and team creativity. Conclusion: Our findings suggest nursing student teams’ interaction behaviors and task conflict are crucial mediating and moderated mediation variables on the relationship between collaboration interactions and team creativity, respectively. The empirical data confirms the validity of our proposed moderated mediation models of team creativity. Therefore, this study's validated moderated mediation model could provide guidance for nursing educators to improve collaboration interaction outcomes and creativity on nursing student teams.

Keywords: team swift trust, team conflict, team interaction behavior, moderated mediating effects, interdisciplinary education, nursing students

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Authors: Feride Eskin Bacaksiz, Arzu K. Harmanci Seren

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The problems about the working hours of nursing personnel, such as overworking, numbers of night or daytime shifts, is stated one of the most complained issues by nurses. Otherwise, besides of nursing shortage, absenteeism of nurses because of sickness, some other health problems, or other reasons enforces nurse managers to make working schedules. In this study, it was aimed to analyse and evaluate the working schedules of nurses working in public hospitals. Working schedule lists of nursing personnel for the months of October and November in two public hospitals were analysed and evaluated. Approvals were acquired from the head nurse managers. Descriptive and comparative analyses were used. Totally 36 lists were analysed from two hospitals. There were totally 416 nurses (manager nurse: 25, nurse: 391) and 6-28 (12.6, SD=5.34) nurses in each list. It was found that nurses were working 8 (42.5%), 12 (27.9%) and 16 (20%) hours, in inpatient clinics (74.8%). Totally 20.2% of the nurses were absent during analysing time due to the annual, paid or unpaid leaves. Nurses were generally working 20-112 hours (80.27, SD=11.92). Most of the nurses over worked 1.5-443 hours (47.436, SD=60.78) the year before that year. It was determined that 11.8% of the nurses (n: 49) were working only night shifts and 42.1% (n: 175) of the nurses were working only daytime shifts. It was found that there were inequities in the working hours of nurses.

Keywords: nurse, public hospitals, working conditions, working schedules

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Authors: Yadav R. K., Baral S.

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Introduction: Nepal is one of the world’s least developed countries and has a high incidence of tuberculosis (TB). The TB prevalence survey in 2019 showed 69,000 Nepalese is developing TB and 4,000 die every year. Given its disproportionate impact on the impoverished segments of society, TB often thrusts patients into extreme poverty or exacerbates their existing economic struggles. Consequently, not only the patients but also their families suffer from the loss of livelihood. This study aims to assess the support of nutritional allowance on treatment compliance among retreatment tuberculosis patients in Nepal. This is a secondary analysis of data from HMIS (Health Management Information System) to investigate treatment compliance among tuberculosis patients and its association with nutritional allowance. The study population consisted of all individuals (N=2972) who had received services from July 16, 2021, to December 14, 2022. The SPSS 21version was used to conduct descriptive and bivariate analysis. Out of the total TB patients (n=2972), a third-fourth (65.9%) of TB patients were male. More than one-tenth (12.3%) of respondents received a nutrition support allowance. The TB treatment compliance rate was more (89.91%) in the nutrition support allowance group compared to the non-nutritional support group (87.98%). TB patients who received the nutritional support allowance were nearly twice as likely to have a higher TB treatment compliance rate compared to those who did not receive the nutritional support allowance. Providing nutritional allowance support to tuberculosis (TB) patients can play a significant role in improving treatment compliance and outcomes. Age and the type of TB are important factors that have shown statistical significance in relation to treatment compliance. Therefore, it is recommended to provide nutritional allowance support to both new and retreatment TB patients. To enhance treatment compliance among TB patients, it is beneficial to provide timely nutrition allowances and arrange home visits by TB focal persons.

Keywords: nutrition, support, treatment compliance, TB, Nepal

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Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

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Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

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Authors: Merve Kadioğlu, Nevin H. Şahin

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Purpose: This research is organized to determine the influence of the web-based learning program. The program has been developed to gain information about normal delivery skill that is one of the topics of nursing students who take the woman health and illness. Material and Methods: The methodology of this study was applied as pre-test post-test single-group quasi-experimental. The pilot study consisted of 28 nursing student study groups who agreed to participate in the study. The findings were gathered via web-based technologies: student information form, information evaluation tests, Web Based Training Material Evaluation Scale and web-based learning environment feedback form. In the analysis of the data, the percentage, frequency and Wilcoxon Signed Ranks Test were used. The Web Based Instruction Program was developed in the light of full learning model, Mayer's research-based multimedia development principles and Gagne's Instructional Activities Model. Findings: The average scores of it was determined in accordance with the web-based educational material evaluation scale: ‘Instructional Suitability’ 4.45, ‘Suitability to Educational Program’ 4.48, ‘Visual Adequacy’ 4.53, ‘Programming Eligibility / Technical Adequacy’ 4.00. Also, the participants mentioned that the program is successful and useful. A significant difference was found between the pre-test and post-test results of the seven modules (p < 0.05). Results: According to pilot study data, the program was rated ‘very good’ by the study group. It was also found to be effective in increasing knowledge about normal labor.

Keywords: normal delivery, web-based learning, nursing students, e-learning

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Authors: Kevin Soubly, Kaysara Khatun

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This study applies the existing Middle-Out Perspective (MOP) as a complementing analytical alternative to the customary dichotomous options of top-down vs. bottom-up strategies of international development and commons governance. It expands the framework by applying it to a new context of land management and environmental change, enabling fresh understandings of decision making around land use. Using a case study approach in Central Kalimantan, Indonesia among a village of indigenous Dayak, this study explores influences from both internal and external middle actors, utilizing qualitative empirical evidence and incorporating responses across 25 village households and 11 key stakeholders. Applying the factors of 'agency' and 'capacity' specific to the MOP, this study demonstrates middle actors’ unique capabilities and criticality to change due to their influence across various levels of decision-making. Study results indicate that middle actors play a large role, both passively and actively, both directly and indirectly, across various levels of decision-making, perception-shaping, and commons governance. In addition, the prominence of novel 'passive' middle actors, such as the internet, can provide communities themselves with a level of agency beyond that provided by other middle actors such as NGOs and palm oil industry entities – which often operate at the behest of the 'top' or out of self-interest. Further, the study posits that existing development and decision-making frameworks may misidentify the 'bottom' as the 'middle,' raising questions about traditional development and livelihood discourse, strategies, and support, from agricultural production to forest management. In conclusion, this study provides recommendations including that current policy preconceptions be reevaluated to engage middle actors in locally-adapted, integrative manners in order to improve governance and rural development efforts more broadly.

Keywords: environmental management, governance, Indonesia, land use, middle actors, middle-out perspective

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Authors: Amal Shehata

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Low back pain related to disc prolapse is localized in the lumbar area and it may be radiated to the lower extremities, starting from neurons near or around the spinal canal. Most of the population may be affected with disc prolapse within their lifetime and leads to lost productivity, disability and loss of function. The study purpose was to examine the effect of rehabilitative nursing program on pain intensity and functional status among patients with discectomy. Design: Aquasi experimental design was utilized. Setting: The study was carried out at neurosurgery department and out patient's clinic of Menoufia University and Teaching hospitals at Menoufia governorate, Egypt. Instrument of the study: Five Instruments were used for data collection: Structured interviewing questionnaire, Functional assessment instrument, Observational check list, Numeric rating Scale and Oswestry low back pain disability questionnaire. Results: There was an improvement in mean total knowledge score about disease process, discectomy and rehabilitation program in study group (25.32%) than control group (7.32%). There was highly statistically significant improvement in lumbar flexibility among study group (80%) than control group (30%) after rehabilitation program than before. Also there was a decrease in pain score in study group (58% no pain) than control group (28% no pain) after rehabilitation program. There was an improvement in total disability score of study group (zero %) regarding effect of pain on the activity of daily living after rehabilitation program than control group (16%). Conclusion: Application of rehabilitative nursing program for patient with discectomy had proven a positive effect in relation to knowledge score, pain reduction, activity of daily living and functional abilities. Recommendation: A continuous rehabilitative nursing program should be carried out for all patients immediately after discectomy surgery on regular basis. Also A colored illustrated booklet about rehabilitation program should be available and distributed for all patients before surgery.

Keywords: discectomy, rehabilitative nursing program, pain intensity, functional status

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Authors: Kang-Mo Jung

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Least squares support vector machine (LS-SVM) is a penalized regression which considers both fitting and generalization ability of a model. However, the squared loss function is very sensitive to even single outlier. We proposed a weighted absolute deviation loss function for the robustness of the estimates in least absolute deviation support vector machine. The proposed estimates can be obtained by a quadratic programming algorithm. Numerical experiments on simulated datasets show that the proposed algorithm is competitive in view of robustness to outliers.

Keywords: least absolute deviation, quadratic programming, robustness, support vector machine, weight

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Authors: Samawi Zepure, Beck Christine, Gallagher Peg

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This community immersion employs the NLN Excellence Model which challenges nursing programs to create student-centered, interactive, and innovative experiences to prepare students for roles in providing high quality care, effective teaching, and leadership in the delivery of nursing services to individuals, families, and communities (NLN, 2006). Senior nursing students collaborate with ethnically and linguistically diverse participants at community-based sites and develop leadership roles of coordination of care linkage within the larger healthcare system, adherence, and self-care management. The immersion encourages students to develop competencies of the NLN Nursing Education Competencies Model (NLN, 2012), proposed to address fast changes in health care delivery, which include values of caring, diversity, and holism; and integrating concepts of context and environment, relationship, and teamwork. Students engage in critical thinking and leadership as they: 1) assess health/illness beliefs, values, attitudes, and practices, explore community resources, interview key informants, and collaborate with community participants to identify learning goals, 2) develop and implement appropriate holistic health promotion and disease prevention teaching interventions promoting continuity, sustainability, and innovation, 3) evaluate interventions through participant feedback and focus groups and, 4) reflect on the immersion experience and future professional role as advocate and citizen.

Keywords: quality of care, health of communities, students as leaders, health promotion

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Authors: Ayse Inel Manav, Saliha Bozdogan Yesilot, Pinar Yesil Demirci, Gursel Oztunc

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Introduction: This study was conducted with a view to evaluating cognitive function level, depression, and quality of life of elderly people living in a nursing home. Methods: This study, which is cross-sectional and descriptive in nature, was conducted in the Nursing and Rehabilitation Center for the Elderly in Adana/Turkey between 1st of May and 1st of August, 2016. The participants included 118 elderly people who were chosen using simple random sampling method. The data were collected using the Personal Information Form, the Standardized Mini Mental State Exam (SMMSE), the Geriatric Depression Scale (GDS), and the World Health Organization Quality of Life-OLD (WHOQOL-OLD) module. The data were analyzed using IBM SPSS Statistics 22 (IBM, SPSS, Turkey) program. Results: Of all the participants, 36,4% (n=43) were female, 63,6% (n=75) were male, and average age was 74,08 ± 8,23 years. The participants’ SMMSE mean score was found 20,37 ± 7,08, GDS mean score was 14,92 ± 4,29, and WHOQOL-OLD module mean score was 69,76 ± 11,54. There was a negative, significant relationship between SMMSE and GDS scores, a positive relationship between WHOQOL-OLD module total scores and a negative, significant relationship between GDS scores and WHOQOL-OLD module total scores. Discussıon and Conclusion: Results showed that more than half of the elderly people living in the nursing home experienced cognitive deterioration and depression; and cognitive state, depression, and quality of life were found to be significantly related to each other.

Keywords: depression, cognitive function level, quality of life

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Authors: Jacob Nortey

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Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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Authors: Hamna Hamid, Kashmala Zaman

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The aim of this study was to evaluate the relationship between self-efficacy, resilience, and social support among clinical psychologists, counselors, and teachers of special schools. The study also assesses the gender differences in self-efficacy, resilience, social support, and vicarious trauma and also vicarious trauma differences among three professions, i.e., clinical psychologists, counselors, and teachers of special schools. A sample of 150 women and 97 men were handed out a set questionnaire to complete: a General Self-Efficacy Scale, Brief Resilience Scale, Multidimensional Scale of Perceived Social Support, and Vicarious Trauma Scale. Results showed that there is a significant negative correlation between self-efficacy, resilience, and vicarious trauma. Women experience higher levels of vicarious trauma as compared to men. At the same time, clinical psychologists and counselors experience higher levels of vicarious trauma as compared to teachers of special schools. The moderation effect of social support is not significant towards resilience and vicarious trauma.

Keywords: self-efficacy, resilience, vicarious-trauma social-support, social support

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