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Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Background: Job satisfaction is a key factor for the successful transition of newly graduated nurses (NGNs) and for retaining NGNs in their workplaces. However, there is limited evidence of the relationship between satisfaction regarding the nursing education program and NGNs' job satisfaction in the first year after graduation. Therefore, this study aims to examine the association of the nursing education related factors and NGNs' job satisfaction. Methods: A cross-sectional study design with the utilization of data collected from the same respondents one year earlier as educational factors was applied. The data were collected from NGNs (n = 557) in 10 European countries using an electronic survey between February 2019 and September 2020, and analyzed in detail for four countries (n = 417). Job satisfaction was measured with three questions: satisfaction with current job, quality of care in the workplace, and nursing profession. Nursing education related factors were satisfaction with nursing education program, level of study achievements, nursing as the 1st study choice, intention to stay in nursing, and generic nursing competence. The data were analyzed statistically using logistic regression. Results: Most of the NGNs in the 10 countries were satisfied with their current job (88.3%), the quality of care (86.4%) and nursing profession (83.8%). Finnish, German, Lithuanian and Spanish NGNs' satisfaction with the nursing education program at graduation was statistically significantly associated with their job satisfaction, i.e., satisfaction with their current job, the quality of care, and the nursing profession. Moreover, NGNs who had fairly often or very often intention to stay in nursing at graduation were more satisfied with their current job, with the quality of care, and with the nursing profession compared with NGNs who had never or fairly seldom intention to stay in nursing at graduation. Conclusions: Nursing education plays a significant role in NGNs' job satisfaction one year after graduation, indicating the importance to start career planning already during nursing education. Both nursing education providers and healthcare organizations could plan in close collaboration a transition program for NGNs to ease the transition phase and thus increase the NGNs' job satisfaction and ultimately the high-quality care of the patients. [ABSTRACT FROM AUTHOR]

Background Despite missing theoretical clarity, quality of life (Qol) has become a major concept as outcome in intervention studies in dementia research. There is no generally accepted definition of Qol for people with dementia. Lawton's model (1991), which includes subjective and objective components, is widely used as framework for the development of Qol measurements and interventions. The aim of the study is the identification of factors that affect dementia-specific quality of life (Qol). Material and methods The meta-synthesis (PROSPERO 2013:CRD 42013005014) followed four methodological steps: (a) database search without time limit including forward and backward citation tracking, (b) data extraction, (c) quality appraisal using formal criteria from the Critical Appraisal Skills Programme, (d) synthesis of findings based on principles and procedures of grounded theory. In particular, the constant comparative method leads the coding, identification of categories and synthesis. Two independent reviewers carried out all four methodological steps. Results The literature search and removal of duplicates revealed 3475 abstracts; 63 full texts were screened for eligibility. Eleven studies from seven countries, published between 1996 and 2011, were included. The papers comprised reports on the perspectives of 410 people with dementia in all stages of dementia on their Qol. The studies were based on narrative and semi-structured interviews and focus group interviews, the latter partly supported by music and art therapy. Conclusions The meta-synthesis will contribute to the theoretical development of the concept of Qol of people with dementia. The resulting model of factors which affect dementia-specific Qol will provide a framework for the development, adaption and validation of dementia-specific Qol measurements and development of psycho-social nursing interventions. [ABSTRACT FROM AUTHOR]

Background: Undergraduate students' clinical experience, working directly with patients and the healthcare team is essential to ensure students acquire the necessary competence for practice. There are differences in the quality of clinical environments and in students' clinical placement experiences and not all clinical sites are optimal learning environments. The Dedicated Education Unit clinical education model allows students to develop the practical knowledge, skills and professionalism they will need as nurses/midwives. Methods: We employed the Consolidated Framework for Implementation Research to identify and compare barriers and facilitators in the implementation of the Dedicated Education Unit in 6 European undergraduate nursing/midwifery student clinical placement settings and to describe the experience of nurses/midwives involved in the Dedicated Education Unit model implementation and evaluation. A pre-post implementation interpretive assessment was based on participants' responses to the Consolidated Framework for Implementation Research construct questions. Results: Although Dedicated Education Unit model implementation in our project was heterogeneous, no main implementation barriers were perceived. Qualitative data showed that educational-service collaboration, including a focus on mutual goals, organizational communication and networking, satisfaction of educational and healthcare professionals, and the establishment of a safe space for professional discussion and feedback, were considered facilitators. Conclusions: This study describes the key elements guiding educational and healthcare stakeholders in Dedicated Education Unit implementation, engaging participants in the entire process, and offering other organizations the opportunity to consider the benefits of this clinical education model. [ABSTRACT FROM AUTHOR]

Complex wounds affect approximately 1.5 people per 1000, impair quality of life and are costly to health services. In the UK community nurses lead the care of people with complex wounds, from assessment to treatment selection. Some of the earliest randomised controlled trials (RCTs) of wound treatments were of oral zinc. Published in the 1970s these trials used different doses of zinc, measured different outcomes, had different eligibility criteria and very small sample sizes. Each new trial failed to build on the evidence that already existed or learned from mistakes. When a systematic review of the evidence for oral zinc was finally conducted, it concluded that we have no idea whether it makes a difference and the evidence is very low quality [1]. Systematic reviews should be the starting point for all new research. Cochrane reviews provide a lens for scrutiny of the quality of wounds trials and the evolution of the evidence. All Cochrane reviews appraise the included studies in a standardised way. The 199 RCTs included in the five largest Cochrane Wounds reviews have a median sample size of only 115, and most are at high risk of bias (due to unmasked outcome assessment, unconcealed allocation or poor randomisation technique) or the risk of bias is unclear due to poor reporting. Happily there is some evidence that study quality is improving over time. There is plentiful evidence that wounds research teams often lack methodological expertise (e.g., in statistics and trials). Nursing research can and should avoid these pitfalls and build evidence that can be used because, in the case of RCTs, there is an adequate sample size for the question and the RCT is designed to minimise bias. One of the main reasons for undertaking systematic reviews is to identify gaps in the evidence so that new research can fill them. A positive impact of systematic reviews in wound care is that they have stimulated research funders to commission high quality research to fill the gaps, particularly in the UK where the National Institute for Health Research is one of the world's largest independent funders of wounds research [2-4]. Finally wounds research has failed to develop a basic theoretical understanding. For example one reason why we do not have many effective treatments for complex wounds is because we do not fully understand their aetiology and prognostic factors so do not target treatments effectively. Again nursing research can avoid this mistake by ensuring indepth theoretical knowledge of the health problem concerned and such an understanding is fundamental to developing complex interventions. [ABSTRACT FROM AUTHOR]

Background: Organisation of working hour schedules in the Northern European countries are rather similar. EU countries are obliged to adopt national legislation regarding duration of weekly working hours and rest periods. Yet, working hour characteristics and schedules are likely to differ with respect to starting times and duration depending e.g. on culture and tradition. Yet, very little is known about potential differences between shifts and schedules across countries among nursing personel. This knowledge is relevant, since the potential differences in working hour characteristics may influence and possibly explain some of the differences observed in studies of health and safety. The aim of the study was to compare characteristics of working hours and work schedules among nursing personel in three Nordic countries: Denmark, Finland and Norway. Methods: The study populations included nursing personnel holding a ≥ 50% position at public hospitals in Denmark (n = 63,678), Finland (n = 18,257) or Norway (n = 1538) in 2013. Objective payroll based registry data with information on daily starting and ending times were used to compare working hour characteristics e.g. starting time, duration of shift, and quick returns (< 11 h between two shifts), as well as work schedules e.g. permanent or 3-shift work between the three countries. Results: Night shifts generally started earlier and lasted longer in Finland (10–11 h starting at 20:00–22:59) than in Norway (10 h starting at 21:00–21:59) and in Denmark (8 h starting at 23:00–23:59). Very long shifts (≥12 h) were more common in Denmark (12%) compared to Finland (8%) and Norway (3%). More employees had many (> 13/year) quick returns in Norway (64%) and Finland (47%) compared to Denmark (16%). The frequency of 3-shift rotation workers was highest in Norway (41%) and lower in Denmark (22%) and Finland (22%). There were few differences across the countries in terms of early morning shifts and (very) long weekly working hours. Conclusion: Despite similar distribution of operational hours among nurses in the three countries, there were differences in working hour characteristics and the use of different types of work schedules. The observed differences may affect health and safety. [ABSTRACT FROM AUTHOR]

Background Insufficient knowledge among nurses and medical doctors regarding evidence-based care recommendations and nurse-doctor-communication failures are assumed to be important determinants of malpractices in dementia care. To address these barriers early in the professionals' careers, an inter-professional dementia care training course was developed for undergraduate nursing and medical students. Aim To explore the feasibility of the novel course and potential effects on participants' knowledge and attitudes. Methods A before-after study was conducted alongside preliminary course implementation in three terms. All participants were asked to complete a questionnaire at the beginning and the end of the course. The questionnaires covered following outcome areas: various dimensions of the course's process quality, including relevance of the interprofessional learning, and knowledge and attitudes related to multiple aspects of dementia care. Data were descriptively analysed. Results In the first term, the course had to be terminated early due to dominating barriers making full implementation not feasible. Across the following terms, the then revised course was attended by 15 nursing and 17 medical students, who all participated in the pilot study. The overall course quality was rated with "2" on a six-step rating scale (1 =very good, 6 = insufficient). The inter-professional course character was highly valued both by the nursing and the medical students. However, differences between these two sub-samples were observed with regard to the assessment of other course aspects (e.g. problem-based learning) and the changes in students' knowledge and attitudes. Conclusions Due to the mixed findings, further revision of the curriculum is required, taking the experiences from this pilot study into account. Relevance for nursing science in Europe This study exemplarily shows how nursing education can be developed further by means of complex intervention research inventory. [ABSTRACT FROM AUTHOR]