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Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

A kuma A .O . & J ordan S . (2012) Pain management in neonates: a survey of nurses and doctors. Journal of Advanced Nursing 68(6), 1288-1301. Abstract Aim. This paper is a report of a descriptive survey of nurses' and doctors' knowledge and reported practice regarding procedural pain assessment and management in neonatal intensive care units. Background. There are concerns that pain is often unrecognized and under-treated in neonates. Current guidelines advocate administration of analgesia and comfort measures, but may be vulnerable to inter-professional differences in guideline implementation. Methods. All nurses and doctors working in all seven neonatal intensive care units in one area of the United Kingdom were surveyed between January to August 2007. Lead clinicians distributed and collected anonymous questionnaires. Findings. Response rate was 44% (62 doctors, 137 nurses). Internal consistency was high, overall Cronbach's alpha 0·976. Respondents were knowledgeable, mean score 82% (SD13·3%). They agreed that neonates feel pain and need analgesia. Chest drain insertion was perceived to be the most painful procedure, heel-prick the least. Respondents reported that analgesia and comfort measures were not usually administered for most procedures: nurses were more likely than doctors to report adhering to guidelines advocating administration of analgesia and comfort measures. Statistically significant differences between current and optimal practice were acknowledged. Few (21% and 37%) had received training on neonatal pain and fewer (2·5%) employed recognized pain assessment instruments. Pain management guidelines were available to 29(47%) doctors and 85(62%) nurses; 20(18%) reported that these had been audited. Conclusion. Clinicians were knowledgeable about neonatal pain, but gaps between knowledge and practice remain. This hiatus could be bridged by providing research evidence for the efficacy of guidelines incorporating validated pain assessment instruments. [ABSTRACT FROM AUTHOR]

Aim To provide depth and breadth in the analysis of nursing students' written narratives of 'most memorable' professionalism dilemmas. Background While nursing students are taught professionalism through formal curricula, they commonly experience workplace-based professionalism dilemmas. Although non-UK studies have begun to explore students' lived experiences of dilemmas, they lack detail about when and where dilemmas occur, who is involved, what students do and why and how students feel. Design Online survey of healthcare students including 294 nursing students from 15 UK nursing schools. Method Nursing students provided a written narrative of their most memorable dilemma (December 2011-March 2012) as part of a survey examining the impact of professionalism dilemmas on moral distress. We conducted thematic and discourse analysis of all narratives and narrative analysis of one exemplar. Findings The most common themes were patient care dilemmas by healthcare personnel or students, student abuse and consent dilemmas. Of the dilemmas, 49·6% occurred over 6 months previously, 76·2% occurred in hospitals and 51·9% of perpetrators were nurses. 79·3% of students reported acting in the face of their dilemma. Of the narratives, 88·4% contained negative emotion talk and numerous significant relationships existed between types of emotion talk and dilemmas. Our narrative analysis demonstrates the impact of dilemma experiences through emotion talk and more subtle devices like metaphor. Conclusion Findings extend previous research with nursing and medical students. Nurse educators should help students construct emotionally coherent narratives to make sense of their experiences, actions and identities and to better prepare them for future professionalism dilemmas. [ABSTRACT FROM AUTHOR]

Aim To develop and validate a bronchiolitis severity scoring instrument for use by nurses and other healthcare professions. Background Bronchiolitis is a viral lower respiratory tract infection of infancy. In industrialized countries, admission rates have increased over the last decade with up to 3% of all infants born being admitted to hospital. A small number of these hospitalized infants will require admission to critical care for either invasive or non-invasive ventilation. During the seasonal epidemic, the number of unplanned admissions to critical care with bronchiolitis substantially increases. Design We will use a mixed methods study design. Methods We will use scale development and psychometric methods to develop a scoring instrument and to test the instrument for content, construct and criterion validity and reliability in several different clinical locations. This study protocol has been reviewed and approved by the NHS National Research Ethics Service, January 2011. Discussion There is an urgent need to develop a valid and reliable severity scoring instrument sensitive to clinical changes in the infant, to facilitate clinical decision-making and help standardize patient care. Furthermore, a valid and reliable scoring instrument could also be used as a proxy patient-reported outcome measure to evaluate the efficacy of clinical interventions in randomized controlled trials. [ABSTRACT FROM AUTHOR]

Aim To explore associations among breastfeeding duration, maternal personality and maternal attitudes and experiences of breastfeeding. Background Understanding influences on breastfeeding initiation and duration is critical to increasing breastfeeding rates and supporting new mothers. Maternal characteristics such as self-efficacy, knowledge and confidence are known to enable women to breastfeed, but little is known about the influence of maternal trait personality on breastfeeding. Design An exploratory cross-sectional survey. Method A total of 602 mothers with an infant aged 6-12 months old completed a self-report questionnaire examining maternal trait personality, breastfeeding duration and attitudes and experiences of breastfeeding. Data were collected between March-June 2009. Results Mothers who reported high levels of extraversion, emotional stability and conscientiousness were significantly more likely to initiate and continue breastfeeding for a longer duration. Attitudes and experiences significantly associated with these personality traits such as perceived difficulties and lack of support may explain these patterns. For example, characteristics associated with introversion and anxiety may prevent women from seeking support or challenging negative attitudes of others at this critical time. Conclusion Understanding the influence of maternal personality may thus be a useful tool in antenatal support to recognize women who may need extra, directed support while facilitating discussion of potential barriers to breastfeeding. [ABSTRACT FROM AUTHOR]

lafond c.m. & van hulle vincent c. (2012) A critique of the National League for Nursing/Jeffries simulation framework. Journal of Advanced Nursing 00(0), 000-000. doi: 10.1111/j.1365-2648.2012.06048.x Abstract Aims. To present a critique of the National League for Nursing/Jeffries simulation framework. Design. Fawcett's criteria for theory analysis and evaluation are used. Background. Use of simulated learning experiences in nursing education is widespread; a sound framework to guide educators across the globe in implementing these experiences effectively is essential. The basic assertion of the National League for Nursing/Jeffries simulation framework is that student-learning outcomes are influenced by the concepts of teacher, student, educational practices, and simulation design characteristics. Data sources. A literature search was performed using Cumulative Index to Nursing and Allied Health Literature, PubMed and Google Scholar to identify studies published in the English language, between 2005-June 2011, where the National League for Nursing/Jeffries simulation framework was tested or used as a theoretical framework for research. Discussion. Sixteen publications (two articles in press) from the USA and UK were identified using the framework to guide research; outcomes included increased student satisfaction, confidence, and improved skill performance. Implications for nursing. As a newer theoretical framework, the National League for Nursing/Jeffries simulation framework offers promise to guide the construction and implementation of simulation experiences resulting in positive student outcomes. Conclusion. Empirically supported definitions of concepts would strengthen the framework and help educators to consistently produce and identify positive outcomes. Additional rigorous research is necessary to further test relationships among concepts and the associated concept variables in the framework. More studies outside of the United States are needed to confirm the framework is relevant to nursing programs in other countries. [ABSTRACT FROM AUTHOR]