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Background Nursing education often employs simulation-based education to prepare for clinical practice. However, despite its perceived importance, there is no common practice for its integration into different nursing curricula. This study aimed to describe and compare the levels of implementation of simulation-based education in nursing curricula across different countries. Methods A quantitative and qualitative exploratory study was conducted in 2019 using a questionnaire developed using the Delphi technique. Eight European member institutions participated in this exploratory study. Qualitative data were hand-coded and analyzed using descriptive analysis. Results Differences were found regarding (a) simulation in nursing programs, (b) the simulation environment, and (c) expert opinions. There exists a wide range of simulation-based education accreditation systems, and the absence of regulatory standards to replace clinical hours in the curriculum is a challenge for international exchange programs. Conclusions Universities should invest in and guarantee high-quality research to evaluate national and international initiatives and contribute to simulation-based education.

Background: The postpartum period, including hospitalization after a birth, requires the woman in puerperium to adjust to her new social role. The subject of satisfaction with life (SWL) in women in the early postpartum period has been rarely addressed in the literature and requires up-to-date, thorough research. Aim of the study: The present study aimed to evaluate the level of SWL among women after delivery according to selected characteristics concerning the course of pregnancy and labor. Material and methods: The study included 128 females who after delivery were hospitalized at maternity units in Lublin, Poland. The participants were administered the Satisfaction With Life Scale (SWLS) and a questionnaire to collect data on the course of pregnancy and labor. Results: It was found that 88 (68.75%) women had a high level of life satisfaction after childbirth, 27 (21.09%) had an average level, and 13 (10.16%) had a low level. Among the analyzed variables, a marginally significant increase in SWL was found for women in the early postpartum period that experienced skin-to-skin contact with the newborn immediately after delivery (p=0.054). The strength of the observed effect, as measured by Cohen’s d coefficient, was low (0.37). Conclusion: The current research contributes to the identification of factors occurring during pregnancy and labor that determine postpartum SWL. These results may enable the early elimination of variables that negatively affect postpartum SWL and place a focus on factors with a positive impact. The use of preventive measures designed to improve SWL are likely to aid in reducing the risk of mood disorders in the later postpartum period.

Several preventive measures have been applied to limit the COVID-19 pandemic, including successful the development and introduction of vaccines. The aim of this study was to investigate adherence to preventive measures and vaccination intentions among nursing students in three European countries and the factors associated with vaccination intention and advising vaccination. A cross-sectional study using convenience/snow-ball sampling strategy was performed in Slovenia, Poland, and Serbia between 12 February and 5 March 2021. Data from 872 eligible respondents were analyzed (mean age 23.5 ± 6.5 years, 89% female). Higher adherence to preventive behavior was declared by those working in healthcare (p &lt, 0.001), engaged in COVID-19 departments (p &lt, 0.001), had not had the disease yet (p &lt, 0.001), and had children (p = 0.01). Those groups also expressed higher vaccination intention and advised vaccination to others. Higher vaccination intention and advising vaccination were mostly associated with belief in benefits of vaccine, trust in institutions, perceived effectiveness of vaccine, influence of social environment, protection of patients and perceived health care professionals’ duty. Fear of side effects and general refusal of vaccines are the main reasons for vaccination hesitancy. The results of the study indicate how higher education institutions can support the development of appropriate professional attitudes and behaviors among nursing students.

Introduction. Nowadays, a professional image is an important element of the identity of individual professions. Its formation is a difficult process, dependent on many factors, including the use of new communication channels, such as social media, which in recent years have become a space for expressing social opinion, including those concerning individual professions. Aim. The analysis of the possibilities of using social media in shaping the image of nurses on the Internet. Material and methods. The study was carried out using the comparative method. The subject of the research were websites (fanpages) related to the professional environment of nurses on the social networking site Facebook.com, chosen deliberately according to the adopted criteria. Findings. During the research, differences in the strategy of administering the analyzed websites were identified, depending mainly on the subject matter and purpose of publishing the content. The topicality, visual attractiveness and cohesion were characterized by a high level. The posts appearing on individual websites were written in the language of the recipients, with different publication frequency. The websites created a long-term group of recipients and tried to influence the image of nursing in Poland in a positive way. Conclusions. Content published on social media can affect both the positive and negative image of the nurse in the public opinion. Among the factors that do not affect the image of nurses can be indicated, among others, offensive language of comments and displaying negative traits of nurses. Positive reception guarantees current knowledge in the field of nursing and emphasizing professional competences.

Introduction Research on the meaning of health and health behaviors is important for the development of health education programmes which should be tailored to the needs of patients. Objective The aim of the study is to determine whether the place of residence and age have an impact on health behaviours and the perception of health by women past menopause. Material and methods A survey method and three research instruments were employed: authors’ questionnaire, the Health Behaviour Inventory and the Health Criteria List by Juczyński, and the Kupperman Index. The study was carried out among a sample of 102 women after menopause hospitalised in a hospital in eastern Poland. Results The overall health behaviour indicator (HBI) in the study group was found to reach an average value of 80.1±12.7points. A higher HBI indicator was found to be characteristic of urban rather than rural residents; however, there was no statistically significant difference (p>0.05). The age of respondents did not differentiate statistically their health behaviours (p>0.05). Women who reported their last menstruation before the age of 50 obtained higher results in the dimension of health practices (HPs) than those whose last menstruation ceased after the age of 50 (p

Introduction. Professional image of the nurse in the opinion of the patient community is conditioned by many variables, including professional attire. A worthy representation of the nurse profession is the responsibility of all those who care for the patient. Aim. Determining the impact of dress code on shaping the professional image of nurses in the opinion of patients. Material and methods. Non-systematic review method of the literature available. The data was obtained by searching online databases, such as: Google Scholar, PubMed, CINAHL Complete as well as electronic resources of nursing magazines. Results. In the perception of hospitalized patients, the nursing dress code affects the level of trust in those who care for patients, it also constitutes an important element in assessing their professionalism, knowledge or confidence when performing specific medical interventions. Adapted to the needs, a suitably selected style of professional attire of a nurse employed in a given health care facility enables her proper identification of them against the background of other members of the therapeutic team or administrative employees. In addition, the comfort of nurses is a significant factor for patients in dress code strategy planning; it often determines professionalism and quality of services provided. Conclusions. There is a relationship between the external appearance of nurses and their professional image and the patients’ perception of their professional skills as well as the level of their professionalism. Dress code in a health care facility may constitute a significant element of image policy for both a health care facility itself and a group of nurses.

Aim. The study was to assess the level of stress and the health locus of control in parents of hospitalized newborns. Material and methods. The study covered a group of 150 parents of 126 newborns who were hospitalized in the Neonatal Pathology Ward at the University Children’s Hospital in Lublin. The diagnostic survey method was applied with the use of an original questionnaire as well as some standardized tools: Perceived Stress Scale (PSS-10) and Multidimensional Health Locus of Control Scale (MHLC – version B). Results. In more than a half of the subjects (54.0%), a high level of stress was observed. Every fourth (26.1%) parent was characterized by an average level of stress and nearly every fifth (19.3%) by a low level of stress. The highest indicator was characterized by the domain of the internal health control locus. Every fifth parent represented an undifferentiated type - weak or magnifying the impact of others (22.0% and 20.0% respectively). The smallest group of parents (5.3%) belonged to the externally-oriented, strong type. Conclusions. The parents of hospitalized newborns are characterized mainly by high and average levels of stress and low level of severity of health control location within each of its domains. The highest indicator of internal locus control and the influence of others are characterized by parents with low and average levels of stress. The dominant type of locus of health control that characterizes parents is the undifferentiated type – weak and magnifying the impact of others.

Introduction. The multitude of changes taking place in the female body in terms of the physiological aspect as well as in the psychological well-being in the perinatal period has become the motivation to fi nd an answer to the question: what is the women’s satisfaction with life (SWL) after childbirth. Aim. The aim of the study was to analyse the level of SWL among women after vaginal delivery and caesarian section according to selected socio-demographic characteristics. Material and methods. The study included 128 females after vaginal delivery (n=58) and caesarian section (n=70) hospitalized at the maternity units in Lublin. The study was voluntary and anonymous. It was conducted in 2020 with the use of survey method and utilized two research tools: the Satisfaction With Life Scale (SWLS) and a questionnaire designed by the author in order to collect socio-demographic data. Results. The mean SWL were 26.12±4.78 in women after vaginal delivery and 24.60±6.17 after cesarean section. Selected socio-demographic factors (age, education, marital status, place of residence, professional status) are signifi cantly related to the satisfaction with life of women after cesarean section; while the material situation and living together with the family among women with vaginal delivery. Conclusions. Analysis of the results obtained indicated that actions aimed at the improvement of SWL should be directed to young, unemployed, with primary and vocational education, unmarried women and with poor fi nancial situation.

Aims and objectives To map and summarise published studies on the career opportunities and roles of doctoral-educated (PhD and DNP) nurses in the clinical setting; to collate actions as proposed in the literature to promote career opportunities and roles for PhD and DNP nurses in the clinical setting. Background To improve healthcare outcomes and strengthen leadership in nursing practice, there is the need to place nurses with a doctorate in clinical settings. However, available evidence has never been summarised to map the state of the science in this field. Design A scoping review, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for scoping reviews statement (PRISMA-ScR). Methods An electronic database of literature was searched by accessing CINAHL Complete and Medline (on EBSCO Host) and SCOPUS to identify studies published between January 2009-December 2019. A thematic analysis was performed by identifying emerging patterns in the research questions. Results Ten studies were found with three types of clinical engagement: (a) a practice influencer/developer; (b) a clinical leader; and (c) a clinical teacher for students. Working in clinical areas, doctoral-educated nurses might influence several outcomes at the patient, research, staff and organisational levels. Conclusions Clinical roles for doctoral-educated nurses are still uncommon. However, in the last ten years, a debate has started to identify the possible careers in clinical settings, the needs and the challenges encountered while developing clinical academic roles, as well as the outcomes and actions that should be undertaken. Relevance to clinical practice Academic nursing bodies, working with professional bodies and healthcare institutions at different levels, are called on to develop career frameworks, allowing the opportunity for doctoral-educated nurses to be involved in clinical practice and to influence its quality and performance; this might in turn lead to an increase in the quality of research.

Galvanic skin response (GSR) Biofeedback uses training to reduce tension and anxiety and improve concentration and self-regulation. The study was aimed to evaluate this method as a form of rehabilitation and quantify the outcomes achieved by patients undergoing training using this technique. Six schizophrenic patients were enrolled in the study and underwent training based on the relaxation training module (CENTER), concentration training module (BALANCE), and self-regulation training module (INSECTS). Training sessions were held twice a week for 6 weeks. From the total group of subjects involved in the study, two patients had a statistically significant increase in measured values after the CENTER exercise, indicating that relaxation was achieved. Four patients showed a statistically significant decrease in measured values after the BALANCE exercise, which was reflective of an improvement in concentration. Three patients had a statistically significant decrease in measured values after the INSECTS exercise, which indicated an improvement in self-regulation. GSR Biofeedback may be used to complement the pharmacological treatment of patients diagnosed with schizophrenia.

Health literacy (HL) is recognised as an important, modifiable factor in the self-management and health performance of elderly people. The aim of this preliminary study was to identify and analyse the level of health literacy among the elderly living in one of the eastern regions in Poland. The cross-sectional study was conducted among a convenience sample of 200 seniors aged 65+ after cognitive pre-screening with the use of the Montreal Cognitive Assessment (MoCA) scale. To collect data, the Polish version of the HLS-EU-Q47 was used. More than half of the elderly surveyed presented problematic levels of general HL (GEN-HL), and also problematic levels of other dimensions: health care health literacy (HC-HL), disease prevention health literacy (DP-HL), and health promotion health literacy (HP-HL). The level of seniors&rsquo, HL is dependent on the level of their education, place of living, participation in activities run by Daily Center for the Elderly, and their self-assessment of health condition (p &lt, 0.05). These results imply the important message that there is a need to create initiatives and programs improving health literacy targeted at seniors living in rural areas, those with lower levels of education, and those with poor access to activities organised by institutions supporting seniors.

The aim of this study was to confirm the correlation between social support and the quality of life of seniors who live without cognitive disorders, but are living in an institutional environment. The measurement of variables was based on a cross-sectional survey method. A representative sample of 957 seniors participated in the survey. The study covered public nursing homes (NHs) and residential care homes (RCHs) selected for the study by stratified sampling. The results confirmed a linear correlation between social support and the quality of life of seniors (p &lt, 0.001). It was also confirmed that there were differences in the range of studied variables depending on the type of institution (NH versus RCH, p &lt, 0.001). Social support is a significant component, and at the same time, a modifier of the perception of the quality of life for older people. Its variable level determines the subjective assessment of functioning in particular domains of quality of life. RCH as an institution of a social nature satisfies the needs for support at a higher level than NH, which translates into a better perception of older people&rsquo, s quality of life.

The aim of this pilot study was to analyse the influence of Galvanic Skin Response (GSR) Biofeedback training in a group of 18 men with schizophrenia at the remission stage. The results were verified according to: Positive and Negative Syndrome Scale (PANSS), Acceptance of Illness Scale (AIS), Self-efficacy Scale (GSES), Beck Cognitive Insight Scale (BCIS) scales, Colour Trial Test (CTT-1, CTT-2), d2 psychological tests, Quantitative Electroencephalogram (QEEG) Biofeedback, auditory event-related potentials (ERPs), and serum levels of brain-derived neurotrophic factor (BDNF). The results were compared in the same patients after 3 months. Statistically significant changes were noted in results for the variables on the PANSS scale. For the BDNF variable, a statistically significant increase occurred, indicating that GSR Biofeedback training may influence serum levels of the neurotrophic factor. Statistically significant changes were noted in results for the variables on the BCIS, AIS, and GSES indicating an improvement in the cognitive and social functioning. Changes were noted for results for theta/beta and theta/Sensory Motor Rhythm (SMR) ratios, which indicate an improvement in concentration and attention. Changes were noted for the N1 wave amplitude in the frontal brain region (F-z), and for the P2 wave latency in the central brain region (C-z), which indicates an improvement in the initial perceptual analysis. The use of GSR Biofeedback in a group of patients with schizophrenia gives interesting results, but requires further in-depth research.

The adaptation of foreign students to a new country can be complicated due to different cultural values, language barriers and the way university courses are structured. The aim of the study was to analyze the lifestyle practices, satisfaction with life and the level of perceived stress of Polish and foreign students studying various medical disciplines in Poland with regard to chosen sociodemographic characteristics. The study included 231 foreign and 213 Polish students (n = 444) taking different medical disciplines at the medical university in eastern Poland. Three research tools were used: Fantastic Lifestyle Questionnaire (FLQ), Satisfaction with Life Scale (SWLS), Perceived Stress Scale (PSS-10). Additionally, students&rsquo, sociodemographic data was collected. Two-factor analysis of variance (ANOVA) was performed and correlations between variables were also examined. Our research indicated that Polish students obtained higher results in FLQ than foreign students. It also demonstrated a significantly higher level of stress among Polish students in comparison to foreign students. The self-assessment of their health condition, lifestyle, and rank associated to being healthy correlated with FLQ, SWLS and PSS-10. The present research can aid the development of support programs for foreign students so that the cultural adaptation processes would more positively influence their lifestyle and an education environment.

The problem of early motherhood is still a serious medical and social problem in many countries around the world. The aim of this study was to analyze the attitudes of teenage mothers towards pregnancy and childbirth. A retrospective cross-sectional study was conducted with the use of an original questionnaire containing a test to measure attitudes on a five-point Likert scale and a Life Orientation Test-Revised (LOT-R) to assess dispositional optimism. The study involved 308 teenage mothers between 13 and 19 years of age. Attitudes of teenage mothers towards pregnancy and childbirth were more often positive (90.6%) than negative (9.4%). Sociodemographic features determining the attitudes of teenage mothers towards both their pregnancy and childbirth included their age, marital status, current occupation, and main source of income. The type of attitude adopted by teenage mothers towards pregnancy and childbirth was significantly related to the level of their dispositional optimism.

BackgroundSpirituality is vital in the holistic approach to nursing care. The personal spirituality of nurses has been documented to have an impact on the spiritual nursing care they provide.AimTo validate the Polish version of the Spiritual Attitude and Involvement List (SAIL) among nurses and to describe spiritual attitudes and involvement of nurses as measured with the tool.DesignA cross-sectional, validation study was performed according to the STrengthening the Reporting of OBservational studies in Epidemiology guidelines.MethodsStudy involving 163 nurses, with the use of four tools: (a) the SAIL; (b) the Self-Description Questionnaire; (c) the Scale of Spiritual Transcendence; and (d) the Brief Religious Coping questionnaire.ResultsThe Explanatory Factor Analysis identified six factors and 25 items were retained explaining a total variance of 67.96%. In the Confirmative Factor Analysis, acceptable index fit values were obtained. Correlations were found between SAIL and the Brief Religious Coping questionnaire, the Self-Description Questionnaire, and the Spiritual Transcendence Scale. Nurses reported the highest scores on 'Meaningfulness' (= 4.95 out of 6.0, Standard Deviation [SD] 0.56) and the lowest on the 'Transcendent Experiences' factor (= 3.21 out of 6.0, SD 0.93). A strong correlation was found between 'Spiritual Activities' and the religious involvement of nurses (r = 0.506), and between 'Connectedness with nature' and the nurses' age and work experience (r = 0.315 and r = 0.321, respectively).ConclusionThe Polish version of SAIL shows acceptable psychometric properties and construct validity. With the validation of SAIL, future studies can be undertaken with the aim of measuring the personal spirituality of nurses in various settings (hospital vs. community), cultures, and countries, thus increasing the opportunity to compare findings. Moreover, more studies should be performed in order to assess whether there is any connection between personal spirituality and the spiritual nursing care provided to patients.

Introduction A healthy lifestyle can help older people maintain their functional ability and, therefore, satisfaction with life. An important aspect of health promotion is the assessment of lifestyle factors over which patients have some control. Objective The aim of this study was to analyze the lifestyle of the elderly in urban and rural areas using the Fantastic Life Inventory (FLI). Material and methods The research group comprised 138 people aged 65-94 years (M = 72.41, SD = 6.90). Participants were recruited from urban 78 (56.5%) and rural 60 (43.5%) areas. The FLI used in this study has 25 closed-ended questions that explore nine domains, including physical, psychological, and social lifestyle components. Results The overall lifestyle of most seniors was 'excellent' (45.7%) or 'very good' (41.3%); none of the respondents scored in the lowest category - 'needs improvement'. The domains that mostly demonstrated the need for a change were related to activity, nutrition, insight, sleep, stress. Participants from rural areas tended to have lower scores in the activity (p= 0.017) and nutrition (p= 0.015) domains. The lifestyle of the elderly is determined by several factors, including age, gender, health status, level of education, and the place of residence. Conclusions The majority of older persons demonstrated an 'excellent' or 'very good' lifestyle with healthy habits. The adoption of healthy lifestyle patterns, in particular a regular balanced diet and proper physical activity, can help prevent functional limitations among the elderly in rural areas.

Introduction. Jehovah’s Witnesses absolutely refuse having blood transfusion performed. The situation is even more difficult when the refusal of blood transfusion concerns a child. Despite existing legal solutions, medical staff experiences value conflicts. Aim. To analyze the opinions of pediatric nurses about problems that may arise in case of Jehovah’s Witnesses refusal of blood transfusion for their child. Material and methods. Quantitative research was based on a diagnostic survey method. The variables were measured with the use of a survey questionnaire co-developed by the authors. A group of 104 pediatric nurses from the South-East Poland participated in the study. Results. To the question “Have you ever encountered the situation throughout all your working career when parents refused their child to undergo a blood treatment due to their beliefs?”, 67.31% (n = 70) of the respondents replied the situation rarely happened. Half of the nurses surveyed (n = 52, 50.02%) admitted they did not accept the position of Jehovah’s Witnesses concerning blood treatment. Most of the nurses surveyed – 87.38% (n = 89) think the existence of procedures on how to proceed in this difficult situation is crucial, and 83% (n = 86) of the respondents admitted that there was no better solution than the already existing legal procedure. Conclusions. The most difficult experience of pediatric nurses in the situation of Jehovah’s Witnesses refusal of blood transfusion for their child is in the opinion of surveyed nurses, endangering the child’s health or even life. Thus, most of the respondents agree that the best solution in that case is to implement a legal procedure that allows blood transfusion despite parents’ refusal.

Introduction. Well-implemented, holistic care of the dying patient requires appropriate qualifications from the medical personnel. Aim. The aim of the study was to collect the opinions of nursing and medical students before the end of their professional education on their preparation to provide care to the dying patient. Material and methods. The survey was carried out in a group of 213 medical and nursing students during their final year of professional education. Results. Students were unable to clearly express their opinion on their preparation to provide care to patients at the end of their lives (87; 40.8%). Nursing students were more likely to perceive themselves as prepared for such care – 30 (26.7%) than medical students – 11 (10.9%). Statistically significant correlation was observed. A large group of the students (92; 43.2%) had never been present at the scene of a patient’s death during clinical classes. The majority of the respondents chose ‘definitely not’ (59; 27.7%) and ‘rather not’ (53; 24.9%) answers when asked if their university education had prepared them for work with patients at the end of their lives. Students considered their knowledge to be lacking mostly in areas such as coping with their own emotions in the face of a patient’s death (137; 64.3%); communicating with a dying person (119; 55.9%); providing care to the patient’s family (154; 72.3%); cooperating with the patient’s family (125; 58.7%). Conclusions. Students of both majors are not certain about the level of their preparation to provide care to people at the end of their lives, nor about the extent to which their university education had introduced them to the specificity of care of a dying patient. The medical students were observed to exhibit higher statistical significance as compared to the nursing students. The university curriculum prepared the students to take care of the dying patient’s biological sphere, but did not prepare them to assume a holistic approach to care of the patient and his family.

Background Pro-health behaviours aim at disease prevention, recovery from an illness and maintenance of good health in a physical, mental and social sphere. The study had two main objectives: (a) to analyse health behaviours of postmenopausal women and their understanding of the notion of health, and (b) to analyse the relationship between individual categories of health behaviours and prophylactic activities undertaken by postmenopausal women. Methods A cross-sectional study was conducted among a convenience sample of 510 postmenopausal women. Three study instruments were used: an original questionnaire and two instruments designed by Juczyński: the List of Health Criteria and the Health Behaviour Inventory. Results In the view of the respondents health was primarily synonymous with a feature, because the following three associations were given the highest priority when defining health: to be healthy means ‘have all body parts functioning well’ (M = 1.82), ‘do not experience any physical problems’ (M = 1.43) and ‘not be sick, only occasionally suffer from flu, cold or indigestion’. The score for health behaviours was average (M = 86.18). The highest score was achieved in the area of prophylactic behaviours. General indicator of health-related behaviours was higher in women who rated their health as very good (p p Conclusions Results showed that women after menopause treat health mainly as a feature of their body and condition specific for this period of life. The analysis of postmenopausal women’s health behaviours and their perception of health helped to identify areas that require the focus of medical personnel in regard to health promotion and prophylaxis. The average general indicator of health-related behaviours is positive for this group of women as it shows that they care about their health, especially in terms of prophylaxis.

OBJECTIVES: To determine the level of cultural competence of European critical care nurses.DESIGN: A multi-country survey performed in 2017 as a part of the European project Multicultural Care in European Intensive Care Units.METHOD: Online survey of critical care nurses in 15 European countries (n = 591) using the Healthcare Provider Cultural Competence Instrument consisting of 49 items divided into five subscales: awareness and sensitivity, behaviour, patient-centred orientation, practice orientation and self-assessment. Descriptive and correlational analyses were performed.RESULTS: Critical care nurses scored highest for 'awareness and sensitivity' (M = 5.09, SD = 0.76), and lowest for 'patient-centred communication' (M = 3.26, SD = 0.94). Nurses from northern and southern Europe scored higher across all subsets of the cultural competence instrument (all subsets, p < 0.001) than nurses from central Europe. Speaking other languages significantly correlated with higher scores in all subscales (all > 0.05) except 'practice orientation'. Previous education on multicultural nursing significantly correlated with higher scores in all subscales (all > 0.01) except patient-centred communication; and visits to other countries was negatively correlated with all subscales (all, p > 0.001) except patient-centred communication.CONCLUSION: Being exposed to cultural diversity in different ways, like living in a multicultural country, speaking a second language and visiting other countries may influence development of cultural competence. Therefore, programmes which facilitate multicultural clinical practice are strongly recommended in nursing education.

Introduction. The essence of the nurse profession is to provide patients with comprehensive care that will help them achieve optimal health. During the time of planning a reform of the health sector and the time of introduction of managed health care, it is reasonable to consider whether the current professional role of the nurse will change. Method. Analysis of the literature in the field of health care and nursing systems reform from the period of 5 years. Results. Coordinated care has a chance of success only when the current thinking stereotypes are broken, because it is important to be aware of how important teamwork is to a particular patient with respect for one’s own professional competences.

Introduction.The ongoing process of globalisation is contributing to the reconfiguration of social behaviour, even in small and relatively stable communities. The increased migration of people has led to more-varied groups of patients. The provision of nursing care which is consistent with a given culture, and adjusted to the particular needs of its recipient, is becoming a necessity. The development of cultural competence in the nurse's education, aimed at responding to the needs and demands of the global community, constitutes a current challenge for nursing.Aim.The aim of this paper is to describe the assumptions put forward within the selected theoretical models of transcultural nursing, the nurses' cultural competences arising from them, and the possibility of their scientific evaluation.Method.A non-systematic review of the literature based on the thematic selection of content and authors.Results.The paper presents four basic theories and theoretical models of transcultural nursing which are well described in the literature on nursing, i.e. theories by M. Leininger, L. Purnell, J. Campinha-Bacote, J.N. Giger and R.E. Davidhizar, and their related cultural competences. The theoretical models constitute a foundation for the provision of nursing care to various populations, providing resources to overcome obstacles and challenges in situations where nurses care for patients with various cultural backgrounds. The article also presents the most important tools for the assessment of cultural competences based on the basic theoretical models of transcultural nursing.Conclusions.Cultural competences in nursing set the direction for investment in self-development for both nurses-theorists and nursing practitioners. Understanding the components of cultural competences and their assessment plays an important and necessary role in the implementation of the concept of multiculturalism in nursing.

Religiosity is considered as one of the many factors shaping an individual’s health consciousness. The aim of the study is an analysis of the correlation between the religiosity of Jehovah’s Witnesses and their attitudes towards health and disease. A cross-sectional study was performed on the convenience sample of 171 Jehovah’s Witnesses from eastern Poland with the use of two research tools: the author’s questionnaire, focusing on attitudes towards health, disease, death and the use of stimulants, and the Duke University Religion Index (DUREL). The research involved 99 females (57.9%) and 72 males (42.1%), with an average age of 37.25 (SD = 12.59) years. On average, they have been a Jehovah’s Witness for 29.21 (SD = 13.22) years and are characterised by a high ratio of organisational religious activity (ORA) (M = 5.60, SD = 0.62) and intrinsic religiosity (IR) (M = 4.81, SD = 0.37). Those who had never smoked before becoming one of Jehovah’s Witnesses had a higher IR (Z = −2.822, p = 0.005), similarly to those respondents who smoked cigarettes before they became Jehovah’s Witnesses (Z = −2.977, p = 0.003) and those who did not abuse alcohol before they became Jehovah’s Witnesses (Z= −1.974, p = 0.048). Jehovah’s Witnesses are a group characterised by a high degree of consistency when it comes to religiosity, attitudes regarding health and disease and health behaviours. This means that they follow the teachings of their religion with regard to health issues. Knowledge about the association between religiosity and health behaviours is important to provide effective health education, health promotion and development of health prevention policy, specifically when dealing with more religious groups of clients.

The year 2016 marked the 125th anniversary of the birth of physician-venereologist and passionate writer Mikhail Afanasievich Bulgakov (1891-1940). From his essays emerges a figure of a man torn between medicine and literature. His works contain fragments pertaining to his personal ailments and health problems, which are described with medical precision, for example, morphine addiction. Bulgakov's essays are full of metaphors and references to the political situation of Soviet Russia. He compared this situation to syphilis as in treacherous infections, a slow destroying and enslaving of a social organism.

Background The need to provide care for the dying patient and his/her family may occur in every medical setting. Newly graduated nurses and physicians should therefore be prepared to deliver it at a high-quality level. Objectives To explore (a) the primary difficulties participants anticipate they will encounter whilst working with dying patients, (b) their interest in developing competencies in caring for dying patients, and (c) their interest in working in palliative/hospice settings or with dying patients in the future. Design A cross-sectional study. Settings A medical university in Poland. Participants Convenience sample of nursing (=112) and medical students (=101) at the end of their undergraduate education. Methods Questionnaire distributed online and in hard-copy format. Results Half of the participants anticipated experiencing various emotional and professional difficulties in caring for dying individuals, especially medical students. These difficulties pertained mostly the reaction of family members to the patient's death, addressing the psychological needs of the dying person, and coping with his/her own emotions when dealing with the patient's death. Students reported that working with dying patients could cause occupational stress – more so among medical students. The majority of them showed an interest in improving knowledge regarding palliative care and also in this case this was mostly true of medical rather than nursing students. However, more than half of the participants preferred avoiding work in palliative/hospice settings, with no differences between the two groups. Participants attributed this attitude to two factors: (a) the desire to avoid negative emotions and stress that could be triggered by dealing with death and dying; and (b) because they felt they lacked the required skills and personal abilities to handle such situations. Conclusions Undergraduate curricula that include strategies for coping with negative emotions associated with facing the process of death and dying should be developed. Interprofessional education should be encouraged, especially regarding the psychosocial aspects of end-of-life care.

Background An appropriate clinical learning environment has been identified as pivotal in nursing undergraduate education and should be planned responsibly. Specifically, night shifts placements have been documented as an important opportunity for developing a full understanding of the nursing profession and the whole process of nursing care. However, night shifts during placement have been reported to be stressful and anxiety-provoking, so their usefulness for nursing students is still debated. Objectives To elicit nursing students’ perceptions of night shift placement through metaphors, with the aim of discussing the pedagogical and ethical implications. Design A descriptive qualitative study was performed based on metaphors collected in an international cross-sectional study in 2016. Settings A network comprising five Bachelor of Nursing Science degrees located in the Czech Republic, Italy, Poland, Portugal, and Slovakia was established. Methods A total of 907 out of 1347 eligible nursing students from the five European countries described their learning experience on night shifts using a metaphor. Results Overall, 288/907 (31.7%) metaphors emerged as being negative-oriented and 137/907 (15.1%) as positive, while the remaining students (482; 53.2%) did not report any metaphors. In all five countries, negative metaphors prevailed: ‘Wasting time’ (37/288), ‘Useless’ (32/288) and ‘Handyman’ (22/288) were the most negative reported metaphors on working a night shift. However, doing a night shift is also perceived as a ‘Learning opportunity’ (22/137), a ‘New experience’ (20/137) and an ‘Opportunity to socialize with the profession’ (14/137) as underlined by the positive metaphors. Conclusions Students perceive night shift placements mainly as a negative experience, which has little to do with education. While planning night shift placements, nursing educators should responsibly consider the whole process of education, analysing not only the learning outcomes that should be achieved but also the position of students and their experience as a person. Clinical mentoring can be a key resource in supporting students in transforming their night shift placements’ experiences into a more meaningful or worthwhile experience. Moreover, night shifts should be offered to more experienced students, independent in their self-learning processes and capable of managing the limited possibility of interacting with other team members and patients.

Introduction. In the subject literature there were five conceptual dimensions of empathy defined which were specified as a human trait, the basis of professional work, communication process, a manifestation of concern and the special relations. Empathy is the essence of understanding the other person in nursing. The empathic competences have a significant meaning for building caring and therapeutic relations in the work of nurses.Aim. An indication of the essence of empathy in nursing in the aspect of theoretical assumptions and practical activities together with its selected empirical determinants.Method. Topic and unsystematic review of literature looking at the last 30 years. The analysis carried out by the authors of the research included 55 sources.Results. The study of empathy in nursing quite often used the concept formulated by Neuman team and a definition of empathy coined by Mercer and Reynolds, resulting from the concept : “Empathy involves ability (…) (a) to understand the perspective of patient’s situation and feelings and related meanings; (b) conveying information about understanding patient’s state and checking their determinants; and (c) to act within the closeness agreement with a patient in the way consistent with the therapeutic assumptions. Research studies indicate that nurses in general have quite high levels of empathy which positively influences the process of communication with patients and their families and dealing with patients who have psychosocial problems.Summary. Empathy model most often used in nursing is based on the relations in the communication process. Empathy has positive influence over the quality of relations between nurses and patients, as well as the quality of nursing care. The empathic competences of nurses require system education and professional development with use of training and other active forms.

Aim. The aim of the research was to determine the elements of a nurses’ professional image, which most frequently appear in the media and the analysis of their connotations. Material and method. A survey was conducted on 171 women and 10 men; professionally active nurses. The study was carried out in 2015 using a questionnaire created by the author. Results. Among the most common elements influencing the nurses’ professional image in electronic media there were strikes/protests (54.1%) and the nurses’ external appearance (40.9%). The tone of the above mentioned elements was assessed by the respondents as indifferent. According to the surveyed nurses, the most infrequently appearing professional traits were: confidence (7.7%), independence (10.5%), honesty and conscientiousness (13.3%). The overtone of these elements was evaluated as indifferent except for the ‘independence’ which was described by 36.5% of the respondents as negative. According to the respondents, the efforts to improve the image in electronic media should be done by professional organizations of nurses and midwifes and the nurses themselves. The most important task that should be undertaken by professional organizations in order to improve the overall image would be to increase wages and improve nurses’ working conditions and their identification with the professional environment. Conclusions. The most frequently appearing elements of the professional image of nurses in the electronic media were strikes and protests. Rarely such features of nurses and the profession as self-confidence, independence and honesty and conscientiousness were mentioned. Thus there is a great need for acting towards changing the nurses’ professional image in the electronic media.

Background Organising clinical placements during nights has been reported as an additional opportunity to introduce students to the whole picture of their future responsibilities. However, studies in this field are still lacking. Objectives To describe and compare (a) the night shift experience of nursing students across Europe, (b) the patient-related problems that they face during night shifts, (c) the night care activities nursing students are called to perform, and (d) the perceived effects of night shift work on learning outcomes. Design A cross-sectional study, 2016. Settings Five European countries: Czech Republic, Italy, Poland, Portugal, and Slovakia. Participants Nursing students from nine Bachelor of Nursing Science degree programmes attending night shifts during their study period and who were willing to participate were included. A total of 907 out of 1347 (67.3%) eligible students participated. Methods Questionnaire based on the available literature, translated into five languages. Results The duration of the night shift was from an average of 9.8 (CI 95% 9.6–10.0) in Italy to 11.9 (CI 95% 11.7–12.0) in the Czech Republic. Students faced mainly patients' pain without statistical differences across countries (at the overall level, 717 out of 907; 79%; p = .318). However, significant differences in the tasks performed during nights emerged: Polish students reported being more involved in performing basic nursing care (72; 93.5%) as compared to other countries (e.g., Portuguese students 337; 84.9%), (p = .02). Overall, an average of 28.9% of the night shift time was reported to be free of commitments, with higher values among Polish (38%, CI 95% 33.6–42.3) and Slovakian students (33.4%, CI 95% 30.6–36.3) and lower values among Czech Republic students (20.4%, CI 95% 17.6–23.2) (p .001). Boredom and satisfaction were reported as the main feelings during night shifts, with significant differences (p .001) across countries. Students reported significant different effects (p .001) of night shifts on their understanding of a nurse's role (from 5.2 out of 10 in Poland to 6.5 in the Czech Republic), on the understanding of the continuity of nursing care (from 5.2 in Poland to 6.7 in Italy), and on having a relationship with the clinical mentors (from 2.7 and 4.2 in Poland and the Czech Republic, respectively, to 6.9 in Italy). Conclusions Night shifts can be both a valuable and a non-valuable learning experience, suggesting the need to carefully plan and assess their effectiveness at the unit level.

Professional nursing education in Poland began in 1911 in Krakow. Since then, the nursing education system has continued to change. From the establishment of the first professional nursing school, Poland experienced partition, war and the German occupation, short-lived independence, the Soviet regime and the regaining of its freedom, as well as the development of democracy processes. All of these events impacted on nurses' education. The current state of nursing training is determined by the requirements of the Council of the European Communities. Today, the challenge for nursing education in Poland is the permanent process of the country's education system's adjustment to the European Higher Education Area to ensure the quality of education and to support the mobility of students and academic teachers. Additionally, new competencies pertaining to nurse prescribing, which have been in force in Poland since 2016, will cause new changes to the under- and postgraduate programmes of nursing education. The aim of this study is to present the development of nursing education in Poland in the context of socio-political changes in the country and from the perspective of current nursing challenges worldwide.

Background Assessing clinical competence in nursing students abroad is a challenge, and requires both methods and instruments capable of capturing the multidimensional nature of the clinical competences acquired. Objectives The aim of the study was to compare the clinical competence assessment processes and instruments adopted for nursing students during their clinical placement abroad. Design A case study design was adopted in 2015. Setting and Participants A purposeful sample of eight nursing programmes located in seven countries (Belgium, Denmark, Greece, Norway, Poland, Portugal and Italy) were approached. Methods Tools as instruments for evaluating competences developed in clinical training by international nursing students, and written procedures aimed at guiding the evaluation process, were scrutinised through a content analysis method. Findings All clinical competence evaluation procedures and instruments used in the nursing programmes involved were provided in English. A final evaluation of the competences was expected by all nursing programmes at the end of the clinical placement, while only four provided an intermediate evaluation. Great variability emerged in the tools, with between five and 88 items included. Through content analysis, 196 items emerged, classified into 12 different core competence categories, the majority were categorised as ‘Technical skills’ (= 60), ‘Self-learning and critical thinking’ (= 27) and ‘Nursing care process’ (= 25) competences. Little emphasis was given in the tools to competences involving ‘Self-adaptation’, ‘Inter-professional skills’, ‘Clinical documentation’, ‘Managing nursing care’, ‘Patient communication’, and ‘Theory and practice integration’. Conclusions Institutions signing Bilateral Agreements should agree upon the competences expected from students during their clinical education abroad. The tools used in the process, as well as the role expected by the student, should also be agreed upon. Intercultural competences should be further addressed in the process of evaluation, in addition to adaptation to different settings. There is also a need to establish those competences achievable or not in the host country, aiming at increasing transparency in learning expectations and evaluation.

Developing caring competences is considered to be one of the most important aims of undergraduate nursing education and the role of clinical placement is recognised as special in this regard. Students' reflection on caring, their experience and obstacles in being caring is recommended as a key strategy in the process of teaching and studying the nursing discipline. Therefore, the aim of this study was to describe the concept of caring, its manifestations and possible obstacles while caring, as perceived by first-year nursing students before and after their first clinical placement. Qualitative content analysis of 15 Polish students' narratives written before and after their clinical experience in the form of text-diaries was undertaken. The findings revealed that students entered their nursing education with a deep humanistic vision of caring both on theoretical and practical levels and the first clinical placement has enriched this vision. Expressive caring was more appreciated by students than the instrumental one and their concept of caring was coherent with the caring behaviours as described in their narratives. Several internal and external obstacles for caring have been reported by students, indicating a specific tension between their ideal of caring and their practical experience of caring in the clinical reality.

Background: Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom. Aims: To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession. Research design: A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project. Findings: In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses. Discussion: Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed. Conclusion: The call for investing in nurses and nurses’ care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

Commentary on : Skomakerstuen Odbehr L, Kvigne K, Hauge S, et al. A qualitative study of nurses’ attitudes towards and accommodations of patients’ expressions of religiosity and faith in dementia care. J Adv Nurs 2015;71:359–69.[OpenUrl][1][CrossRef][2][PubMed][3] A lot of the research published during the last two decades has indicated the insufficiency of the biopsychosocial model and has suggested adding a spiritual dimension to it. This especially concerns elderly patients with chronic diseases, as they may need … [1]: {openurl}?query=rft.jtitle%253DJ%2BAdv%2BNurs%26rft.volume%253D71%26rft.spage%253D359%26rft_id%253Dinfo%253Adoi%252F10.1111%252Fjan.12500%26rft_id%253Dinfo%253Apmid%252F25092229%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1111/jan.12500&link_type=DOI [3]: /lookup/external-ref?access_num=25092229&link_type=MED&atom=%2Febnurs%2F19%2F2%2F63.atom

Summary Background In spite of the number of studies available in the field and policy documents developed both at the national and the international levels, there is no reliable data available regarding the variation of roles occupied by clinical mentors (CMs) across countries. Objectives To describe and compare the CM's role; responsibilities; qualifications; employment requirements and experience in undergraduate nurse education as enacted in 11 European Union (EU) and non- EU countries. Design A case study design. Participants and Setting A panel of expert nurse educators from 11 countries within and outside of the EU (Croatia, Czech Republic, England, Iceland, Ireland, Italy, Poland, Serbia, Slovenia, Spain, and the USA). Methods A questionnaire containing both quantitative and qualitative questions was developed and agreed by the panel using a Nominal Group Technique (NGT); four cycles of data collection and analysis were conducted involving key experts in nursing education in each country. Results In all countries, there are at least two types of clinical mentorship dedicated to undergraduate nursing students: the first is offered by higher education institutions, and the second is offered by health care providers. Variation was noted in terms of profile, responsibilities and professional requirements to act as a CM; however, the CM role is mainly carried out by registered nurses, and in most countries there are no special requirements in terms of education and experience. Those who act as CMs at the bedside continue to manage their usual caseload, thus the role adds to their work burden. Conclusions Whilst it is imperative to have respect for the different national traditions in undergraduate nurse education, the globalisation of the nursing workforce and greater opportunities for student mobility during the course of their undergraduate education suggests that in areas such as clinical mentorship, jurisdictions, particularly within the EU, should work towards greater system harmonisation.