In particular, mental health nurses MHNs determine their nursing actions by first noticing things that are unusual or different from before and developing a sense of discomfort in the form of worry or unease, and following up by detecting violence and infliction of harm to self or others, selecting the responding staff nurse based on depth of involvement or relationship with the patient in question, and responding flexibly depending on the situation or context.
They then need to analyze the patient responses and their own speech and behavior while these nursing actions are being performed or by self-reflection after the actions. Like observation, it requires sufficient training Baly, However, reflection is not limited to competent or proficient nurses; it is also seen in nurses with little practical psychiatric clinical experience.
Therefore, taking reflection to be a reconstruction of experience, we focused on emotions that are strongly perceived as subjective experience. Our emotions can be assessed with an emotional intelligence EI scale. Previous studies on EI include cross-sectional studies of student subjects Chan and Hamamura, ; Orak et al. Actual EI in nursing outside Japan has been demonstrated in countries including Netherlands, South Korea, and China, and while the characteristics differ depending on the assessment scale used and the country surveyed, the need for continuous education and follow-up has been suggested Van Dusseldorp et al.
However, EI in Japanese nurses has yet to be elucidated. The results showed a significant positive correlation between EI and age, but no correlation was found between EI and nursing experience. Moreover, this survey targeted only MHNs and the characteristics of MHNs compared with other nursing fields have not been clarified.
Therefore, there is a need to clarify the EI that MHNs need to nurture reflective practice and self-awareness in psychiatric clinical practice. Based on specialized knowledge and skills in mental health nursing, length of experience in clinical nursing practice, and literature review Takei, ; Ishii et al. The purpose of this study was to measure the EI of Japanese nurses and among them to clarify the characteristics of MHNs.
The participants of this study were Japanese nurses in their 20s and 30s. Anonymous, self-administered questionnaires were distributed to nurses working in three psychiatric hospitals and two internal medicine hospitals in the Kyushu region from December to March We provided a written explanation of the purpose and methods of the study to participants in advance, including that return of the questionnaire sheet would be taken as consenting to participate in the study, and that individuals would incur no disadvantage whatsoever by refusing to participate.
The anonymity of individuals and the protection of privacy were guaranteed by coding the questionnaires after each of the consenting participants completed the questionnaire and sealed it in an envelope. Questionnaires with incomplete responses were excluded, leaving participants valid response rate, Internal consistency reliability for the four factors abilities ranged from 0. The response format of each item is a 7-point Likert scale, with a score range of 1—7 points.
Higher scores indicate higher EI. The participants were divided into two groups, one comprised of MHNs and another comprised of internal medicine nurses IMNs , and mean scores were compared using an unpaired t -test.
SPSS We confirmed the basic attributes of the participants. By sex, there were women and 51 men. The mean age was Participant demographics are shown in Table 1. The total mean score and mean scores for the four factors on the J-WLEIS were compared between the two groups using a t -test. Accurate clinical judgments are high-level practical nursing skills. Therefore, we decided to compare and clarify the actual EI of MHNs compared with nurses in non-psychiatric clinical practice.
Considering the specialized knowledge and skills in psychiatric nursing, the length of experience in clinical nursing practice, and a review of the literature in Japan, we expected that the EI of MHNs would be at a higher level than that of nurses in other fields. Three reasons may be considered for this. First is that the scales used were different. Third is that while psychiatric treatment in Japan is currently being shifted to community medicine, there are still many patients under long-term hospitalization Tachimori et al. In such a treatment environment, there is a strong possibility of an effect from excessive closeness in the relationships built up between patients and nurses and the length of those relationships.
Nursing is said to be emotional labor Hochschild, ; Smith, Itabashi et al. Bechtoldt et al. Thus, it may be that evaluating the EI of the MHNs that participated in this study had an effect on their sense of fulfillment in their work. Self-awareness is not a skill that can be improved by the individual.
That is because reflection is elicited and developed by involvement with and support for others Smith and Gray, ; Clouder and Sellars, Therefore, involvement with others is needed in the reflective practice and thought of nurses. Ishii suggested three things to raise the EI of MHNs: education programs for newly graduated nurses, planning and methods of postgraduate education programs, and evaluation of education programs.
However, EI will probably not improve with new nurse training and continuous learning within hospitals alone. MHNs in Japan need to actively participate in workshops and conferences outside their own workplace, be involved with nurses and many specialists from other institutions, learn, and reflect back on themselves. Training for learners to reflect back on their own emotions through dialog with supervisors or records during or after practice in basic nursing education is also an issue.
Mental health nurses always faces the different emotions of patients with mental disorders and their families. If they are a profession, they will believe it is natural. The reason may be the emotion regulation of MHNs as a profession. Therefore, MHNs need a working environment and team emotional engagement that can communicate not only positive but also negative emotions. The participants in this study were limited to five hospitals in the Kyushu region of Japan, and generalization may not be possible.
Thus, it is difficult to derive firm conclusion based on the results of this study, and interpretation needs to be done carefully. In the future, the universality of results will be increased by conducting surveys on a more national scale. It will also be necessary to elucidate actual involvement with others to raise self-awareness in the reflective practices of MHNs. The analysis results indicated that the self-awareness of MHNs was significantly lower than that of nurses in other fields.
The results of this study provide a basis for future research on the EI of nurses in Japan. The kinds of people nurses are involved with and the content of their support for others also needs to be clarified. All datasets generated for this study are included in the manuscript and or the supplementary files.
The purpose of the study was explained to all the participants during the delivery of the anonymous self-reported questionnaire.
SI searched and reviewed the study, performed the data collection and analyzed the data, and wrote the manuscript. EH critically reviewed the manuscript and supervised the entire research process. Both authors contributed to data interpretation and writing the manuscript and approved the final version of the manuscript for submission.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Advancing practice: From staff nurse to nurse consultant. Part 7: Problem solving. Br J Nurs ; The effect of problem-solving training on the counseling skills of telephonic nurse care managers.
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BMC Med Educ ; Self-appraised social problem solving abilities, emotional reactions and actual problem solving performance. Beh Res Therapy ; McCallin A, Bamford A. Interdisciplinary teamwork: Is the influence of emotional intelligence fully appreciated? J Nurs Manag ; Ahghar GH.
Effect of problem-solving skills education on auto-regulation learning of high school students in Tehran. Shahba S, Allahvirdiyani K. Comparative study of problem-solving and emotional intelligence on decreasing of third grade girl students' aggression of the Rajaee guidance school of Tehran. Procedia Soc Behav Sci ;9; Users Online: Effects of problem-solving skill training on emotional intelligence of nursing students: An experimental study.
J Edu Health Promot ; Table 2: The mean standardized scores of the Emotional Quotient Inventory before the intervention and immediately and 2 months after it Click here to view. Table 3: The mean changes in problem-solving skill scores before the intervention and immediately and 2 months after it Click here to view. Descriptive analyses, comparisons between and within groups were performed. At the end of education, all samples exhibited positive attitudes to research and the main barrier was related to the setting. Scandinavian students reported higher critical thinking.
Indonesian students perceived greater barriers on two Barrier subscales. No differences were found between the samples regarding research utilization. Significant changes over time varied among the samples except for the Norwegian sample. Indonesian students diploma exhibited most changes over time. Teachers must support nursing students to strengthen their critical thinking ability and develop professional competence. Nursing education in Norway and Sweden differs from that in Indonesia in some respects.
Newly graduated nurses are required to employ research-based knowledge combined with clinical experience and patient values in their practice. The use of research findings in practice is an important cornerstone of high-quality patient care. In recent years nursing curricula have been developed to a more academic level, despite this the theory—practice gap still exists.
The barriers included, for example, insufficient time to implement new ideas, and lack of time to read research reports. The barriers were consistent over time, geographic location and other conditions, e. In order to meet the requirements for EBP, nursing students need to develop their critical thinking ability, as it can result in nurses having the necessary skills and dispositions, e. Studies have shown that a majority of nursing students and newly graduated nurses have a positive inclination towards critical thinking and positive attitudes to research utilization.
However, low research use and several barriers to research utilization in practice have also been reported. Longitudinal studies of nursing students regarding professional development have been requested. It would therefore be of interest to study these matters among nursing students in different countries. The present study is a part of a larger collaboration project about life-circumstances, health status and professional development among nursing students in Norway, Sweden and Indonesia. The aim was to describe and compare perceptions of professional development, i.
Data were collected in T1 , T2 and T3. A questionnaire package was administered to the students during the course of ordinary lessons. Teachers, not involved in the present study , informed the students about the study and handed out the envelopes containing the coded questionnaires. The students returned the questionnaires in a sealed envelope. This process was carried out at the beginning at the end of the first semester — T1 , in the middle during the fourth semester — T2 and at the end of their education at the end of the sixth semester — T3. In Norway questionnaire packages were handed out at T1, at T2 and at T3.
In Sweden 71 questionnaire packages were handed out at T1, 66 at T2 and 63 at T3. In Indonesia diploma level questionnaire packages were handed out at T1, at T2 and at T3. The translation process followed the Eurostat procedure. Critical thinking disposition was measured T1, T2, T3 by means of the CTQ, specifically developed for the present study. The total score, ranging from 28 to , was calculated by summarizing the item scores of each respondent.
Higher scores indicate a greater inclination towards critical thinking. Face and content validity were established by pilot testing of the questionnaire with a group of Norwegian nurse teachers and Swedish nursing students, after which some minor changes to the wording were made. At T1 only the attitude index was utilized. All three indexes were utilized at T2 and T3. The indexes were calculated in two ways. A The index scores were summarized and then divided by the number of items in the index.
The index scores ranged from 1 to 5. Higher values indicate a more positive attitude towards research, better availability of research and more research use. Barriers to using research in practice was measured by means of the Barrier Scale T2, T3.
The Value of Critical Thinking in Nursing
The subscales were calculated in the following ways: A The subscale scores were summarized and then divided by the number of items in the subscale. The scores ranged from 1 to 5. Higher values indicate greater barriers. The Barrier Scale has been translated into Swedish 18 and into Norwegian.
SPSS version Secondly, the same analyses were performed with analyses of covariance ANCOVA to control for gender as a factor and age as a covariate. The students gave their consent by completing the questionnaires. Table 1 shows that the two Indonesian samples are significantly younger than the two Scandinavian Norwegian, Swedish samples.
The Value of Critical Thinking in Nursing | Carson-Newman University
Table 1. Characteristics of the Norwegian, Swedish and Indonesian nursing students at the beginning of their nursing education Time 1. Table 2. The mean values on the Nurse subscale were 2.
The mean values on the Setting subscale were 1. The mean values on the Research subscale were 1. The mean values on the Presentation subscale were 1. Table 3. Table 4 , which is based on raw scale scores, reveals that the Indonesian samples scored significantly lower than the Norwegian 4 of 10 comparisons and the Swedish samples 7 of 10 on scales designed to measure critical thinking and research utilization.
Regarding barriers to research, the Scandinavian samples scored lower, indicating fewer barriers than the Indonesian samples on five comparisons of 8. Table 4. Table 5 shows the same between-group comparisons as Table 4 , now controlled for age and gender. Only statistically significant differences are presented in this table. As can be seen, a different picture emerges, where most of the above-mentioned statistically significant differences between the two Indonesian and the Scandinavian samples disappear. Critical thinking constitutes an exception. On the CTQ, significant differences were noted on all three assessments occasions between the Indonesian Diploma sample and the two Scandinavian samples, with the latter scoring higher see also Table 4 , indicating a higher inclination towards critical thinking.
No significant differences were observed between the two Indonesian samples or between the two Scandinavian samples not shown in the table. Table 5. Only statistically significant differences are shown. The Scandinavian samples scored lower, i. Most significant changes were found in the Indonesian diploma sample.
Thus, their scores see also Table 4 indicate increasing levels of critical thinking disposition, less positive attitudes towards research and more perceptions of barriers related to the Nurse, Research and Presentation subscales. The Swedish sample shows an increased disposition for critical thinking between T1 and T3 and less positive attitudes towards research between T1 and T2, but no significant difference between T1 and T3. No significant changes over time were found on any of the scales in the Norwegian sample. Table 6. Mean differences M diff Standard deviations SD and p -values paired t -test are shown.
There is a global challenge for nurses to provide care based on current scientific knowledge, 6 and studies have shown that EBP results in improved quality of care, better patient outcomes and decreased costs. These results are in line with results among newly graduated nurses. Further, support to implement research findings has been shown to be a strong predictor of research use. Comparison of the results of the professional development scales between the samples was initially based on the raw scores showing that the Indonesian samples scored significantly lower than the Scandinavian samples on the CTQ and the RUQ, in addition to reporting greater barriers to research utilization.
After controlling for age and gender most of the significant differences disappeared.
Critical thinking constituted an exception. One reason for the lower CTQ values might be that the Indonesian samples were younger.
This result is supported by Shinnick and Woo who found that age positively predicted total critical thinking skills scores. This might be due to these students developing a more critical view on this aspect, which could be supported by the fact that they scored significantly higher on the CTQ over time.