Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Nursing, Chronic care, Competencies, Curricula, Nursing students, Education, Self-management support, Self-efficacy, SEPSS-36, CHRONIC ILLNESS, BEHAVIOR, EDUCATION, CARE, COMPETENCE, SKILLS, Adult, Belgium, Chronic Disease, Female, Goals, Humans, Male, Models, Nursing, Nurse-Patient Relations, Self Care, Self Efficacy, Students, Nursing, Surveys and Questionnaires, Young Adult, 1110 Nursing, 4204 Midwifery, 4205 Nursing

Abstract:

BACKGROUND: Chronic conditions put a heavy burden on healthcare in every country. Supporting persons with a chronic illness to take an active role in the management of their condition is a core component in the Chronic Care Model. It implies confidence and good skills from professionals. To date, there is no evidence on final year nursing students' performance in supporting patients' self-management, nor on factors associated with this performance. OBJECTIVES: To explore self-reported performance of supporting patients' self-management by final year nursing students, and person-related factors associated with this performance. DESIGN: A correlational multi-centre study of final year nursing students (N=256) from eight nursing schools. METHODS: Students were recruited from a convenience sample of eight nursing schools. All final year students were invited to participate. Data were collected between January 2015 and May 2016 using self-administered validated questionnaires. Theoretical behavioural frameworks were used to select hypothesized associated factors for self-management support: self-efficacy to perform self-management support and socio-structural factors (Social Cognitive Theory); needs for autonomy, competence and relatedness, and patient-invested contingent self-esteem (Self-Determination Theory); and attitudes towards supporting patients' self-management (Theory of Planned Behaviour). RESULTS: Final year nursing students (N=256) reported an overall low level of performance in delivering self-management support during internship. Students lacked mainly competencies in collaborative goal setting and shared decision making. Students reported a significant gap between their confidence and their actual performance in self-management support (p<0.001). About 33% of the variance in students' performance is predicted by four person-related factors, i.e. self-efficacy to perform self-management support, general feeling of competency on internship, belief on patients' knowledge about condition management, and contingency of a student's professional self-esteem upon patients' achievements. CONCLUSION: Final year nursing students are actually not ready to support patients' self-management even though they will soon be in practice as qualified nurses. Nursing curricula should be further attuned to the complex competencies of self-management support. Special attention is needed to broaden the perspective on self-management support. Learning opportunities can be introduced in classroom activities and on internship.