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Shiv Khera
Over recent years decline in morale in health care and related professions is recognized
because of long-term involvement in situations that are exhausting characterized by feelings
of being physically and emotionally drained. This leads to the development of negative
attitudes and feelings towards patients and a growing evaluation of self-competence and
achievement .
Nursing is a profession often characterized with high level of stress, physical and
mental demands at work, which brings personal and social strains in nurses’ life. It is
important to identify the factors, which can lead to better subjective wellbeing . Recent study
conducted in twelve European countries showed that long working hours and high burnout in
hospital nurses may pose safety risks for patients as well for nurses.
Positive thinking is a special storehouse consciousness, the ability to control the own
mind. It is believed that if a man can control his mind, he can control his life. Not
accidentally, many sages say that your world is a reflection of man’s thoughts. If you are
afraid of life, you will for sure have some problems. Once you are oriented on the path of joy,
prosperity, happiness, your life is changing for the better.
To date, there is no prior research on the influence of positivity on well being among
nursing students globally. The literature review available for influence of selected modules is
scarce. So, there is need to investigate whether the VIHASA programme, could enhance the
well-being of nursing students. Moreover, this study will also help to investigate applicability
of VIHASA and its benefits in future.
The aim of the study is to explore the extent to which the “VALUES IN HEALTH
CARE” selected module intervention enhances well-being among nursing students.
Objectives
experimental group.
Operational definition
Values in health care: Values in health care includes values such as inner values,
peace, positivity, compassion, cooperation, valuing self, spirituality in their personal
and professional practices followed by nursing students.
Well-being: It includes physical, mental, emotional, social and spiritual aspects of the
health as measured by self-completed validated questionnaires of Singh and Gupta
well – being scale.
Nursing students: Nursing students refers to those who are studying in B.Sc. nursing
1st to 4th year in selected nursing colleges of Sri Muktsar Sahib, Punjab.
Nursing colleges: It refers to the selected nursing colleges of Sri Muktsar Sahib,
Punjab.
Hypothesis
H0 - There will be no statistically significant difference in mean pre- & post intervention
of well-being of nursing students in experimental group at 0.05 level of significance .
H1 - There will be statistically significant difference in mean pre- & post intervention of
well-being of nursing students in experimental group at 0.05 level of significance .
Delimitation
B.Sc. nursing students of 1st to 4th year of selected nursing colleges of Sri Muktsar Sahib,
Punjab.
REVIEW OF LITRATURE
Yamin Tin Maung Maung et al (2016) . A pilot study was
conducted on 11 third year medical students’ perceptions of the “values in healthcare”
selective module on their mental wellbeing in Sefako Makgatho Health Sciences
University (SMU) .The aim of the study was to explore the extent to which the
‘Values in healthcare’ selective module intervention enhances mental well-being of
medical students. Both quantitative and qualitative results suggest an improvement in
the mental well-being of participants. A key factor highlighted the extent to which the
students’ awareness of the concepts of mental well-being, and in fact their awareness
of their own mental well-being, increased.
METHODOLOGY
Research approach and research design
Research approach for the present study will be Quantitative research approach and
research design will be Quasi experimental non randomized control group research design.
Research setting
The study will be conducted in selected nursing colleges of Sri Muktsar Sahib,
Punjab.
Target population
Target population consists of the nursing students of B.Sc. nursing 1st to 4th year in
selected nursing colleges of Sri Muktsar Sahib, Punjab.
Sample size and sampling technique
The sample size will be 60 B.Sc. nursing students of 1st to 4th of selected nursing
colleges of Sri Muktsar Sahib, Punjab. 30 samples will be in experimental group and 30 will
be in control group. Sample will be selected by non-probability purposive sampling
technique.
Variables
Independent variable:
Dependent variable:
Inclusion criteria
Nursing students of selected nursing colleges of Sri Muktsar Sahib in Punjab only
The nursing students who will be willing to participate in this study.
The nursing students who will be present at the time of data collection.
Exclusion criteria
Tools will be prepared after extensive review of literature, consultation and discussion
with the experts of nursing, medicine and research.
It will be determined by experts’ opinions from the field of nursing, medicine and
research for content face and criterion validity.
The reliability will be checked by conducting pilot study and obtaining reliability
coefficient.
Pilot study
It will be conducted to try out the reliability, feasibility and predictability of the study
on 1/10th part of the total sample size.
Prior to data collection, permission will be obtained from the research ethical
committee, concerned authority of mental health and nursing colleges’ authorities to conduct
study. Total 60 nursing students of B.Sc. nursing 1st to 4th year will be selected on the basis
of inclusion criteria and exclusion criteria through non probability purposive sampling
technique and explained about objectives, activities and duration of their involvement.
Informed consent will be obtained. Confidentiality and anonymity of the subjects will be
maintained. Nursing students will have full autonomy to participate in research and withdraw
from research at any time. Firstly, Pre intervention score will be assessed on experimental
and control group by using self- completed validated questionnaires Singh and Gupta
standardized well-being scale. Then, “VALUES IN HEALTH CARE” selected module will
be implemented to experimental group only and followed for 2 days. No intervention will be
given to control group. After 2 days, post intervention score on well-being will be assessed of
nursing students in experimental and control group.
Ethical consideration
Research and ethical committee of SINPMS, Badal Sri Muktsar Sahib and BFUHS,
Faridkot .
The investigator will plan data for the analysis and interpretation of data based on
objectives and done by using descriptive and inferential statistics.
Discussion
Discussion will be based on statistical analysis, current trends and previously related
research studies.
(INTERVENTION)
POSITIIVTY MODULE (Harness the power of thoughts )
Introduction :
Values in health care (VIHASA) is a kind of innovative programme planned and developed
by UK based Janki Foundation for Global Healthcare which helps health care individuals to
learn about themselves and their personal values . Moreover, this will also help them to learn
about values in healthcare which ultimately help them to provide best and effective care to
the patients . The values in health care (VIHASA) contains selected modules about core
values of an individual like values, compassion , positivity , creativity , peace ,
cooperation , valuing yourself and spirituality in health care which facilitate reflection
and the application of the gained insights into everyday challenges and situations. This helps
to improve their reflective and interactive skills with the patients and also promote their self
awareness. This helps to promote positive thinking and well being in health care
professionals and to improve their ability to deal with challenges of health care profession
and daily lives. Because if they are able to handle their own lives positively only then they
will be able to provide care to the patients with affection and empathy . But if their own lives
are stressed out , then they won’t be able to provide better and effective care to the patients
and they will be burned out easily . This will ultimately deteriorate their personal and
professional growth . So, to overcome all these challenges values in health care (VIHASA)
programme is planned and developed for all the health care professionals .
Health care professionals needs to deal with many difficult situations sometimes in which it
is not easy to stay positive all time . In this condition , they will easily get stressed and burn
out . this leads to decrease in their work performance . Positivity helps to bring clarity in their
decision making in critical situations and also bring balance in their personal and professional
lives. This is because when health care professionals are positive in their lives , only then
they will be able to provide better care to the patients and coordinate with other colleagues.
Changing our thinking to being more positive about our own work and that of colleagues will
improve our own self-esteem and raise morale.
Benefits :
● Mental – improves self-esteem and makes tasks easier . Also helps to raise morale
● Social – improves relationships , better coordination and improve ability to make right
decisions in critical situations . Clarity of thought which ultimately influences
relationships in personal and professional life.
● Spiritual – increases the capacity to be hopeful for the better future and outcomes.
The aim of this session is to recognise that we all have inner beliefs based on ‘positivity’
which we can surface and find ways of expressing, with many benefits on how we see
ourselves and how we relate to others. The first half of the module is mainly about
recognising the benefits of positive thinking and about developing positive thoughts about
oneself and others. The second half builds on these insights by applying the learning to work
contexts, and by introducing some more specific techniques for dealing with negative
thoughts and cycles of thinking. The timetable plan of positivity module is adapted from
Values in healthcare: a spiritual approach (2011). The module is divided into two sessions –
Being positive and interaction at work
THEME :
WORKSHEET 1
On your own, consider what are the gains or benefits of being positive, on:
A) Valuing the self : 15 minutes ( To identify positive thoughts and qualities about
themselves)
Process : Appreciation
Material : relaxing background music , worksheet
WORKSHEET 2
Identify your positive qualities and thoughts by answering the questions on this sheet. Be
spontaneous and jot down any thoughts which arise, rather than spending too long
considering your response:
List some positive thoughts and beliefs which come to mind in each of these areas:
1 Self 2 Others
C) Thought exchange- 10 minutes (learn how to change negative thoughts into positive
ones)
Process: Appreciation and play
Material : Paper (A5) and pens
D) Inspired to be me – 15 minutes (learn how to develop positive thoughts)
Process: Meditation
Materials : tape recorder , Paper and pens/coloured pencils
B) POSITIVE INTERACTION AT WORK
a) Appreciating others at work – 35 minutes ( Learn appreciate others through
positive thoughts )
Process: Appreciation
Materials : hand outs , worksheets , card , pin board
o Part A:Rules for appreciating others (10 minutes)
o Part B: Appreciating others in practice (10 minutes)
o Part C: Appreciating each other (10 minutes)
b) S.O.S.– a visualisation – 25 minutes ( to learn how to observe negative thoughts
and then change into positive thoughts)
Process: Visualisation
Materials : CD player
c) Being positive at work – 40 minutes( recognise benefits of being positive at work)
Process: Play
Materials : worksheet , flip chart , marker pens
Pre-prepared flipchart with three headings (allowing space to write a list under each):
a) Your health and effectiveness at work
b) Your relationships with patients/clients
c) Your relationships with colleagues/your team
WORKSHEET 4
The themes
It consisted of five sub-scale namely-physical well being, mental well being, social well
being, emotional well being and spiritual well being. Each sub-scale has ten items and there
are 50 items in total.
Scoring
Scores on all the sub-scale are added up to get a composite score as total well being.
Minimum and maximum score can be 50 and 250 respectively. Only 10-15 minutes are
required to administer the well being scale. It consist 29 positive items and 21 negative items.
Reliability of tool
Test-retest reliability of the scale was 0.98 and split half reliability was found 0.96.
Validity
Content and concurrent validity of the Well being Scale was established. Concurrent validity
of the scores of well being scale was determined by comparing it with the scores of
Subjective Well being Inventory Sall and Nagpal (1992).
Correlation between subjective well being inventory and physical well being, subjective well
being inventory and social well being, subjective well being inventory and emotional well
being, subjective well being inventory and spiritual well being and subjective well being and
total well being were -0.45, 0.87, -0.90, 0.28, 0.18 and 0.53 respectively.
PART I
DEMOGRAPHIC VARIABLES
This part comprises of some questions regarding the subject and their
educational background.
The subject is assured that the information obtained here will be kept a secret and will
1. Age in ……..
a) Below 18 years
b) 18-19 years
c) 19-20 years
d) Above 20 years
2. Gender
a) Male
b) Female
4. Father’s education
a) Illiterate
b) Primary
c) Secondary
d) Graduate
e) post graduate
5 . Mother’s education
a) Illiterate
b) Primary
c) Secondary
d) Graduate
e) post graduate
6. Father’s Occupation
a) Daily wager
b) Farmer
c) Government job
e) home maker
7. Mother’s Occupation
a) House Wife
b) Government job
c) Daily wager
d) Any other
a) Below 10000
b) 10001-20000
c) 20001-30000
d) Above 30000
9. Diet pattern
a) Vegetarian
b) Non-Vegetarian
10. Religion
a) Hindu
b) Sikh
c) Muslim
d) Others (specify)…………
a) Rural
b) Urban
12. Previous source of information about values in health care (VIHASA) selective
module
a) Mass media
c) Conferences
d) Institute/ teachers
e)
There are fifty items. You are requested to answer each item and not leave any item
unanswered. Using the Numerical Ranking below, indicate how strongly you agree
with each of the following statements. (Circle it)
No time limit.
SCORING TABLE
Physical Well-
1. Being
2. Mental Well-Being
3. Social Well-Being
4. Emotional Well-Being
Spiritual Well-
5. Being
Total =
INTERPRETATION OF WELL BEING SCALE
This is to certify that tool for A study to assess the effectiveness of “VALUES IN HEALTH
CARE” selected module on well-being of nursing students in selected nursing colleges of
Punjab prepared by Ms. Kiranbir Kaur, M.Sc. Nursing 2nd year, Mental Health Nursing
student, State Institute of Nursing and Paramedical Sciences, Badal is found to be valid and
up to date and she can proceed with this tool to conduct the study.
Name:
Date:
Place:
VALIDITY OF A TOOL
Respected Validator,
Please place the tick mark against the criteria given for each item. The fourth
column is for suggestions in case you find the respective item is not relevant or
needs modification.
INTERPRETATION OF SCORE
Sr.no. Score Validity Interpretation
1) 15-18 High valid The tool is valid and can provide
unbiased data with allowing less than 0-
10 % error
2) 11-14 Valid The tool is valid and can provide
unbiased data with allowing less than 11-
20 % error
3) 6-10 Not valid The tool is valid and can provide
unbiased data with allowing less than 21-
30 % error
SIGNATURE OF EXPERT