scholarly journals Assessing Students’ Well-being in Primary Health Care Setting as a Clinical Learning Environment

Author(s):  
Rabab Abdel Raoof Abed

Introduction: Well-being in learning environment requires a culture that actively helps students to achieve their own potential. It requires a learning environment (LE) that supports physical, social and spiritual development. It has been shown that medical students experience high levels of stress that can hinder their performance, professionalism, and overall health. With respect to primary health care (PHC), some studies have shown the relative advantage of PHC centers to provide opportunities for “hands on” practice by pre-clinical students, availability of general practitioners (GPs) to supervise students, and with respect to the scope of PHC, which includes, beside patient care, community health education. Unfortunately, some aspects of the training process in clinical learning environment (CLE) have unfavorable effect on students’ well-being. Medical students face personal distress with negative effect on academic achievement, competency, professionalism, and health. We aimed to measure students wellbeing during their training in primary health care units. Materials and Methods: This is a cross sectional study to assess well-being of undergraduate students in primary health care (PHC) centers affiliated to the Faculty of Medicine, Suez Canal University (FOM-SCU). In addition, to test psychometric prosperities of The MED-NORD (Medical Education in Nordic Countries) questionnaire through exploratory factor analysis (EFA). A comprehensive (purposive) Sample was taken from year 1, 2, and 3. Results: Testing the psychometric prosperities of MED-NORD questionnaire revealed that the questionnaire contained 7 factors and 41 items. The seven factors are: Conceptions of learning and knowledge, Approaches to learning, Perceptions of the learning environment, Problems in studying, Optimism, Reflective learning, and Lack of interest. There were adequate correlations between the factors. Conclusion: The study concluded that the students positively perceived their well-being. Furthermore, Students preferred collaborative knowledge building in learning. However, they use surface approach in their learning more than deep approach. This study also concluded good reliability and construct validity of MED-NORD questionnaire.

Author(s):  
Dian Puspita Dewi ◽  
Gandes Retno Rahayu ◽  
Tri Nur Kristina

Background: Learning environment is an important factor in learning process and can affect students' competence and work-readiness. Learning environment is not only about physical facilities but also social and psychological condition. The complexity of clinical learning environments pose challenges and problems that may affect students learning process so it is necessary to monitoring and evaluating students learning environments. This study aims to assess students' perception of their learning environment and the effect of primary, secondary and tertiary health care services utilization as clinical learning environments.Method: This study was conducted with a cross sectional study design. The subjects were 36 students of obstetrics and gynecology department. Data obtained from learning environment questionnaires in tertiary, secondary and primary health care services. A non-parametric test was applied to compared learning environment score in each health care level.Results: Students perception of their learning environment between tertiary and secondary as well as tertiary and primary health care services were significantly different. Students stated advantages and disadvantages of each learning environment that can affect their competence level. Conclusion: Students have a good perception of the their learning environment. There was significant difference between tertiary and two other health care services.


Author(s):  
Manal Badrasawi ◽  
May Hamdan ◽  
Mohammad Al Tamimi

BACKGROUND: Diabetes mellitus (DM) is a lifelong metabolic disease with a high rate of mortality and morbidity. Uncontrolled and untreated diabetes results in serious complications that subsequently cause patients’ quality of life (QoL) to deteriorate. Adherence to Mediterranean diet (MD) may relieve the complications of diabetes, thereby improving the quality of life for these patients. OBJECTIVE: The aim of this study was to assess the QoL of DM patients who adhered to MD. METHODS: In this cross-sectional study, we examined the QoL and MD data of 106 DM II patients being treated at a primary health care clinic in Hebron. We used the SF-36 questionnaire to measure the patients’ QoL and the MEDAS tool to assess their MD adherence. We also recorded their anthropometric measurements, abdominal obesity, lifestyle habits and blood biochemical results. RESULTS: The sample comprised male and female DM II patients between the ages of 35 and 72, with their mean age being 55.8±10.24. Patients’ QoL scores showed a significant relationship with three BMI categories, i.e., total QoL score, physical function, and pain domains (p <  0.05). In terms of diet, high adherence to MD had a positive impact on all domains and on patients’ total QoL with significant differences in physical functioning, emotional well-being, social functioning and pain domains. CONCLUSION: Patients’ QoL domains were relatively low and highly affected by DM II. Patients with greater MD adherence reported higher scores in all QoL domains. Significantly higher scores were noted for the physical, social and pain domains. Hence, MD is a recommended dietary pattern for DM II patients to achieve a better QoL.


2015 ◽  
Vol 5 (4) ◽  
pp. 197-203
Author(s):  
Yukiko Kusano ◽  
Erica Ehrhardt

Background: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable.Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization.Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access;addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making.Conclusions:Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on people-centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is an essential contribution of nurses to people-centered PHC. Nurses’ contributions can be optimised through positive practice environments, appropriate workforce planning and implementation andadequate education and quality control though strong regulatory principles and frameworks. People-centered approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people-centered PHC.


Author(s):  
Adinda Kharisma Apriliani ◽  
Eti Poncorini Pamungkasari ◽  
Amandha Boy Timor Randita

Background: Needs of health workers, especially general practitioners, relatively high in Indonesia. Career choices among medical students are various, such as general practitioner, specialist, medical researcher, etc. Many factors affect medical students’ career choices, one of them is learning environments. This study aims to prove the correlation between clerkship students’ perceptions of clinical learning environments and their career choices.Methods: This research was an analytical observational research with cross sectional approach. The subjects were clerkship students who underwent clinical rotation. The samples were 178 clerkship students from all departments. They were chosen by probability proportional to size sampling. Every respondent was given career choices questionnaire and PHEEM questionnaire which has analyzed for its validity and reliability with α≥0,6 (α=0,826) and r≥0,30 (r=0,442). The result of this study was analyzed by Chi-square test and followed by Contingency Coefficient with 95% confidence level (α = 0,05). Result: The result showed that students’ perception of clinical learning environment “good but still need improvement” category was nearly the same as “plenty of problems” category. The result on the students’ career choices, most students choose clinical career. There was significant correlation between perception of clinical learning environment and career choices on clerkship students of medical faculty, Sebelas Maret University with p <0,05 (p= 0,018), x2 count (x2=5,625) > x2 table (x2=3,841) and also very weak correlation (C= 0,189).Conclusion: There was very weak correlation between perception of clinical learning environments and career choice on clerkship students. 


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