Self-confidence in the care of critically ill patients: before and after a simulated intervention

Almeida, Rodrigo Guimarães dos Santos; Mazzo, Alessandra; Martins, José Carlos Amado; Jorge, Beatriz Maria; Souza, Valtuir Duarte de; Mendes, Isabel Amélia Costa

doi:10.1590/0034-7167-2018-0758

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (6) • Nov-Dec 2019 • https://doi.org/10.1590/0034-7167-2018-0758 copy

Self-confidence in the care of critically ill patients: before and after a simulated intervention

Autoconfianza en el cuidado del paciente crítico: antes y después de intervención simulada

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the self-confidence of nurses in the care of critically ill patients, before and after a simulated intervention.

Method:

A quasi-experimental study was carried out with 103 nurses who participated in a workshop on the care of critically ill patients in the first semester of 2016. A clinical simulation pedagogical instrument was used throughout the event, and self-confidence was assessed by the Portuguese version of the Self-confidence Scale (SCSvp).

Results:

Most participants reported not being prepared to provide first care to critically ill patients, which was carried out during care practice. The participants presented a significant increase in self-confidence after the simulated intervention (p<0.001) in the cardiac, neurological, and respiratory dimensions.

Conclusion:

Simulation has proved to be an effective strategy for the development of individuals’ self-confidence, which contributes to the improvement of skills required for professional practice.

Descriptors:
Emergency Nursing; Nursing Care; Behavior; Confidence; Simulation

	f	%
Gender
Male	13	12.6
Female	90	87.4
Age group
≤30 years	48	46.6
31 to 40 years	44	42.1
41 to 50 years	9	8.7
>50 years	2	1.9
Education level^* * More than one answer can be given by participants;
No specialization	20	19.4
Lato Sensu specialization	64	62.1
Master’s degree^ Either completed or in course.	47	45.7
Doctorate degree^ Either completed or in course.	20	19.4
Employment bond
Yes	77	74.8
No	26	25.2
Practice area (considering employment bond)
Nursing care	48	46.6
Nursing management	6	5.8
Teaching activity	23	22.3
Experience with clinical simulation
Yes	51	49.5
No	52	50.5
First care for clinically ill patients
Care practice	83	80.6
Laboratory practice	20	19.4
Preparedness to provide care
Yes	17	16.5
No	86	83.5

		Factor 1 PR^* * PR=Pre-intervention	Factor 1 PO^ PO=Post-intervention.	Factor 2 PR	Factor 2 PO	Factor 3 PR	Factor 3 PO	General scale PR	General scale PO
Mean		2.75	3.57	3.02	3.84	2.68	3.53	2.82	3.65
Mode		3.00	3.00	3.00	4.00	3.00	3.00	3.00	3.00
Standard deviation		0.63	0.76	0.64	0.78	0.69	0.74	0.58	0.71
Minimal		1.50	1.75	1.25	1.75	1.00	1.75	1.50	1.75
Maximal		5.00	5.00	5.00	5.00	5.00	5.00	5.00	5.00
Percentage	25	2.25	3.00	2.75	3.00	2.25	3.00	2.50	3.00
	50	2.75	3.50	3.00	4.00	2.50	3.50	2.75	3.66
	75	3.00	4.00	3.25	4.25	3.00	4.00	3.00	4.00

	Mean difference	Standard deviation	Standard error of the mean	T-test	Degrees of freedom (df)	p value
Factor 1 (Neurological)	-0.82	1.03	0.10	-8.06	103	<0.001
Factor 2 (Respiratory)	-0.81	1.03	0.10	-7.98	103	<0.001
Factor 3 (Cardiovascular)	-0.84	1.03	0.10	-8.32	103	<0.001
General scale	-0.82	0.94	0.09	-8.88	103	<0.001

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[1] Corresponding Author: Isabel Amélia Costa Mendes E-mail: iamendes@usp.br