BackgroundUniversity nursing students experience higher levels of academic stress than those of other disciplines. Academic stress leads to psychological distress and has detrimental effects on well-being. The ability to overcome such adversity and learn to be stronger from the experience is regarded as resilience. Resilience is found to have an impact on learning experience, academic performance, course completion and, in the longer term, professional practice. Resilience and positive coping strategies can resist stress and improve personal well-being. However, the relationship between resilience and well-being remains unexplored in nursing students, which are significant attributes to their academic success and future career persistence.MethodsThe study was a cross-sectional descriptive correlational design. Inclusion criteria for recruitment was students studying pre-registration nursing programmes at both undergraduate and postgraduate levels. The 10-item Connor-Davidson Resilience Scale (CD-RISC-10) and World Health Organisation-5 Well-Being Index (WHO-5) were used to measure resilience and psychological well-being respectively.ResultsA convenience sample of 678 university nursing students was recruited from a university. The mean score of CD-RISC-10 was 24.0. When comparing the resilience levels of undergraduate and postgraduate students, the total scores were found to be 23.8 and 24.9 respectively. There was a statistically significant difference between the groups (p = .020). With regard to perceived well-being, the mean score of WHO-5 was 15.5. There was no significant difference between undergraduates and postgraduates (p = .131). Bivariate analysis showed that self-reported resilience had a medium, positive correlation with perceived well-being (r = .378, p = .000), and senior students had significantly higher level of perceived well-being than junior students (16.0 vs 15.1, p = .003). Multivariable regression analysis on perceived well-being indicated that self-reported resilience emerged as a significant predictor of perceived well-being (regression coefficient B = 0.259; p < .001).ConclusionsThe results demonstrate that nursing students with a high level of resilience have better perceived well-being, and the level of resilience of postgraduates was significantly higher than that of undergraduates. Therefore, educational strategies should be developed in the nursing curriculum and a supportive learning environment should be created to foster resilience in the students.

The Chinese older people's experience revealed that hospital readmissions are complex experiences shaped by their sociocultural context. Older people appear to accept and cope well with hospital readmissions. However, this study uncovered their unmet needs, which may undermine their dignity. The findings of this study offer implications for promoting wellness among Chinese older people with COPD.

Background Developing students’ generic capabilities is a major goal of university education as it can help to equip students with life-long learning skills and promote holistic personal development. However, traditional didactic teaching has not been very successful in achieving this aim. Kember and Leung’s Teaching and Learning Model suggests an interactive learning environment has a strong impact on developing students’ generic capabilities. Metacognitive awareness is also known to be related to generic capability development. This study aimed to assess changes on the development of generic capabilities and metacognitive awareness after the introduction of active learning strategy among nursing students. Methods This study adopted a quasi-experimental single group, matched pre- and posttest design. It was conducted in a school of nursing at a university in Hong Kong. Active learning approaches included the flipped classroom (an emphasis on pre-reading) and enhanced lectures (the breaking down of a long lecture into several mini-lectures and supplemented by interactive learning activities) were introduced in a foundational nursing course. The Capabilities Subscale of the Student Engagement Questionnaire and the Metacognitive Awareness Inventory were administered to two hundred students at the start (T0) and at the end of the course (T1). A paired t-test was performed to examine the changes in general capabilities and metacognitive awareness between T0 and T1. Results A total of 139 paired pre- and post-study responses (69.5 %) were received. Significant improvements were observed in the critical thinking (p < 0.001), creative thinking (p = 0.03), problem-solving (p < 0.001) and communication skills (p = 0.04) with the implementation of active learning. Significant changes were also observed in knowledge of cognition (p < 0.001) and regulation of cognition (p < 0.001) in the metacognitive awareness scales. Conclusions Active learning is a novel and effective teaching approach that can be applied in the nursing education field. It has great potential to enhance students’ development of generic capabilities and metacognitive awareness.

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Aim To examine the effect of a video‐supported nurse‐led advance care planning to frail geriatric patients on end‐of‐life decision‐making outcomes in patients and their carers. Design This is a double‐blinded randomized controlled trial with parallel arms. Methods The protocol was approved by the Institutional Review Board of the participating hospital on 1 August 2018. Frail elders and their carer if any are enrolled during hospitalization, and undergo randomization after discharged. The intervention group receives a 2‐week video‐supported nurse‐led advance care planning programme (N = 149) while the control group receives a 2‐week health education program at home (N = 149). Follow‐up surveys via telephone at 1 and 6 months measure outcomes regarding end‐of‐life decision‐making from both the patients and the carers. Conclusion Advance care planning discussion is to understand patient's values, preferences and treatment for care on their anticipation of future deterioration. Treatment options for end‐of‐life care may not be well‐received especially elders because in the discussion process, technical medical terms are presented in an abstract, hypothetical way that are hard to understand. The present study aims to evaluate the effect of a nurse‐led advance care planning supplementing with a video showing end‐of‐life treatment options to promote end‐of‐life care decision‐making among frail geriatric patients. Impact The results will help identify effective elements of advance care planning and inform the development of an evidence?based structured advance care planning intervention in response to the need for quality end‐of‐life care. Trial registration Chinese Clinical Trial Registry ChiCTR‐IOR‐17012341