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    Relationship between nursing students' global climate change awareness, climate change anxiety and sustainability attitudes in nursing: a descriptive and cross-sectional study
    (Bmc, 2024) Ilaslan, Nagihan; Orak, Nuray Sahin
    BackgroundAs a major global health threat, climate change is an important issue for nurses who play a pivotal role in health protection and improvement, and in the development of climate-smart healthcare systems. Sustainability attitudes in nursing should be developed together with awareness and concern for climate change.AimThe aim of this study was to determine the relationship between nursing students' global climate change awareness, climate change anxiety, and sustainability attitudes in nursing.MethodsThis descriptive, correlational study was conducted with 289 nursing students at a state university. Data were collected using the Descriptive Characteristics Form, the Global Climate Change Awareness Scale, the Climate Change Anxiety Scale, and the Sustainability Attitudes in Nursing Survey. Mean and percentage distributions, the Independent Samples t-test, ANOVA test, Pearson correlation and multiple regression analysis were used to analyze the data. The STROBE checklist was used to report this study.ResultsGlobal climate change awareness of the nursing students was at a moderate level, and the levels of climate change anxiety and sustainability attitudes in nursing were above average. There was determined to be a moderate positive correlation between climate change awareness and sustainability attitude in nursing, between anxiety and sustainability attitude in nursing, and between climate change awareness and anxiety. Climate change awareness and anxiety explained 25.1% of the sustainability attitude in nursing.ConclusionsThe study provides evidence of the relationship between nursing students' global climate change awareness and anxiety, and sustainability attitudes in nursing. It can be recommended that climate change and sustainability awareness-raising content are integrated into the nursing curriculum. The development of a sustainability attitude in nursing will contribute to the development of sustainable and low-carbon healthcare practices.
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    Sustainable healthcare education using cooperative simulation in developing nursing students' knowledge, attitude and skills: A randomized controlled study
    (Churchill Livingstone, 2025) Ilaslana, Nagihan; Orak, Nuray Sahin
    Background: The effectiveness of sustainable healthcare education in improving nursing students' knowledge and attitudes has been demonstrated through short-term studies with pre-post test design. However, there is a need to study long-term retention of students' knowledge and attitudes, also their skills in achieving sustainable healthcare from the use to disposal of healthcare resources by providing a hands-on learning experience via simulation. Aim: This study investigated the effects of sustainable healthcare education using cooperative simulation on nursing baccalaureate students' sustainable nursing knowledge, attitude and skills by comparing the self-directed learning. Design: This randomized controlled experimental study with pre-post-follow up design was registered under ClinicalTrials.gov with number NCT05504421. Settings: The study was conducted at a nursing faculty in a state university. Participants: The study sample comprised 70 third grade nursing students. Methods: Following narrative-based lectures explaining sustainability in nursing, students were randomly assigned to two study groups; an intervention group using cooperative learning-based NurSusToolkit Project cases and the control group using self-directed learning throughout 4 consecutive weeks. Both groups then performed a high-fidelity simulation practice focusing on sustainable healthcare. Data were collected using the Sustainability Attitudes in Nursing Survey, Sustainable Healthcare Knowledge Form, Skill Checklist and Debriefing Form. Quantitative data were analyzed using t-tests, Friedman test, Fisher's Exact test, intraclass correlation coefficients and Cohen Kappa calculations in IBM SPSS Statistics version 23 software. Qualitative data were analyzed via an inductive approach. Ethical approval and official permission were obtained. The students completed informed consent forms. Results: In the post-test, no significant differences were determined between the groups in terms of sustainable nursing knowledge (U = 557.5, p = 0.503), motivation (U = 514.5, p = 0.237) and attitudes (U = 610, p = 0.976). In the follow-up test, the sustainable nursing knowledge (U = 221.500), motivation (U = 282.500) and attitudes (U = 191) were significantly higher in the intervention group (p < 0.001). In the simulation practice, the intervention group had higher rates of correct separation of nursing care-related waste (intervention group = 77.77 % for both observers, the control group was 0 % and 11.11 % for observer 1 and 2, respectively, Cohen Kappa = 0.898, p < 0.001). In the debriefing, the intervention group requested more simulation practices (33.33 %) to acquire sustainable nursing skills, while the control group did not. Conclusions: Sustainable healthcare education using cooperative simulation that has long-term effects can enable future nurses to lead the shift towards climate-smart and sustainable nursing care.