Song, Claire

Aim: To evaluate the maximum number of patients per nurse before quality and safety outcomes deteriorate in medical-surgical settings. Design: A secondary analysis of cross-sectional survey data. Conclusion: The findings provide preliminary evidence in support of minimum nurse-to-patient ratios of 1:4 in British Columbia's medical-surgical areas. Policy-makers and decision-makers should augment minimum nurse-to-patient ratios with other nurse-driven tools and nurse-management staffing methods that provide more flexibility to better meet fluctuating environmental, patient and staffing needs. No patient or public involvement: This study did not include patient or public involvement in its design, conduct, or reporting.

Generally positive perceptions, with a few notable exceptions. Factors across teaching situations such as instructors’ personality, design of online teaching platform, individual class dynamics, student motivation levels, and course content are also important to consider when evaluating the success of a methodology. Hybrid learning is a feasible and innovative way to deliver nursing skill classes if used appropriately. More research is needed to elucidate which learning contexts can be ideally matched with a specific learning methodology.

Depression is one of the main public health challenges among Canadian adolescents. However, research suggests that Chinese adolescents in Canada may experience or express depressive symptoms differently compared to White adolescents, and this may influence the way Chinese adolescents answer items in the Center for Epidemiologic Studies Depression Scale (CES-D). Additionally, research suggests that gender and the strength of ethnic identity may influence the rate of depression among Chinese adolescents only, and how they report depressive symptoms. This study aims to evaluate the measurement equivalence of the CES-D among Chinese and White adolescents living in Canada, and to conduct further investigation of the impact of strength of ethnic identity on responses to CES-D items among Chinese adolescents. Data were collected from 961 high school students aged 13–17 years participating in the British Columbia Adolescent Substance Use Survey. The Ordinal Logistic Regression method was used to test for Differential Item Functioning (DIF) on items in the CES-D across Chinese and White adolescents. The initial set of DIF analyses identified non-uniform DIF in CES-D Item 7 between Chinese and White adolescents (χ² = 41.972, R²= 0.046). After controlling for gender and strength of ethnic identity, the results remained the same. In the second set of analyses, CES-D Item 8 demonstrated the statistically significant differential functioning in Chinese participants across different levels of ethnic identity, uniform DIF among Chinese adolescents (χ² = 10.779, R²= 0.044). Controlling for gender did not alter the results. CONCLUSION: The result of this study suggests that there may be a systematic difference in experience or expression of depression among Chinese adolescents. Specifically, CES-D Item 7 did not appear to discriminate the level of depression among Chinese adolescents. Additional research is needed to understand the complex process of DIF to replicate and investigate the process associated with detected DIF in this study.

This study examined differential item functioning (DIF) in the Center for Epidemiologic Studies Depression Scale (CES-D) between Chinese and White adolescents (aged 13 to 17 years) living in Canada. A series of ordinal logistic regressions were used to test for uniform and non-uniform DIF on items in the CES-D. The DIF analyses identified non-uniform DIF for Item 7 (“I felt that everything I did was an effort”). Controlling for gender and strength of ethnic identity in the DIF analyses did not alter the DIF results. The results of this study suggest that CES-D Item 7 does not appear to discriminate at higher levels of depression in Chinese adolescents. The results of this study hold notable implications for the use of the CES-D given that Chinese adolescents demonstrated a systematic difference in expression/experience of depression.