Elizana Petrela
University Hospital Center "Mother TERESA", Tirana, Albania

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Predictors of nursing students’ satisfaction with the clinical learning environment in Kosovo: A multivariate analysis using the Clinical Learning Environment, Supervision and Nurse Teacher framework Musa Oruqi; Elizana Petrela; Hasan Gashi
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4656

Abstract

Background: A supportive clinical learning environment is essential in nursing education; however, evidence regarding predictors of student satisfaction in Southeast European higher education contexts remains limited. Objective: To identify demographic and item-level CLES+T predictors of nursing students’ overall satisfaction with the clinical learning environment in Kosovo. Methods: A cross-sectional study was conducted between April and May 2025 among 300 undergraduate nursing students. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) scale, while overall student satisfaction was assessed using a separate single-item measure. Data were analyzed using descriptive statistics, non-parametric tests, and multiple linear regression analyses. The primary demographic model included sex, year of study, and economic status, while a second model included all 34 CLES+T items simultaneously. Results: The demographic model was statistically significant, F(4, 295) = 35.894, p < 0.001, explaining 32.7% of the variance in satisfaction (R² = 0.327; adjusted R² = 0.318). Compared with first-year students, second- and third-year students reported significantly lower satisfaction, while sex and Economic Status were not significant predictors. The CLES+T item-level model was statistically significant, F(34, 265) = 18.319, p < 0.001, explaining 70.2% of the variance (R² = 0.702; adjusted R² = 0.663). The strongest positive predictors were positive joint meetings with the mentor and nurse teacher (β = 0.415), feeling comfortable going to the ward at the start of the shift (β = 0.335), and sufficient meaningful learning situations (β = 0.249). Because several item-level predictors showed elevated multicollinearity, individual coefficients, particularly negative coefficients, should be interpreted cautiously. Conclusion: Nursing students’ satisfaction was associated with both academic year and specific relational, supervisory, and pedagogical characteristics of the clinical learning environment. Supportive mentorship, meaningful learning opportunities, and effective integration of theory and practice remain important components of positive clinical learning experiences.
Levels of stress and depression among patients with type 1 and type 2 diabetes mellitus in primary care in Kosovo: A cross-sectional study Elvana Podvorica; Edmond Zaimi; Elizana Petrela; Musa Oruqi
Belitung Nursing Journal Vol. 12 No. 5 (2026): September - October
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4667

Abstract

Background: Psychological distress, including stress and depressive symptoms, is common among people with diabetes and may negatively influence self-management and clinical outcomes in primary care settings. Objective: To assess and compare levels of perceived stress and depression among patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Methods: This cross-sectional study included 297 patients with diabetes recruited using convenience sampling from eight primary care centers in Prishtina, Kosovo, between March 2025 and August 2025. Perceived stress was measured using the Perceived Stress Scale (PSS), while depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Demographic characteristics and selected clinical parameters, including waist circumference and systolic and diastolic blood pressure, were obtained from medical records. Categorical and continuous variables were analyzed using chi-square and Mann–Whitney U tests, with Cramér’s V measuring categorical effect size. Statistical significance was set at p < 0.05. Results: Patients with type 1 diabetes mellitus (T1DM) were significantly younger than patients with type 2 diabetes mellitus (T2DM). Exploratory item-level analysis of perceived stress did not demonstrate consistent differences between the groups; however, interpretation of stress-related findings should be approached cautiously due to the low internal consistency of the PSS in the present sample. Depressive symptom severity differed significantly between groups (p = 0.005, Cramér’s V = 0.224). Conclusion: Significant differences were observed in depressive symptom severity between patients with T1DM and T2DM, whereas interpretation of perceived stress findings remains limited. Although these findings support the importance of psychological assessment in diabetes care, they should be interpreted cautiously given the cross-sectional design and methodological limitations of the study. Healthcare professionals, including physicians and nurses,  should routinely screen for depression in diabetes care and provide appropriate follow-up or referral based on symptom severity.