Search

Aim: To describe activities and professional characteristics of nurses in expanded roles in acute care in Germany and achieve a greater understanding of the current situation of advanced practice nursing. Background: Advanced practice nursing plays an important role in meeting increased demands in healthcare and promoting high‐quality care. Introduction: In Germany, advanced practice nursing is still at an early stage with a lack of studies describing the scope of practice of nurses in expanded roles. Methods: We conducted a cross‐sectional‐study using a paper‐and‐pencil questionnaire. In a nationwide convenience sample, we surveyed nurses with an academic degree, who work in an acute care hospital and take over expanded roles in direct patient care. Reporting followed the STROBE checklist. Results: Of 108 eligible nurses, 84 (77%) completed the survey. The majority had a Master's degree (63.1%) and the average work experience was 18.2 years. Participants carried out activities in all the domains that were queried (direct clinical practice, guidance and coaching, consultation, leadership and research) with differences within and between domains. Foci were on direct clinical practice and coaching and guidance. Discussion: In Germany, qualifications are nearing the international standard of advanced practice nursing. Results suggest that participants partly undertake activities within the scope of registered nurses' practice that do not correspond fully to their formal qualifications. Conclusion and implications for nursing and/or health policy: In order to foster the role development of expanded practice nurses in Germany, political efforts are needed in terms of training (e.g. specific Master's programmes), funding of corresponding positions in practice and control mechanisms (e.g. professional registration). [ABSTRACT FROM AUTHOR]

Aims: This study investigated how patient safety is currently taught in pre‐registration nursing programmes across South Korea and explored nurse educators' perspectives on curriculum change. Background: Pre‐graduate education plays a critical role in preparing nurses with the requisite patient safety competencies. However, little is known about how patient safety education is addressed in South Korean nursing schools or the perspectives of nurse educators regarding patient safety education and a need for change. Methods: This descriptive study used data collected during a 2019 accreditation workshop provided by the Korean Accreditation Board of Nursing Education. A paper‐and‐pencil survey was completed by 80 nurse educators working in 16 regions throughout Korea. Results: A little consistency was found in approaches to teaching patient safety. Patient safety topics are addressed throughout various nursing courses, and patient safety education is limited in hours of instruction and breadth of content. A majority of respondents indicated that additional supports are needed, including a national standardized curriculum for patient safety education. Conclusion: A new approach to teaching patient safety is needed in Korean pre‐registration nursing education. Overall, patient safety education is limited and provided through a fragmented approach with little attention to systems, workplace design or human issues that are necessary for developing the critical reasoning and skills to support patient safety. Implications for nursing policy: The accrediting and regulatory bodies in South Korea should work together to develop and implement explicit standards of patient safety education and patient safety competencies for nursing students. Development of a standardized national curriculum is essential for providing a consistent, systematic and comprehensive approach to patient safety education in nursing programmes. [ABSTRACT FROM AUTHOR]

Background As future health educators, nursing and physiotherapy students will play an essential role in the prevention of smoking. Aim To determine the prevalence of smoking among students and to analyse their knowledge of and attitudes towards smoking. Method This was a descriptive cross-sectional study using an anonymous questionnaire and conducted in a Spanish Faculty of Health Sciences in 2013. Findings 247 nursing and physiotherapy students (82.33%) participated in the study. The global prevalence of smoking (18.2%) was lower compare with the general population group of the same age. We have observed statistical significance in relation to previous studies. Nursing and physiotherapy students showed a low nicotine dependence. We found a lack of knowledge about the harmful effects of cigarette consumption on health. Statistically significant results were also found in relation to degree courses (p < 0.01) as regards students' opinions about their knowledge of strategies and methods to help patients stop smoking. Conclusion Most students started smoking before commencing their university studies; consequently, interventions should focus on cessation programmes. An analysis of university curricula leading to the award of a degree in the health sciences could serve to identify educational deficiencies in order to implement the necessary modifications. Implications for nursing and health policy This paper presents an update in tobacco use characteristics amongst nursing and physiotherapy students. Those results have showed a need to improve the curricula in order to develop specific programmes to improve knowledge, attitudes and beliefs. Measures to prevent smoking must be taken at school. [ABSTRACT FROM AUTHOR]

Aims and objectives: To evaluate demographic and occupational factors of professional life on life satisfaction among nurses in Serbia and Poland. Background: Compassion satisfaction and compassion fatigue, as aspects of a nurse's professional life, may affect their satisfaction with life in general. However, most studies on this topic have been conducted in Asian countries, and because there are differences in health care system performance across countries amid a global shortage of nurses, it is necessary to investigate professional quality of life in the European nursing context. Methods: This multicenter, comparative, and correlational study was conducted on a sample of 669 hospital nurses in Serbia and Poland. The survey data were collected between November 2019 and February 2020 using the Demographic and Occupational Questionnaire (DOQ), Professional Quality‐of‐Life Scale (ProQOL‐5), and Satisfaction with Life Scale (SWLS). STROBE Statement guidelines for cross‐sectional studies were followed. Results: Most nurses from both countries reported having moderate compassion satisfaction, moderate risk for compassion fatigue, and an average life satisfaction. The predictive factors of life satisfaction that most stand out include country of origin, financial situation, education, job satisfaction, and compassion fatigue. Discussion and conclusion: Quality of professional life is significantly affected by shift duration, age, work experience, and job satisfaction. Negative aspects of professional life are significant predictors of life satisfaction. Implications for nursing policy: The findings of this study indicate a need for implementing flexible shift patterns and enhancing interventions that will improve job satisfaction and compassion satisfaction while reducing the risk of compassion fatigue. [ABSTRACT FROM AUTHOR]

Background: Currently, there are no cut‐off points for levels of empathy, making it difficult to assess the change experienced in its development or as a result of its intervention. It is an unsolved problem. Introduction: Empathy is a cognitive‐affective attribute that enables nursing staff to maintain a professional relationship that entails various benefits for the patient. Its strengthening and development during university education is desirable. Empathy studies in Latin American nursing students are based on the direct scores obtained on an empathy test, based on which the variable is described and groups are compared. Statistical comparisons are not enough to discriminate substantive changes since two statistical values can show differences without implying that the post‐intervention levels may correspond to a higher category in relation to those of pre‐intervention or that two compared groups are qualitatively different. The above applies to empathic behaviour and is valid for students and professionals of health. This study aimed to establish cut‐off points that allow defining ordinal categories in empathy. Methods: In this multicenter and cross‐sectional study, 3712 students from 11 Latin American nursing schools participated. The Jefferson Empathy Scale (JES) was applied; the psychometric properties were confirmed by Factor Analysis Confirmatory and Invariance. Results: The JSE empathy scale is a measure with adequate reliability and construct validity. Examined cut‐offs determined a structure of five empathy intervals that allowed them to be classified as empathy values in very high, high, medium, low and very low. Discussion: The sequence of statistical tests carried out allowed us to determine ranges of categorical values in the empathy levels of groups of students. However, the determined categories may constitute a specific characteristic of them. It is not possible to extrapolate these results to regions other than those of Latin America. Conclusion: The estimated rankings allow comparing levels of empathy between groups of nursing students and the real effect of empathic interventions. Implications for nursing: To contribute with strategies to evaluate changes in the empathic skills of nursing students, resulting in a well‐valued skill in health services. Implications for nursing policy: The cut‐off points define evaluative categories (very low, low, medium, high and very high) that allow objective classification of levels of empathy achieved after (for example) an empathic intervention. This allows assessment of substantive changes experienced by nursing students (and professionals). [ABSTRACT FROM AUTHOR]

Aim: To investigate organizational commitment among Chinese nurses and analyze factors influencing organizational commitment during COVID‐19. Background: Organizational commitment is the most important link between nurses and the organization because it is effective in work retention and the motivation of nurses, especially when addressing the COVID‐19 crisis. However, there has been no empirical study conducted to predict organizational commitment in the field of nursing by combining work values with professional practice environments. Methods: A cross‐sectional predictive study was done with 362 nurses recruited from two tertiary hospitals in China. The Organizational Commitment Questionnaire, the Work Values Scale, and the Practice Environment Scale of the Nursing Work Index were used to collect data. Two factors related to the organizational commitment of nurses were investigated by using binary logistic regression analyses. Results: Increased work values and a professional practice environment were associated with an increased likelihood of higher organizational commitment. Discussion: The COVID‐19 crisis became the utmost challenge to global healthcare systems and professional organizational commitment. Nurses' organizational commitment was directly influenced by the professional practice environment and work values, especially intrinsic work values, in which the spirit of collectivism was consequential. Conclusion and implications for the field of nursing and health policy: Study results provide information for global hospital administrators to promote these organizational commitment predictive factors, including work values and a professional practice environment in nursing practice. This helped foster a stronger organizational commitment among nurses to reduce nurse resource flow during COVID‐19. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the properties of a reduced‐item Healthcare Environment Survey measuring nurses' job satisfaction across eight countries. Background: There is currently no rigorously tested international measure of nurses' job satisfaction that can be used internationally to improve the nurse work environment. Methods: Nursing staff from 11 hospitals in eight countries participated in this study. The original 57‐item, 11‐facet Healthcare Environment Survey was evaluated for reliability, validity, and measurement invariance: Cronbach's alpha was used to test for reliability; construct, discriminate, and convergent testing were used to test validity; and invariance testing including configural, metric, and scalar tests were used to study measurement invariance between the countries. Results: 2,046 nursing staff completed the survey. Reliability was established for all six subscales and the combined composite score. Both validity and measurement invariance were supported in every test conducted. An excellent model fit was found for the final 19‐item, 6‐facet Healthcare Environment Survey that explained 82% of the variance of nurses' job satisfaction. Conclusions: Findings suggest the instrument is an efficient measure of nurses' job satisfaction across multiple countries. Longitudinal testing for invariance will be needed to ensure the model remains a good fit. Testing more countries will also verify model fit. Implications for nursing: The instrument can be used to measure nurse job satisfaction globally. Implications for nursing policy: The instrument can be used to assess interventions to improve the social (patient, unit manager, and coworker) and technical (professional rewards, autonomy, and professional growth) aspects of nurse job satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To explore the impact of the COVID‐19 pandemic on the mental health of nurses working in primary, secondary, and tertiary healthcare centers in Navarre (Spain). Background: Healthcare workers, especially nurses, are at high risk for developing mental health problems during the COVID‐19 pandemic. Introduction: Spain ranks among the European countries with the highest incidence of and mortality from COVID‐19 and has a 31% deficit in the number of nurses compared with the average for the European Union. Methods: This was a cross‐sectional study involving 800 Registered Nurses in Navarre, Spain. Four standardized instruments, along with a self‐administered online questionnaire, were used to measure the impact in terms of depression, anxiety, insomnia, and posttraumatic stress disorder. The STROBE checklist for cross‐sectional studies was used to report this study. Results: Of the 800 nurses, 68% had some level of depression, anxiety, insomnia, and distress, and of these, 38% had moderate or severe symptoms. Those who worked in hospital COVID units and in nursing homes showed a higher impact on their mental health. Discussion: The sustained pressure that nurses have experienced in their work during the COVID‐19 pandemic has negatively affected their mental health. Conclusion: This study found that nurses who worked in hospital COVID units and in nursing homes during the pandemic had worse mental health outcomes. Implications for nursing/policy: Recommendations for nursing policy include the need to implement coaching and emotional programs to support nurses on the frontlines of the pandemic. There is also an urgent need for the implementation of national training programs to strengthen health emergency preparedness, improve response capacity, and increase the resilience of nurses to disasters. [ABSTRACT FROM AUTHOR]

Aim: To compare the occurrence and the reasons for unfinished care among coronavirus disease (COVID‐19) and non‐COVID‐19 patients as perceived by nurses. Background: The recent pandemic has imposed tremendous changes in hospitals in all countries. Introduction: Investigating the occurrence of and the reasons for unfinished care as perceived by nurses working in COVID‐19 and non‐COVID‐19 units might help to gain insights and to address future pandemics. Methods: A comparative cross‐sectional study based on the STROBE guideline has been conducted during November 2020–January 2021. The Unfinished Nursing Care Survey, comprising part A (elements) and part B (reasons), was administered online to all 479 nurses working in medical and surgical units converted progressively into COVID‐19 and non‐COVID‐19 units. A total of 90 and 200 nurses participated, respectively. Results: No differences in the unfinished care occurrence have emerged at the overall level between nurses caring for COVID (2.10 out of 5; 95% confidence interval [CI], 1.94–2.27) and non‐COVID‐19 patients (2.16; 95% CI, 2.06–2.26). Reasons for unfinished care reported significant higher averages among nurses caring for COVID (2.21; 95% CI, 2.10–2.31) as compared with those caring for non‐COVID‐19 patients (2.07; 95% CI, 2.01–2.14; p = 0.030). Discussion: The overall occurrence of unfinished care was slightly higher compared with pre‐pandemic data in all patients. Conclusions: Reasons triggering unfinished care were slightly different and were due to priority setting and human resources issues, which were perceived at higher significance among nurses working in COVID‐19 compared with non‐COVID‐19 units. Implication for nursing and health policies: A clear map of action has emerged that might be valid in the post‐COVID‐19 era as well as in the case of future pandemics. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the differences in practices, policies, and perceptions of nurses regarding work‐related utilization of smartphones in acute‐care settings. Background: Mobile devices utilizing emerging technology are widely used in acute‐care settings; however, concerns such as potential distraction, improper use, and negative impact on the nursing image in clinical practice remain valid. Methods: Nurse managers (n = 8) and nurses (n = 181) were enrolled from eight academic tertiary hospitals that have comprehensive electronic medical record systems and mobile versions. Between October 2018 and February 2019, participants completed a questionnaire designed to explore their use of smartphones. The reporting guide for self‐administered surveys of clinicians was applied. Results: Approximately 80% of nurses carried personal smartphones while working, with 70% using their devices for work. The prevalence of work‐related smartphone use ranged from 3% to 43% by functionality, which was lower than that estimated by managers. Frequent uses included taking pictures/videos and internet browsing. Nurses were more positive than managers about the benefits of smartphone use and less burdened by related concerns. Novice and junior nurses were more optimistic than senior nurses. Only one hospital had a policy on nurses' use of personal devices at work. Conclusion: Two unmet needs in the current clinical information system were identified: information supporting task‐related knowledge at the bedside and security of data capture and communication. Implication for nursing policy: The unintended perception gaps between nurses and managers regarding work‐related smartphone use can be closed by nursing leadership. Unmet nursing informatics, particularly for information‐seeking purposes, can be addressed in the context of quality assurance. Nurse leaders can advocate secure and proper use of smartphones in clinical practice. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

Background: Studies performed in Central European countries showed a high prevalence of missed nursing care in various clinical settings before the COVID‐19 pandemic. Aims: The aim of the study was to investigate which domains of the work environment were significant predictors of missed nursing care activities in Czech hospitals during the COVID‐19 pandemic. Methods: A cross‐sectional study was used. The RANCARE guideline and STROBE checklist were followed for reporting in the study. The sample consisted of 371 nurses from four acute care hospitals. The MISSCARE Survey and the Practice Environment Scale of the Nursing Work Index questionnaires were used to collect data. The data were analyzed using multiple linear and logistic regression analyses. Results: Nurses reporting unfavorable environments consistently describe a higher frequency of episodes of missed care. Prevalence estimates of missed care in Czech acute care hospitals during the COVID‐19 pandemic was predicted from the overtime work, the nurses' perception of the "Nursing foundations for the quality of care," and their satisfaction with their current position. Conclusions: Missed nursing care could be mitigated by improving the nurses' work environment. Domains of the nurse work environment are known as structural modifiable factors and their refinement could be a cornerstone for interventions to reduce the prevalence of missed nursing care. Implications for nursing policy: Monitoring the conditions and aspects of the nurse work environment in hospitals and considering nurses' concerns about the work environment on an ongoing basis are important strategies for nurse supervision as well as for policymakers. [ABSTRACT FROM AUTHOR]

Background: Stronger healthcare models are increasingly sought to address new population needs, health workforce inefficiencies and nursing shortages. One strategy is to focus on employees' strengths to capitalize on their competencies and maximize their scope of practice. Introduction: Globally, there is an exponential demand for advanced practice nursing services. This study aimed to identify the roles and positions of nurses who align with APN defining criteria at all levels of care in Catalonia, Spain. Methods: The first step of the study included the translation and validation to Catalan of the Advanced Practice Nurse Role Delineation Tool (IDREPA) and step 2 comprised a multicentre cross‐sectional study, in which 126 healthcare centres participated: 1209 nurses were included in the study. The STROBE checklist was used to report this study. Results: Transcultural equivalence and validation of the instrument showed a content validity index of 0.958 and the reliability of the questionnaire. The instrument identified 269 nurses who align with international APN defined criteria. They worked in specialized care, mental healthcare and primary and community care, especially in chronic conditions, ageing and end‐of‐life care. Discussion: Most areas of Catalonia have access to nurses practicing at APN defining criteria. These nurses were developed as an optimal resource to respond to patient needs in the context of study. Both recognition and strategic implementation are necessary to apply their full competencies to solve healthcare problems. Conclusion: Understanding the supply of services delivered by nurses practicing at an advanced level and their scope of practice may lay the foundations for effective workforce planning in a dynamic context. Nurses who align with APN defining criteria are working mainly in large acute services without regulation and recognition. Implications for nursing: Advanced practice nurses show the value of their role and activities in healthcare services. Implications for health policy: Promoting the establishment of APN defining criteria that includes credentialing and a regulatory framework within international guidelines should be a priority to make an impact on healthcare policy. [ABSTRACT FROM AUTHOR]

Aim: To describe the impact of the COVID‐19 pandemic on stress, resilience and depression in health professionals from a public hospital in Barcelona, Spain after the first peak of pandemic. Background: The COVID‐19 pandemic in Spain has pushed boundaries in health systems and, especially, for health professionals. Analysis of resilience as an individual resource and it is essential to understand the mechanisms that make staff react unfavourably to stressors caused by the pandemic. Design: A descriptive cross‐sectional study was designed. Participants: Health professionals supervised by the nursing department, including registered nurses, health care assistants, health technicians, final year nurse student nurses, foreign nurses, and other nurse‐related health workers. Methods: The study complies with the STROBE checklist for cross‐sectional studies. An online survey was administered to all health professionals supervised by the nursing department between 6 and 27 May 2020. The survey included the ER‐14 Resilience Scale, the widely‐used PHQ‐9 depression scale, the Spanish version of the Nursing Stress Scale, and an ad‐hoc questionnaire to obtain sociodemographic and occupational variables. Results: A total of 686 participants answered the survey. Resilience was high or very high in health professionals, with an inverse correlation with stress and depression scores. Personal on fixed shifts showed better resilience. The most stressed health professionals were full‐time registered nurses, followed by health care assistants. Up to 25% of nursing professionals had depression. Conclusion: Our study showed a high degree of resilience among nurse professionals despite the overwhelming nature of the COVID‐19 pandemic. Relevant signs of depression and stress were detected among participants. Occupational factors heavily influenced nurses' resilience, stress and depression. Implications for Nursing & Health Policy: Government policy shifts are needed in Spain to improve nurses' workforce conditions, enhance the ratio of nurses to patient numbers, and avoid workforce losses. Maintaining the resilience of health professionals would assist in improving their health and their capacity to possible future emergency situations. [ABSTRACT FROM AUTHOR]

BATTISTELLI A., PORTOGHESE I., GALLETTA M. & POHL S. (2013) Beyond the tradition: test of an integrative conceptual model on nurse turnover. International Nursing Review 60, 103-111 Aim: This paper aimed to extend research on nurse turnover by developing and testing a theoretical model of turnover intention that includes two emergent key off-the-job constructs, work-family conflict (WFC) and community embeddedness (CE). Background: Nurse turnover is considered one of the most significant issues in health care. There is a considerable body of knowledge that has focused on the study of the on-the-job factors of nurse turnover, showing the important role of job attitudes. Recently, WFC and job embeddedness (JE) have been identified as variables that could help explain levels of nurse turnover. Methods: Using structural equation modelling from a cross-sectional survey, the relationships between the variables were explored in a sample of 440 nurses from an Italian public hospital. The questionnaire measures demographic data and psychosocial factors such as job satisfaction, organizational commitment, WFC, CE and turnover intentions. Results: The findings supported the importance of non-work dimensions in turnover models. Conclusions: The results suggest that when studying turnover phenomena in health organizations, the extra-work domains (WFC and JE) can contribute to a decrease in the intention to leave, in addition to the more typically emphasized attitude dimension. [ABSTRACT FROM AUTHOR]

IOANNIDOU C., GALANIS P., TSOUMAKAS K. & PAVLOPOULOU I.D. (2012) Characteristics of dog bites among nursing students and knowledge about their emergency management. International Nursing Review 59, 245-251 Background: Dog bites represent a significant health concern leading to a variety of consequences. Nursing students should be appropriately educated in order to manage and help prevent such injuries. Aim: This paper is the first to report the lifetime experience and characteristics of dog bites among Greek nursing students and their knowledge in managing the above injuries. Methods: A cross-sectional quantitative study was performed using an anonymous questionnaire distributed to first and fourth year nursing students from April though June 2009. A knowledge score based on key questions was set on a scale from 0 to 7, to assess their competence on bite injuries management. Results: Of 237 nursing students recruited, 56 (23.6%) had experienced a dog bite. Men outnumbered women as dog bite victims [ n = 15 (39.5%) vs. n = 41 (20.6%), P = 0.012]. Mean age at the attack was 11.1 (standard deviation = 5.6) years and legs sustained the majority of injuries ( n = 31; 55.4%). Most bites ( n = 39; 69.9%) involved a dog known to the victim, were provoked ( n = 30; 53.6%) and occurred in a public place ( n = 35; 62.5%). Ten (17.9%) of the victims sustained a moderate or severe injury. The majority (67.9%) of students answered correctly to less than or equal to three out of seven key knowledge questions. After multiple linear regression analysis, previous educational course attendance was the only factor associated with increased score (b = 0.48, standard deviation = 0.17, 95% confidence interval = 0.12-0.84, P = 0.009). Conclusions: Dog bites were common and presented characteristic patterns among nursing students, but knowledge in their management was suboptimal. Improved education should be provided during undergraduate studies. [ABSTRACT FROM AUTHOR]

GURKOVÁ E., ČÁP J., ŽIAKOVÁ K. & ĎURIŠKOVÁ M. (2011) Job satisfaction and emotional subjective well-being among Slovak nurses. International Nursing Review 59, 94-100 Purpose: The purpose of this study is to investigate job satisfaction and emotional subjective well-being and the correlations between these two constructs among Slovak nurses. Design: A cross-sectional survey was used to investigate this relationship among nurses ( n = 104) working in seven public hospitals in Slovakia. Methods: Data were collected using a set of questionnaires that included the questionnaire to measure job satisfaction, the Positive Affect Scale, the Negative Affect Scale and a demographics form. Findings: Findings of this study confirmed some general satisfying and dissatisfying elements for the nursing profession across different clinical specialties and different cultures. The results also indicate that there is a positive correlation between positive emotions and job satisfaction of Slovak nurses. Conclusion: The paper has drawn attention to the job satisfaction and emotional well-being among nurses. Further studies in this field, extended to different countries, work settings and nursing specialties, may help to improve subjective well-being of nurses. Study limitations: Participants came from a limited number of hospitals in Slovakia. A larger sample from different hospitals in Slovakia could have enhanced the generalizability of the results and increased the power of the study to detect significant differences and associations. [ABSTRACT FROM AUTHOR]

LIU W., GERDTZ M.F. & LIU T.Q. (2011) A survey of psychiatrists' and registered nurses' levels of mental health literacy in a Chinese general hospital. International Nursing Review 58, 361-369 Background: Mental health literacy (MHL) is the term used to describe people's knowledge and beliefs about mental disorders which aid in the recognition, management or the prevention of illness. Health professionals' levels of MHL will shape the therapeutic relationship in which they work in partnership with patients. Studies have been conducted in Australia and Singapore to determine levels of MHL among members of the general public and health professionals. To date, no such studies have been published in Chinese populations. Aim: The study aims to compare levels of MHL between registered nurses and psychiatrists in a Chinese general hospital. The paper reports participants' diagnosis and beliefs about interventions used to manage depression and schizophrenia. Methods: A descriptive cross-sectional survey was undertaken among a group of psychiatrists and registered nurses in the psychiatric department of one large teaching hospital in China ( n = 70). Participants completed the survey by rating written vignettes related to depression and schizophrenia. Results: The psychiatrists were highly accurate in correctly diagnosing both depression and schizophrenia; the registered nurses were less so for diagnosing depression. In terms of treatment options, the two groups reached a broad agreement on beliefs about the use of mental health interventions, but differed significantly in the use of some specific mental health interventions. Conclusions: This study provides preliminary information about levels of MHL among Chinese mental health professionals and describes their attitudes towards the helpfulness of interventions used to restore mental health and well-being. Future large-scale studies are required to identify factors that influence beliefs about the use of mental health interventions. The findings have implications for further education of registered nurses in the specialization of mental health nursing in China. [ABSTRACT FROM AUTHOR]

Aim: To assess whether expatriate‐specific factors were associated with nurses' overall job dissatisfaction after controlling for known factors. Background: Current evidence about job dissatisfaction among nurses in Saudi Arabia is not specific to expatriate nurses. Specific aspects such as job insecurity, fear of litigation, and language barriers have not been assessed in the context of job dissatisfaction. Introduction: The majority of nurses in the Arab Gulf countries are expatriate. The motive for employment here is purely financial because there is no path to permanent residency. Methods: This was a cross‐sectional electronic survey of 977 expatriate nurses in Al‐Qassim, Saudi Arabia. The survey included questions on demography, job dissatisfaction (overall and related to salary, workload, and teamwork), job characteristics, job duration as an expatriate, communication issues with patients and doctors, fear of litigation, and job insecurity. We used a hierarchical logistic regression to evaluate whether unique factors were associated with overall job dissatisfaction either as a group, or individually. Results: The mean age of the nurses was 32 years, and 19% reported overall job dissatisfaction. The unique expatriate factors as a group contributed significantly to the model. Job insecurity, patient communication problems, and shorter job duration were significantly associated with higher overall job dissatisfaction. Conclusions: Job insecurity, job duration, and patient communication were significant correlates of overall job dissatisfaction among expatriate nurses. Implications for nursing policy: A longer job contract and organizational initiatives to help new expatriate nurses acculturate will likely decrease feelings of job insecurity and increase job satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To predict nurses' intent to stay on the job as a function of organizational culture. Background: Organizational climate significantly contributes to retention of nurses. Communication by conflict and organizational control over problem‐solving has not thoroughly been studied. Methods: A cross‐sectional design was used with a randomly selected final sample of 367 nurses from regional hospitals in Hungary. Organizational climate, perceived stress, locus of control and self‐esteem were assessed as main measures. Nurses indicated their intent to stay for the next 5 years. Spearman correlation coefficients were calculated to evaluate associations. Bivariate logistic regression was performed to predict intent to stay in nursing. Findings: Organizational climate was negatively correlated with perceived stress and personal locus of control and positively with personal self‐esteem. Organizational level internal locus of control (belief that employees have control over problem‐solving) doubled the probability of staying on the job. Conflictual communication and perceived stress both decreased intent to stay by 50%. Discussion and conclusions: Organizational internal locus of control, stress and conflictual communication were main predictors of intent to stay. The belief that nurses had collective control over problem‐solving capabilities had a positive and greater impact on nurse retention compared to other measures. Implication for nursing policy: Healthcare organizations should routinely scan workplace culture for conflictual communication, stress and organizational problem‐solving capacities. Graduate nurse and nurse manager training should include practices that enable developing positive work atmospheres. Hospital managements should allocate training budget to stimulate and achieve cultural change. Implications for nursing practice: Nurse managers should promote internal trainings to help staff nurses adopt techniques that minimize conflict and emphasize positive impact of collaborative problem‐solving. [ABSTRACT FROM AUTHOR]

Aim: To explore nursing and midwifery managers' views regarding obstacles to compassion‐giving across country cultures. Background: The benefit of compassionate leadership is being advocated, but despite the fact that health care is invariably conducted within culturally diverse workplaces, the interconnection of culture, compassion and leadership is rarely addressed. Furthermore, evidence on how cultural factors hinder the expression of compassion among nursing and midwifery managers is lacking. Methods: Cross‐sectional, exploratory, international online survey involving 1 217 participants from 17 countries. Managers' responses on open‐ended questions related to barriers for providing compassion were entered and thematically analysed through NVivo. Results: Three key themes related to compassion‐giving obstacles emerged across countries: 1. related to the managers' personal characteristics and experiences; 2. system‐related; and 3. staff‐related. Conclusions: Obstacles to compassion‐giving among managers vary across countries. An understanding of the variations across countries and cultures of what impedes compassion to flourish in health care is important. Implications for nursing practice and policy: Nursing mangers should wisely use their power by adopting leadership styles that promote culturally competent and compassionate workplaces with respect for human rights. Policymakers should identify training and mentoring needs to enable the development of managers' practical wisdom. Appropriate national and international policies should facilitate the establishment of standards and guidelines for compassionate leadership, in the face of distorted organizational cultures and system‐related obstacles to compassion‐giving. [ABSTRACT FROM AUTHOR]

Aim: To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses' job satisfaction and inform future healthcare provision and policy. Background: Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There was a paucity of evidence regarding nurses' experiences during Hajj. This gap in knowledge needed to be addressed. Methods: A cross‐sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24‐item Nurses' Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co‐workers. Results: Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items 'multiple policies and procedures that were perceived as complicating nursing work', 'incompetence of other people they work with' and 'too much burden at work'. Conclusion: Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology. Implications for nursing policy and practice: Hajj‐specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses' work during Hajj. Improvements to the nurse work environment should focus on evidence‐based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide. [ABSTRACT FROM AUTHOR]

Aim: This investigation explored the extent to which nurses' own health is a priority for global National Nursing Associations. Background: There is a growing body of evidence linking staff health and well‐being and key dimensions of service quality, including patient safety, patient experience and the effectiveness of patient care. Introduction: The International Council of Nurses is a federation of more than 130 National Nurses Associations, representing more than 20 million nurses worldwide. Representatives from these Associations attended a Congress in Singapore in 2019 at which a survey was conducted. Methods: A convenience sample of 37 leaders of National Nurse Associations from 33 countries and 61 nurse representatives took part in a survey. Results: The majority of nurse leaders and participants believed that nurses' own health should be a priority to be addressed, principally because a healthy nurse is better able to provide good patient care. All of the examples offered about how these Associations address nurses' own health were about actions to prompt individual health behaviour change. Discussion: The National Nurses Associations did not have a common terminology to talk about nurses' own health. Taking care of one's own health was included as part of the professional role and most nurse leaders thought that working conditions contributed to ill health. Conclusions: There is widespread agreement that nurses' own health matters but for most National Nurses Associations it is not a current priority. Implications for Nursing Policy: Going forward nurse health and wellbeing should be a core principle for health services and professional associations, and additional research is needed that demonstrates if improving working environments contributes to nurse retention and recruitment. [ABSTRACT FROM AUTHOR]

Aim: To investigate nurses' knowledge, attitudes and practices related to intimate partner violence among women in Saudi Arabian healthcare settings. Background: There is a global focus on abuse experiences in clinical settings. However, nurses' practice in managing intimate partner violence patients in Saudi healthcare settings has not yet been examined. Introduction: Intimate partner violence is a health issue that can lead to mortality and morbidity. It has recently received attention in an Arabian context. Thus, scrutinizing nurses' role in responding to intimate partner violence patients is needed to fill a current gap. Methods: A cross‐sectional study was conducted with a convenience sample of 114 nurses from two hospitals in Saudi Arabia using a questionnaire. Results: Minimal previous intimate partner violence training was reported, as 63% of nurses had not received training related to intimate partner violence, and 52% believed that they did not receive adequate training to respond to intimate partner violence survivors. The results show that nurses had both low perceived knowledge and low preparedness in managing intimate partner violence, and only had basic intimate partner violence knowledge. Results indicated that nurses did not have appropriate attitudes towards intimate partner violence. The majority were not aware about intimate partner violence protocols or policies in their institutions. Only 2.6% had diagnosed intimate partner violence in the last six months. Conclusion: There were gaps in nurses' perceived preparedness, knowledge, attitudes and behaviours. There was also limited training and preparation for nurses to assess and address intimate partner violence. Implications for nursing and health policy: The study suggests the need for clear institutional health policies related to detecting, responding to, and preventing intimate partner violence. Guidelines about integrating intimate partner violence in nursing curricula and implementing in‐service training should be developed and implemented. A multi‐level intervention that enables nurses to respond to intimate partner violence is also needed. [ABSTRACT FROM AUTHOR]

Aim: This study examined the role of job dimensions, job satisfaction, psychological stress and job burnout in predicting turnover intention at one and five years' time among professional nurses in the Philippines. Methods: A cross‐sectional design was utilized in the study using a convenience sample of 549 registered nurses from six hospitals in the Central Philippines during the period of October 2018 to January 2019. Five self‐report scales were used in this study. Results: Overall, 46.1% (n = 253) and 78.9% (n = 433) of nurses reported planning to leave the organization at one and five years' time, respectively. The type of hospital, job satisfaction and job burnout explained variances for turnover intention at one and five years' time. Separately, hospital bed capacity and job stress predicted turnover intention at five years' time. None of the job dimensions accurately predicted turnover intention in nurses. Conclusion: Higher turnover intention results at one and five years' time were dependent on nurses' psychological stress, job burnout and job satisfaction. Implications for nursing practice and policy: Organizational measures aimed at reducing stress and burnout and increasing job satisfaction in nurses are critically important to enhance the retention of nurses and ensure continued quality of nursing care. [ABSTRACT FROM AUTHOR]

Background: Nursing shortages, the substitution of practical nurses for registered nurses, an ageing workforce, the decreasing number of nurse graduates and the increasing migration of young nurses are important factors associated with the hospital safety climate in Central European countries. Aims: The aim of the study was to investigate nurses' perceptions of the safety climate in four selected central European countries (Croatia, the Czech Republic, Poland and Slovakia) and to determine the relationship between safety climate and unfinished nursing care. Methods: A cross‐sectional study was used. The sample consisted of 1353 European nurses from four countries. Instruments used were the Hospital Survey on Patient Safety Culture and the Perceived Implicit Rationing of Nursing Care. Data were analysed using descriptive statistics and multiple regression analyses. Results: Significant differences were found between countries in all unit/hospital/outcome dimensions. 'Perceived Patient Safety' and 'Reporting of Incident Data' were associated with aspects of 'Organizational Learning' and 'Feedback and Communication about Error'. Higher prevalence of unfinished nursing care is associated with more negative perceptions of patient safety climate. Conclusions: Cross‐cultural comparisons allow us to examine differences and similarities in safety dimensions across countries. The areas with potential for initiating strategies for improvement in all four countries are 'Staffing', 'Non‐punitive Response to Error' and 'Teamwork across Hospital Units'. Implications for nursing and health policy: 'Feedback and Communicating about Error' and 'Organizational Learning ‐ Continuous Improvement' were the main predictors of 'Overall Perception of Patient Safety' and 'Reporting of Incident Data'. Therefore, nurse managers should focus on how to empower nurses in these areas in order to foster a no‐blame culture and effective reporting. In addition, it is important for policymakers to update nursing education standards in order to address patient safety. [ABSTRACT FROM AUTHOR]

Aim: To develop and psychometrically test the Stanford Presenteeism Scale‐6 to assess presenteeism in the Spanish healthcare population. Background: Presenteeism, referring to going to work despite being ill, has been associated with job stress, productivity losses, reduced patient safety and increased health problems among the professionals who suffer from it. Introduction: The highest prevalence of presenteeism in the healthcare sector is among nurses. Their decision to attend work while ill has been related to role overload, lack of supervisor support, mental health and physical conditions. Methods: A cross‐sectional and validation study was conducted between September 2015 and June 2016 in a hospital in Asturias, Spain. Four hundred and ninety‐five healthcare professionals voluntarily agreed to participate (281 nurses, 122 physicians and 92 nursing assistants). Results: Presenteeism prevalence was high; the majority of it being in the nursing category. Bartlett's test and the Kaiser–Meyer–Olkin test indicated that the data meet the conditions for factorial analysis, evidencing a small variability in the median of each sample item and a significant standard deviation. Adjustment rates obtained in the exploratory factor analysis showed adequacy, and reliability rates also showed adequacy for both factors. It was verified by a confirmatory analysis that the factors of presenteeism are positively associated with burnout. Conclusion: The Stanford Presenteeism Scale‐6 showed good psychometric properties to study presenteeism in the Spanish healthcare sector. Implications for Nursing and Health Policy: Nursing leaders must develop measurements to assess and control psychosocial risks in order to improve the physical and mental health of professionals and reduce patient safety risks. [ABSTRACT FROM AUTHOR]

Aim: To determine the relationship between knowledge, attitude and the practice of hand hygiene by nursing and midwifery students in Cambodia. Background: Hand hygiene is the most cost‐effective means to prevent hospital‐acquired infections. Techniques of hand hygiene are simple; however, many researchers have found hand hygiene knowledge, attitude and practice to be poor in many healthcare settings worldwide, especially in developing countries. Cambodia is a developing country in Southeast Asia and data regarding hand hygiene are limited. Methods: A cross‐sectional descriptive study was conducted to assess the level of knowledge, attitude and practice of hand hygiene. Students in nursing and midwifery programmes were the target population (n = 300). Survey data were collected from January to May 2017. Descriptive statistics, t‐tests and correlation coefficients were calculated to assess relationships between student knowledge, attitude and hand hygiene practice. Result: The level of knowledge, attitude and practice of hand hygiene in nursing and midwifery students was moderate. A majority of students had received hand hygiene training. There was no significant difference between nursing and midwifery students in knowledge, attitude and practice of hand hygiene. However, a Pearson correlation of attitude and practice had a weak positive relationship. Conclusion: Both nursing and midwifery students demonstrated moderate levels of knowledge, attitudes and practice of hand hygiene. Implication for nursing and health policy: This study identified a need for hand hygiene training. Developing training programmes to improve attitudes about hand hygiene is strongly recommended. Effective training may contribute to change behaviours of hand hygiene (attitude), improve practice and ultimately reduce hospital‐acquired infections. [ABSTRACT FROM AUTHOR]

Aim: To compare Spanish nursing students' and registered nurses' perception of professional values from the perspective of gender and professional experience. Background: Nursing has traditionally been a female profession; however, the analysis of professional nursing values from a gender perspective has received little attention. The integration of professional values typically begins during academic life and is, thereafter, reinforced during professional activities. Methods: A descriptive cross‐sectional study was conducted with 159 students (97.4% females) and 386 registered nurses (86.8% females) from primary healthcare centres, hospitals and management positions within the public health system. The validated Spanish adaptation of the Nurses Professional Values Scale was used. This instrument measures three dimensions: ethics, commitment and professional mastery. Descriptive statistics were used to analyse the data, together with bivariate analysis using the chi‐squared test. Results: Females granted more importance to professional values. Important gender differences among students were detected. Ethical values were considered to be the most important for both students and nurses, followed by professional mastery and commitment. The importance given to values progressively decreased in the groups under study: students, less‐experienced nurses and expert nurses (in decreasing order). Conclusions: Significant gender differences exist with regard to professional nursing values. The values related to professional commitment and mastery should be integrated and promoted during academic education and specifically focus on male students' perceptions. As professional experience increases, the importance attributed to professional values decreases. Implications for Nursing Policy: Professional nursing values should be promoted among universities, health services and professional organizations, encouraging their dissemination, implementation and evaluation. [ABSTRACT FROM AUTHOR]

Aim: This study explores Australian clinical nurses' and midwives' familiarity with a new code of conduct and understanding in what ways the code is important for nurses as they carry out clinical practice. Background: Codes specify the expectations of nurses' responsibilities, legal requirements, behaviour and conduct. Being familiar with the code is central to being a professional nurse or midwife. As nursing continues to advance, updating the code is crucial to maintain professional and safe practice. Design: This project utilized a cross‐sectional descriptive design. Methods: A survey was developed incorporating Likert‐type scale assessments of the 7 value statements from the 2018 Australian Nurses' Code of Conduct for familiarity and importance. The survey included open‐ended questions to elicit clinical nurses' experiences of conduct breaches, opinions regarding usefulness and relevance of the code for current practice. Data were collected at an acute care hospital in Sydney during January 2018. Results: Significant differences relating to cultural and patient‐centred approaches were revealed in the study. The new value involving the role of research was least understood and ranked least important by nurses and midwives. Professional 'integrity' resonated with participants when considering the behaviour of nurses, and short, unambiguous values were the most popular. Additionally, a substantial number of participants had no knowledge of the code or were not aware of the recently revised version. Conclusion and implications for nursing: A code of conduct provides structure and guidance for workplace values and principles. A respected code is important to the nursing profession to help prevent inappropriate and incompetent behaviour and as a guide for nursing performance. Nurses in this study claimed the code was highly relevant to their work as a nurse and was incorporated into their daily practice. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this project was to analyse the level of satisfaction with life amongst Polish oncology nurses compared to their system of values. Background: There are a large number of scholarly reports on job satisfaction and occupational burnout among oncologic nurses, and hardly any impact on their level of life satisfaction. Introduction: Satisfaction with life, positive feelings and lack of negative feelings are the three important elements of subjective well‐being. Methods: A cross‐sectional survey study design was used. One hundred and forty registered nurses working at oncology centres in Poland were surveyed during the 21st Annual Polish Oncology Nursing Conference. The study used a diagnostic survey method utilizing the Satisfaction With Life Scale, the List of Personal Values and an original survey questionnaire for collecting socio‐demographic data. Results: There was significant relationship between the level of satisfaction with life in oncology nurses and their age, work seniority, the working system and family life. Discussion: Satisfaction with life and work is interconnected, and oncology nursing is characterized by significant physical and mental strain. The level of satisfaction depends on many variables, such as preferred system of values, work organization, age and work seniority. Conclusions: Age and years of work experience affect oncology nurses' satisfaction with life. Working on a shift system and having a second job lower their satisfaction with life. Nurses who identify happiness symbols in the category of happy family life present a higher level of satisfaction with life. Implications for nursing policy and practice: The low level of satisfaction with life among Polish oncology nurses is an important factor in the contemporary threats in nursing, and commitment to the improvement of the quality of life in this professional group should become a priority of shaping the image of the profession. [ABSTRACT FROM AUTHOR]

Background: Understanding how nursing students in European countries perceive their future professional role is an important step in creating awareness of the diversity and similarities between countries. Investigating nursing students' perceptions of their future profession could help in the design of education and the retention of nurses. Aim: To compare nursing students' perceptions of the professional nurse's role between Belarus, Lithuania, Poland and Sweden. Method: A cross‐sectional design was implemented. The study used two scales of the Professional Nursing Image Survey, which has questions about 10 skills and abilities and 14 functions and duties of a nurse. Results: A total of 392 final‐year nursing students in four countries participated in the study. Statistically significant differences were found between countries in terms of all 10 skills and abilities and in the distribution of responses concerning functions and duties of a nurse. Conclusions: Nursing students in Belarus, Lithuania, Poland and Sweden perceive differently the role of a nurse in terms of some functions and responsibilities. This may influence the adaptation of nurses who enjoy freedom of movement among the countries. Implications for nursing policy: The knowledge gained in this study could be beneficial in improving nursing education, as it could illuminate the discrepancy between educational goals and students' perceptions of their future professional role. [ABSTRACT FROM AUTHOR]

Aim: To investigate nurses' knowledge, attitudes and practices related to physical restraint in tertiary hospitals and identify the factors that influence physical restraint use. Background: Physical restraint is used to maintain patient safety. Nurses play an important role in the restraint process. It is important to identify their understanding, feelings and approach regarding the use of physical restraint. Introduction: Physical restraint is widely practiced in hospitals in China. However, it results in a range of serious negative consequences. This article provides a clear description of nurses' knowledge, attitudes and practices related to physical restraint. Methods: A cross‐sectional survey was conducted. The participants were asked to complete a questionnaire examining their knowledge, attitudes and practices related to physical restraint use. A total of 200 questionnaires were distributed in four tertiary hospitals in Hubei Province, China between August and October 2014. Results: The nurses' responses indicated a good level of knowledge regarding physical restraint use. However, they held some misconceptions. The nurses' attitudes towards physical restraint tended to be neutral. The nurses were well experienced in the use of physical restraint. Nurses who had received on‐the‐job training performed better than those who had received no training related to knowledge and practices regarding physical restraint use. Conclusions and implication for nursing/health policy: In‐service training is highly recommended for nursing managers to improve nurses' physical restraint related knowledge and practices. Regulations regarding the use of restraints should be established as soon as possible by healthcare administration system. Implications for nursing: Nurses should be open to evaluate and improve their views and attitudes regarding effective physical restraint use via multidimensional interventions. [ABSTRACT FROM AUTHOR]

The article discusses research on the role of nurses in providing cost-effective medical care to homeless men in Sydney, Australia. Topics include the impact of multimorbidity on the patients in the study, the role of medication administration as a primary health care (PHC) task in the study, and the need to collaborate with specialists such as mental health professionals through referrals.

Aim: To assess the psychometric properties of the Cultural Capacity Scale Spanish version in Chilean nursing students. Background: The increased diversity in healthcare facilities and the current shortage of local nursing workforce in Chile present a significant challenge to the nursing education to train future competent local nurses. To facilitate cultural competence development among Chilean nursing students, it is necessary to regularly assess their cultural competence, which necessitates a culturally adapted valid and reliable tool. Methods: A convenience sample of 502 Chilean nursing students was surveyed in this cross-sectional study using the culturally adapted scale. Reliability of the instrument was established by internal consistency and stability reliability, while validity was established by content and construct. Results: The Cronbach's α value of the entire scale was 0.95, and the test-retest reliability was 0.85. The Corrected Item-Total Correlations ranged from 0.45 to 0.78. The tool manifested an excellent content and construct validity. The exploratory factor analysis confirmed a single factor of the scale. Discussion: The tool demonstrated evidence of internal consistency, stability reliability, content validity and construct validity. The study provided cross-cultural evidence for the potential application of this scale in Chile and other Spanish-speaking countries. Conclusion: The Cultural Capacity Scale Spanish version demonstrated sound psychometric properties for assessing the cultural competence of Chilean nursing students. Limitations: The sample was restricted to one university, and the tool was only used in Chilean nursing students. Implications for nursing policy: The establishment of the Spanish version of the tool will facilitate accurate and timely monitoring of the cultural competence among Chilean nursing students and other Spanish-speaking nursing students and nurses, which can inform the creation of nursing policies aimed at ensuring cultural competence development. [ABSTRACT FROM AUTHOR]

Background: Smoking rates are higher among adolescents in South Korea than among those in other Asian countries. Researchers have reported associations between the presence of licensed tobacco retailers and adolescent smoking rates. However, few researchers have examined the factors that influence adolescent smoking including those that are intrapersonal, interpersonal or related to the tobacco retailers' environment. Aim: The purpose of this study was to describe factors related to the students, the licensed tobacco retailers and the schools and how those factors are associated with adolescent smoking outcomes such as tobacco marketing receptivity, lifetime smoking and current smoking. Methods: The survey data were gathered from 740 South Korean adolescents, and geographic data for 3488 licensed tobacco retailers were also used. Geographic Information Systems and multilevel modeling were used to describe the variables and determine the factors associated with smoking outcomes in the sample. Results: The factors that influenced receptivity to tobacco marketing included the presence of peers who smoke and the frequencies of licensed tobacco retailers passed on the way to school. The factors that influenced lifetime smoking included gender, perceived economic status, weekly income, the presence of siblings or peers who smoke and frequencies of licensed tobacco retailers passed on the way to school. The factors that influenced current smoking included gender, weekly income, and the presence of siblings or peers who smoke. Conclusions: These factors will guide adolescent tobacco prevention programs and policies. Implications for nursing practice and health policy: The study's implications for nursing practice and health policy are that school nurses and public health nurses need to be encouraged to use retailer-related factors in adolescent smoking-prevention programs. There is also a need for zoning and licensing regulations to restrict licensed tobacco retailers in areas that adolescents frequent, including schools. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to investigate the barriers inhibiting the use of spousal presence for childbirth pain relief in health facilities and recommendations from three perspectives: the midwife, the woman, and the spouse. Background Spousal presence is a non-invasive, participatory and inexpensive technique used in pain management during childbirth. Although it contributes to a large extent in relieving childbirth pain, it is underutilized in Nigerian hospitals. Overcoming the challenges impeding spousal presence and participation during childbirth will improve maternal outcome, satisfaction and midwifery care practices. Method A cross-sectional survey conducted in four hospitals in Nigeria involving midwives ( n = 100), women ( n = 142) and their spouses ( n = 142) from June to December 2014 using pretested questionnaires. Results Five themes were identified: poor infrastructural facility, lack of adequate pain management policy, lack of midwife pain management practices, midwives' attitudes towards spousal presence during childbirth and feelings about spousal presence during childbirth pain relief. Conclusion Infrastructural defects in the health facilities resulting in the lack of privacy in maternity units for both spouses and partners negatively influence the presence of a spouse during childbirth and pain relief. Adopting effective strategies such as good infrastructural facilities, staff training and spouse-friendly hospital policies will encourage spouses to fully participate in and contribute to childbirth pain relief. Implications for nursing and health policy This study identified poor staff attitudes towards pain relief and spousal presence during childbirth as barriers. Providing adequate policies on pain management, continuous staff education and orientation on spousal relationship will improve active spousal participation and maternal satisfaction during childbirth. [ABSTRACT FROM AUTHOR]

Aim To determine factors contributing to stress experienced by preregistration nursing students in Pakistan, using the Stressors in Nursing Students scale. The aim was to explore the psychometric properties of this instrument and to investigate the effect of a range of demographic variables on the perception of stressors in nursing students. Background Nursing is a stressful profession, and nursing students may experience more stress due to competing demands and challenges of nursing education, assessment, placements and worries about employment prospects. Methods In this cross-sectional survey, data from 726 nursing students from 11 schools of nursing in Karachi, Pakistan, were collected using a questionnaire. Data were analysed using descriptive as well inferential statistics. An exploratory factor analysis was also conducted. Results There was no apparent factor structure to the Stressors in Nursing Students scale, unlike in previous studies. The total score on the Stressors in Nursing Students scale was related to gender with males scoring higher. The score generally increased over 4 years of the programme, and students in private schools of nursing scored higher than those in public schools of nursing. Conclusion Nursing students in Pakistan do not appear to differentiate between different stressors, and this may be due to cultural differences in the students and to the structure of the programme and the articulation between the academic and clinical aspects. Likewise, cultural reasons may account for differences between stress experienced by male and female students. Implications for nursing and policy The fact that scores on the Stressors in Nursing Students scale increased over 4 years of the programme and males scored higher than females should alert nursing schools and policymakers related to nursing education and workforce to pay attention to prevent attrition from nursing programmes. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to identify the most common contributing factors to medication errors in everyday practice of Serbian nurses. Background Nurses have the key role in medication, and it is very important that they understand why errors occur. Methods This research study was a cross-sectional study in five healthcare institutions. The sample was 965 nurses. A specially designed questionnaire was used as the research instrument. Results The most dominant contributing factor of medication errors was insufficient number of nurses. Interestingly other dominant factors given in literature were not recognized in this research study. Discussion The study results confirm that the recommendations we find in literature cannot be simply copied and implemented into the existing system, but can be used as a starting point for further research. Limitation The obtained data were compared with the studies of the countries with different healthcare systems and different educational structures of nurses. Conclusion The results of the study imply that healthcare institutions have to take the initiative and the responsibility for teaching safe medication use during formal education, as well as in clearly planned programmes of continuous education for nurses. Implications for nursing To reduce errors to the least possible level, it is important that nurses clearly define what an error is and recognize the causes and the importance of reporting and analysing them. Implications for health policy Systemic practices are required in the health system in Serbia and the culture of patients' safety accepted as the common goal and imperative of everyday practice. [ABSTRACT FROM AUTHOR]

Aim This study assessed the cultural competence of nursing students in a Saudi University. Background With the current situation of immigration in Saudi Arabia, the cultural diversity in healthcare facilities is anticipated to grow. This presents a great challenge to the members of the healthcare team. Methods A cross-sectional study was conducted among 272 nursing students in a Saudi university using a self-administered questionnaire consisting of two parts, namely the respondents' demographics and cultural background information sheet and the Cultural Capacity Scale Arabic version. Results The respondents showed the highest competence in their ability to demonstrate communication skills with culturally diverse patients and lowest in the familiarity with health- or illness-related cultural knowledge or theory. Gender, academic level, clinical exposure, prior diversity training, the experience of taking care of culturally diverse patients and patients belonging to special population groups were significant factors that could likely to influence cultural competence. Discussion The findings suggest that the Saudi nursing students possess the ability to provide culturally appropriate nursing care to patients with a diverse cultural background. Conclusions Despite the good cultural competence reflected in this study, some aspects in ensuring a culturally competent care rendered by Saudi nursing students need to be improved. Implications for nursing & health policy With the country's Saudization policy in health care (replacing foreign nurses with Saudi nurses), the findings can be used in designing training and interventions to meet the needs of Saudi nursing students regarding cultural competence development, which is integral in their preparation to assume their future roles as nurses. Policy guidelines, such as including cultural competency training and foreign languages training as mandatory continuing education for nurses, as well as integrating cultural competency and foreign languages in the prelicensure curriculum, should be developed and implemented in Saudi Arabia and other countries. [ABSTRACT FROM AUTHOR]

Aim To identify the practice patterns of the Australian registered nurse workforce according to position title and to map these disparate titles across all jurisdictions of the country. Introduction Effective nursing workforce planning can contribute to improved patient care and increased effectiveness and efficiency of healthcare systems. Background The prevailing approach to nursing workforce planning focuses on number of nursing staff needed in relation to the number of patients. The level of expertise and skill mix of registered nurses as a variable in workforce planning is rarely considered. Methods A national cross-sectional electronic survey of registered nurses in Australia was conducted using the validated Advanced Practice Role Delineation tool developed from the Strong Model of Advanced Practice. The study involved a sample of 5599 registered nurses. Results Sixty-six nursing position titles nationally were mapped using cluster analysis technique and gave rise to seven clusters of equivalent Australian jurisdictional nursing position titles and practice profiles. Discussion Effective workforce policy and planning is reliant upon access to reliable evidence. This research is an international first in that it has provided comprehensive knowledge of the clinical level and practice profiles of a national nursing workforce. Implications for nursing policy Effective, patient-centred workforce planning must consider both the numerical and expertise mix of a nursing workforce. This research provides Australian health service and policy planners with evidence-base knowledge of the nursing workforce. Internationally, this research establishes a platform from which to develop validated tools and established processes to support replication of this research. [ABSTRACT FROM AUTHOR]

Aim: To report on the outcomes of the European project ENS4Care, which delivered evidence‐based guidelines enabling implementation of eHealth services in nursing and social care. Background: Within a policy context of efficiency, safety and quality in health care, this project brought together a diverse group of stakeholders from academia, industry, patient and professional organizations to lead the development of five eHealth guidelines in the areas of prevention, clinical practice, integrated care, advanced roles and nurse ePrescribing. Sources of evidence: Data were collected through a cross‐sectional, online, questionnaire survey of health professionals from 21 countries. Quantitative data were analysed using descriptive and summary statistics, while comments to open questions underwent a process of content analysis. Discussion: Representing an evidence‐based consensus statement, the five guidelines outline key steps and considerations for the deployment of eHealth services at different levels of enablement. Through analysis of the data, and sharing of best practices, common deployment processes and implementation lessons were identified. Conclusion: Findings reveal the richness, diversity and potential that eHealth holds for enabling the delivery of safer, more efficient and patient‐centred health care. Nurses and social care workers as the main proprietors of such practices hold the key to a healthier future for citizens across Europe. Implications for nursing and health policy: The preparation, agreement and dissemination of the ENS4Care guidelines will enable European Union leaders to diagnose the organizational changes needed and prescribe the development of new skills and roles in the workforce to meet the challenge of eHealth. Nurses and social care workers, with the right knowledge and skills will add considerable value and form an important link between technological innovation, health promotion and disease prevention. [ABSTRACT FROM AUTHOR]

Introduction: A continuing shift of healthcare delivery from hospital to the community has increased the acuity and complexity of care provided in the home. Global financial crises and nursing shortages have prompted policies supporting two tiers of nursing and expansion of the licensed practical nurse, second level or enrolled nurse role and evoked debate surrounding roles traditionally undertaken by registered nurses. Community nursing offers unique challenges for enrolled nurses wanting to enact their full scope of practice. Aim: To compare and describe registered and enrolled nurse opinions of their current and potential enrolled nurse scope of practice in the community health setting. Methods: A cross‐sectional survey of 136 nurses (115 registered and 21 enrolled nurses) was undertaken within a large community nursing team in Australia. Participants reported their opinions of enrolled nurse scope of practice based on 27 core community nursing skills. Results: Although substantial agreement was evident, there were statistically significant differences between registered nurse and enrolled nurse opinions in core skill areas; ‘Patient Education’ and ‘Clinical Observation’. Registered nurses identified some specialized skills—catheter and gastrostomy care—that could be undertaken by enrolled nurses with further education. Conclusion: We confirm that registered nurses do agree with extending the skills of enrolled nurses. Education approaches that build shared confidence in enrolled nurse advanced skills are recommended. Implications for nursing and health policy: The future supply of nurses is at risk. There are limited resources and increasing demand for quality health care where people live and work. While there may be opportunities internationally to improve productivity through advanced nursing roles, these policies should prioritize efficiency by firstly promoting the full enactment of nursing skills in these settings. [ABSTRACT FROM AUTHOR]

Aim: Explore the potential of a part‐time work option for nurses as a strategy for managing domestic markets in Jordan by examining perceptions of working nurses and nursing students in the context of current social and cultural variables. Background: Unemployment among Jordanian nurses has become a reality in recent years. However, labor markets literature in nursing rarely studies what kind of policy responses should occur during a surplus of nurses. Methods: A cross‐sectional design structured the study. The perceptions of nurses and students were measured through a questionnaire developed specifically for the purpose of this exploratory study. Results: Both nurses (n = 51) and students (n = 56) supported the introduction of the new suggested part‐time option. However, students were more willing to start working or transfer into part‐time work, take payment on hourly basis, and support colleagues to transfer into part‐time work. Different solutions were also suggested by participants. Discussion: The results were useful for providing the foundational data to further study the viability of a part‐time work option for Jordanian nurses. The results show how optimistic current and future Jordanian nurses are regarding this employment option. For countries that may need to diversify their employment models due to excess supply of nurses and to address gender imbalances, this work may help inform policy development. Implications for nurses: Both employed and unemployed nurses will benefit if health care managers consider its application. The flexibility of this option may help improve the quality of life of many nurses. Implications for health policy: The results of this study provide nursing leaders and managers with foundational evidence that may be applicable in the Jordanian health sector. Although further studies are recommended, nursing leaders and policy makers should consider such a solution. [ABSTRACT FROM AUTHOR]

Background: When modelling the nursing workforce, estimations of the numbers and characteristics of new graduates over the forecast period are assumed on the basis of previous generations; however, new graduates may have different plans for their future than those documented previously in different socio‐economical contexts. Aims: To explore (a) nursing student plans after graduation and factors influencing their plans, and (b) factors associated with the intention to emigrate. Methods: A survey questionnaire was developed and distributed to students attending their final third year of nursing education in seven universities in Italy in 2015. Nine hundred and twenty‐three (90.4%) students participated. Findings: Four different plans after graduation emerged: about two‐thirds reported an intention to look for a nursing job in Italy; the remaining reported (a) an intention to emigrate, looking for a nursing job abroad, (b) an intention to search for a nursing job in both Italy and abroad, and (c) while a few an intention to continue nursing education in Italy. Having previous experience abroad, the need to grow and be satisfied, trusting the target country and a desire to increase knowledge encouraged an intention to emigrate, whereas the desire to stay in a comfortable environment and nurture personal relationships prevented the desire to migrate. Conclusion: Nursing students may have different plans after graduation, and this should be considered when modelling the nursing workforce of the future. Implications for nursing/health policy: Policymakers should be aware of different plans after graduation to guide healthcare human resource strategies. Knowing these trajectories allows policymakers to estimate the appropriate nursing workforce, and also to act at both macro‐ and meso‐levels, on work environments and opportunities for professional development, according to the different levels of expectations. [ABSTRACT FROM AUTHOR]

Aim: This is a research report examining the influence of organizational politics perceptions on nurses' work outcomes (job satisfaction, work stress, job burnout and turnover intention). Background: Organizational politics is a phenomenon common in almost all institutions and is linked with undesirable consequences in employees. Introduction: Despite the plethora of research around the world on this topic, studies describing organizational politics in nursing remain underexplored. Methods: A cross‐sectional research design was utilized in this study. One hundred sixty‐six (166) nurses participated. Five standardized tools were used: the Job Satisfaction Index, the Job Stress Scale, the Burnout Measure Scale, the Turnover Intention Inventory Scale and the Perception of Organizational Politics Scale. Results: Nurses employed both in private and government‐owned hospitals perceived moderate levels of organizational politics. Positive correlations were identified between perceived organizational politics and job stress, turnover intention and job burnout. Negative correlations were found between perceived organizational politics and job satisfaction. Discussion: Perceptions of workplace politics in Filipino nurses were lower when compared to findings in other international studies. A strong link was found between organizational politics perceptions and the four job outcomes (stress and burnout levels, turnover intention and job satisfaction). Limitations: Use of a self‐reporting questionnaire and exclusion of nurses from other provinces. Conclusion: Perceived organizational politics predicted nurses’ stress and burnout levels, turnover intention and job satisfaction. Implications for nursing and/or health policy: The findings of this study may provide a valuable perspective of this organizational issue and could assist policymakers and nurse administrators in formulating interventions that could minimize the effect of workplace politics. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to determine whether self‐efficacy mediated the relationship between anger expression and interpersonal competency in South Korean nursing students. Background: Interpersonal competency allows nursing students to increase their self‐confidence in caring for patients. There is evidence of complex relationships between anger expression, self‐efficacy and interpersonal competency. Self‐efficacy could be considered a potential mediator in the association between anger expression and interpersonal competency in nursing students. However, few studies have investigated the mediatory role of self‐efficacy in this association. Methods: A descriptive, cross‐sectional study was conducted. In total, 207 Korean nursing students completed a structured questionnaire. Measurement tools included the State‐Trait Anger Expression Inventory, Self‐efficacy Scale and Interpersonal Competence Questionnaire. Findings: Significant correlations were observed between anger expression, self‐efficacy and interpersonal competency. Self‐efficacy exerted a partial mediatory effect on the relationships between interpersonal competency and anger‐in and anger‐control within the anger expression subscales. Conclusion: The study demonstrated that appropriate anger expression could result in enhanced interpersonal competency via an increase in self‐efficacy. Implications for nursing and health policy: The results concerning the mediatory role of self‐efficacy in the association between anger expression and interpersonal competency have provided new knowledge for nursing educators, managers and researchers, allowing them to support nursing students' interpersonal competency. Nursing schools should be required to evaluate students' anger expression patterns and to increase self‐efficacy when developing education programmes that provide interpersonal training for nursing students. [ABSTRACT FROM AUTHOR]

Background: Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high ‐ quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. Aim: The aim of this study was to explore the nurses’ views and experiences of a number of compassion ‐ related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. Methods: An exploratory, cross ‐ sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. Results: The majority of participants (59.5%) defined compassion as “Deep awareness of the suffering of others and wish to alleviate it” but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses’ experiences of compassion and their views about teaching of compassion. Conclusion: Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. Limitations: Self ‐ report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. Implications for nursing policy: Understanding the influence of culture on nurses’ views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff). [ABSTRACT FROM AUTHOR]

Aim: This study aimed to understand nursing practice environment characteristics in Istanbul ‐ area hospitals in Turkey, the relationship between these characteristics, nurse burnout levels and nurses' intentions to leave work. Background: A well ‐ known relationship exists in many countries between nursing practice environments and nurse burnout and intention to leave work. However, little is known about the relationship between practice environment characteristics and nursing outcomes in Turkey. Methods: This cross ‐ sectional study was conducted among 2592 nurses in 20 Ministry of Health and 29 private hospitals in Istanbul, Turkey. A demographic questionnaire, Practice Environment Scale of the Nursing Work Index and Maslach Burnout Inventory were used for data collection. Results: Almost half of nurses suffered from high ‐ level burnout related to emotional exhaustion and personal accomplishment, and one ‐ third reported depersonalization and the intent to leave their jobs within a year. A poor nursing practice environment was the leading factor, increasing nurses' burnout levels in all subdimensions. Burnout related to emotional exhaustion, personal accomplishment and poor practice environment increased intention to leave. Permanent positions decreased intention. Discussion: There was a relationship between poor practice environments and nursing outcomes in Turkey. Limitations: The use of a survey data collection method is a potential study limitation. Quantitative and qualitative methods could be combined to obtain more detailed objective data about nursing practice environments. Conclusion: Poor practice environments, high ‐ level burnout and intention to leave work are significant problems in Istanbul, Turkey. Favourable practice environments and job security should be provided to improve nursing outcomes. Implications for nursing policy: Policymakers and nurse managers should be aware of any negative issues regarding nursing practice environments and job security to improve nursing outcomes. [ABSTRACT FROM AUTHOR]

Aims: To identify the extent of evidence‐based practice implementation among nurses in Slovenian hospital settings, to establish nurses’ beliefs on evidence‐based practice and to identify possible explanatory factors. Background: Conducting and applying research are fundamental nurses’ tasks and an essential expectation in nursing practice. Introduction: Despite verified benefits of evidence‐based practice, research evidence across different countries has shown extremely limited implementation of this practice among nurses. Methods: A cross‐sectional research design was employed. Standardized instruments Evidence‐Based Practice Beliefs and Implementation Scale were used. The sample included 534 nurses from 19 Slovenian hospitals. The obtained data were analysed using descriptive statistics, correlation and factor analysis, and linear regression. Results: Nurses in Slovenian hospitals have positive beliefs about evidence‐based practice, but exhibit a low level of implementation. The beliefs were explained by perceived knowledge on research, job satisfaction and length of employment, whereas a low level of implementation was explained by poor perceived knowledge on research, evidence‐based practice and job satisfaction level. Discussion: Nurses in Slovenian hospitals have positive beliefs about evidence‐based practice, but exhibit a low level of implementation. According to the results, some resources required for improved implementation are not made sufficiently available. Limitations: A low response rate; the sample not being balanced for educational achievement; and the accuracy of self‐report survey methods. Conclusion: In addition to the perceived knowledge and education provided, an important factor is also job satisfaction, which points to the instrumental role of management workers in determining nurses’ professional development. Implications for nursing and health policy: Nursing managers in Slovenian hospitals should promote the development of head nurses in research and evidence‐based care, thereby fostering a culture of evidence‐based practice. [ABSTRACT FROM AUTHOR]