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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]

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]

MANZANO GARCÍA G. & AYALA CALVO J. C. (2011) Emotional exhaustion of nursing staff: influence of emotional annoyance and resilience. International Nursing Review 59, 101-107 Aim: This paper aimed to study the influence of emotional annoyance and resilience on the emotional exhaustion levels of nursing staff. Background: Emotional exhaustion is one of the key factors in understanding both the performance and the quality of care that nurses give to their patients. There is a considerable body of knowledge that has focused on the study of emotional exhaustion in relation to cynicism and professional efficiency. More recently emotional annoyance and resilience have been identified as variables that could help explain levels of emotional exhaustion. Methods: Nine hundred eighty-three nurses who work in five hospitals in the north of Spain were invited to participate in the study. Five hundred questionnaires were distributed, of which 200 were fully completed. The average response rate was 40%. A personal information form, and a questionnaire concerning nurses' emotional annoyance, resilience, professional efficiency and cynicism were used as data collection instruments. To estimate a path model with latent variables, partial least squares was used. Findings: Emotional annoyance and resilience contribute to a better understanding of emotional exhaustion levels of nursing staff. There was a significant association between emotional annoyance and emotional exhaustion (β = 0.26, P = 0.020), while resilience appeared to be protective against emotional exhaustion (β = −0.22, P = 0.004). Conclusion: A more complete explanation and understanding of emotional exhaustion in nursing is achieved when emotional annoyance and resilience is measured in addition elements of burnout, which include professional efficiency and cynicism. [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 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]

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 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 This study investigated the role of social relationships in the sharing of cultural competence by testing two hypotheses: cultural competence is a socially shared behaviour; and central healthcare professionals are more culturally competent than non-central healthcare professionals. Background Sustaining cultural competence in healthcare services relies on the assumption that being culturally competent is a socially shared behaviour among health professionals. This assumption has never been tested. Introduction Organizational aspects surrounding cultural competence are poorly considered. This therefore leads to a heterogeneous implementation of cultural competence - especially in continental Europe. Methods We carried out a social network analysis in 24 Belgian inpatient and outpatient health services. All healthcare professionals ( ego) were requested to fill in a questionnaire (Survey on social relationships of health care professionals) on their level of cultural competence and to identify their professional relationships ( alter). We fitted regression models to assess whether (1) at the dyadic level, ego cultural competence was associated with alter cultural competence, and (2) health professionals of greater centrality had greater cultural competence. Results At the dyadic level, no significant associations were found between ego cultural competence and alter cultural competence, with the exception of subjective exposure to intercultural situations. No significant associations were found between centrality and cultural competence, except for subjective exposure to intercultural situations. Discussion Being culturally competent is not a shared behaviour among health professionals. The most central healthcare professionals are not more culturally competent than less central health professionals. Conclusions and implications for health policies Culturally competent health care is not yet a norm in health services. Health care and training authorities should either make cultural competent health care a licensing criteria or reward culturally competent health care. [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: 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]

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]

Background: Treating patients with care and respecting their cultural values are key factors necessary to enhance the quality of nursing care. Aim: The objective of this study was to explore and describe the difficulties experienced by hospitalized Syrian refugees and their expectations from nurses and hospital administration. Methods: We used a descriptive qualitative research approach to engage 30 Syrian refugees undergoing treatment in internal medicine who met the study criteria. Data were collected using a descriptive questionnaire and a semi ‐ structured interview with open ‐ ended interview questions. Interview transcripts were analysed using an inductive coding approach. Descriptive questions were analysed and presented via number and percentage. Other data were assessed using content analysis methods. Results: Three major themes were developed following the analysis of the interviews. We determined that the refugees who participated in the study experienced difficulties in communicating, meeting their personal needs and correctly following treatment instructions. They also had certain expectations from the hospital administration and nurses, and they felt gratitude for both nurses and the nation of Turkey. Conclusions: The results of this study, shared with the executive administration of the hospital, may result in new policies which will help new Syrian refugee patients and patients with similar needs to have better experience related to patient care, communications and meeting personal needs. Implication for nursing and health policy: It is important that nurses and other healthcare provider consider the difficulties and expectations of refugees regarding healthcare services and include same in the development of provider training programmes. Development of public health welfare and employment law and policies help to lay the groundwork for successful integration of refugees in new cultures and countries. [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]

Aim: The aim was to examine the relationship between the quality of team–member exchange experienced by nursing staff and their intention to leave. Job satisfaction and affective organizational commitment are considered as mediators. Background: While the shortage of nurses is a management and policy priority, few studies have studied the relationships between nursing staff and their team, key organizational attitudes, and intentions to leave the organization. Method: A questionnaire was administered to 217 registered nurses and nurse assistants in Belgium. Data were collected in 2012. To analyse the data, descriptive statistics, correlation, regression and path analyses were conducted. Findings: Team–member exchange has a positive impact on nursing staff satisfaction and affective commitment. Job satisfaction and affective organizational commitment fully mediated the impact of team–member exchange on nursing staff's intention to leave. Conclusion and implications for nursing and health policy: This study illustrates the potential benefits of the positive influence of team–member exchange on key organizational attitudes of nursing staff, and the negative influence on intention to leave through affective commitment and job satisfaction. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to describe nurses' perceptions of workplace culture, especially in regard to stress levels, job satisfaction and the practice environment in primary health care. Background: Health care is facing many challenges related to its attractiveness as a place of employment and the maintenance of a sufficient workforce supply. Previous studies report increasing rates of nurse job dissatisfaction and intentions to leave their current positions both in Finland and also globally. Improving workplace culture is thus vital in meeting the challenges related to recruitment and retention. Methods: A cross ‐ sectional descriptive design was used to describe nurses' perceptions of workplace culture. Data were collected by questionnaire from 22 units in nine primary healthcare organizations in Finland, and analysed using descriptive and inferential statistics. Results: Most of the respondents indicated that they were not certain whether their workplace culture was either positive or negative. Profession, age and work shift characteristics had an effect on the respondents' perceptions of workplace culture. Younger licensed practical and registered nurses assessed their workplace culture more positively, whereas older registered nurses and those working rotating rosters viewed workplace culture more negatively. Conclusions: The findings suggest that both unit and demographic characteristics affect workplace culture. This survey highlights that a positive workplace culture is one of the key factors in retaining and recruiting nurses, and provides an essential evidence that may be considered by other healthcare organizations. Implications for nursing and health policy: Nurse managers and healthcare leaders need to address workload management and take into account the related variables that affect a unit's workplace culture. [ABSTRACT FROM AUTHOR]

Background Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. Aim To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. Methods Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. Results The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. Limitations Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. Conclusions Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. Implications for nursing and health policy Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems. Policymakers need to be aware of the issues regarding nurses' extended work hours, which has been found to contribute to burnout. Urgently, nurse and health administrators need to develop and implement appropriate nursing overtime policies and strategies to help reduce this phenomenon, including measures to overcome the nursing shortage. [ABSTRACT FROM AUTHOR]

Aim This study aimed to determine the attitudes of adolescents towards sexual health and to assess their understanding of contraception use and knowledge about sexually transmitted infections in three ethnically different areas of Croatia and Bosnia and Herzegovina. Methods A total of 146 adolescent high school students between 17 and 19 years of age from three different cities were enrolled in this cross-sectional study. The participants completed two anonymous questionnaires: one that measured attitudes towards safe sex practice and another that measured contraception and general sexual health knowledge. Results Shame was identified as the main factor why adolescents did not seek information about sexual health and contraception. On average, respondents correctly answered only 35% of questions regarding sexual health. Adolescents from East Mostar, with a predominantly Bosniak population, had more positive attitudes towards safe sex and showed less contraception knowledge in comparison to their colleagues from two cities in Croatia. Limitations Our study design might be burdened by socially desirable reporting and other biases inherent to the survey design. Conclusion Adolescents from Croatia and Bosnia and Herzegovina, countries that experienced war and are still undergoing post-communist socio-economic transition, generally did not have adequate knowledge with respect to safe sex lifestyles. Respondents had major problems identifying sexually transmitted infections and their knowledge about contraception was insufficient. Implications for nursing and health policy Providing care for adolescent populations should address specificities in local ethnical and socio-economical circumstances. There is a need for further studies to determine social, cultural and religious factors influencing the knowledge and attitudes towards sexual health in order to provide most effective interventions for specific adolescent populations. [ABSTRACT FROM AUTHOR]

Background The concept of a 'specialist nurse' has existed for many years and related education programmes are proliferating. However, while literature clearly outlines the roles and practice of registered nurses and advanced practice nurses, those of specialist nurses remain unclear and nursing specializations across Europe need clarifying. Aim This pilot study aimed to explore the competencies, education requirements and regulation of specialist nurses in Europe. Design A descriptive cross-sectional survey. Methods An online questionnaire named 'Specialist nurse and specialization in Europe' was sent to 550 members of the European Federation of Nurse Educators and ten members of the European Specialist Nurses Organizations. Snowball sampling was then used to build a convenience sample of nurse educators, clinical nurses and specialist nurses, national nursing association members, and chief nursing officers from all European countries. Besides quantitative aspects, responses to open-ended questions were analysed using a qualitative content analysis process. Results A total of 77 experts from 29 European countries responded to the questionnaire. Findings highlighted variations in titles, levels and length of education, certification, regulation and scope of practice for specialized nurses in Europe. Analysis of the promoted competencies revealed dominant clinical and technical aspects of the role with a high level of knowledge. Conclusions The study emphasized the need to improve standards for education, certification and regulation for specialist nurses. Interpretation of the role and competencies is diverse with a weak presence of health policy that would enhance and develop the specialities. Implications for nursing and health policy To address the current lack of provisions for automatic recognition of specialist nurses, common training frameworks corresponding to the relevant level of the European Qualifications Framework should promote lifelong learning and mobility, and enhance levels of health care and patient safety. [ABSTRACT FROM AUTHOR]

Introduction Ageing and problems concerning the aged are an increasing and concerning reality in developing and underdeveloped countries such as Indonesia. Improving service quality is important to promote and maintain wellness of older persons, especially in rural areas. Aim To explore programs and services offered to the elderly in a rural area of Indonesia to support them in promoting and maintaining their wellness. To describe roles and practices of health professionals and teams responsible for delivering services to older people. Methods Action research was used with mixed method data collection (interview and survey). Results Results demonstrated that activities related to the elderly health programs were limited due to budget and facilities. Practices of health staff for elderly in the community focused on intervention tasks, rather than prevention. Limitation Lack of available information on the range of programs and services implemented in Indonesia for the elderly in community settings was a limitation of this study. Conclusion Programs and services for older people have been implemented in Indonesia. However, these do not yet meet their needs, especially in rural areas. There is a need for greater focus on health promotion and illness prevention. Implication for Nursing and Health Policy Findings contribute to development of international knowledge in community health nursing, as these issues may not be only relevant to Indonesia. It is timely for governments, including in Indonesia, to evaluate health workforce needs in the community and appropriate educational qualifications for delivering optimal health services for older people. [ABSTRACT FROM AUTHOR]

Background Of elders with mild cognitive impairment, around half recover their cognitive function at some point in time. However, very little is known about the factors that influence their cognitive change towards recovery. Aim This study evaluated the role of depression, instrumental activity of daily living and sleep quality as they affect cognition recovery among community-dwelling elders. Methods The study follows a longitudinal comparative research design using secondary data analysis. Community-dwelling elders with mild cognitive impairment were assessed twice with a 1-year interval to assess their levels of cognition. Adult participants were drawn from those who visited a community health centre, were aged 65 or over and who were assessed as having MCI. Results Those with mild cognitive impairment when compared with the normal cognition group were more likely to be younger, have more education, living with their spouses and had better cognitive function at baseline assessment than other participants. Predictors for cognitive recovery among elders with mild cognitive impairment were age, depression and cognitive function at baseline assessment. Limitations Participants included only those who visit a community health centre in an urban area of Korea, so the findings may not be applicable to other elders with less mobility or who live in rural areas. Implications for nursing and health policy With the understanding that cognitive function and depression predict the recovery of mild cognitive function, nurses might be able to identify and target those older adults who are likely to achieve recovery of cognitive function. Additionally, health policy options, as suggested by the study as having the potential to improve mild cognitive impairment recovery, could include public education strategies. [ABSTRACT FROM AUTHOR]

Background It is important to integrate adolescent health domains into pre-service nursing education in order to enhance undergraduate nursing students' competencies in promoting adolescent health. Aim To determine the effectiveness of a structured adolescent health summer programme for Chinese undergraduate nursing students. Methods A quasi-experimental design was used to evaluate differences in the Chinese undergraduate nursing students' perceived competency in promoting adolescent health. A stand-alone adolescent health course was implemented as an intervention with pre- and post-tests of a 2-week intensive summer programme in 2010. The questionnaire included demographics, adolescent health competency checklist and programme evaluation. Descriptive statistics with the Wilcoxon signed-ranks test and the Mann- Whitney U-test were used for data analysis. Results Of the 113 nursing students, seniors perceived higher adolescent health competence mean scores than the juniors in the post-test phase. Majority of nursing students revealed the increasing awareness of the importance in promoting healthy lifestyle behaviours and psychosocial well-being after attending the summer programme. They agreed that nurses do have a role to play. Limitations This 2-week summer programme may only have short-term impacts on students' perception. Conclusions A stand-alone adolescent health summer programme can prepare nursing students to respond to the health issues of adolescents by enhancing their competence in health need assessment and service delivery. Implications for nursing and health policy Nurses serve in a leadership role for health policies and programmes. In nursing education, it is important for students to understand how to put in place policies to resolve adolescent health issues. [ABSTRACT FROM AUTHOR]

Aims To describe perceived work-related quality of life of Ugandan healthcare workers. A secondary aim was to seek participant input on ways to improve work environments. Background Poor patient outcomes, decreased employee motivation and decisions to leave the organization have been linked to poor work conditions. Interventions to correct healthcare worker shortage in developing countries require information about work quality of life. Methods Descriptive cross-sectional study conducted in health and educational settings in Uganda in July 2011. Participants completed the Biographical Information Scale demographic questionnaire and the validated 24-item Work-Related Quality of Life scale. Results Sample included 146 healthcare workers employed in various settings. Participants reported poorer quality of work life on the work conditions, control at work and home-work interface subscales. Participants perceived stress at work to be low and experienced higher job career satisfaction. There was a significant relationship between work-related quality of life, gender and hours worked. Participants' suggestions to improve work life ranged from simple no-cost suggestions to more complex system level interventions. Discussion Work-related quality of life was low in this convenience sample. Perceived stress at work was lower than expected, but may have been due to nurses' expectations of a normal work assignment. Predominantly women, the participants had significant caregiving responsibilities. Nursing implications Nurses must acquire a seat at the table where crucial decisions about nursing and its future are made. By advancing leadership skills, nurses can effectively advocate for organizational changes that address broad factors related to increasing job satisfaction, and retaining and attracting nurses. Conclusion Nurses can influence work quality of life individually and collectively by identifying workplace concerns, demanding safe work environments, fostering teamwork and enhancing professional growth. [ABSTRACT FROM AUTHOR]

Aim To investigate public health nursing content in undergraduate and postgraduate programmes in Turkey. Methods This study included all of the nursing schools in Turkey that provide university level education. The data were collected through a self-administered questionnaire designed to identify the existing status of undergraduate and postgraduate public health nursing education between February 2011 and June 2011. The questionnaire was completed only by the head of the department of public health nursing in each school. Data were analysed with descriptive statistics using SPSS for Windows 17.0 software. Results The study achieved a response rate of 72.5%. All participants reported offering a course in public health nursing in their undergraduate programmes. Fourteen (24.1%) participants reported offering Master of Science degrees in public health nursing. Seven (12.1%) participants reported offering doctorate degrees in public health nursing. In the responding schools, the public health nursing course was given in one semester (14 weeks) for an average of 5.54 ± 1.43 h/week for theory and an average of 13.48 ± 5.11 h/week for clinical practice. Of the participants, 43 (74%) reported problems related to public health nursing education. Conclusion There are problems in Turkey with regard to public health nursing education. The nursing school curriculum must be revised on a national level if public health nursing is to be revived and strengthened. [ABSTRACT FROM AUTHOR]

Background Previous research has focused on physician's perspectives of end-of-life ( EOL) decision making as well as patient and family EOL decision making. There is a lack of research pertaining to the EOL treatment preferences of nurses and especially nurses working in a variety of care settings. Aim The aim of this study was to compare nurses' EOL treatment preferences in Hong Kong, Ireland, Israel, Italy and the USA. Methods A comparative descriptive design was used with a convenience sample of nurses (n = 1089). A survey questionnaire using EOL hypothetical clinical case scenarios was used to collect data between June 2011 and July 2012. Results Nurses in every country consistently chose a more aggressive option for patients than for themselves or for a parent. The treatment preferences of nurses varied from country to country. Lack of knowledge of patients' wishes and duty of care were the main influencing factors on treatment preferences. Study Limitations The study was limited to the hypothetical nature of the scenarios; however, the study highlights numerous future research questions. Conclusions This study is the first to examine and compare nurses' preferred EOL treatment choices in five countries from three different continents. The findings of this study raise several important questions for healthcare researchers, for policy development, and highlight the need for further international collaboration. [ABSTRACT FROM AUTHOR]

Purpose Family planning ( FP) is a key global health issue for achieving millennium development goals by 2015. The aim of this study was to identify predictors of changes in FP practice before and after interventions among Ethiopian women of reproductive age in a rural area. Methods This study used a panel survey to identify predictors that placed women at greater risk for non-use of FP methods. The sample consisted of 407 women aged 19-49 years old living in a rural community of Ethiopia who completed both a baseline and follow-up survey. Trained local enumerators conducted face-to-face interviews during home visits. Patterns of FP practice were categorized into four groups: FP use at both baseline and follow-up; use at baseline but non-use at follow-up; non-use at baseline but use at follow-up; non-use at both baseline and follow-up. Logistic regression and classification and regression tree analyses were used. Results In a binary logistic regression, women over 35 years old with a negative attitude towards FP and resided in the Sibu area were less likely to start FP practice. Women over 35 years who were in poor health and resided in Sibu were less likely to continue FP practice. For the decision tree, age was the primary node for FP non-users at baseline while area of residence was the primary node for FP users at baseline. Conclusion Age, health status, attitude towards FP, and area of residence are the primary considerations when developing FP interventions for Ethiopian women in a resource-limited rural area. [ABSTRACT FROM AUTHOR]

Background The demonstration of competence and continuing competence for nurses is becoming increasingly important internationally, and many countries have developed continuing competence frameworks. Aim To explore nurses' perceptions and understanding of and satisfaction with the Nursing Council of New Zealand ( NCNZ) Continuing Competence Framework ( CCF) and the effectiveness of associated processes. Method A total of 1157 New Zealand ( NZ) nurses responded to a web-based survey designed to determine their satisfaction with the NCNZ CCF. The sample was representative of the NZ nursing population with a margin of error of 2.85 and 95% confidence level. Findings The majority of participants believe that the CCF provides a mechanism to ensure nurses are competent and fit to practice. While some participants indicated an element of poor understanding with regard to aspects of the CCF, overall it is perceived as a credible and reliable process to ensure public safety. Conclusions The international literature describes a variety of frameworks and competence indicators used by regulatory authorities to safeguard the public. In the 5 years since the NCNZ implemented the CCF less than 0.02% of notifications related to 'competence' have been recorded. The majority of NZ nurses believe that the CCF provides a mechanism to ensure nurses are competent and fit to practice. However, it is important to note that CCF processes may infer competence but they are not a guarantee that a nurse is safe to practice on any given day. [ABSTRACT FROM AUTHOR]

AL-DOSSARY R., VAIL J. & MACFARLANE F. (2012) Job satisfaction of nurses in a Saudi Arabian university teaching hospital: a cross-sectional study. International Nursing Review 59, 424-430 Background: Saudi Arabia is developing very fast in all disciplines, especially in nursing and health. Only about five studies between 1990 and 2010 have been undertaken in Saudi Arabia concerning factors influencing job satisfaction of nurses, although a body of knowledge exists globally. Aim: The purpose of this research was to measure nurses' job satisfaction in Saudi Arabia in a university teaching hospital and to determine the influencing factors. Methods: A quantitative, cross sectional method, self-administered questionnaire was used for this study. A systematic sample of N = 189 nurses was used to collect data. The SPSS version 16.0. was used to analyze the data. An independent t-test and one-way analysis of variance were used to test hypotheses concerning different groups, and correlation tests (the Pearson's and Spearman's rank tests) were used to examine relationships between variables. Results: Overall, nurses were neither satisfied nor dissatisfied with their jobs. However, nurses indicated satisfaction with supervision, co-workers and nature of work. The sources of dissatisfaction were with subscales such as pay, fringe benefits, contingent rewards and operating conditions. Conclusion: These findings indicate that there is a need to increase nurses' salaries and bonuses for extra duties. More training programmes and further education also should be encouraged for all nurses. Therefore, it is imperative that nursing managers and policy makers in Saudi Arabia consider these findings to improve nurses' job satisfaction. [ABSTRACT FROM AUTHOR]

WILLIAMS G., BOST N., CHABOYER W., FULBROOK P., ALBERTO L., THORSTEINSDÓTTIR R., SCHMOLLGRUBER S. & CHAN D. (2011) Critical care nursing organizations and activities: a third worldwide review. International Nursing Review 59, 73-80 Aim: The study aim was to profile the issues and activities of critical care nurses and professional critical care nursing organizations (CCNOs), and to identify expectations of the role of the World Federation of Critical Care Nurses. This information will determine how the critical care nursing specialty is changing over time and assist to formulate strategies that provide ongoing support to critical care nursing internationally. Background: This study is the third worldwide review of CCNOs. Two previous surveys were undertaken in 1999-2000 and in 2005. Data were collected from 23 and 51 countries, respectively. Methods: An online descriptive survey was e-mailed to 97 countries with CCNOs or known nursing leaders. Responses were analysed descriptively by geographical region. Results: Sixty-five respondents completed the questionnaire, achieving a 67% return rate. The most common issues identified were teamwork, access to educational programmes, formal practice guidelines/competencies, staffing levels and working conditions. Respondents perceived professional representation, national conferences, practice standards/guidelines, educational course standards, website provision, skills courses and educational workshops as the most important activities that should be provided by national CCNOs. Furthermore, less affluent countries showed greater emphasis on educational and training needs compared with wealthier counties and had poorer access to Internet and other supportive infrastructure. Conclusions: Teamwork, education, development of practice guidelines and workforce remain important issues to critical care nurses and have changed very little over the last 10 years, although the emphasis on teamwork is stronger than a decade ago. Differences in emphasis occur between affluent and less affluent countries and need to be acknowledged. Future research is recommended to better understand those priorities to enable the global community of critical care nurses to respond constructively. [ABSTRACT FROM AUTHOR]