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hack t.f.,crooks d., plohman j. & kepron e. (2010) Research citation analysis of nursing academics in Canada: identifying success indicators. Journal of Advanced Nursing 66(11), 2542-2549. Aim. This article is a report of a citation analysis of research publications by Canadian nursing academics. Background. Citation analysis can yield objective criteria for assessing the value of published research and is becoming increasingly popular as an academic evaluation tool in universities around the world. Citation analysis is useful for examining the research performance of academic researchers and identifying leaders among them. Methods. The journal publication records of 737 nursing academics at 33 Canadian universities and schools of nursing were subject to citation analysis using the Scopus database. Three primary types of analysis were performed for each individual: number of citations for each journal publication, summative citation count of all published papers and the Scopus h-index. Preliminary citation analysis was conducted from June to July 2009, with the final analysis performed on 2 October 2009 following e-mail verification of publication lists. Results. The top 20 nursing academics for each of five citation categories are presented: the number of career citations for all publications, number of career citations for first-authored publications, most highly cited first-authored publications, the Scopus h-index for all publications and the Scopus h-index for first-authored publications. Conclusion. Citation analysis metrics are useful for evaluating the research performance of academic researchers in nursing. Institutions are encouraged to protect the research time of successful and promising nursing academics, and to dedicate funds to enhance the research programmes of underperforming academic nursing groups. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effectiveness of PainReApp, an mHealth system, based on physical exercise recommendations for patients with chronic pain (low back pain, fibromyalgia and diabetic neuropathic pain) based on pain intensity, quality of life, anxiety and/or depression, and sleep quality. Design: Single‐blinded randomized controlled trial. Methods: One hundred patients from three different chronic conditions (low back pain, fibromyalgia and neuropathic diabetic pain) will be recruited and randomized into two groups to receive the intervention with a physical activity program guided by the PainReApp system (experimental group) or with the program information in paper format (control group). All patients will attend a first face‐to‐face session in which the smartphone application usage (experimental group) and exercise execution will be explained (both groups). Data will be collected at baseline, 4, 12 and 24 weeks. Nevertheless, the users of the application will have a daily registry of the exercise performed and the self‐perceived difficulty. The primary outcomes of the trial will be the intensity of pain and quality of life. Anxiety and/or depression and sleep quality will be also assessed to evaluate the influence of the physical activity at multiple levels. Discussion: Physical exercise is becoming one of the leading evidence‐based interventions to treat chronic pain. It needs to be adapted to the necessities of each pain condition. One of the major problems is the low adherence to the proposed program. New strategies that empower the patients, such as the m‐Health, are reliable and useful tools to ease this end. Impact: To the best of our knowledge, this is the first long‐term randomized controlled trial researching the impact of an m‐health system on chronic pain from different origin. The intervention is based on international physical exercise recommendations and can be performed without specific material, allowing the home‐based practice. Trial registration: Australian and New Zealand Clinical Trials Registry (ACTRN12621000783820). [ABSTRACT FROM AUTHOR]

Scales and instruments play an important role in health research and practice. It is important that studies that report on their psychometric properties do so in a way such that readers can understand what was done and what was found. This paper is a guide to writing articles about the development and assessment of these tools. It covers what should be in the abstract and how key words should be chosen. The article then discusses what should be in the main parts of the paper: the introduction, methods, results and discussion. In each of these parts, it suggests the statistical tests that should be used and how to report them. The emphasis throughout the paper is that reliability and validity are not fixed properties of a scale, but depend on an interaction among it, the population being evaluated and the circumstances under which the instrument is administered. [ABSTRACT FROM AUTHOR]

desborough j., forrest l. & parker r. (2012) Nurse-led primary healthcare walk-in centres: an integrative literature review. Journal of Advanced Nursing 68(2), 248-263. Abstract Aims. This paper is a report of an integrative review of the international literature examining established nurse-led primary healthcare walk-in centres and their outcomes to understand whether they are effective in improving access to primary health care. Background. Reviews of nurse-led primary care walk-in centres have included centres staffed by family physicians and general practitioners. There is a paucity of evidence about walk-in centres staffed solely by nurses. Data sources. Studies were identified through an electronic search using the databases Medline, Cinahl and EBSCO from 1990 until July 2010. Papers were included if they examined walk-in centres providing nurse-led primary care for the general community. Only peer reviewed studies published in English were included. Review methods. An integrative approach utilizing Bowling's checklist facilitated a systematic appraisal of studies in regard to clarity of aims, objectives, methods and appropriate analysis of data. Results. Thirteen publications were categorized into five themes: 'users of walk-in centres', 'quality of care provided at walk-in centres', 'impact on other healthcare providers', 'perceptions of walk-in centres' and 'satisfaction with walk-in centres'. Conclusion. The possibility that walk-in centres create demand highlights the need for clearer evidence of the drivers of demand for health care in walk-in centres. Innovations in healthcare provision need to be matched with adaptation to nursing education to ensure an adequately prepared nursing workforce. Improvement in access to primary healthcare needs to be measured in terms of equity and the capacity this access has to fill identified gaps in primary healthcare provision in the community. [ABSTRACT FROM AUTHOR]

azhar s., hassali m.a., mohamed ibrahim m.i., saleem f. & siow yen l. (2012) A survey evaluating nurses' perception and expectations towards the role of pharmacist in Pakistan's healthcare system. Journal of Advanced Nursing 68(1), 199-205. Abstract Aim. This paper is a report of a study of nurses' perception towards the role of pharmacist in Pakistan healthcare setup. Background. Collaborative care by the healthcare professionals has the potential to improve patient care, enhance patient safety and to reduce workload issues that cause burn out among healthcare professionals. Design. A quantitative (cross-sectional) study design was adopted. Method. A sample of 458 nurses was selected from government hospitals of three cities of Punjab, Pakistan. The study took place from 10 January 2009 to 15 March 2009. Results. Two hundred and sixty-six questionnaires were returned, giving the response rate of (58·07%). Three-fifths of the nurses reported that they had once a day interaction with the pharmacist. Seven-tenths of the nurses expected the pharmacist to take personal responsibility for resolving any drug-related problems. Moreover they appear to have high expectations of the pharmacist, almost nine-tenths regarded pharmacists as knowledgeable drug therapy experts, and almost two-thirds of the nurses emphasized on counselling of patient by the pharmacist. Conclusion. Nurses in Pakistan showed negative perception towards the role of pharmacist in healthcare setting. Although nurses considered pharmacist as a drug information expert but their expectation did not match their experience. A possible factor for this behaviour could be due to nurses' belief that incorporating the role of pharmacist in patient care, may decrease their worth and can result in intrusion into their duties. [ABSTRACT FROM AUTHOR]

shacklock k. & brunetto y. (2012) The intention to continue nursing: work variables affecting three nurse generations in Australia. Journal of Advanced Nursing 68(1), 36-46. Abstract Aims. The aims of the study were to examine how seven variables impacted upon the intention of hospital nurses to continue working as nurses and to investigate whether there are generational differences in these impacts. Background. There is a critical shortage of trained nurses working as nurses in Australia, as in many other Organisation for Economic Co-operation and Development member countries. The retention of nurses has been examined from the traditional management perspectives; however, this paper presents a different approach (Meaning of Working theory). Methods. A self-report survey of 900 nurses employed across four states of Australia was completed in 2008. The sample was hospital nurses in Australia from three generational cohorts - Baby Boomers (born in Australia between 1946 and 1964), Generation X (1965-1979) and Generation Y (1980-2000). Results. Six variables were found to influence the combined nurses' intentions to continue working as nurses: work-family conflict, perceptions of autonomy, attachment to work, importance of working to the individual, supervisor-subordinate relationship and interpersonal relationships at work. There were differences in the variables affecting the three generations, but attachment to work was the only common variable across all generations, affecting GenYs the strongest. Conclusion. The shortage of nurses is conceptualized differently in this paper to assist in finding solutions. However, the results varied for the three generations, suggesting the need to tailor different retention strategies to each age group. Implications for management and policy planning are discussed. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

choi y., lawler e., boenecke c.a., ponatoski e.r. & zimring c.m. (2011) Developing a multi-systemic fall prevention model, incorporating the physical environment, the care process, and technology: a systematic review. Journal of Advanced Nursing 67(12), 2501-2524. Abstract Aims. This paper reports a review that assessed the effectiveness and characteristics of fall prevention interventions implemented in hospitals. A multi-systemic fall prevention model that establishes a practical framework was developed from the evidence. Background. Falls occur through complex interactions between patient-related and environmental risk factors, suggesting a need for multifaceted fall prevention approaches that address both factors. Data sources. We searched Medline, CINAHL, PsycInfo and the Web of Science databases for references published between January 1990 and June 2009 and scrutinized secondary references from acquired papers. Review methods. Due to the heterogeneity of interventions and populations, we conducted a quantitative systematic review without a meta-analysis and used a narrative summary to report findings. Results. From the review, three distinct characteristics of fall prevention interventions emerged: (1) the physical environment, (2) the care process and culture and (3) technology. While clinically significant evidence shows the efficacy of environment-related interventions in reducing falls and fall-related injuries, the literature identified few hospitals that had introduced environment-related interventions in their multifaceted fall intervention strategies. Conclusion. Using the multi-systemic fall prevention model, hospitals should promote a practical strategy that benefits from the collective effects of the physical environment, the care process and culture and technology to prevent falls and fall-related injuries. By doing so, they can more effectively address the various risk factors for falling and therefore, prevent falls. Studies that test the proposed model need to be conducted to establish the efficacy of the model in practice. [ABSTRACT FROM AUTHOR]

kelo m., martikainen m. & eriksson e. (2011) Self-care of school-age children with diabetes: an integrative review. Journal of Advanced Nursing 67(9), 2096-2108. Abstract Aim. This paper is a report of an integrative review of findings from empirical studies on self-care in school-age children with type 1 diabetes. The purpose is to generate insight into opportunities to develop empowering patient education. Background. Managing diabetes is demanding and requires parental involvement in care. Good self-care forms the basis for diabetes management and self-care patterns are established at school age, but how and to what extent school-age children increase their self-care capabilities is unclear. Data sources. A search for studies from 1998 to 2010 focusing on self-care in school-age children with diabetes was conducted through electronic databases. Review methods. Using integrative methods, quantitative and qualitative papers surveyed were analysed separately, but the themes that arose were combined at the end of the analysis. Findings. Self-care is formed in a learning process involving the objectives of normality, being able to cope and independence. The content of self-care is a combination of knowledge and skills. Children have the technical skill, but they need their parents to participate in the care and share responsibility for it. The factors related to self-care comprised the characteristics of the child; the nature of the illness and care; and support from the parents, school environment, peers and healthcare team. Conclusion. A balance between diabetes care requirements and a child's maturity should be found. Nurses must adopt an empowering manner of education and recognize and assess a child's readiness to learn diabetes care and bear responsibility for it. Nurses must also help parents and other adults to gradually shift the responsibility to the children. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: To describe the changes in moderate‐to‐late preterm infants' (MLPIs) growth during 12 months of corrected age (CA) and to examine the predictive role of NICU‐related stress, postpartum depression trajectory and family coping ability on the physical developmental trajectory of MLPIs. Design: A prospective longitudinal study. Methods: There were 237 mother–infant dyads with at least two follow‐up data records included. General characteristics and NICU‐related stress were recorded from medical records at baseline. Infants' physical growth was measured at 40 weeks, 1, 3, 6, 9 and 12 months CA during outpatient follow‐up. Maternal postpartum depressive symptoms and family coping ability were assessed by questionnaires at 1, 3, 6, 9 and 12 months CA and 1 month CA respectively. We investigated the modifiable factors inside and outside of NICU on the trajectories of physical growth in the first year in MLPIs, mainly by using latent growth curve models with time‐varying covariates. Results: The curved trajectories of weight, length and head circumference in the first year in MLPIs demonstrated gradually slowed growth rates and these infants were above the WHO growth standards for the same age and sex. The latent growth curve models indicated that more NICU‐related stress was negatively associated with the weight and length at 40 weeks CA, and family coping ability (parent–child relationship) at 1 month CA was associated with the growth rate of weight. Besides, more NICU‐related stress predicted faster length growth rate. The infants of mothers who were in the group of high‐level postpartum depression trajectory had a slower growth rate of head circumference. Conclusions: Our study identified the modifiable factors along the care continuum influencing the trajectory of MLPIs' physical growth. Nurses should receive more training about infant stress measurement and family‐centred care to work in partnership with parents so that MLPIs can reach their full developmental potential. Also, multidisciplinary interventions including stress reduction strategies, close psychological monitoring and education improving parent–infant relationships should be further developed to achieve optimizing growth in the first year of MLPIs. Implications for the Profession and/or Patient Care: It is recommended that nurses pay attention to the long‐term physical growth status of MLPIs, and closely support their families. Quantifying NICU‐related stress and developing reduction strategies should be the priority for clinical staff during hospitalization. After discharge, persistent screening of depressive symptoms, psychological intervention and education about the parent–child relationship need to be included in the follow‐up visits. Patient or Public Contribution: No patient or public contribution. The study only included patients who were research participants. [ABSTRACT FROM AUTHOR]

Aims: The objective of this study is to explore the various latent categories within the sleep quality of night shift nurses and to investigate whether shift‐related factors predispose nurses to higher levels of occupational stress and anxiety. Design: This is a cross‐sectional study. Methods: From November to December 2020, registered nurses from 18 tertiary hospitals and 16 secondary hospitals in Chongqing were selected through convenience sampling for this study. Latent class analysis was used to investigate the sleep quality of nurses working night shifts. Furthermore, univariate analysis and logistic multivariate analysis were utilized to identify the contributing factors to occupational stress and anxiety. Results: The four latent categories of Pittsburgh Sleep Quality Index for night shift nurses were identified as 'Low Sleep Disorder Group' (56.34%), 'Moderate Sleep Disorder Group' (37.27%), 'High Sleep Disorder Non‐Reliant on Sleeping medication Group' (4.89%) and 'High Sleep Disorder Reliant on Sleeping medication Group' (1.50%). The results showed that having a night‐shift frequency of 3–4 times per month, night‐shift durations of 9–12 h, sleep time delay after night shift (≥2 h), total sleep time after night shift less than 4 h were shift‐related factors that increased the levels of occupational stress and anxiety. Conclusion: The sleep quality of night shift nurses demonstrates heterogeneity and can be classified into four latent categories. Higher frequency of night shifts, extended work hours and insufficient rest time are all associated with increased levels of occupational stress and anxiety. Impact: By identifying the four latent categories of sleep quality among night shift nurses, this study sheds light on the relationship between sleep patterns and levels of occupational stress and anxiety. These findings have important implications for healthcare institutions in the management of nurse well‐being and work schedules. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To examine (1) the association between healthcare workers' workplace ostracism and job satisfaction, stress and perceived health, and (2) whether this relationship is mediated by loneliness and self‐esteem. Design: A cross‐sectional study. Methods: Healthcare (N = 569) managers and employees (nurses, practical nurses, doctors and social workers) in Finland responded to a semi‐structured survey in January 2021 and evaluated their experiences of workplace ostracism, job satisfaction, stress, perceived health, loneliness and self‐esteem during the last year. To examine the association of these variables, linear regression and mediator model tests were performed. Results: Workplace ostracism had a clear direct association with job satisfaction, stress and perceived health. Loneliness fully mediated the relationship between workplace ostracism, stress and perceived health, and partly mediated the association between workplace ostracism and job satisfaction. Self‐esteem partly mediated the association between workplace ostracism, stress, job satisfaction and perceived health. Conclusion: The experience of workplace ostracism in organizations is a significant factor in job satisfaction, stress and perceived health. Healthcare organizations could strengthen job satisfaction and increase workers' well‐being by strengthening social relationships in the organization and, via that, reducing turnover intention. Implications for the profession and patient care: This study gives understanding and information to the healthcare profession on how workplace ostracism affects work well‐being and workplace relationships. Workplace ostracism decreases interaction, which can also endanger patient care if information is not openly exchanged. Impact: This study indicated that workplace ostracism weakened job satisfaction more than loneliness. More commonality and consideration for others at work are needed because these factors may help increase work well‐being and decrease exits from working life. Further research is needed on why workplace ostracism occurs in healthcare workplaces. Reporting Method: STROBE. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Authentic leadership and empowered nurses are necessary if a healthy work environment is to be created and patient safety maintained; however, few studies have examined the impact of authentic leadership, on nurse empowerment and the patient safety climate. Purpose: The aim of the study was to investigate the impact of an educational intervention delivered through a multi-faceted training programme on nurses' perceptions of authentic leadership, nurse empowerment (both structural and psychological) and the patient safety climate. Design: A quasi-experimental study using a one-group pretest–posttest design consistent with TREND guidelines. Methods: The study was conducted in a university hospital between December 2018 and January 2020. Participants were followed for 6 months. The programme involved 36 head nurses (leaders) and 153 nurses (followers). The effectiveness of the programme was evaluated using repeated measures of analysis of variance, dependent sample t-tests and hierarchical regression analysis. Results: Following the intervention, safety climate and authentic leadership scores increased among both leaders and followers. Structural and psychological empowerment scores also increased among followers. We found that authentic leadership and structural empowerment were predictors of safety climate. Conclusion: The implementation of the education programme resulted in positive changes in participants' perceptions of authentic leadership and empowerment, which can enhance patient safety. Implications: Healthcare organizations can implement similar multi-faceted training programmes focused on authentic leadership, and nurse empowerment to increase patient safety. Achieving effective results in such programmes can be facilitated by motivating participants with the support of the top management. Patient or Public Contribution: The study included nurses in the intervention and the data collection processes. Impact: • Patient safety is a global concern, and improving patient safety culture/climate is a key strategy in preventing harm. • Authentic leadership and nurse empowerment are essential in creating healthy work environments and delivering safe, high-quality care. • Training programmes addressing these issues can help bring about improvements in healthcare organizations. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to test a moderated-mediation model, explaining how and under which circumstances a process- or an outcome-accountability focus affects performance. Design: Randomized controlled design, using screen-based simulations. Methods: Data were collected during 2021. Two screen-based simulations of medication administration (for low- and high-complexity tasks) were used. Each participant was randomly assigned to one of the six experimental conditions. Nurses completed validated questionnaires on strain levels and their perceptions of the simulated task complexity and accountability focus. Performance was assessed via validated checklists assessing nurses' performance of the simulation. Results: Task complexity significantly moderated the relationship between accountabilityfocus conditions and strain. For the process-accountability-focus condition, strain levels were lower during high-complexity tasks compared with low-complexity tasks, while for the outcome-accountability-focus condition, strain levels were lower during lowcomplexity tasks compared with high-complexity tasks. The highest strain levels were observed under the no accountability-focus condition. Additionally, this interaction had an impact on performance, with nurses' strain playing a mediating role. Conclusions: Any accountability focus reduces strain levels and enhances performance compared with having no accountability focus. The choice of accountability focus should be based on task-complexity considerations. Implications for the Profession and Patient Care: Managers can effectively reduce nurses' strain and improve performance by prioritizing outcome accountability focus for simpler tasks and process accountability focus for complex tasks. Impact: The study addressed previous ambiguous findings regarding the type of accountability focus that better motivates nurses' performance. By considering accountability focus, nurse managers can balance nurses' strain levels with improved performance. Reporting Method: We have adhered to the relevant EQUATOR guidelines: CONSORT. Patient or Public Contribution: There is no patient or public contribution, as the study only concerns the providers of the service, that is the nurses themselves. [ABSTRACT FROM AUTHOR]

yorke j., horton m. & jones p. w. (2012) A critique of Rasch analysis using the Dyspnoea-12 as an illustrative example. Journal of Advanced Nursing 68(1), 191-198. Abstract Aim. This paper is a report of a study of the application and critique of Rasch analysis to the development of the Dyspnoea-12 questionnaire; an instrument that measures breathlessness severity. Background. The development of questionnaires has traditionally involved application of classical test theory. Rasch analysis has gained international momentum as a robust application of 'modern' psychometric testing for the development of new instruments and the refinement of existing ones. Method. A total of 358 patients [mean age 62 ( sd = 8); chronic obstructive pulmonary disease = 123, interstitial lung disease = 129, heart failure = 106], responded to an initial list of 81 items (between May 2006 and February 2008). Hierarchical modelling reduced the list to 34 items. Rasch analysis was used to inform decisions about further item removal and fit to the unidimensional model. Rasch analysis included tests of item response appropriateness, item residual, differential item functioning (including gender and diagnosis) and unidimensionality. Results. Twenty-two items failed to reach the requirements of the Rasch model and were removed. Reasons included high residuals and item bias associated with gender and diagnosis. The 12-items conformed to the Rasch unidimensional parameters (number of statistically significant t-tests 6·7%; confidence interval: 4·4-9·0%). Conclusion. We have presented the steps involved in reducing and refining a large item-set by identifying those items which possessed the most reliable measurement properties. The Dyspnoea-12 is reliable and simple to use and should find utility in both practice and research settings. We recommend that nurses consider Rasch analysis in the development of health-related questionnaires. [ABSTRACT FROM AUTHOR]

myny d., van goubergen d., gobert m., vanderwee k., van hecke a. & defloor t. (2011) Non-direct patient care factors influencing nursing workload: a review of the literature. Journal of Advanced Nursing 67(9), 2109-2129. Abstract Aims. The aim of this paper was to detect which non-direct patient care factors are related to nursing workload in acute hospital nursing care and to develop a conceptual model to describe the relationship between the non-direct patient care factors and nursing workload. Background. Since the 1930s, efforts to measure nursing workload have been undertaken. Still, it remains unclear which of the non-direct patient care elements are essential to the nursing workload. Data sources. PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, Engineering Village 2, Elin and the British Nursing Index were searched from 1970 up to July 2009. Review methods. Studies were included in this integrative review if they described factors that are related to nursing workload or if they presented models that explored the association between potential factors, excluding the factors related to direct patient care. Results. Thirty publications were included. The influencing variables were classified in five categories based on their level of impact: the hospital and ward, nursing team, individual nurse, patient and family and meta-characteristics. The variables were also classified, based on their cause-effect relationship. Some factors have a direct impact on the patient-nurse relationship, while others have an effect on the work fluency or on the subjective perception of the nursing workload. A conceptual model was built, based on the interaction between both classifications and derived from the systems theory. Conclusions. Nursing workload has a multi-causal aetiology. The influencing factors from this review can be integrated in a workload measurement tool. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study of the process of social rehabilitation, and the analysis of the main elements and influencing factors which are important in the process. Background. The process of social rehabilitation lacks conceptual and empirical understanding in Neurology because most rehabilitation programmes have focused on cognitive and physical recovery. Methods. An action research project was undertaken in two neurological wards of a highly specialized hospital in Spain, and was completed in 2006. A social rehabilitation programme based on the assessment of social needs and individualized social education was planned with health professionals, and implemented and evaluated with patients and carers. Several instruments were used to explore how patients and carers perceived the process of social rehabilitation before and after the programme: semi-structured interviews, socio-demographic forms, field notes, participant observations, and scales of activities of daily living, social impairment and adjustment. Comparative content and statistical analyses were undertaken. Findings. Social rehabilitation was identified as a dynamic process in which the environment, activities, social interaction, self-recognition and awareness of social problems, coping and satisfaction played an essential role. Some defining criteria for social rehabilitation related to patients' and carers' attitudes, behaviour and the external implications that the socialization process had for them. Conclusion. This study shows the advantages of multidisciplinary work, and user and family involvement in social rehabilitation and provides in-depth knowledge about how patients and carers experience and could face barriers to develop a role in their family environment, social groups and society. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to describe primary healthcare personnel's knowledge of multidrug-resistant and preventive hygiene measures. Background. The group of patients at risk for multi-drug resistant bacteria is largely cared for in primary care. Knowledge of multidrug-resistant and hygiene preventive measures among primary healthcare personnel is therefore essential. Method. A descriptive and comparative questionnaire survey among primary healthcare personnel was performed in 2008. In total, five urban and rural primary healthcare centres situated in one county in central Sweden were included. Convenient sampling was used and 10 physicians, 38 district nurses and 10 nursing assistants participated. Knowledge/medical facts concerning multidrug-resistant and hygiene preventive measures were investigated and data were analysed using a quantitative approach. Results. Knowledge/medical facts concerning several aspects of multidrug-resistant bacteria, particularly Extended-Spectrum-Beta-Lactamase producing bacteria, were deficient as was knowledge of different aspects of hygiene preventive measures. Physicians showed significantly better results than district nurses and nursing assistants did. Awareness of proper hand-washing as an effective preventive method and use of aprons in nursing care was high among all participants. Staff who knew they had cared for these patients had significantly better results than the others did. Conclusion. Our findings suggest that evidence-based education of multidrug-resistant and hygiene preventive measures, in primary health with subsequent follow-ups should become a prioritized clinician and management concern. Research is needed that focus implementation of evidence-based educations, staff attitudes and responsibilities related to the work with patients at risk of multidrug-resistant bacteria. [ABSTRACT FROM AUTHOR]

Aim. This paper is the report of a study to determine whether changing the needle before administering an intramuscular injection could reduce pain, and to investigate gender differences in pain perception. Background. A skilled injection technique can make the patient's experience less painful and avoid unnecessary complications, and the use of separate needles to draw up and administer medication ensures that the tip of the needle is sharp and free from medication residue. Method. A randomized controlled trial was carried out between January 2009 and May 2009 with 100 patients receiving diclofenac sodium intramuscularly in an emergency and traffic hospital in İmir, Turkey. The primary outcome was pain intensity measured on a numerical rating scale. Each patient received two injections by the same investigator using two different techniques. The two techniques were randomly allocated and the patients were blinded to the injection technique being administered. After each injection, another investigator who had no prior knowledge of which injection technique was used immediately assessed pain intensity using a numerical rating scale. Descriptive statistics, paired t-test and t-test were used to evaluate the data. Results. Findings demonstrated that changing the needle prior to intramuscular medication administration significantly reduced pain intensity. A statistical difference in pain intensity was observed between the two injection techniques. Conclusion. The results supported the hypothesis that changing the needle prior to administering the medicine significantly reduced pain intensity. [ABSTRACT FROM AUTHOR]

chang a.m., gardner g.e., duffield c. & ramis m.-a. (2010) A Delphi study to validate an Advanced Practice Nursing tool. Journal of Advanced Nursing 66(10), 2320–2330. Aim. This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background. Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method. An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results. After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion. The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce. [ABSTRACT FROM AUTHOR]

fero l.j., o’donnell j.m., zullo t.g., dabbs a.d., kitutu j., samosky j.t. & hoffman l.a. (2010) Critical thinking skills in nursing students: comparison of simulation-based performance with metrics. Journal of Advanced Nursing 66(10), 2182–2193. Aim This paper is a report of an examination of the relationship between metrics of critical thinking skills and performance in simulated clinical scenarios. Background Paper and pencil assessments are commonly used to assess critical thinking but may not reflect simulated performance. Methods In 2007, a convenience sample of 36 nursing students participated in measurement of critical thinking skills and simulation-based performance using videotaped vignettes, high-fidelity human simulation, the California Critical Thinking Disposition Inventory and California Critical Thinking Skills Test. Simulation-based performance was rated as ‘meeting’ or ‘not meeting’ overall expectations. Test scores were categorized as strong, average, or weak. Results Most (75·0%) students did not meet overall performance expectations using videotaped vignettes or high-fidelity human simulation; most difficulty related to problem recognition and reporting findings to the physician. There was no difference between overall performance based on method of assessment ( P = 0·277). More students met subcategory expectations for initiating nursing interventions ( P ≤ 0·001) using high-fidelity human simulation. The relationship between videotaped vignette performance and critical thinking disposition or skills scores was not statistically significant, except for problem recognition and overall critical thinking skills scores (Cramer’s V = 0·444, P = 0·029). There was a statistically significant relationship between overall high-fidelity human simulation performance and overall critical thinking disposition scores (Cramer’s V = 0·413, P = 0·047). Conclusion Students’ performance reflected difficulty meeting expectations in simulated clinical scenarios. High-fidelity human simulation performance appeared to approximate scores on metrics of critical thinking best. Further research is needed to determine if simulation-based performance correlates with critical thinking skills in the clinical setting. [ABSTRACT FROM AUTHOR]

Aims: Finding out whether there are differences in the levels of stress and burnout between workers providing care to dependent adults and those caring for independent older adults would provide comparative information about two different models of care. During the COVID‐19 pandemic, workers caring for older adults were subjected to maladaptive situations that produced stress and burnout. Design: A cross‐sectional survey design using the STROBE checklist. Methods: A total of 900 nursing home and égidas workers were assessed for stress and burnout. Data were collected online from October 2020 to February 2021, when Puerto Rico was experiencing the peak of the third wave of COVID‐19. MANOVAs were performed to study the interactions between the workplace and having had COVID, the workplace and the size of institution and the workplace and position held. Data Sources: October 2020 to February 2021. Results: All interactions were significant. Nursing homes showed higher levels of stress and burnout when workers had undergone COVID, when the size of the institution was larger and for technical staff other services; in égidas, having undergone COVID did not influence stress or burnout, which increased when the institution was smaller and for executive staff. Conclusions: This study showed that the effects of the COVID‐19 pandemic affected nursing home workers more significantly than those working in other types of residential models with independent older adults. Implications for the Profession and/or Patient Care: Applying preventive interventions aimed at reducing stress and burnout would facilitate the adaptation of workers caring for older adults and help to improve the quality of care. Impact: This study analysed the impact of COVID‐19 on the stress and burnout of workers providing services to older adults. Nursing home workers who have had COVID‐19 have higher stress and burnout. The size of the institution has a different effect depending on whether older adults are dependent or independent. Workers in institutions dedicated to the care of the older adults. Reporting Method: This study has adhered to the relevant EQUATOR guidelines: STROBE. Patient or Public Contribution: During the different waves of the COVID‐19 pandemic, it was difficult to establish direct contact with workers providing care to older adults; this reason made it necessary to apply online systems to obtain information. The workers appreciated the fact that the implications for stress and burnout of the situation experienced during this difficult process were investigated. [ABSTRACT FROM AUTHOR]

Aims: To identify the roles and activities of nurses, including advanced practice nursing (APN), and to determine nursing practice patterns across health facilities in Saudi Arabia. Methods: A descriptive cross‐sectional design was used to collect data from 207 nurses working in the Saudi health sector between November 2021 and March 2022 through an online questionnaire. The Advanced Practice Role Delineation tool was used to measure and delineate nursing practice patterns and activities. Data were analysed using descriptive statistics and analysis of variance. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. Results: Findings showed that participants, regardless of their current role, reported high scores across all domains of practice. The highest average score was obtained for the Clinical Care domain. Except for the leadership domain, findings showed that those reported working as advanced practice nurses had higher average scores across all domains than those working as staff nurses or being in managerial/administrative positions. There were significant differences in the average Clinical Care scores between advanced practice nurses and staff nurses. Conclusion: Advanced practice nursing roles and activities are being practised in Saudi Arabia; however, there is no clear delineation of these roles and activities according to a unified and national‐level APN scope of practice. Impacts: Advanced practice nursing roles are evolving in Saudi Arabia; however, no study has examined the existing patterns of APN activities in Saudi Arabia. This study highlights the practice patterns of advanced practice nurses and adds to the international evidence base on the need for delineating APN activities under a unified scope of practice. The findings of this study are beneficial to practitioners, researchers, and stakeholders as well as the legislative and regulatory bodies. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim This paper presents a feasibility trial protocol the purpose of which is to prepare for a future randomised controlled trial to determine the effectiveness of vibrating vaginal pelvic floor training balls for postpartum pelvic floor muscle rehabilitation. Background Vibrating vaginal pelvic floor training balls are available in Austria to enhance women's pelvic floor muscles and thus prevent or treat urinary incontinence and other pelvic floor problems following childbirth. Nonetheless, there is currently little empirical knowledge to substantiate their use or assess their relative effectiveness in comparison to current standard care, which involves pelvic floor muscle exercises. Design Single blind, randomised controlled feasibility trial with two parallel groups. Methods It is planned to recruit 56 postpartum women in Vienna, who will be randomised into one of two intervention groups to use either vibrating vaginal balls or a comparator pelvic floor muscle exercises for 12 weeks. As this is a feasibility study, study design features (recruitment, selection, randomisation, intervention concordance, data collection methods and tools) will be assessed and participants' views and experiences will be surveyed. Tested outcome measures, collected before and after the intervention, will be pelvic floor muscle performance as reported by participants and measured by perineometry. Descriptive and inferential statistics and content analysis will serve the preparation of the future trial. Discussion The results of this feasibility trial will inform the design and conduct of a full randomised controlled trial and provide insight into the experiences of women regarding the interventions and study participation. [ABSTRACT FROM AUTHOR]

Aim This paper aims to describe the research protocol that will be used to determine the effectiveness of a health-social partnership intervention programme among community-dwelling older adults. Background Ageing in place is a preferred option for overcoming challenges of the increasing prevalence of chronic diseases and the risk for hospitalization associated with the ageing population. Nevertheless, our knowledge of how to implement this concept is limited. The integrated efforts of health and social services may help to enable older adults to live with a sense of control over their daily life and to be independent to the fullest extent possible in the community. Design This is a randomized, controlled trial. Methods Participants are community-dwelling older adults referred from a community centre. Sample size calculation was based on power analysis. The intervention group will receive the programme with the standard protocols guided by a comprehensive assessment-intervention-evaluation framework. Home visits and telephones follow-up will be employed as means of conducting the interventions and monitoring their progress. The customary care group will receive placebo social calls. The duration of the interventions will be 3 months. The study was funded by the School of Nursing in Hong Kong. Research Ethics Committee approval was obtained in September 2014. Discussion The results of this research are expected to enable older adults to stay in the community with optimal health and well-being. Health and social sciences are integrated into the practice in this research protocol. The scarce literature on this topic means that this study can also provide an opportunity to bridge the caring gap among older adults. [ABSTRACT FROM AUTHOR]

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Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

Aims: To describe nurses' perceptions of family nursing practice and to explore the influence of their perceptions of the benefits, barriers and activities of family engagement in care on family nursing practice. Design: A cross‐sectional correlational study. Methods: In total, 460 nurses from two tertiary hospitals in the central region of Uganda participated. Quantitative and qualitative data were collected between August 2020 and January 2021 using the Family Nursing Practice Scale. Analyses included descriptive statistics, t‐test, Pearson correlation, analysis of variance and ordinal logistics regression. Quantitative content analysis was carried out on the textual data. Results: Nurses who perceived that family engagement in care improves patient and family outcomes were more likely to rate family nursing practice highly. Perceived barriers to family engagement in care particularly time constraints, work overload and family‐related conflicts have a negative and significant influence on family nursing practice. Nurse characteristics such as education, usual shift pattern and personal experience of having a family member in hospital are significantly associated with family nursing practice; nurses who work morning shifts were likely to report higher family nursing practice. Conclusion: The study reveals that several parameters (perceived barriers, perceived benefits and nurse characteristics) influence nursing practice with families. Thus, bearing in mind the diversity of healthcare contexts, the findings show that multiple interacting factors are important for advancing family nursing interventions and practice. Impact: Probabilistic factor‐specific predictions of nursing practice with families are provided in this study – this addresses a gap in the evidence regarding the elements that should be optimized when designing well‐informed policies and interventions to advance family nursing practice. A comparison of results in the literature with the present study's findings suggests a need to broaden the scope and context perspective in future research and broaden the understanding of how nurses´ perceptions influence family engagement in care. Reporting method: The study adheres to the STROBE reporting guidelines. Patient or public contribution: Family members/caregivers were involved in the design of the study particularly in assessment of validation of the tools used in the study. [ABSTRACT FROM AUTHOR]

Aim This paper reports a study testing of the validity and reliability of the personnel version of the Family Empowerment Scale in family services in Finland. Background The role of family services in parental reinforcement is important, given their extensive reach to most families and their aim of promoting family welfare. No instruments applicable to this situation were available in Finland. The Family Empowerment Scale is a widely used instrument that measures parent's empowerment. The personnel version of the Family Empowerment Scale enables an evaluation of the reinforcement of empowerment. Design This study used a cross-sectional survey design. Methods The Family Empowerment Scale was modified to measure how family services personnel evaluate reinforcement of parental empowerment. In May 2009, a questionnaire was sent to unit heads ( n = 457) in public social, health and educational services for families with children aged 0-9 years. The construct, convergent and discriminant validities, reliability and responsiveness of the personnel version of the Family Empowerment Scale were assessed. Results According to confirmatory factor analysis, the personnel version of the Family Empowerment Scale comprised three subscales (family, service system and community) as in the original Family Empowerment Scale. Confirmed convergent and discriminant validities supported the same construct. The reliability of the personnel version of the Family Empowerment Scale was acceptable. The reinforcement level of parental empowerment was high. Parental empowerment was reinforced most in health and least in educational services. Conclusion The psychometric properties of the personnel version of the Family Empowerment Scale were acceptable. It can serve as a generic instrument for assessing reinforcement of empowerment in family services in Finland. [ABSTRACT FROM AUTHOR]

Aim This paper reports a study on how men cope with the side-effects of radiotherapy and neo-adjuvant androgen deprivation for prostate cancer up to 1 year after treatment. Background With early detection and improved treatments, prostate cancer survivors are living longer with the disease and the side-effects of treatment. How they cope affects their long-term physical and mental health. Design A prospective, longitudinal, exploratory design using both qualitative and quantitative methods was used in this study. Method Between September 2006-September 2007 149 men who were about to undergo radical radiotherapy ± androgen deprivation for localized prostate cancer in Northern Ireland were recruited to the study. They completed the Brief Cope scale at four time-points. Results Acceptance, positive reframing, emotional support, planning and, just getting on with it, were the most common ways of coping. Fewer men used coping strategies less at 6 months and 1 year after radiotherapy in comparison to pre-treatment and 4-6 weeks after radiotherapy. Interviews with these men demonstrated that men adapted to a new norm, with the support of their wives/partners and did not readily seek professional help. A minority of men used alcohol, behavioural disengagement and self blame as ways of coping. Conclusion Men used a variety of ways of coping to help them deal with radiotherapy and neo-adjuvant androgen deprivation for up to 12 months after radiotherapy. Interventions need to be developed to take account of the specific needs of partners of men with prostate cancer and single men who have prostate cancer. [ABSTRACT FROM AUTHOR]

Aims This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct, in older people with heart failure. Background Heart failure is a major health problem worldwide, with high mortality and morbidity, making it a leading cause of hospitalization. Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention. Hence, managing salt and fluid intake is important and can be enhanced by improving patients' self-efficacy in changing their behaviour. Design Randomized controlled trial. Methods Heart failure patients attending cardiac clinics in northern Taiwan from October 2006-May 2007 were randomly assigned to two groups: control ( n = 46) and intervention ( n = 47). The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms. Data were collected at baseline as well as 4 and 12 weeks later. Data analysis to test the hypotheses used repeated-measures anova models. Results Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control, self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group. However, the two groups did not differ significantly in health service use. Conclusion The self-management programme improved self-efficacy for salt and fluid control, self-management behaviours, and decreased heart failure-related symptoms in older Taiwanese outpatients with heart failure. Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease. [ABSTRACT FROM AUTHOR]

Aims This paper assessed the reliability and construct validity of the new version of a patient classification instrument. Background In the development of patient classification instruments, monitoring validity and reliability is essential to assure that patient care requirements and nursing staff workload are appropriately measured. Design method The sample included 194 patients (construct validity test) and 60 patients (inter-rater reliability test) at medical, surgical, and specialized wards of a teaching hospital in the south east of Brazil. The study was conducted in 2009-2010. For analysis purposes, Spearman's correlation and Cronbach's alpha (internal consistency) were used, and weighted kappa (inter-rater reliability), factor analysis with principal axis factoring extraction method (construct validity) and ordinal regression (instrument's predictive ability). Results A high level of inter-rater agreement was found. The importance of all care areas and their contribution to distinguish patient care needs and category in the new instrument were demonstrated. Results also showed the instrument's high predictive ability (99·6%). Conclusion The findings give the evidence that the new scale is a reliable and valid tool to assess patient care needs and care category and that it can be used to guide nursing management practice in determining the nursing staff workload. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report on a study analysing the effect of the umbilical cord cutting experience on fathers' emotional involvement with their infants. Background. Participation in childbirth offers an opportunity for father and mother to share the childbirth experience, so it is vital that midwives improve the fathers' participation in this event. Design. A quasi-experimental study with a quantitative methodology was implemented. Methods. One hundred and five fathers were recruited as part of a convenience sample in a Maternity Public Hospital in a Metropolitan City in Portugal, between January and May of 2008. The Bonding Scale, the Portuguese version of the 'Mother-to-Infant Bonding Scale' was used to evaluate the fathers' emotional involvement with the neonate at different moments: before childbirth, first day after childbirth and first month after childbirth. After childbirth, the fathers were divided into three separate groups depending on their umbilical cord cutting experience. Results. The results demonstrate that the emotional involvement between father and child tends to increase during the first days after childbirth and to decrease when evaluated 1 month after birth, for fathers who did not cut the umbilical cord. However, fathers who cut the umbilical cord demonstrate an improvement in emotional involvement 1 month later. Conclusion. Results suggest that the umbilical cord cutting experience benefits the father's emotional involvement with the neonate, supporting the benefits of his participation and empowerment in childbirth. [ABSTRACT FROM AUTHOR]

arts e.e.a., landewe-cleuren s.a.n.t., schaper n.c. & vrijhoef h.j.m. (2012) The cost-effectiveness of substituting physicians with diabetes nurse specialists: a randomized controlled trial with 2-year follow-up. Journal of Advanced Nursing 68(6), 1224-1234. Abstract Aims. To evaluate the cost-effectiveness of an intervention substituting physicians with nurse specialists. Background. Increasing populations of people with diabetes in most Western countries require creative solutions that give high-quality chronic care while controlling costs. Instigating nurse specialists as a substitute for physicians yields positive results in this area. Research about such interventions in a hospital-based setting is limited. Methods. This paper is a report of a study of a randomized, non-blinded clinical trial including people with diabetes mellitus types 1 and 2. In the intervention group nurse specialists were the central carers, providing care that conformed to a preset protocol. Patients were included between 2004 and 2007. Costs, quality of life and adverse events were measured, cost-effect ratios and incremental cost-effect ratios were calculated based on health-resource utilization rates, corresponding market prices and national tariffs from 2007. Results. Health related quality of life scores did not differ significantly between the control and the intervention group. In the intervention group, fewer patients were hospitalized and fewer side effects from drugs were reported compared to controls. Nurse specialists as central care givers generated a modest reduction in costs per quality adjusted life year gained compared to usual care. Conclusion. Nurse specialists give diabetes care that is similar to care provided by physicians in terms of quality of life and economic value. Instigating a nurse specialist as central carer yields opportunities to generate cost savings. Developing interventions which also focus on prevention of complications is recommended when aiming for long-term organisational cost savings. [ABSTRACT FROM AUTHOR]

linden m. & kavanagh r. (2012) Attitudes of qualified vs. student mental health nurses towards an individual diagnosed with schizophrenia. Journal of Advanced Nursing 68(6), 1359-1368. Abstract Aim. This paper is the report of a study which sought to compare the attitudes held by student and qualified mental health nurses towards individuals with schizophrenia in the Republic of Ireland. Background. Media portrayals of individuals with schizophrenia often include images of aggression and violence. With global initiatives aimed at reducing the stigma and exclusion associated with mental illness, the attitudes of those who care for people with schizophrenia are of particular interest. Methods. A survey was administered to 66 student mental health nurses, and 121 qualified mental health nurses. Participants completed the community attitudes to mental illness scale and the social interaction scale in 2009. Multivariate analysis of variance was used to test for the effects of qualification, work setting, years of experience and education on the measures. Results. Nurses employed in a community setting held more positive attitudes, when compared with colleagues who worked in an inpatient setting, as measured by the community mental health ideology subscale, indicating their desire to promote community care for individuals with schizophrenia. Nurses working in an inpatient setting held more socially restrictive attitudes indicating that they felt individuals with schizophrenia were dangerous and should be avoided. These findings were statistically significant at the P < 0·05 level. Conclusions. Mental health nurses must be alerted to the fact that holding negative attitudes may adversely affect the therapeutic relationship and ultimately lead to stigmatization and its negative consequences. [ABSTRACT FROM AUTHOR]

papastavrou e., efstathiou g., tsangari h., suhonen r., leino-kilpi h., patiraki e., karlou c., balogh z., palese a., tomietto m., jarosova d. & merkouris a. (2011) A cross-cultural study of the concept of caring through behaviours: patients' and nurses' perspectives in six different EU countries. Journal of Advanced Nursing 68(5), 1026-1037. Abstract Aim. This paper is a report of an international study of patients' and nurses' perceptions of nurse caring behaviours. Background. Current economic constraints on healthcare systems, demand to increase the quality of care and the incorporation of the consumers' perspective into care, have created a need to develop a clear understanding of nursing behaviours which convey caring. Patients in different areas of the world report different expectations of nurses' caring actions when compared to nurses' views. Method. A descriptive comparative survey design was used to analyse a sample of surgical patients ( n = 1659) and their nurses ( n = 1195) in 88 wards of 34 hospitals in Cyprus, the Czech Republic, Finland, Greece, Hungary and Italy. Data were collected in autumn 2009 using the Caring Behaviours Inventory-24. Nurses' and patients' responses were compared using both inferential and descriptive statistics. Results. Independent samples t-tests showed important differences between nurses' and patients' views. Although both groups perceived knowledge and skill as being the most important sub-scale, the nurses' responses were higher compared to patients ( P < 0·05) with important differences in the 'assurance of human presence' ( P < 0·001) and the 'respectful deference to others' ( P < 0·001) sub-scales. Cross-country comparisons showed important differences between the nurses' ( F = 24·199, P < 0·001) and patients' views on caring ( F = 26·945, P < 0·001). Conclusions. Important differences were observed between patient-nurse perceptions in the participating countries. The results form a foundation for future research into the development of a common international perspective about caring behaviours between patients and their nurses. [ABSTRACT FROM AUTHOR]

van de mortel t.f., kermode s., progano t. & sansoni j. (2012) A comparison of the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students. Journal of Advanced Nursing 68(3), 569-579. Abstract Aim. This paper reports a study examining the hand hygiene knowledge, beliefs and practices of Italian nursing and medical students with the aim of informing undergraduate curricula. Background. In comparison with registered nurses, physician status is a risk factor for non-compliance with hand hygiene guidelines. Little research has been conducted to determine if differences between the professions in relation to hand hygiene are apparent at the undergraduate level. Cross-disciplinary studies that may provide an insight into this topic are lacking. Methods. A questionnaire was administered to a convenience sample of 117 nursing and 119 medical students in a large university in Rome, Italy, to determine their hand hygiene knowledge, beliefs and practices. The data were collected in 2007-2008. Results. Nursing students' hand hygiene knowledge ( F = 9·03(1,230); P = 0·003), percentage compliance ( Z = 6·197; P < 0·001) and self-reported hand hygiene practices ( F = 34·54(1,230); P < 0·001) were significantly higher than that of medical students. There were no statistically significant differences between hand hygiene beliefs. Mean scores on the knowledge questions were low for both groups, reflecting primarily a knowledge deficit in relation to the use of alcohol-based hand rubs to decontaminate hands in the healthcare setting. Conclusion. Statistically significant disciplinary differences in hand hygiene knowledge and self-reported practices were apparent among undergraduate Italian healthcare students. Further research is needed to determine the causative factors. The overall low scores on the knowledge items indicate that these students require further education on hand hygiene, particularly in relation to the use of alcohol-based hand rubs. [ABSTRACT FROM AUTHOR]

o'leary d.f. & ni mhaolrúnaigh s. (2012) Information-seeking behaviour of nurses: where is information sought and what processes are followed? Journal of Advanced Nursing 68(2), 379-390. Abstract Aim. This paper is a report of a study on how nurses inform their decision-making in the workplace. Background. Despite the growing availability of research evidence, nurses have been slow to adopt it into their daily decision-making. Method. The study was undertaken in Ireland between 2006 and 2007 using a sequential mixed methods approach. In phase 1, the views of a quota sample of 29 nurses were explored using semi-structured interviews incorporating vignettes. Phase 2 involved the design and dissemination of a survey to a disproportionate stratified random sample of 1356 nurses. The response rate was 29%. Findings. In decision-making, nurses accessed other people, especially nursing colleagues, the most frequently. Sources that provided prepackaged information such as guidelines were favoured over sources that provided access to original research. The process of information-seeking for routine and non-routine decisions was different. Nurses making routine decisions relied mostly on their experience and an assessment of the patient. In non-routine decision-making, participants experienced more uncertainty about their decisions. Accordingly, sources of information used were more varied and the information-seeking process more extensive. The study highlighted the complexities of establishing whether information used in decision-making is research based or not. Conclusion. Routine practices should be reviewed and updated regularly through organizational mandates, as nurses do not generally question them. Research information to inform non-routine decision-making must be easily available to nurses in their workplace, as information searches generally prioritize finding enough, rather than the best, information to make a decision. [ABSTRACT FROM AUTHOR]

salmela s., eriksson k. & fagerström l. (2012) Leading change: a three-dimensional model of nurse leaders' main tasks and roles during a change process. Journal of Advanced Nursing 68(2), 423-433. Abstract Aim. This paper is a report of a qualitative study which explored how nurse leaders described and understood their main tasks and roles during a change process. Background. During a database search for literature, no actual research that highlighted the main tasks and roles of nurse leaders during a change process was found. Earlier research has indicated the need for different leadership styles and the importance of strategies and values. Method. In-depth interviews with 17 nurse leaders took place in 2004. A phenomenological-hermeneutical approach was used for data analysis. Results. The findings resulted in a model of leading change in health care that focuses on good patient care and consists of three dimensions: leading relationships, leading processes and leading a culture. In addition to leading relationships and processes, nurse leaders, as role models, greatly impact caring culture and its inherent ethical behaviour, especially about the responsibility for achieving good patient care. Nurse leaders are also instrumental in leading ward culture. Conclusion. Nurse leaders need guidance and knowledge of what is expected of them during a structural change process. They play different roles by directing, guiding, motivating, supporting and communicating without losing their cultural ethos of caring and use various leadership styles to bring about actual change, which, in turn, requires learning so that the thought patterns, values and attitudes of personnel can be changed. [ABSTRACT FROM AUTHOR]

garmon bibb s.c., padden d.l. & ferguson w. (2012) Moderators of access and utilization of clinical preventive services in older adults. Journal of Advanced Nursing 68(2), 335-348. Abstract Aim. This paper reports a study exploring the relationships between potential moderators of access and utilization of clinical preventive services in a homogeneous sample of older adults with near universal health coverage. Background. Advancements have occurred in eliminating financial and structural barriers to utilization of clinical preventive services (primary, secondary and tertiary prevention) in most developed countries, but variations in utilization continue. These variations may be attributed to non-social determinants of health moderators that impact utilization in older adults. Methods. Theorized relationships were explored using questions from the United States Behavioral Risk Factor Surveillance System Survey and a homogenous convenience sample of 202 older adults (mean age 84; sd 5·23) with near universal health coverage. Data collected across a 2 year period (2007-2009) were analysed using Chi-square, Mann-Whitney U and Hierarchical Logistic Regression. Findings. Several logistic regression models of personal access (advised to lose weight, high blood pressure, high cholesterol); moderators (gender, perceived health status, BMI ≥ 30 kg/m2); and clinical preventive services utilization (check-up in last 12 months; ever had colonoscopy/sigmoidoscopy) showed statistically significant ( P < 0·05) improvement in model fit by adding interaction terms (access X moderator). Conclusion. Exploring the impact of moderators on utilization may yield more insight into variations than could be explained by measurement of the direct affect of having near universal health coverage alone. [ABSTRACT FROM AUTHOR]

zeng y.c., liu x. & loke a.y. (2012) Addressing sexuality issues of women with gynaecological cancer: Chinese nurses' attitudes and practice. Journal of Advanced Nursing 68(2), 280-292. Abstract Aim. This paper reports a study conducted to describe Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. Background. Women with gynaecological cancer face numerous challenges to their sexuality. The importance of addressing sexuality concerns of people with cancer is emphasized by a growing body of literature in Western countries. Methods. This is a descriptive and correlational study. An inventory was adopted to explore Chinese nurses' attitudes and practice related to sexuality care in nursing. Data were collected from December 2009 to February 2010. Results. A sample of 202 nurses working in gynaecological units in China was recruited. Study results revealed that the majority (77·7%) held the attitude that 'sexuality is too private an issue to discuss with patients'. Only 34·2%'make time to discuss sexual concerns with patients'. Regression analysis revealed that nurse' marital status and hospital type in which they were working influenced their practice in sexuality care. Nurses' conservative attitudes towards sexuality, their prejudices about gynaecological cancer, the lack of availability of private environment, the lack of sexuality care training and the failure to include sexuality care in routine nursing care, were found to be factors that significantly influenced sexual care and nursing practice (adjusted R2 = 0·542, P < 0·001). Conclusions. The study findings contribute to the understanding of Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. There is a need to increase Chinese nurses' awareness of their roles and the importance of equipping themselves with relevant skills in sexuality care in nursing practice. [ABSTRACT FROM AUTHOR]

meretoja r. & koponen l. (2012) A systematic model to compare nurses' optimal and actual competencies in the clinical setting. Journal of Advanced Nursing 68(2), 414-422. Abstract Aim. This paper is a report of a study to develop a model to compare nurses' optimal and actual competencies in the clinical setting. Background. Although future challenge is to focus the developmental and educational targets in health care, limited information is available on methods for how to predict optimal competencies. Method. A multidisciplinary group of 24 experts on perioperative care were recruited to this study. They anticipated the effects of future challenges on perioperative care and specified the level of optimal competencies by using the Nurse Competence Scale before and after group discussions. The expert group consensus discussions were held to achieve the highest possible agreement on the overall level of optimal competencies. Registered Nurses ( n = 87) and their nurse managers from five different units conducted assessments of the actual level of nurse competence with the Nurse Competence Scale instrument. Data were collected in 2006-2007. Results. Group consensus discussions solidified experts' anticipations about the optimal competence level. This optimal competence level was significantly higher than the nurses' self-reported actual or nurse managers' assessed level of actual competence. The study revealed some competence items that were seen as key challenges for future education of professional nursing practice. Conclusion. It is important that the multidisciplinary experts in a particular care context develop a share understanding of the future competency requirements of patient care. Combining optimal competence profiles to systematic competence assessments contribute to targeted continual learning and educational interventions. [ABSTRACT FROM AUTHOR]

meyer k., bjørk i.t. & eide h. (2012) Intensive care nurses' perceptions of their professional competence in the organ donor process. Journal of Advanced Nursing 68(1), 104-115. Abstract Aims. This paper is a report of a study that explored Norwegian intensive care nurses' perceptions of their professional competence to identify educational needs in the organ donor process. Background. Intensive care professionals are requested to consider organ donation each time they care for patients with severe cerebral lesion to ensure donor organs for transplantation. The donor process challenges intensive care nurses' professional competence. Nurses' knowledge and experience may influence their professional competence in caring for organ donors and their relatives. Methods. A cross-sectional survey was conducted in all 28 Norwegian donor hospitals between October 2008 and January 2009. Intensive care nurses ( N = 801) were invited to participate and the response rate was 71·4%. Dimensions of professional competence, learning needs and contextual and demographic variables were explored. Data were analysed using descriptive and inferential statistics. Findings. Few intensive care nurses had extensive experience of or competence and training in organ donation. Nurses working at university hospitals had more experience, but lesser training than nurses in local hospitals. Experience of donor acquisition had an impact on intensive care nurses' perceptions of their professional competence in the donor process. Discussions on the ward and educational input were seen as important for the further development of professional competence. Conclusion. Training provided by experienced colleagues and a culture that encourages discussion about aspects of the donor process can develop nurses' professional competence and communally defined professional practice. Educational input that cultivates various types of knowledge can be beneficial in organ donation. [ABSTRACT FROM AUTHOR]

chuang l.-l., lin l.-c., cheng p.-j., chen c.-h., wu s.-c. & chang c.-l. (2012) Effects of a relaxation training programme on immediate and prolonged stress responses in women with preterm labour. Journal of Advanced Nursing 68(1), 170-180. Abstract Aim. This paper is a report of an experimental study of the effects of relaxation-training programme on immediate and prolonged stress responses in women with preterm labour. Background. Hospitalized pregnant women with preterm labour experience developmental and situational stress. However, few studies have been performed on stress management in such women. Methods. An experimental pretest and repeated post-test design was used to compare the outcomes for two groups in northern Taiwan from December 2008, to May 2010. A total of 129 women were randomly assigned to an experimental ( n = 68) or control ( n = 61) group. The experimental group participants were instructed to listen daily to a 13-minute relaxation programme. Measurements involved the stress visual analogue scale, finger temperatures, State Trait Anxiety Inventory, Perceived Stress Scale and Pregnancy-related Anxiety. Two-way analysis of variance and hierarchical linear modelling were used to analyse the group differences. Results. Compared with those in the control group, participants in the experimental group showed immediate improvements in the stress visual analogue scale scores and finger temperatures. The State Trait Anxiety Inventory-State subscale score for the experimental group was significantly lower than that for the control group ( P = 0·03). However, no statistically significant differences for the Perceived Stress Scale and Pregnancy-related Anxiety scores were found between the experimental group and the control group. Conclusions. The relaxation-training programme could improve the stress responses of women with preterm labour. [ABSTRACT FROM AUTHOR]

liebel d.v., powers b.a., friedman b. & watson n.m. (2012) Barriers and facilitators to optimize function and prevent disability worsening: a content analysis of a nurse home visit intervention. Journal of Advanced Nursing 68(1), 80-93. Abstract Aims. This paper is a report of an analysis of how to better understand the results of the nurse home visit intervention in the Medicare Primary and Consumer-Directed Care Demonstration in terms of facilitators and barriers to disability improvement/maintenance as compared with disability worsening. Background. There is a lack of literature describing how nurse home visit interventions are able to maintain/improve disability among older persons with disability. The present study is one of only six reporting beneficial disability outcomes. Methods. Cases were purposefully sampled to represent change in the disability construct leading to selection of ten cases each of disability maintenance/improvement (no change or decrease in total Activities of Daily Living score from baseline) and worsening (an increase in total Activities of Daily Living score from baseline). Data from nurses' progress notes and case studies (collected in March 1998-June 2002) were analysed using qualitative descriptive analysis (May 2009). These results remain relevant because the present study is one of the few studies to identify select nurse activities instrumental in postponing/minimizing disability worsening. Results/findings. Three primary themes captured the facilitators and barriers to effective disability maintenance/improvement: (1) building and maintaining patient-centred working relationships, (2) negotiating delivery of intervention components and (3) establishing balance between patients' acute and chronic care needs. Sub-themes illustrate nurse, patient and system factors associated with effective disability maintenance/improvement (e.g. nurse caring, communicating, facilitating interdisciplinary communication) and barriers associated with disability worsening (e.g. dementia, depression and recurring acute illnesses). Conclusion. This study provides new insights about the facilitators and barriers to effective disability maintenance/improvement experienced by patients receiving home visits. Potential opportunities exist to integrate these insights into best-practice models of nurse home visiting. [ABSTRACT FROM AUTHOR]

erlingsson c., ono m., sasaki a. & saveman b.-I. (2012) An international collaborative study comparing Swedish and Japanese nurses' reactions to elder abuse. Journal of Advanced Nursing 68(1), 56-68. Abstract Aim. This paper reports an analysis of aggregated data from two national studies on Swedish community-based nurses' and Japanese Public Health Nurses' responses to hypothetical elder abuse cases. Background. Elder abuse is an under-researched area despite being globally recognized as a serious and escalating problem. Yet research, adding needed socio-cultural perspectives to current knowledge has been limited. Methods. Eighty-one community-based nurses in Sweden and 124 Public Health Nurses in Japan responded to a questionnaire based on three hypothetical elder abuse cases. Swedish and Japanese results (data collection 2006-2007) were combined and the aggregated data were analysed using manifest and qualitative content analyses. Results. Nurses' response patterns in the aggregated data were similar across all three hypothetical cases and within themes Awareness, Assessment and Intervention. However, there were also noteworthy differences between Swedish and Japanese responses, e.g. Swedish responses were generally practical, action oriented and involved increased levels of suspicion and personal intervention to achieve increased control; whereas Japanese responses concerned better understanding that involved the family members and their situation, focusing on interventions grounded in collaboration. Conclusion. Despite cultural differences, responses of Swedish and Japanese nurses were very similar which points to a global 'humanness' of the problem of, and nurses' responses to, elder abuse. Results endorse the value of international collaborations that give information and inspiration to nursing colleagues across cultural boundaries. Results also give hope that global tools for elder abuse assessment and intervention can be developed. [ABSTRACT FROM AUTHOR]

dickinson t. & hurley m. (2012) Exploring the antipathy of nursing staff who work within secure healthcare facilities across the United Kingdom to young people who self-harm. Journal of Advanced Nursing 68(1), 147-158. Abstract Aims. This paper is a report of a study that compared relevant attitudinal dimensions of Registered Nurses and nursing aides working within a Young Offenders' Institute and two young people's forensic units in the United Kingdom towards young people in their care who self-harm. Background. Nurses caring for young people within secure environments may engage at some point with patients who harm themselves. These staff often experience strong negative emotional reactions which can lead to antipathy and alienation. Methods. Forty seven Registered Nurses and 22 nursing aides completed the Self-Harm Antipathy Scale, which consists of 30 attitudinal self-report items. The data were collected between June 2008 and December 2008, and analysed using spss version 17. Results. Results displayed that age per se, length of service with self-harming clients, and whether the participant was a Registered Nurse or nursing aide, and number of self-harming clients worked with did not influence the Self-Harm Antipathy Scale score or any of its component sub-scores. However, field of nursing the nurse was registered under, previous study of self-harm, year first registered and gender showed significant effects. Conclusions. Given that responses reflect a degree of both empathy and apathy it seems that there is a need to promote greater therapeutic alliances and communication; for example, the use of positive regard to help reduce the incidence of labelling and the negative effects this has upon relationships. There is a significant need for nursing staff working with young people who self-harm to have access to relevant educational programmes. A focus on harm minimization could be key areas for further development. [ABSTRACT FROM AUTHOR]

salamonson y., bourgeois s., everett b., weaver r., peters k. & jackson d. (2011) Psychometric testing of the abbreviated Clinical Learning Environment Inventory (CLEI-19). Journal of Advanced Nursing 67(12), 2668-2676. Abstract Aim. This paper is a report of a test of the psychometric properties of a 19-item version of the Clinical Learning Environment Inventory. Background. Although the clinical learning environment provides the 'real-life' context essential for preparing nursing students for their professional role, the quality of student learning is influenced by the quality of the clinical placement. Methods. Nursing students completed an abbreviated (19-item) form of the Clinical Learning Environment Inventory to rate their perception of the clinical learning environment. Descriptive statistics, principal component analysis, discriminant validity and Cronbach's alpha reliabilities were computed. Results. Between March and December 2009, 231 online surveys were submitted. The mean age of participants was 30·3 years ( sd: 10·4) and 87% were female. All 19 items loaded on two factors, 'Clinical Facilitator Support of Learning' and 'Satisfaction with Clinical Placement', with factor loadings above the 0·4 threshold. Cronbach's alpha coefficient was 0·93 for the total Clinical Learning Environment Inventory-19, with subscales ranging from 0·92 to 0·94. Multiple regression uncovered that participants who engaged in health-related paid work were independently and significantly more positive on the 'Clinical Facilitator Support of Learning' subscale, whereas those who worked >16 hours a week, or allocated the afternoon shift were independently and significantly more negative on the 'Satisfaction with Clinical Placement' subscale. Conclusion. Providing an effective and productive clinical experience is vital in preparing nursing students to become competent clinicians. The Clinical Learning Environment Inventory-19 offers a useful measure to explore nursing students' satisfaction with two aspects of this clinical experience - clinical facilitator support of learning and the clinical learning environment. [ABSTRACT FROM AUTHOR]