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Aims: To explore the relationship between nurse practitioner work environment and nurse practitioner outcomes (job satisfaction and intent to leave) in the United States. Design The study used a cross‐sectional survey design to collect survey data from primary care nurse practitioners in six states in the United States. Methods: We sent mail surveys to 5689 eligible nurse practitioners in Arizona, New Jersey, Washington, Pennsylvania, California and Texas. The mail also contained an online link. Participants could complete either the paper or online questionnaire. In total, 1244 participants completed the survey in 2018–2019. The work environment was measured using the Nurse Practitioner‐Primary Care Organizational Climate Questionnaire comprised of four subscales: Nurse Practitioner‐Administration Relations, Nurse Practitioner‐Physician Relations, Independent Practice and Support and Professional Visibility. Global items measured job satisfaction and intent to leave. We used mixed‐effect proportional‐odds cumulative logit models to assess the association between work environment and job satisfaction and intent to leave. Results: Overall, 90% of participants were either very satisfied or somewhat satisfied with their job and 22% reported intent to leave their job in 1 year. With a one‐unit increase in the organizational‐level Nurse Practitioner‐Administration Relations score, the odds of having a higher job satisfaction level increased by about four times and the odds of intent to leave job decreased by about 60%. A higher organizational‐level Nurse Practitioner‐Physician Relations score was significantly associated with higher job satisfaction and lower odds of intent to leave. Conclusion: Improvements in work environments may improve nurse practitioner job satisfaction and retention. Impact This study examined the relationship between work environment, job satisfaction and turnover intention of nurse practitioners. Better work environment is associated with higher job satisfaction and lower turnover intention. Findings have implications for clinical leadership who can take actions to create better work environments to increase the nurse practitioner workforce capacity. [ABSTRACT FROM AUTHOR]

Aim: To identify the barriers and facilitators to seasonal influenza vaccination uptake among nurses. Background: Seasonal influenza causes significant mortality and morbidity among older people and high‐risk groups. Vaccinating nurses against influenza is an essential public health measure to reduce the burden of disease. Yet despite annual recommendations, nurses' influenza vaccine uptake rates remain low. Design: An explanatory sequential mixed methods study design. Data Sources: Qualified nurses attending mandatory training in two large acute hospitals in Ireland. Methods: A paper‐based questionnaire assessing nurses' knowledge, risk perception, health beliefs and influenza vaccination practices was distributed to a convenience sample of qualified nurses (N = 462) between September 2017 – February 2018. A self‐selected sample of 35 nurses who completed the questionnaire participated in five focus groups to explore in depth the barriers and facilitating factors associated with their vaccination practices between September 2018 – October 2018. The questionnaire data were analysed statistically and thematic analysis was applied to the qualitative data. The quantitative and qualitative findings were integrated using the Pillar Integration Process. Results: Seven themes emerged: (a) the influence of nurses' knowledge on vaccine uptake; (b) dissemination of information; (c) vaccine fears and concerns; (d) protection, risk and vulnerability: self and others; (e) influencers; (f) accessibility; and (g) organizational pressure. Conclusion: Achieving high vaccine uptake rates among nurses through voluntary vaccination programmes remains a challenge. Multi‐faceted influenza campaigns based on the HBM should be prioritized to address dissemination of evidence‐based knowledge, accessibility, and external cues to action. Impact: Low influenza vaccine uptake among nurses compromises patient safety and contributes to a significant burden on health services. This study identified factors associated with vaccine practices among nurses and will inform the development of specific tailored interventions for nurses. [ABSTRACT FROM AUTHOR]

Aim This paper reports the prevalence and its related sociodemographic factors of informal caregiving by underage children in Austria. The quantity and intensity of caregiving activities, the motivation for and effects of caregiving and how this differs from non-caregiving children were investigated. Background Young carers are a worldwide phenomenon. Due to methodological and sampling problems, little quantitative data are available. Design Cross-sectional, descriptive study. Methods Based on a random selection of 85 schools and 474 classes, a total of 7403 children aged 10-14 years completed a self-reporting questionnaire that asked for children's help in their families. Descriptive and inferential statistics were used to analyse the data. Results In the sample, 4·5% caregiving children were identified. The average age of young carers was 12·5 years. Most young carers were female (69·8% vs. 52·7% in the non-young carers group). Young carers assumed more responsibilities (household tasks, general care and sibling care) than their peers. They showed a higher level of physical (e.g. headache 38·2% vs. 24·4%) and mental (e.g. to worry about 68·1% vs. 41·8%) adverse effects than non-young carers. Extrapolation suggests a rate of 3·5% young carers in underage children of 5-18 years in Austria. Conclusion Data on national level are essential preconditions to initiate support for young carers. Nurses can promote children's health and well-being through prevention of an inappropriate caregiving role. [ABSTRACT FROM AUTHOR]

Aims This paper is a report of a study, which seeks to determine if self-reported estimates of RNs' self-rated confidence in responding to alcohol use in patients is a psychometrically sound measure. Background Alcohol-related harm is a global public health problem. Nurses are the largest group of health professionals worldwide, with evidence showing that despite being well placed to respond, they are not engaging in this important role. Design Instrument development. Method The study was a survey set in a large teaching hospital in England, UK. The Clinical Confidence Questionnaire was made available to a convenience sample of 200 RNs in 2007, with a response rate of 22%. Rasch analysis was used to develop a scale for future learning based on the conjoint estimates of registered hospital nurses abilities to meet needs of patients requiring nursing care of different complexities related to alcohol use in patients. Results Outcomes verify that registered hospital nurses' self-rated clinical confidence measures for their own nursing abilities in responding to alcohol use in patients can be reliably estimated and a hierarchical scale of learning can be generated to inform curricula content and learning processes. Conclusion Current health policy in the UK identifies nurses as having a role in responding to alcohol-related harm. More focus should, therefore, be placed on ensuring that they are prepared to fully engage with patients in assessing and responding to alcohol use through specific education, training and skill development. The self-rated clinical confidence tool offers evidence as an acceptable method of measurement in this area. [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]

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]

scott k., white k., johnson c. & roydhouse j.k. (2011) Knowledge and skills of cancer clinical trials nurses in Australia. Journal of Advanced Nursing 68(5), 1111-1121. Abstract Aims. This paper is a report of the development and testing of a questionnaire measuring knowledge and skills of cancer clinical trials nurse in Australia. Background. The role of cancer clinical trials nurse, widely acknowledged as an integral member of the clinical research team, has evolved in recent years. Elements of the clinical trials nurse role in cancer have previously been described. To evaluate specific cancer clinical trials nurse educational and training needs, the development of a valid and reliable tool is required. Methods. In 2009, a study was conducted in three stages. Stage I: questionnaire development and pilot testing; stage II: focus group; stage III: national survey. Internal consistency reliability testing and multi-trait analysis of item convergent/divergent validity were employed. Regression analysis was used to identify predictors of clinical trials nurse knowledge and skills. Results. The national survey was a 48-item questionnaire, measuring six clinical trial knowledge and seven skills sub-scales. Of 61 respondents, 90% were women, with mean age 43 years, 19 years as a Registered Nurse and 5 years as a cancer clinical trials nurse. Self-reported knowledge and skills were satisfactory to good. Internal consistency reliability was high (Cronbach's alpha: knowledge = 0·98; skills = 0·90). Criteria for item convergent/divergent validity were met. Number of years as cancer clinical trials nurse was positively related to self-reported knowledge and skills. Conclusion. Preliminary data suggest that the national survey is reliable and valid. Data have contributed to better understanding the knowledge and skills of cancer clinical trials nurse in Australia and development of a postgraduate course in clinical trials. [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]

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]