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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.)

Aim: To examine the mental health conditions of family caregivers residing away from their loved ones who experienced visitation restrictions during the coronavirus disease 2019 pandemic. Design: A mixed-methods design applying the Kessler Scale-10 for the quantitative measurement of psychological distress and an open-ended question for qualitative analysis. Methods: The participants were recruited from care facilities between February and September 2021. This cross-sectional study included 197 family caregivers who were utilizing formal residential care services for their loved ones. Using thematic analyses, open-ended responses regarding the impact of visitation restrictions were coded. These themes were then examined to determine thematic patterns across caregiver characteristics. Results: Thirteen themes were identified regarding the impact of visitation restrictions. Many participants reported primary harmful effects as follows: ‘inability to confirm the type of care and lifestyle assistance provided to an older relative’ and ‘difficulty communicating with an older relative because of the inability to converse face-to-face’. Younger age, being employed, poor sleep, poor relationship quality with the care recipient and experiencing harmful effects from the visitation restrictions were associated with psychological distress. Conclusion: Our findings suggest that to maintain positive mental health after a care transition, it is important for family caregivers to take part in the care of their loved ones and ensure information sharing between the care recipient's family and institution. Impact: These findings suggest that both residents and family caregivers living outside facilities may feel distressed due to separation. Therefore, institutional care staff needs to consider how to adjust facility procedures or communication with family caregivers. [ABSTRACT FROM AUTHOR]

Aim: To explore which factors, influencing dietary behaviour change support among patients by Dutch community nurses (CNs; nurses), are key focal points in training programmes. Background: Nurses have an important role in counselling patients towards healthier dietary behaviour to prevent or delay long‐term complications from chronic lifestyle‐related diseases. Most nurses do not incorporate dietary behaviour change support in their routines to the fullest potential. Design: A qualitative descriptive study. Methods: Data were collected in the Netherlands in 2018–2019 via semi‐structured face‐to‐face interviews with 18 nurses. Interview guide themes were informed by the COM‐B model, using validated descriptions in Dutch. Data were recorded, transcribed and analysed using inductive thematic analysis. Results: Factors that affected dietary behaviour change support were linked to (1) the nurse (role identity, dietary knowledge and competences such as methodical approach, behaviour change techniques and communication techniques), (2) nurse–patient encounter (building a relationship with a patient, supporting patient autonomy and tailoring the approach) and (3) cooperation and organizational context. Conclusion: It is of utmost importance to pay attention to nurses' role identity regarding dietary behaviour change support, as this underlies professional behaviour. This should be accompanied by improving competences on dietary behaviour change support. Focus on competences regarding the application of behaviour change technique is crucial. Furthermore, having a relationship of trust with a patient was important for discussing sensitive topics such as diet. Impact: The promotion of a healthy diet provides opportunities to contribute to patient autonomy and self‐management. Well‐fitted training offers for (senior) nurses will lead to improved professional practice of nurses, leading to healthier dietary behaviour of patients. Patient or Public Contribution: A nurse provided feedback on the interview guide. [ABSTRACT FROM AUTHOR]

Aims To report on a survey of sexual health service needs among substance-misusing women attending a substance misuse service. Background Substance-misusing women carry a disproportionate burden of sexual ill health, yet the range and frequency of their sexual health risks, morbidities and service engagement are poorly understood. Design A cross-sectional survey of a convenience sample of substance-misusing women attending a substance misuse service. Methods From 4 April 2010-17 September 2010, substance-misusing women in Hastings & Ore, UK, were invited to complete a paper questionnaire addressing: drug use; cervical cytology, sexually transmitted infection and HIV screening history; pregnancy history, perceived pregnancy risk and contraceptive advice and supply; sexual activity and assault. Of 91 respondents, 77 attended local drug treatment services - results comprise analysis of this sub-sample. Results The study sample was characterized by long-term opioid and crack cocaine use. Of 53% sexually active in the previous 4 weeks, 66% perceived they had experienced sexual intercourse that could lead to pregnancy during that time. Fifty-five per cent had been forced to have sex against their will during their lifetime. High rates of sexually transmitted infections, pregnancy termination, miscarriage and abnormal cervical cytology were reported. Conclusions Findings indicate the need to recognize the breadth of elevated sexual health risks and morbidities experienced by substance-misusing women with long-term opioid/crack use, including those not identifying as intravenous drug users. Poor recall of drop-in and appointment times, reluctance to disclose substance misuse and likelihood of previous sexual assault present significant challenges to nurses, who must take a sensitive, opportunistic approach to referral and provision of sexual health interventions to substance-misusing women. [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]

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]

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]

he h.-g., jahja r., lee t.-l., ang e.n.k., sinnappan r., vehviläinen-julkunen k. & chan m.f. (2010) Nurses' use of non-pharmacological methods in children's postoperative pain management: educational intervention study. Journal of Advanced Nursing 66(11), 2398-2409. Aim. This paper is a report of study of the impact of an educational intervention in pain management on nurses' self-reported use of non-pharmacological methods for children's postoperative pain relief and their perceptions of barriers that limited their use of these methods. Background. Non-pharmacological methods have been shown to be effective in relieving pain; however, many barriers, including lack of knowledge, limit nurses' use of these methods. Pain education is a promising strategy for changing nursing practice, but only a few authors have examined the effectiveness of educational interventions for nurses to help relieve children's postoperative pain. Methods. A quasi-experimental one-group pre- and post-test design was used. Questionnaire surveys were conducted with a convenience sample of 108 Registered Nurses in two public hospitals in Singapore in 2008. Results. Statistically significant increases were found in nurses' self-reported use of imagery, positive reinforcement, thermal regulation, massage and positioning in the postintervention survey. Before the intervention, these methods were less frequently used compared to other methods. Heavy workload/lack of time and the child's inability to cooperate were the most commonly reported barriers at pre- and post-test. Conclusion. The educational intervention had a positive effect on nurses' use of several non-pharmacological methods. Regular dissemination of updated information to nurses on these pain management methods is recommended to maintain the positive changes. Nevertheless, education alone was not sufficient to optimize nurses' use of these methods, as various barriers limited their practice. [ABSTRACT FROM AUTHOR]

shin s.m., kim m.j., kim e.s., lee h.w., park c.g. & kim h.k. (2010) Medical Aid service overuse assessed by case managers in Korea. Journal of Advanced Nursing 66(10), 2257–2265. Aim. This paper is a report of a study conducted to describe characteristics of overusers of the Medical Aid service, assess appropriateness of overusers’ medical service use, and determine contributing factors to medical aid overuse in Korea. Background. Medical Aid use in Korea has increased in recent years, but no systematic studies reported the characteristics of overusers and appropriateness of their medical service use. Method. In a cross-sectional study, case managers conducted interviews, evaluated participants’ insurance claim data, and determined overusers by the case managers’ determination of the appropriateness of their medical service use and their expenditures during the year of 2006. Descriptive statistics, chi-square analysis, analysis of variance, and multiple logistic regression were used for data analysis. Result. Most heavy users were elderly, female, less educated, and had stress, lower perceived health status and multiple clinic visits. Twenty-five per cent of inpatients and 63·9% of outpatients were classified as overusers. The average total cost per capita of an overuser was 43·3% higher than that of an optimal user. Age, education, stress, arthritis, multiple clinic visits and frequent clinic visit recommendations by providers were statistically significant contributing factors to the overuse. Conclusion. Preventive measures are needed to decrease the overuse of Medical Aid in Korea; such measures should focus on characteristics contributing to overuse, including the provider-induced demand for more clinic visits. Case managers could play an important role as gatekeepers, managers, and educators for optimal use of Medical Aid in Korea and elsewhere in the world that faces similar problems. [ABSTRACT FROM AUTHOR]

rochefort c.m. & clarke s.p. (2010) Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units. Journal of Advanced Nursing 66(10), 2213–2224. Aim. This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses’ perceptions of care rationing, job outcomes, and quality of care. Background. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Methods. Over a 6-month period in 2007–2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). Results. A total of 339 nurses (61·3%) completed questionnaires. Overall, 18·6% were dissatisfied with their job, 35·7% showed high emotional exhaustion, and 19·2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Conclusion. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. [ABSTRACT FROM AUTHOR]

Aim: To understand the postpartum care received by birthing people with disabilities and their newborns, from their own perspectives. Design: A qualitative study with semi‐structured interviews. Methods: Between July 2019 and February 2020, in‐person and virtual interviews were conducted with 31 people with physical, sensory, and intellectual/developmental disabilities in Ontario, Canada, about the formal inpatient and outpatient services and supports they used in the first few months after they gave birth. Thematic analysis was used identify common themes. Results: We identified three overall themes concerning participants' postpartum care experiences and the different types of formal services received in and out of hospital: (1) lack of adequate care, (2) lack of provider awareness of disability and disability accommodations, and (3) fear of judgement, discrimination, and intrusive surveillance. The identified themes were applicable across disability groups. However, most comments on disability accommodations came from participants with physical or sensory disabilities, while participants with intellectual/developmental disabilities most commonly reported concerns about lack of adequate care and fear of judgement, discrimination, and intrusive surveillance. Conclusion: Findings indicate that postpartum care often fails people with disabilities. This could contribute to negative health consequences for them and their newborns. Impact: Birthing people with disabilities need multidisciplinary, proactive, and strengths‐based postpartum care to mitigate risk for health complications. Further, disability‐related training and guidelines for health and social service providers is required. Reporting method: Consolidated criteria for reporting qualitative research (COREQ). Patient or Public contribution: Our research team included two peer researchers with physical disabilities who served as co‐interviewers and participated in data analysis, contributing their lived experience of disability and interactions with the health care system. All stages of the study were also informed by feedback from the study's Advisory Committee, which comprised women with disabilities (many of whom are parents), disability organization staff, clinicians, and policy representatives. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to investigate nursing students' clinical decision‐making by using high‐fidelity simulation of a deteriorated patient scenario. Design: A convergent parallel mixed methods research design was used consisting of quantitative and qualitative data collection. Methods: Twenty‐three students completed the Health Science Reasoning Test before and after the simulation between October 2015 and June 2016. They were presented with a simulated scenario and asked to 'think aloud' during and after the simulation. The students were audio‐video recorded and observations were collected by the researcher. Results: There was a significant moderate increase in the 'deduction' and 'analysis' sub‐scale scores and overall test score, suggestive of improved analytical decision‐making processes through the simulation experience. Think‐aloud and observation data identified that students predominantly applied 'forward' reasoning during the simulated 'patient's' deterioration, focusing mainly on cue acquisition. 'Backward' reasoning with a focus on cue interpretation was most prominent in the debriefing data, in line with the survey outcomes. Accurate cue interpretation of critical, key cues appeared more useful than the total number of cues in solving the main clinical case problem. Conclusion: Students learn different clinical decision‐making skills during the simulation compared to what they learn from debriefing. Using observation and think‐aloud methods have significant benefits for researchers seeking to optimize the evaluation of the clinical decision‐making process. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses perceived having a calling to nursing. Design A mixed‐method study. Methods: Survey data collected in autumn 2020 and semi‐structured individual interview data collected in spring 2021. The 7925 survey respondents were care professionals and 414 of them were registered nurses. The 23 interview participants were registered nurses who responded to the survey. We examined the survey results using analysis of variance and t‐tests and the interview data with qualitative thematic analysis. Results: Registered nurses had a lower calling than other care professionals. Based on the interviews, having a calling to nursing produce four key findings. Nurses with a calling experienced their work as meaningful. They also adopted a humane and holistic approach to their work. However, their calling could change during their professional career. Due to its historical roots, having a calling was seen as a risk for the nursing profession, as it meant nurses had an oppressed position in society and nurses associated it with poor working conditions and low pay. Conclusion: Our study showed that having a calling to nursing had multidimensional benefits for the individual nurse, their patient, colleagues, organization and society, but showed strong association between calling and nurses' poor working conditions and low pay. Impact We found that nurses had a lower calling than other care professionals. Calling still exists, but it can produce tension in modern nursing. Organizations and society need to focus on how calling can be seen as a more positive attribute of nursing and improve nurses' working conditions and pay. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to identify the predicting factors of quality of life (QoL) from a set of psychosocial, sociodemographic and clinical variables amongst older adults in a long‐term care setting. Design: A cross‐sectional, descriptive correlational study. Method: The study was conducted in a nursing home and a day care centre from July to December 2019. Two hundred older adults were recruited. Guided by the salutogenic model, the sense of coherence (SOC) scale, Connor–Davidson resilience scale, de Jong Gierveld loneliness scale and World Health Organization quality of life instrument‐older adults (WHOQOL‐OLD) were used. The sociodemographic and clinical profiles of participants were collected. Descriptive statistics, Pearson product‐moment correlation coefficient, independent‐samples t test, one‐way analysis of variance and stepwise regression were utilised in the analysis. Results: The mean score for WHOQOL‐OLD was 94.42 ± 19.55. The highest mean score was observed in the "Death and Dying" facet, while the lowest mean scores were reflected in the "Autonomy" and "Intimacy" facets of QoL. Regardless of resident type, most QoL scores were similar across different variables. Based on the stepwise regression, higher manageability and meaningfulness in SOC, higher resilience, lower social loneliness, lower emotional loneliness and hearing impairments are significantly associated with higher QoL. Conclusion: Manageability, meaningfulness and resilience should be enhanced while ameliorating feelings of loneliness to improve the QoL amongst older adults receiving long‐term care. Age, marital status, educational level, care arrangement, body mass index, performance in activities of daily living, comorbidities and hearing and mobility impairments could influence QoL and thus warrant more attention. Impact: Future interventions can be conducted in group sessions to facilitate social interaction and alleviate loneliness. More resources should be allocated to enhance older adults' care arrangements and coping mechanisms to provide them with the support, as they face challenges in daily life due to mobility impairment and other restrictions. [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.)

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 analyse the changes in senior students' opinions about the nursing profession over a 10-year period. Design: A descriptive and comparative study. Method: Data were collected using a questionnaire form, which was completed by 400 senior high school students in Çankiri city center during 2007-2008 (Group 1) and 2017-2018 (Group 2) academic years. Results: Compared with 10 years ago, more students referred to nurses as 'knowledgeable, concerned, and tolerant'. There were fewer students who knew the duties of nurses. There were significantly fewer students who wanted to be nurses and many who wanted to be nurses in both groups said it was 'because they love nursing'. Compared with 10 years ago, more students said they wanted to be nurses because their parents wanted them to be nurses, but fewer students said they wanted to be nurses because they love people. There were more students who did not want to be nurses 'because it is tiring and entails irregular work hours'. However, more students said that they would like to go into nursing if the salary was satisfactory. Conclusion: The study showed that, compared with 10 years ago, more students defined nurses as knowledgeable and professional. They reported they did not currently wish to enter the nursing profession, but that they would do so if the wages were high. Impact: This study aims to determine the change in young individuals' opinions about the nursing profession in Turkey over a 10-year period. Due to poor work conditions in the nursing profession, most of the students did not want to be nurses, but their opinions might change if nurses' salaries were satisfactory. Academicians and nurses play an important role in introducing the nursing profession to students when they choose their career and informing high school teachers, who advise these students. [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.)

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.)

Aim: To explore Registered Nurses' attitudes and behaviour towards patients' use of complementary therapies. Background: Despite high rates of use of complementary therapies by the general population, little is known of how nurses respond to patients' use of these therapies. Design: A two-phase sequential exploratory mixed methods design. Methods: Nineteen Registered Nurses working in Australia participated in a semi-structured interview in 2015-2016 and emerging themes informed the development of a quantitative survey instrument administered online nationwide in 2016. Findings: Emerging key themes "Promoting safe care"; "Seeking complementary therapies knowledge";" Supporting holistic health care"; and "Integrating complementary therapies in practice" were reflected in survey results. Survey responses (N = 614) revealed >90% agreement that complementary therapies align with a holistic view of health and that patients have the right to use them. Most nurses (77.5%) discussed complementary therapies with patients and 91.8% believed nurses should have some understanding of the area. One-third did not recommend complementary therapies and there was a lack of overall consensus as to whether these therapies should be integrated into nursing practice. Nurses with training in complementary therapies held more positive views than those without. Conclusion: Nurses were generally supportive of patients' interest in complementary therapies, although their primary concern was safety of the patient. Despite broad acceptance that nurses should have a basic understanding of complementary therapies, there was a lack of consensus about recommendation, integration into nursing practice and referral. Further research should explore how nurses can maintain safe, patient-centred care in the evolving pluralistic healthcare system. [ABSTRACT FROM AUTHOR]

Aim: To determine the relationships between job satisfaction, work environment and successful ageing and how these factors relate to Registered Nurses' intent to retire. Background: Although little studied, retention of older nurses by delaying early retirement, before age 65, is an important topic for research. Qualitative and quantitative studies have indicated that job satisfaction work environment and successful ageing are key motivators in acute care Registered Nurses retention and/or delaying retirement. This study was designed to provide information to administrators and policy makers about retaining older, experienced RNs longer and more productively. Design: This was a correlational, descriptive, cross-sectional study. Methods: An online survey of acute care Registered Nurses (N = 2,789) aged 40 years or older working in Florida was conducted from September - October 2013. Participants completed items related to job satisfaction, work environment, successful ageing and individual characteristics. Hypotheses derived from the modified Ellenbecker's Job Retention Model were tested using regression analysis. Results: Job satisfaction scores were high. Highest satisfaction was with scheduling issues and co-workers; lowest with advancement opportunities. Successful ageing scores were also high with 81% reporting excellent or good health. Work environment explained 55% of the variance in job satisfaction. Years to retirement were significantly associated with successful ageing (p < .001), age (p < .001) and income (p < .010). Conclusions: This study provides quantitative evidence that environment and successful ageing are important areas that have an impact on job satisfaction and delay of retirement in older nurses and further studies in these areas are warranted to expand on this knowledge. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. Background: Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes. Design: A descriptive correlational design with stratified random sampling. Method: The sample included 96 nurses from the major geographic regions of the United States. Over 9 months in 2016-2017, data were collected using a webbased survey. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function. Results: Overall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses' work function. However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function. Conclusion: Nurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care. Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress. [ABSTRACT FROM AUTHOR]

Abstract: Background: The validity of instruments is crucial in ensuring that data collected are sound and that these data represent what the instrument claims to measure. When an instrument is revised or used in a different population, it is useful to re‐examine its construct validity. Aim: To test the psychometrics properties of an instrument—the revised Families’ Importance In Nursing Care—Nurses’ Attitudes, designed to measure nurse’ attitudes towards involving family in nursing care in an adult acute care setting. Design and methodology: A cross‐sectional survey design was used in April–May 2016 with a sample of Enrolled and Registered Nurses (N = 212) to test the factor structure of the revised Families’ Importance In Nursing‐Nurses’ Attitudes instrument. The instrument had 26 items with a five‐point Likert response scale. Principle components analysis and exploratory factor analysis were performed with oblique rotations to assess the internal structure of the instrument. Setting: A regional referral hospital in Queensland, Australia. Results: Using Principal Components Analysis and Principal Axis Factoring, we obtained the same factor structure to that originally identified for the instrument. Our results suggested the removal of six items to refine the instrument and achieve simple structure. Conclusion: The removal of several items, relabeling of factors and residual cross‐loading issues suggest that further revisions to the instrument are needed. [ABSTRACT FROM AUTHOR]

Abstract: Aims: The aim of this study was to understand the context of the inpatient setting for the treatment of anorexia nervosa and the implications for the therapeutic alliance between nurses and consumers. Background: The nature of the therapeutic alliance is dependent on the contextual factors that influence interactions. The inpatient setting for the treatment of anorexia nervosa is one such setting where the therapeutic alliance is operative, yet challenging and poorly understood. Design: A two‐phase explanatory sequential design was employed. Descriptive statistics from phase one informed phase two interviews. Phase two data were analysed through thematic analysis. Methods: A convenience sample of nurses and consumers were recruited from six wards, in five hospitals. Phase one involved the completion of a survey (N = 128) that measured the strength of the therapeutic alliance, as well as other elements of ward context. Phase two interviews (N = 54) were focused on the therapeutic alliance between nurses and consumers and the implications of the inpatient setting. Data collection occurred between May 2014 ‐ February 2015. Results: Anorexia nervosa as an illness carries destructive implications for the quality of the therapeutic alliance. Nurses’ intimate position in the inpatient setting and interpersonal capacity is influential in overcoming the obstacles that impede the therapeutic alliance. Conclusion: Nurses’ capacity for developing therapeutic alliances is in part dependent on a supportive ward organization and the adequacy of resources to permit meaningful interactions with consumers with anorexia nervosa. Understanding the contextual factors specific to the inpatient setting enhances nurses’ ability to develop therapeutic alliances. [ABSTRACT FROM AUTHOR]

Aims To examine the impact of errors or adverse events on emotional distress and professional quality of life in healthcare providers in the neonatal intensive care unit, and the moderating role of coworker support. Background Errors or adverse events can result in negative outcomes for healthcare providers. However, the role of coworker support in improving emotional and professional outcomes has not been examined. Design A cross-sectional online survey from a quality improvement initiative to train peer supporters in a neonatal intensive care unit. Methods During 2015, 463 healthcare providers in a neonatal intensive care unit completed a survey assessing their experiences with an error or adverse event, anxiety, depression, professional quality of life and coworker support. Results Compared with those who did not experience an error or adverse event (58%), healthcare providers who observed (23%) or were involved (19%) in an incident reported higher levels of anxiety and secondary traumatic stress. Those who were involved in an event reported higher levels of depression and burnout. Differences between the three groups (no event, observation and involvement) for compassion satisfaction were non-significant. Perceived coworker support moderated the association between experiencing an event and both anxiety and depression. Specifically, experiencing an event was associated with higher levels of anxiety and depression when coworkers were perceived as low in supportiveness, but not when they were viewed as highly supportive. Conclusion Findings suggest that errors or adverse events can have a harmful impact on healthcare providers and that coworker support may reduce emotional distress. [ABSTRACT FROM AUTHOR]

Aims To investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities. Background Many older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High-quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents' well-being is recognized, more research is needed. Design A cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data were nested in the facilities, a multilevel analysis was conducted. Methods Data were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents' demographic and health data were collected via medical records and interviews. Residents' well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument. Results Multilevel analysis indicated that cognitive support in the physical environment was associated with residents' social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents' psychological well-being. Conclusion Our study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high-quality specifications. [ABSTRACT FROM AUTHOR]

Aims To outline the way the culture of austerity arising from the Global Financial Crisis has been used by Australian and New Zealand governments to maintain and extend healthcare budget cuts, through new public management strategies leading to missed nursing care. Background Ten years on the cost of the Global Financial Crisis continues to be borne by tax payers and those employed by the welfare state, yet analysis shows clearly that it was caused by a failure to adequately regulate markets, particularly the banks and multinational corporations. In health care, one of the impacts is increased workload for nurses leading to missed care. Design/Methods Registered Nurses and midwives ( n = 7,302) completed the MISSCARE surveys between 2012 - 2015, in four Australian states and New Zealand providing quantitative and qualitative responses. The qualitative comments were analysed using a template analysis approach based on key features of New Public Management. Findings Sixty-two qualitative responses identified measures in place directly linked to austerity and new public management strategies that impacted on the quality of patient care and nursing work, as well as contributing to missed care. Conclusion Opportunities for resistance may lie outside public and private health organizations in civil society, in the nurse union movements and other health and nursing professional associations. [ABSTRACT FROM AUTHOR]

Aim To identify items for a new instrument that measures emotional behaviour abilities of meaningful learning, according to Fink's Taxonomy. Background Meaningful learning is an active process that promotes a wider and deeper understanding of concepts. It is the result of an interaction between new and previous knowledge and produces a long-term change of knowledge and skills. To measure meaningful learning capability, it is very important in the education of health professionals to identify problems or special learning needs. For this reason, it is necessary to create valid instruments. Design A Delphi Study technique was implemented in four phases by means of e-mail. Methods The study was conducted from April-September 2015. An expert panel consisting of ten researchers with experience in Fink's Taxonomy was established to identify the items of the instrument. Data were analysed for conceptual description and item characteristics and attributes were rated. Expert consensus was sought in each of these phases. An 87·5% consensus cut-off was established. Results After four rounds, consensus was obtained for validation of the content of the instrument 'Assessment of Meaningful learning Behavioural and Emotional Abilities'. This instrument consists of 56 items evaluated on a 6-point Likert-type scale. Foundational Knowledge, Application, Integration, Human Dimension, Caring and Learning How to Learn were the six major categories explored. Conclusions This content validated tool can help educators (teachers, trainers and tutors) to identify and improve the strategies to support students' learning capability, which could increase their awareness of and/or responsibility in the learning process. [ABSTRACT FROM AUTHOR]

Aims To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text + visual and text-only) with usual care. Background Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for acute coronary syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions. Design A three-arm web-based, parallel randomized controlled trial of a theory-based intervention. Methods The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n = 177 participants who have experienced acute coronary syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care, ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text + visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of acute coronary syndrome ≥15-minute duration, assessed using two randomized series of eight scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014. Discussion Positive results changing intentions would lead to a randomized controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms. Trial registration Registered at ClinicalTrials.gov: NCT02820103. [ABSTRACT FROM AUTHOR]

Aim This study was aimed to develop and test the Pro-environmental Behavior Scale for Women's Health. Background Women adopt sustainable behaviours and alter their life styles to protect the environment and their health from environmental pollution. The conceptual framework of pro-environmental behaviours was based on Rogers' protection motivation theory and Weinstein's precaution adoption process model. Design The cross-sectional design was used for instrument development. Method The instrument development process consisted of a literature review, personal depth interviews and focus group interviews. The sample comprised 356 adult women recruited in April-May 2012 in South Korea using quota sampling. For construct validity, exploratory factor analysis was conducted to examine the factor structure, after which convergent and discriminant validity and known-group comparisons were tested. Results Principal component analysis yielded 17 items with four factors, including 'women's health protection,' 'chemical exposure prevention,' 'alternative consumption,' and 'community-oriented behaviour'. The Cronbach's α was 0·81. Convergent and discriminant validity were supported by performing correlations with other environmental-health and health-behaviour measures. Conclusion Nursing professionals can reliably use the instrument to assess women's behaviours, which protect their health and the environment. [ABSTRACT FROM AUTHOR]

Aim To present the rationale, design and methodology of the GERAS project, which examines whether assessment of frailty and mild cognitive impairment could enhance risk prediction for biomedical, psychosocial outcomes and foster efficient resource allocation in kidney transplantation. Background For the burgeoning cohort of older patients considered for kidney transplantation, evidence gaps regarding frailty and mild cognitive impairment limit clinical decision-making and medical management. As known risk factors for 'hard' clinical outcomes in chronic illness, both require further study in transplantation. Integrating these and other bio-psychosocial factors into a comprehensive pre-transplant patient assessment will provide insights regarding economic implications and may improve risk prediction. Design A nation-wide multi-centre prospective cohort study nested in the Swiss Transplant Cohort Study. Methods Our nationally representative convenience sample includes 250 adult kidney transplant recipients. Data sources include the Swiss Transplant Cohort Study and primary data collected at time of transplantation, 6 months, 1 and 2 years post-transplant via established measures (the Montreal Cognitive Assessment, Psychosocial Questionnaire, Fried Frailty Instrument and a blood analysis), investigator-developed instruments and datasets compiled by hospitals' management control units, sickness funds, the Swiss Federal Statistical Office and the European Renal Association. Descriptive, competing risk survival and mixed effects analyses will be performed. Research Ethics Committee approval was obtained in January 2016. Discussion This pioneering project jointly examines frailty and mild cognitive impairment from bio-psychosocial and health economic perspectives. Results may significantly inform risk prediction, care tailoring and resource optimization to improve health outcomes in the ageing kidney transplant cohort. [ABSTRACT FROM AUTHOR]

Aims To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery. Background The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan. Design Two-phase mixed methods sequential explanatory design and grounded theory. Setting: critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20). Methods Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis. Results Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance. Conclusion There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making. [ABSTRACT FROM AUTHOR]

Aim Sexual risk behaviour was explored and described using Social Action Theory. Background The sexual transmission of HIV is complex and multi-factorial. Social Action Theory provides a framework for viewing self-regulation of modifiable behaviour such as condom use. Condom use is viewed within the context of social interaction and interdependence. Design Cross-sectional survey. Methods Self-report questionnaire administered to adults living with HIV/ AIDS, recruited from clinics, service organizations and by active outreach, between 2010 - 2011. Findings Having multiple sex partners with inconsistent condom use during a 3-month recall period was associated with being male, younger age, having more years of education,substance use frequency and men having sex with men being a mode of acquiring HIV. In addition, lower self-efficacy for condom use scores were associated with having multiple sex partners and inconsistent condom use. Conclusion Social Action Theory provided a framework for organizing data from an international sample of seropositive persons. Interventions for sexually active, younger, HIV positive men who have sex with men, that strengthen perceived efficacy for condom use, and reduce the frequency of substance use, may contribute to reducing HIV-transmission risk. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to determine whether the Comprehensive Reminder System based on the Health Belief Model improves health belief, health behaviours, medication adherence and blood pressure control as a means of decreasing the rate of stroke recurrence among hypertensive ischaemic stroke. Background Hypertensive patients having experienced recent ischaemic strokes are at high risk for stroke recurrence. Several trials attempted to improve secondary stroke prevention via patient education, however, patient outcomes remained poor. Long-term follow-up studies regarding secondary stroke prevention are limited. Design A multi-centre, 12-month, assessor-blinded, parallel-group, randomized controlled longitudinal trial. Methods Hypertensive patients having experienced an ischaemic stroke are the target population. The intervention consists of health belief education, a calendar handbook, a weekly automated short-message service and four telephone follow-up interviews. Outcomes will be assessed at baseline and at 3, 6 and 12 months following discharge. The primary outcome is blood pressure control. The secondary outcomes include health belief, health behaviours and medication adherence. The clinical endpoint is the rate of stroke recurrence. Discussion Although many efforts to improve secondary stroke prevention have been undertaken, research indicates that improvements remain possible and warranted. This research protocol based on the Health Belief Model will improve our understanding of stroke education and transitional care needed in China and with the world-wide target population. [ABSTRACT FROM AUTHOR]

Aims. The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Background. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. Design. A cross-sectional descriptive survey design. Methods. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Results. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Conclusions. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. [ABSTRACT FROM AUTHOR]

Aim To describe a research protocol designed to formulate a conceptual framework of informal caregiver resilience in palliative care. Background Resilience is the ability to adapt or to improve one's own conditions following experiences of adversity. The end-of-life care provided by informal caregivers is a form of adversity because it entails objective difficulties, emotional involvement and deep levels of introspection that have been stimulated by the death event. Resilience has not yet been addressed in association with end-of-life care. Design This is a multicentre cross-sectional study. Methods We will administer a questionnaire to a sample of informal end-of-life caregivers to collect data about the main psychological, behavioural and healthcare factors that impact resilience. Data analysis will include descriptive and correlational statistical techniques, multiple linear regressions and structural equation modelling. Data will be collected in multiple palliative care centres and statistical analysis will be carried out using software: SPSS version 19.0 and MPlus version 7.3. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship in Italy (Research Grant number 2.13.10) that was awarded in March 2013. Discussion The study seeks to identify the predictive, mediating and moderating roles of select variables: caregivers' self-efficacy, burdens of caregiving, depression and resilience. The results of this analysis will impact the theoretical study of resilience in palliative care and will have practical implications for interventions aimed at supporting caregivers through healthcare teams. [ABSTRACT FROM AUTHOR]

Aims The aims of this study are to describe: (1) the frequency of nurse-reported missed care in neonatal intensive care units; and (2) nurses' reports of factors contributing to missed care on their last shift worked. Background Missed nursing care, or necessary care that is not delivered, is increasingly cited as a contributor to adverse patient outcomes. Previous studies highlight the frequency of missed nursing care in adult settings; the occurrence of missed nursing care in neonatal intensive care units is unknown. Design A descriptive analysis of neonatal nurses' self-reports of missed care using data collected through a cross-sectional web-based survey. Methods A random sample of certified neonatal intensive care nurses in seven states was invited to participate in the survey in April 2012. Data were collected from nurses who provide direct patient care in a neonatal intensive care unit ( n = 230). Descriptive statistics constituted the primary analytic approach. Results Nurses reported missing a range of patient care activities on their last shift worked. Nurses most frequently missed rounds, oral care for ventilated infants, educating and involving parents in care and oral feedings. Hand hygiene, safety and physical assessment and medication administration were missed least often. The most common reasons for missed care included frequent interruptions, urgent patient situations and an unexpected rise in patient volume and/or acuity on the unit. Conclusion We find that basic nursing care in the neonatal intensive care unit is missed and that system factors may contribute to missed care in this setting. [ABSTRACT FROM AUTHOR]

Aim To report a study protocol that tests the effectiveness of an educational intervention on outcomes of parents and their children who undergo inpatient elective surgery. Background Inadequate children's postoperative pain management remains a global problem. Parents are required to be involved in their child's pain assessment and management, yet they often lack relevant knowledge and skills. Education is an effective strategy for enhancing a person's knowledge, attitudes and behaviour. However, few studies have examined its effectiveness in parents and their children undergoing inpatient elective surgery. Design Randomized controlled trial and embedded qualitative process evaluation. Methods One hundred and sixty-two pairs of participants (each comprised of one parent and his/her child undergoing inpatient elective surgery) will be recruited (protocol approved in January 2013). Participants will be randomized to either a Control group (routine care), an Intervention group 1 (routine care and an educational intervention with face-to-face teaching), or an Intervention group 2 (routine care and an educational intervention without face-to-face teaching). Outcome measures will include parents' knowledge, attitude and behaviour related to postoperative pain management; their child's postoperative pain; and parents' satisfaction with their child's pain management at baseline and around 6, 12 and 24 hours after the operation. Discussion A standardized educational intervention protocol and detailed study procedure have been developed in this study to improve parents' knowledge, attitude and behaviour related to postoperative pain management and reduce their child's postoperative pain. [ABSTRACT FROM AUTHOR]

Aim To develop and examine the effectiveness of a home-based self-help psychoeducation programme on health-related quality of life, stress level, anxiety and depression symptoms, self-efficacy, cardiac risk factors and health service use of outpatients with coronary heart disease. Background Hospital-based cardiac rehabilitation programmes have been shown to improve, effectively, the quality of life of patients with coronary heart disease. However, a majority of these patients do not participate in these programmes, while those who do enrol in these programmes fail to complete the programmes. Design Randomized controlled trial with repeated measures. Methods This study was approved and received the grant in July 2013. A convenience sample of 128 coronary heart disease outpatients will be recruited from a tertiary hospital in Singapore. Participants are randomly assigned to the 4-week experimental group and will participate in the programme or the control group who will not participate in the programme. The outcome measures include the: 12-item Short Form Health Survey, Perceived Stress Scale, Hospital Anxiety and Depression Scale and General Self-Efficacy Scale. Data will be collected at baseline, then 4 and 16 weeks from baseline. At the end, a process evaluation will be conducted to assess the acceptability, strengths and weaknesses of our programme based on the participants' perspectives. Discussion Our programme offers coronary heart disease patients an additional option to the existing cardiac rehabilitative services in Singapore hospitals. It aims to help them manage their disease effectively by reducing cardiac risk factors and improve their health-related quality of life and psychological well-being. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to examine the psychometric properties of the 11-item Chinese version of the Career Success Scale. Background Nurses play an important role in the healthcare system. Opportunities to achieve success and satisfaction from one's career affect the retention and stability of the nursing workforce. The Career Success Scale was originally developed in English and has been translated into Chinese. Psychometric testing of the Chinese Career Success Scale for measuring career success in nurses has not been performed. Design A cross-sectional survey was conducted. Method A convenience sample of 1148 clinical nurses were recruited from 10 level-3 hospitals in Guangdong Province, mainland China, from December 2010-December 2011. Results Results indicated that the Chinese Career Success Scale demonstrated good internal consistency and test-retest reliability. Principal component analysis supported the three-factor structure of the original instrument: Career Satisfaction, Perceived within Organization Competitiveness and Perceived External Organization Competitiveness. There were significant correlations among the three factors, which demonstrated the good construct validity of the Chinese version of this scale. Conclusion The Chinese Career Success Scale appears to be a reliable and valid instrument. It has the potential to be used to measure nurses' career success in mainland China. The findings will be useful for nurse leaders and policymakers in the evaluation of nurses' self-perceived career success and to develop strategies to promote nurse retention and career development. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the Paediatric Intensive Care Unit-Nursing Knowledge and Skills Test - a multiple-choice test for measuring the key nursing knowledge and skills required for safe, competent practice. Background Intensive care graduate nurse residency or orientation programmes are key strategies in the development of safe and competent practitioners. Essential to these programmes is an evaluation of knowledge and skills. Multiple-choice examinations provide a valuable way of evaluating broad knowledge and skills; however, there has been limited work in this area to date. Design Psychometric evaluation. Methods The instrument was administered to 79 nurses from four paediatric intensive care units in Australia and New Zealand over 18 months between 2008-2010. Internal consistency using Kuder-Richardson 20, item analysis and construct validity using the 'known groups' technique were explored. Results Kuder-Richardson 20 reliability estimate for the 109-item test was 0·85. Instrument scores were significantly higher amongst nurses with postgraduate education and more years of paediatric intensive care experience. Item difficulty indices ranged from 0·08 to 1, with a mean item difficulty of 0·66. Item discrimination ranged from 0·2-0·8. Conclusion Testing of the instrument demonstrated encouraging psychometric properties. With additional refinement, this tool could provide educators and managers with an instrument to assist in the assessment of knowledge and skill acquisition. The instrument requires further testing in different samples of paediatric intensive care nurses to enable validation in other settings and cross-cultural comparisons. [ABSTRACT FROM AUTHOR]

Aim To investigate and understand patient's satisfaction with nursing care in the intensive care unit to identify the dimensions of the concept of 'satisfaction' from the patient's point of view. To design and validate a questionnaire that measures satisfaction levels in critical patients. Background There are many instruments capable of measuring satisfaction with nursing care; however, they do not address the reality for critical patients nor are they applicable in our context. Design A dual approach study comprising: a qualitative phase employing Grounded Theory and a quantitative and descriptive phase to prepare and validate the questionnaire. Methods Data collection in the qualitative phase will consist of: in-depth interview after theoretical sampling, on-site diary and expert discussion group. The sample size will depend on the expected theoretical saturation n = 27-36. Analysis will be based on Grounded Theory. For the quantitative phase, the sampling will be based on convenience ( n = 200). A questionnaire will be designed on the basis of qualitative data. Descriptive and inferential statistics will be used. The validation will be developed on the basis of the validity of the content, the criteria of the construct and reliability of the instrument by the Cronbach's alpha and test-retest approach. Approval date for this protocol was November 2010. Discussion Self-perceptions, beliefs, experiences, demographic, socio-cultural epistemological and political factors are determinants for satisfaction, and these should be taken into account when compiling a questionnaire on satisfaction with nursing care among critical patients. [ABSTRACT FROM AUTHOR]

Aim To describe the tasks and the roles of nurses and midwives in Sub- Saharan African health services. Background The current roles of nurses and midwives in the African region of the World Health Organization have not been empirically established, with only studies from two countries found ( South Africa and Mozambique). This makes it difficult to establish whether current nursing/midwifery education programmes and regulations adequately address the needs in the health services. Design A descriptive quantitative study. Methods A survey questionnaire was administered to ambulatory and hospital services. Data were collected between June- December 2010, with completed responses from 734 nurses from nine African countries (five Anglophone and four Francophone). Results The highest reported role functioning in both settings was for 'General Care and Treatment'. The lowest role functioning reported in both settings was in the role 'Maternal and Child Health' and in 'The Provision of Mental Health Care'. The reported role performance in Anglophone countries was significantly greater than in Francophone countries. Conclusion The development of competency in nursing/midwifery roles other than medical surgical roles (general assessment and care) should receive more attention in curricula. Special attention needs to be given to Francophone countries, where the professions of nursing and midwifery are poorly developed. [ABSTRACT FROM AUTHOR]

Aim To report the psychometric testing of the Household Risk Perception and Self-Efficacy in Environmental Risk Reduction instruments using principal components analysis. Background There are limited instruments available to test household risk perception and self-efficacy related to environmental health behaviours. The Household Risk Perception instrument was developed to measure personal perceptions of household environmental health risks. The Self-Efficacy in Environmental Risk Reduction instrument was designed to measure caregivers' confidence in taking steps to reduce household risks. Design An exploratory analysis of previous data was undertaken. Method Baseline data from 235 caregivers enrolled in a randomized clinical trial testing a healthy housing intervention were collected between 2006-2009. Principal components analysis was used to determine principal components from measured responses to each instrument. Results Components were explored and compared to constructs used to design the original instruments. A five-component structure showed the simplest solution and explained 65% of variance in the Household Risk Perception analysis. Cronbach's alpha values indicated satisfactory internal consistency for four of five identified components. Risk perception varied according to available sensory input of the specific risk. A four-component structure explained 64% of the variance in the Self-Efficacy in Environmental Risk Reduction analysis. Cronbach's alpha values were satisfactory. Items mapped to steps in an action-oriented process vs. agent-specific actions. Results from both analyses suggest that environmental tobacco smoke is perceived differently than other household risks. Conclusion Previously, both instruments relied on item reliability and content validity testing. This study provides a basis for further instrument revision and theoretical testing. [ABSTRACT FROM AUTHOR]

Abu Hamad B.A. & Sammour H.K. (2013) Weaning practices of mothers attending United Nations Relief and Works Agency health centres in the Gaza Governorates. Journal of Advanced Nursing 69(4), 773-781. doi: 10.1111/j.1365-2648.2012.06057.x Abstract Aim. To report a study about weaning patterns and practices among Palestinian mothers attending health centres managed by the United Nations Relief and Works Agency in the Gaza Strip. Background. Although breastfeeding and weaning are important domains in child health, weaning has gained little attention from healthcare providers and researchers. In Arab culture, weaning practices are problematic and information gaps exist in relation to how and when weaning takes place. Design. A descriptive/analytical cross-sectional study. Methods. A multi-stage stratified random sample of 285 mothers of infants from 6-24 months, attending six health centres, was selected and completed an interviewed questionnaire in 2009. The Statistical Package for Social Sciences Program was used to conduct descriptive and analytical analysis. Results. The rate of exclusive breastfeeding for infants from 0-6 months of age was low. Pregnancy was reported as the main reason for weaning. The mean weaning age was 13·5 months. The vast majority of mothers used sudden weaning, from them, the majority used traditional methods. The most popular traditional methods used by mothers were putting substances with bad taste especially aloe vera (Subra Murra) on the nipples, using of alternatives as pacifiers, putting red substances, and placing coffee on the nipples. Variations were found in the use of traditional methods in reference to mothers' demographic characteristics. Conclusion. During counselling mothers, nurses should focus on promoting gradual weaning practices and abstain from using traditional methods. Also, nurses should receive training and supervision on the appropriate weaning practices. [ABSTRACT FROM AUTHOR]