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Aims To report a systematic review of the psychometric properties of self-report instruments to identify the symptoms of anxiety in pregnancy to help clinicians and researchers select the most suitable instrument. Background Excessive anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. Design Psychometric systematic review. Data sources A systematic literature search of the multiple databases (1990-September 2014). Review methods Identification of self-report instruments to measure anxiety in pregnancy using COSMIN guidelines to assess studies reporting a psychometric evaluation of validity and reliability. Results Thirty-two studies were included. Studies took place in the UK, Australia, Belgium, Canada, Germany, Italy, Scandinavia, Spain and the Netherlands. Seventeen different instruments were identified. Measures of validity were reported in 19 papers and reliability in 16. The overall quality of the papers was rated as fair to excellent using the COSMIN checklist. Only one paper scored excellent in more than one category. Conclusion Many instruments have been adapted for use in different populations to those for which they were designed. The State Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale and the Hospital Anxiety and Depression Scale have been tested more frequently than other instruments, yet require further assessment to confirm their value for use in pregnancy. [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]

Aim: To gain insight into the perceived emotional impact of providing palliative care among nursing assistants in Dutch nursing homes, their strategies in coping with this impact and associated needs. Design: Exploratory qualitative study. Methods: In 2022, 17 semistructured interviews with nursing assistants working in Dutch nursing homes were conducted. Participants were recruited via personal networks and social media. Interviews were open‐coded by three independent researchers following the thematic analysis approach. Results: Three themes emerged regarding the elements that contribute to the emotional impact of providing palliative care in nursing homes: impactful situations (e.g. witnessing suffering and sudden deaths), interactions (e.g. close relationship and receiving gratitude) and reflection on provided care (e.g. feeling fulfilment or feeling inadequate in caring). Nursing assistants used different strategies to cope, including emotional processing activities, their attitude towards death and work and gaining experience. Participants experienced a need for more education in palliative care and organized peer group meetings. Conclusion: Elements that play a role in how the emotional impact of providing palliative care is perceived by nursing assistants can have a positive or negative impact. Implications for the Profession and/or Patient Care: Nursing assistants should be better supported in coping with the emotional impact of providing palliative care. Impact: In nursing homes, nursing assistants are most involved in providing daily care to residents and have a signalling role in recognizing the deteriorating conditions of residents. Despite their prominent role, little is known about the emotional impact of providing palliative care among these professionals. This study shows that although nursing assistants already undertake various activities to reduce the emotional impact, employers should be aware of the unmet needs in this area and the responsibility they have in this regard. Reporting Method: The QOREQ checklist was used for reporting. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

zwijnenberg n.c. & bours g.j.j.w. (2012) Nurse practitioners and physician assistants in Dutch hospitals: their role, extent of substitution and facilitators and barriers experienced in the reallocation of tasks. Journal of Advanced Nursing 68(6), 1235-1246. Abstract Aims. This paper is a report of a study exploring the role of nurse practitioners and physician assistants, the extent of substitution and the barriers and facilitators experienced by them as a consequence of substitution in public hospitals. Background. Nurse practitioners and physician assistants are emerging worldwide. However, despite the large amount of evidence showing the added value of these professionals, little evidence is available concerning the role, extent of substitution and facilitators and barriers experienced by them as a consequence of substitution. Methods. Interviews were conducted and a questionnaire was completed by 43 nurse practitioners and 13 physician assistants employed in public hospitals in the south of the Netherlands in 2007. Results. Nurse practitioners and physician assistants performed a broad spectrum of tasks, but differed significantly in the time spent and the kind of tasks performed. Nurse practitioners spent 25% (10·4 hours; sd = 5·5) and physician assistants 40% (18·7 hours; sd = 7·6) of their time on medical procedures. They both also performed new tasks or tasks for which there previously was insufficient capacity. Many of them experienced policy/organizational, legal, financial or facility problems in the reallocation of tasks. Conclusion. Nurse practitioners and physician assistants have wide ranging but different responsibilities in public hospitals. By performing medical procedures and new tasks or tasks for which there was not enough capacity, they function as substitutes and supplements for doctors. However, barriers are affecting the extent of substitution. The challenge ahead is to remove the barriers experienced by nurse practitioners and physician assistants. [ABSTRACT FROM AUTHOR]

ockhuijsen h.d.l., gamel c.j., van den hoogen a. & macklon n.s. (2011) Integrating preconceptional care into an IVF programme. Journal of Advanced Nursing 68(5), 1156-1165. Abstract Aim. This paper is a report of a mixed method study of the outcomes of integrating preconceptional care into an in-vitro fertilization programme on nurses' and patients' attitudes and patients' weight and smoking behaviour. Background. Increasing evidence points to the significant effect of lifestyle factors on in-vitro fertilization outcomes. Optimizing the health of couples before they commence in-vitro fertilization may improve the chance of achieving success. Method. In 2007, 130 couples attending a university hospital in-vitro fertilization unit and seven nurses were invited to participate in the study. Questionnaires were developed to assess the attitudes of both patients and nurses. Furthermore, the impact of interventions on body mass index and smoking patterns were evaluated. Results. All nurses ( n = 7) and 101 patients (77·7%) returned completed questionnaires. Analysis revealed a considerable degree of scepticism among the nurses at the outset as to the value of the programme and their ability to perform their new role effectively. Patients valued positively the increased attention to adjusting lifestyle factors with the goal to improve fertility outcomes. Of those participants who smoked or had a body mass index >30, 30% ( n = 7/23) of the patients quit smoking and 50% lost weight ( n = 15/30), mean loss: 6·1 kg. Conclusion. Fertility nurses can play a key role in the provision of preconceptional care. Patients with a fertility problem can be motivated to address lifestyle issues before embarking on in-vitro fertilization treatment. The integration of preconceptional care and lifestyle interventions was shown to be feasible in our clinical setting. [ABSTRACT FROM AUTHOR]

paans w., sermeus w., nieweg r.M.B. & van der schans c.P. (2010) Prevalence of accurate nursing documentation in patient records. Journal of Advanced Nursing 66(11), 2481-2489. Aim. This paper is a report of a study conducted to describe the accuracy of nursing documentation in patient records in hospitals. Background. Accurate nursing documentation enables nurses to systematically review the nursing process and to evaluate the quality of care. Assessing nurses' reports in patient records can be helpful for improving the accuracy of nursing documentation. Method. In 2007-2008, we screened patient records ( n = 341) from 35 wards in 10 hospitals in the Netherlands. The D-Catch instrument was used to quantify the accuracy of the (1) record structure, (2) admission data, (3) nursing diagnosis, (4) nursing interventions, (5) progress and outcome evaluations and (6) legibility of nursing reports. Items 2-5 were measured as a sum score of quantity criteria (1-4) and quality criteria (1-4), whereas Items 1 and 6 were measured on a 4-point Likert scale that addressed only quality criteria. Findings. The domain 'accuracy of the interventions' had the lowest accuracy scores: 95% of the records revealed a scale score not higher than 5. However, the domain 'admission' had the highest scores: 80% of the records revealed a scale score over 5. Conclusion. Effective documentation systems that support nurses in linking diagnoses, interventions and progress and outcome evaluations could be helpful. To improve the accuracy of the documentation, further research is needed on what factors influence nursing documentation. Comparable outcomes from other studies indicate that applying our study findings to international contexts might support the development of universal criteria for accurate nursing documentation. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to develop insights into how and why Dutch government policies on deployment and training of nurse practitioners and physician assistants have effect and under what circumstances. Design: A realist analysis using qualitative interviews. Methods: Data analysis of 50 semi‐structured interviews conducted in 2019 with healthcare providers, sectoral and professional associations, and training coordinators. Stratified purposive and snowball sampling were used. Results: Policies stimulated employment and training of nurse practitioners and physician assistants by: (1) contributing to the familiarity of participants in the decision‐making process in healthcare providers with and medical doctors' trust in these professions; (2) contributing to participants' motivation in employment and training; and (3) eliminating barriers perceived by medical doctors, managers and directors. The extent to which policies affected employment and training was largely determined by sectoral and organizational circumstances, such as healthcare demand and complexity, and decision‐makers in healthcare providers (medical doctors or managers/directors). Conclusion: Effectuating familiarity and trust among participants in the decision‐making process is a crucial first step. Next, policymakers can motivate participants and lower their perceived barriers by extending the scope of practice, creating reimbursement opportunities and contributing to training costs. Theoretical insights into nurse practitioner and physician assistant employment and training have been refined. Impact The findings highlight how governments, health insurers, sectoral and professional associations, departments, councils, healthcare providers and professionals can facilitate and support nurse practitioner and physician assistant employment and training by contributing to familiarity, trust and motivation, and by clearing perceived barriers. [ABSTRACT FROM AUTHOR]

Aim: To understand self‐employed long‐term‐care workers' experiences of precariousness, and to unravel how their experiences are shaped at the intersection of gender, class, race, migration and age. Background: In the Netherlands, increasing numbers of nurses and nursing aides in long‐term care (LTC) opt for self‐employment. Societal organizations and policy makers express concerns about this development, as self‐employment is seen as a risk factor for poor health. Self‐employment is not necessarily precarious work but can contribute to the precariousness of specific groups. Knowledge about inequities among self‐employed nurses and nursing aides in long‐term care is lacking. Design: A participatory, qualitative interview study. The research team consisted of four academic researchers and five (un)paid care workers. Methods: Semi‐structured interviews with 23 self‐employed nurses and nursing aides in LTC (2019–2020). Data were analysed from an intersectional perspective. Results: First, we describe that feeling precarious as a hired employee—due to increasing workloads, health risks, poverty and discrimination—shapes care workers' choice for self‐employment. Second, we describe inequities between self‐employed care workers who could (financially) afford to turn to self‐employment as a health strategy and those who felt squeezed out of the organizations due to poverty or discrimination. They more often dealt with precarious work in the context of precarious lives, negatively impacting their health. Third, we describe how negotiating an entrepreneurial identity with a caring identity required material sacrifices and thus contributed to self‐employed care workers' financial precariousness, particularly as women. Conclusion: Our findings indicate that working in LTC is becoming increasingly precarious for all care workers, both for hired and self‐employed, with younger, lower‐paid and racialized women with unpaid caring responsibilities seemingly most at risk for precariousness. Impact Our findings urge policy makers and care organizations to develop gender and diversity‐sensitive policy responses to address these inequities. [ABSTRACT FROM AUTHOR]

Aims: This interview study focuses on the needs and wishes of Arabic‐speaking migrant women in the Netherlands to culturally adapt and optimize the digital support platform SAFE (safewomen.nl) for intimate partner violence and abuse (IPVA) for their use. Design: This is a qualitative interview‐based study. Methods: We conducted the study between March 2020 and 2021. The study entailed 16 semi‐structured interviews with Arabic‐speaking women in the Netherlands with a migration background. Results: Findings suggest that a cultural gap, a lack of knowledge of the Dutch law, and the prevalence of restrictive gender roles amongst the participants and their spouses affected their acknowledgement of the different forms of IPVA. Furthermore, mental health consequences of IPVA were also strongly stigmatized. Clear information in their native language, summarizing infographics and potential interactive features should be main components of any eHealth intervention for this target group. Conclusion: The participants in our study deemed e‐help a potentially valuable support option for women experiencing IPVA in their community. The impact of IPVA on mental health is currently overlooked within this target group and should be emphasized in future interventions. Impact Cultural sensitivity proved crucial in understanding the concepts of IPVA amongst women with migrant backgrounds. To ensure effective eHealth interventions for migrant women, they should be involved in the design and delivery of these interventions. [ABSTRACT FROM AUTHOR]

Aims: To explore caregivers' needs and problems in three European countries and associate the clusters of caregivers' needs with their sociodemographic characteristics. Design: A qualitative focused mixed methods design was used. Methods: In total, 52 caregivers of heart failure (HF) people were interviewed in three European countries between March 2017 and December 2018. Transcripts were analysed using the seven‐phase method of the exploratory multidimensional analysis according to Fraire with Reinert lexical classes findings were organized in dendrograms. Mayring's content analysis was also performed. Results: Three clusters of caregivers were identified: spouses, adult children and non‐family members. Caregivers not only provide HF patients with vital unpaid support for their physical and emotional needs, but they are continually trying to cope with their social isolation and deteriorating health. Conclusions: Informal caregiving emerged as a complex process influenced by various sociodemographic factors. Gender, relationship type and economic status are the important factors to be considered planning to develop approaches to address the needs of caregivers serving people with heart failure. Impact A comprehensive understanding of the nature of informal caregiving of individuals with heart failure, the complexity of the real‐world sociodemographic and cultural factors is warranted. The use of the EMDA method gave us the possibility of processing large masses of qualitative data through rapid, complex calculations. In detail, AATD allowed us to study in deep the significant fuzziness of what caregivers expressed and to analyse the content of the entire interviews and to produce global knowledge by using multi‐dimensional statistical methods to grasp the fundamental sense of the interviews, beyond the simple words. Three clusters were identified in the samples, including spouses, adult children and non‐family members. This study demonstrated that some sociodemographic characteristics could lead to everyday needs. Therefore, these demographic characteristics should be considered in developing targeted interventions. The research was conducted in Europe, but the technique shown can be replicated everywhere. The findings not only impact nursing but can be extended to all those stakeholders who concur with a public health educational mission. Patient or Public Contribution: Carers were involved in this study after the discharge of their loved ones or at the time of the outpatient visit. They were involved after they had been observed in their dynamics of involvement in caring of the familiars or friends with heart failure. [ABSTRACT FROM AUTHOR]

Aim: To identify and follow‐up on the transition towards differentiated nursing practice among bachelor trained and vocationally trained nurses in Dutch hospitals. Design: A multiphase general qualitative interview study. Methods: Fifty semi‐structured interviews with project managers in charge of introducing differentiated nursing practice to their hospital were conducted. Purposive sampling was used, and data were collected in 2017, 2019 and 2020. A meta‐analysis was conducted after independent primary thematic analysis of each data collection. Results: The introduction of differentiated nursing practice to Dutch hospitals was perceived as uncertain and ambiguous. Three themes were identified during the transition towards differentiated nursing practice: (1) call to action; (2) sitting and waiting; and (3) new beginnings and open ends. The change to differentiated nursing practice is not straightforward and these findings highlight the emerging awareness among project managers of the nature and complexity of the transition. During the study period, professionalization of the nursing profession was recognized as fundamental in hospital organizations. Conclusion: Nursing cannot be separated from differentiated nursing practice. Visible leadership is important at all organizational levels and nurses' opinions must be considered as nurses are essential to such changes in healthcare. Impact: Differentiated nursing practice based on nursing education allows nurses to make the best use of their experience, skills and competencies, and could promote the provision of effective and high‐quality patient care. However, in many cases, a nurse's practice role is based on their nursing licensure instead of their educational background. The change to differentiated nursing practice in hospitals is not straightforward and the nature and complexity of the transition needs to be acknowledged. Nurses have an important role in healthcare transformation and need to be active in developing and formulating rather than just implementing the changes. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effects of the implementation of a professional practice model based on Magnet principles on the nurse work environment in a Dutch teaching hospital. Design: A quasi‐experimental study. Methods: Data were collected from registered nurses working on the clinical wards and outpatient clinics of the hospital in June/July 2016 (baseline) and in June/September 2019 (measurement of effects). Participants completed the Dutch Essentials of Magnetism II survey, which was used to measure their perception of their work environment. After baseline measurements were collected, interventions based on a professional practice model incorporating Magnet principles were implemented to improve the nurse work environment. Descriptive statistics and independent t‐tests were conducted to examine differences between survey outcomes in 2016 and 2019. Results: Survey outcomes revealed significant changes in the nurse work environment between 2016 and 2019. Seven of the eight subscales (essentials of magnetism) improved significantly. Score for overall job satisfaction increased from 7.3 to 8.0 and score for quality of care increased from 7.0 to 7.6. On unit level, 17 of the 19 units showed improvement in the nurse work environment. Conclusion: The implementation of a professional practice model positively affects the nurse work environment, job satisfaction and quality of care. Impact: Nowadays, the quality of care is threatened by workload pressure and the low autonomy experienced by nurses. Considering the global shortage of nurses and growing complexity of healthcare, it is important to invest in improving the nurse work environment. The Magnet concept created a work environment in which nurses can deliver optimal quality of care. Knowledge of how Magnet principles affect the nurse work environment in the Netherlands is missing. These study results, including the description of how the interventions were implemented, will assist other hospitals to develop improvement strategies by focusing on the nurse work environment. [ABSTRACT FROM AUTHOR]

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Aims To understand how nursing homes employ baccalaureate-educated Registered Nurses ( BRNs) and how they view the unique contributions of baccalaureate-educated Registered Nurses to staff and residents in their organizations. Background Although providing care for nursing home residents is complex and thus requires a high level of skills, organizations often struggle to recruit and retain BRNs. Some nursing home organizations do not employ baccalaureate-educated Registered Nurses at all. Among those that do, it is unknown how well these organizations make use of baccalaureate-educated Registered Nurses' expertise or if their roles are different from those of other staff. Design A qualitative study, consisting of 26 individual and three group interviews was conducted in the Netherlands. Methods Interviews were conducted at the board-, management- and staff-level in six nursing home organizations. Data were collected between January 2016-May 2016. Results Organizations employed baccalaureate-educated Registered Nurses to fulfil an informal leadership role for direct care teams. Organizations that do not employ baccalaureate-educated Registered Nurses were unable to articulate their role in the nursing home setting. Difficulties baccalaureate-educated Registered Nurses experienced during role implementation depended on role clarity, the term used to refer to the baccalaureate-educated Registered Nurse, the extent to which nurses received support, openness from direct care teams and baccalaureate-educated Registered Nurses' own behaviour. The unique contribution of baccalaureate-educated Registered Nurses perceived by respondents differed between and in organizations. Conclusion Our findings suggest that there is no 'one size fits all' approach to employing baccalaureate-educated Registered Nurses in nursing homes. To ensure the satisfaction of both baccalaureate-educated Registered Nurses and the organizations that employ them, careful implementation and evaluation of their role is crucial. [ABSTRACT FROM AUTHOR]

Aims We aimed to elucidate facilitators and barriers that HIV nurses experience in discussing sexual risk behaviour with HIV-positive men who have sex with men, using variables from a previous qualitative study and the theory of planned behaviour. Background HIV-positive men who have sex with men are frequently diagnosed with sexually transmitted infections, which can be reduced if HIV nurses discuss sexual risk behaviour. Design An online questionnaire was disseminated in April 2015 among all HIV nurses in the Netherlands. Methods We assessed variables, such as attitudes, shame, ability, knowledge and time concerns. A regression analysis was conducted with 'intention to discuss sexual risk behaviour' as an outcome variable. Results The questionnaire was completed by 60 of 79 HIV nurses. Overall, participants reported high intentions to discuss sexual risk behaviour, and 38% of the variance was explained by attitude, sexual preference, knowing ways to introduce the topic and experiencing enough time or viewing it as a priority. In addition, high intenders significantly differed from low intenders in 'experienced shame,' 'relation with patients,' 'non-verbal communication,' 'subjective norm' and 'knowledge.' Conclusion Improving sexual health in HIV care translates into improving opportunities and the facilitating factors in initiating the discussion of sexual risk behaviour rather than removing barriers HIV nurses experience. Interventions should mainly focus on improving the HIV nurses' perceived ability to initiate the topic of sexual risk behaviour and to utilize the jargon and terminology that is commonly used among men who have sex with men. [ABSTRACT FROM AUTHOR]

Aim To gain insight into the quantity and quality of spiritual care provided by nurses in curative cancer care, from the perspectives of both patients and nurses. Background Cancer causes patients to suffer from diverse symptoms related to their illness. Nurses play an important role in the care for people with cancer. Next to paying attention to physical and psychosocial needs, caring for spiritual needs of patients also belongs to good nursing. Most of the research concerning spirituality and spiritual care in relation to cancer has focused on palliative care. Design A mixed methods design will be used in two sub-phases. First, we will conduct semi-structured interviews with 72-90 patients coming from nine hospitals. Subsequently, approximately the same number of nurses working on oncology wards of these hospitals will be interviewed. Methods We meticulously composed both interview guides so that only near the end of the interview explicit terms like spirituality and spiritual care are explicitly mentioned. Until that point, we will use other words to define the concepts. Next to the interviews, demographics, answers to some statements and several questionnaires will be gathered. Content analysis supported by DEDOOSE will be used to answer the research questions. Discussion The insight we will gain in this study enables us to compare experiences from the perspective of both patients and nurses. This can also provide us with suggestions for the improvement of nursing care for people with cancer who are treated with curative intent, a topic until now hardly addressed. [ABSTRACT FROM AUTHOR]

Aim This study examined the impact of family group conferences on coercive treatment in adult psychiatry. Background Coercive treatment in psychiatry infringes the fundamental rights of clients, including the right to control their lives. A promising intervention is the family group conferences, which has the potential to prevent crises through the integration of the expertise of informal and professional networks. Design A responsive evaluation, including qualitative and quantitative methods, was deployed to study the process leading up to the FGC, the proceedings and the impact of the conference. Method From 2013-2015, 41 family group conferences were studied in three regions in the Netherlands. The impact of every conference was examined with scales (ranging from 0-10) during interviews with attendees (clients, family members, friends, mental health professionals and family group conferences coordinators) who reflected on three outcome measures: belongingness, ownership and coercion. Results After the family group conferences, respondents indicated a slight reduction in their experience of coercive treatment. They also mentioned an increase in ownership and belongingness. Conclusion Family group conferences seems a promising intervention to reduce coercion in psychiatry. It helps to regain ownership and restores belongingness. If mental health professionals take a more active role in the pursuit of a family group conferences and reinforce the plans with their expertise, they can strengthen the impact even further. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the self-efficacy and performance in self-management support ( SEPSS) instrument. Background Facilitating persons with a chronic condition to take an active role in the management of their condition, implicates that nurses acquire new competencies. An instrument that can validly and reliably measure nurses' performance and their perceived capacity to perform self-management support is needed to evaluate current practice and training in self-management support. Design Instrument development and psychometric testing of the content and construct validity, factor structure and reliability. Methods A literature review and expert consultation ( N = 17) identified the content. The items were structured according to the Five-A's model and an overarching category of 'overall' competencies. The initial instrument was tested in a sample of 472 nurses and 51 nursing students from Belgium and the Netherlands, between June 2014-January 2015. Results Confirmatory factor analyses revealed satisfactory fit indices for the six-factor structure. Discriminating power was demonstrated for subgroups. The overall internal consistency (Cronbach's alpha) was high both for the self-efficacy and the performance items. The test-retest intra-class correlation coefficients were good. Conclusion The SEPSS instrument is a 36-item, Likert-scaled self-reporting instrument with good content and construct validity, and good internal consistency reliability and good test-retest reliability. Therefore, it is a promising instrument to measure self-efficacy and performance with regard to self-management support. [ABSTRACT FROM AUTHOR]

Aims. To unravel outpatient nurses' views on the role of people with chronic conditions in self-management, nurses' own support role and to establish how these views relate to nurse-led self-management interventions. Background. Providing self-management support is a core task of nurses in outpatient chronic care. However, the concept of self-management is interpreted in different ways and little is known about nurses' views on patients' role in self-management and nurses' own support role. Design. Qualitative design. Methods. Individual semi-structured interviews were held in 2012-2013 with outpatient nurses at a university medical hospital in the Netherlands. After transcription, data-driven codes were assigned and key elements of views and experiences were discussed in the research team. Finally, insights were merged to construct and characterize types. Results. Twenty-seven nurses were interviewed. The analysis identified three divergent views on self-management support: adhering to a medical regimen; monitoring symptoms; and integrating illness into daily life. These views differ with respect to the patient's role in self-management, the support role of the nurse and the focus of activities, ranging from biomedical to biopsychosocial. The first two were mainly medically oriented. Nurses applied interventions consistent with their individual views on self-management. Conclusion. Nurses had distinct perceptions about self-management and their own role in self-management support. Social and emotional tasks of living with a chronic condition were, however, overlooked. Nurses seem to lack sufficient training and practical interventions to provide self-management support that meets the integral needs of patients with a chronic condition. [ABSTRACT FROM AUTHOR]

Aim This article presents a discussion of the conceptual model of ethical sensitivity. Background Recent research pays little attention to the tacit dimension of ethical knowledge. We focus on care practices, drawing a distinction between explicit moral knowledge and tacit moral knowing. This focus has far-reaching methodological consequences, influences the research design of empirical research and enables healthcare workers to discern both explicit and tacit knowing. Data sources This article draws on literature about tacit knowledge, practices and ethical sensitivity, covering publications from 1958-2011. Data used in the illustrative cases were gathered in 2009 during the phenomenological phase of a multiple-case study. Discussion Taking practices as the point of entry for exploring ethical sensitivity makes it possible to study empirically both explicit moral knowledge and tacit moral knowing. Given how relevant practical knowledge is, we aim to put forward a theoretical framework that leaves room for the discernment of this tacit moral knowing. Implications for nursing Creating opportunities to reflect on daily ethical concerns in an inter-professional team can contribute to improvement on quality of care. Conclusion The broadened perspective on ethical sensitivity can be used as a heuristic device to discern what both explicit and implicit moral knowledge in care are about. This empirical way of looking at care practices can enhance the awareness of the moral knowing of the professional caregiver. [ABSTRACT FROM AUTHOR]

Aims To identify determinants of practice nurses' intention to implement a new smoking cessation intervention and to investigate the independent value of attitude and Rogers' innovation characteristics. Background While effective smoking cessation interventions exist, implementation is often suboptimal. No previous studies have disentangled the independent value of beliefs towards implementation and innovation characteristics in explaining implementation. Design A cross-sectional descriptive study. Methods In 2010, 56 of 91 general practice nurses who participated in an intervention effectiveness trial completed an online questionnaire concerning demographics, patient population characteristics, attitude, innovation characteristics, self-efficacy, perceived social influence and intention to implement the intervention in the future. Recruitment success during the trial was defined as the number of patients participating. To detect differences between intending and non-intending practice nurses, independent sample t-tests and Chi-squared tests were conducted. Correlation coefficients were calculated to identify associations between potential determinants of intention. To identify significant determinants logistic hierarchical regression analyses were conducted. Results Innovation characteristics and attitude were both significantly associated with practice nurses' intention to implement. While recruitment success showed a significant positive association with intention, perceived patient support was only a significant determinant when including innovation characteristics or attitude. Conclusion To increase new interventions' implementation rates, it is most important to convince health professionals of its beneficial characteristics, to generate a positive attitude towards the intervention, to aid practice nurses in recruiting smoking patients and to increase perceived patient support. [ABSTRACT FROM AUTHOR]

dijkstra a., yönt g.h., korhan e.a., muszalik m, kędziora-kornatowska k. & suzuki m. (2012) The Care Dependency Scale for measuring basic human needs: an international comparison. Journal of Advanced Nursing 68(10), 2341-2348. Abstract Aim. To report a study conducted to compare the utility of the Care Dependency Scale across four countries. Background. The Care Dependency Scale provides a framework for assessing the needs of institutionalized patients for nursing care. Henderson's components of nursing care have been used to specify the variable aspects of the concept of care dependency and to develop the Care Dependency Scale items. Design. The study used a cross-cultural survey design. Method. Patients were recruited from four different countries: Japan, The Netherlands, Poland and Turkey. In each of the participating countries, basic human needs were assessed by nurses using a translated version of the original Dutch Care Dependency Scale. Psychometric properties in terms of reliability and validity of the Care Dependency Scale have been assessed using Cronbach's alpha, Guttman's Lambda-2, inter-item correlation and principal components analysis. Data were collected in 2008 and 2009. Results. High internal consistency values were demonstrated. Principal component analysis confirmed the one-factor model reported in earlier studies. Conclusion. Outcomes confirm Henderson's idea that human needs are fundamental appearing in every patient-nurse relationship, independent of the patient's age, the type of care setting and/or cultural background. The psychometric characteristics of the Care Dependency Scale make this instrument very useful for comparative research across countries. [ABSTRACT FROM AUTHOR]

hesselink a.e. & harting j. (2011) Process evaluation of a multiple risk factor perinatal programme for a hard-to-reach minority group. Journal of Advanced Nursing 67(9), 2026-2037. Abstract Aim. This article is a report of an evaluation of a multiple risk factor perinatal programme tailored to ethnic Turkish women in the Netherlands. Background. The programme was directed at multiple risk factors and aimed at improving maternal lifestyle, infant care practices and psychosocial health during pregnancy and after delivery. The programme was carried out by ethnic Turkish community health workers in collaboration with midwives and physiotherapists. Methods. Our multiple case study included three Parent-Child Centres providing integrated maternity and infant care. Participants ( n = 119) were first and second generation pregnant ethnic Turkish women with relatively unfavourable risk profiles. Data were collected between 2005 and 2008 using mixed methods, including field notes, observations and recordings of group classes, attendance logs, semi-structured individual interviews, a focus group interview, and structured questionnaires. Findings. Most participants (82%) were first generation ethnic Turkish; 47% had a low educational level; 43% were pregnant with their first child; and 34% had a minimal knowledge of the Dutch language. The community health workers' Turkish background was vital in overcoming cultural and language barriers and creating a confidential atmosphere. Participants, midwives and health workers were positive about the programme. Midwives also observed improvements of knowledge and self-confidence amongst the participants. The integration of the community health workers into midwifery practices was crucial for a successful programme implementation. Conclusions. A culturally sensitive perinatal programme is able to gain access to a hard-to-reach minority group at increased risk for poor perinatal health outcomes. Such a programme may be well received and potentially effective. [ABSTRACT FROM AUTHOR]

The article presents a study on the experiences of healthcare professionals in implementing nurse-delivered cardiovascular prevention to high risk patients in primary care. The study revealed that implementation of nurse-delivered cardiovascular prevention are being hindered by lack of knowledge on guidelines, lack of communication, and insufficient coaching by doctors. It is suggested that there should be mutual confidence between care providers to remove the barriers in such implementation.

The article discusses a study in the Netherlands regarding the experiences of nurses involved in palliative sedation at home. Such study involved 387 nurses that provide medical technical care in 2007, 201 of which filled out the questionnaire. 42% of the respondents revealed that sedation is insufficiently effective. It is concluded that the Dutch guideline for palliative sedation is followed adequately but shortcomings in medication policy, communication, and medical control were found out.