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Objectives: To explore the rate of NUPs and associated factors in the PED of the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain) using Andersen's Behavioural Model. Methods: We conducted a descriptive cross‐sectional study using Andersen's Behavioural Model in parents visiting the PED with their children at the 'Hospital Universitario y Politécnico La Fe' in Valencia (Spain). Results: The study involved a total of 530 participants, of whom 419 (79%) had made an NUP. The predisposing factors identified were: (I) paediatric patients brought in by their fathers (OR = 0.460; p = 0.005), (II) lower educational attainment (OR = 3.841; p = 0.000), (III) first‐time parenthood (OR = 2.335; p = 0.000) and (IV) higher parental stress (OR = 1.974; p = 0.023). The enabling factors included: (I) responsibility for a significant part of the childcare shared with others (OR = 0.348; p = 0.041) and (II) the perception that PEDs provide better care than primary care (PC) services (OR = 1.628; p = 0.005). The need factors were: (I) existing chronic illness in the child seeking care (OR = 0.343; p = 0.000) and (II) the perceived severity of the urgency (OR = 0.440; p = 0.031). Conclusions: The NUP rates found in this study are similar to those found internationally. In accordance with Andersen's Behavioural Model, we identify predisposing, enabling and need factors to explain the multifactorial nature of NUPs in PEDs. Implications for Practice: Identifying the factors associated with NUPs enables interventions to be targeted at those groups most likely to engage in NUPs, thereby optimising the functioning of the PED and improving the well‐being of children and families. These interventions should focus on improving parental health literacy, providing education on making appropriate decisions about accessing health services and recognising severe symptoms in children, as well as improving access to high‐quality PC services. Providing support to parents during the transition to parenthood would also be beneficial. Reporting Method: This paper adheres to the STROBE initiative guidelines. Contribution from patients or members of the public: Participants, who voluntarily agreed to take part, contributed to the study by completing a paper‐based questionnaire containing all the study variables as prepared by the research team. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. Background. Globally, the environments in which nurses work influence the quality of nursing practice and health care. Design. A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. Method. A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. Results. A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 2-66-3-05. All subscales except work motivation (3-05, standard deviation: 0-44) scored less than 3-0. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. Conclusion. This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. Relevance to clinical practice. A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factors is important in optimising work place environments. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine Korean registered nurses' level of perceived knowledge and practice of venous thromboembolism risk assessment as well as prevention, self-efficacy in venous thromboembolism care and actual knowledge of venous thromboembolism. Background For hospitalised patients, venous thromboembolism is a preventable clinical disorder. Caring for venous thromboembolism patients requires coordination across multiple providers and settings. Clinical nurses can play a major role in improving venous thromboembolism prevention care, assessing venous thromboembolism risks and providing appropriate prophylactic measures to those who are at risk for venous thromboembolism. Design A cross-sectional descriptive study. Methods Anonymous paper-based surveys were conducted for a convenience sample of registered nurses' ( n = 452) from two university-affiliated hospitals in South Korea. Results The majority of participants indicated that their overall self-rated venous thromboembolism knowledge was 'fair', while only 2·4% rated it as 'very good' or 'excellent'. The overall mean score of the venous thromboembolism knowledge questions was 50·9 (±13·0) of a possible score of 100. The mean score of self-efficacy in practising venous thromboembolism prevention/prophylaxis was 3·0 (based on a one to five Likert scale). The self-reported venous thromboembolism assessment performance on patients varied among clinical units. Only 9·3% of participants reported having received in-service venous thromboembolism education from their hospital. Conclusions The findings showed that overall venous thromboembolism knowledge and self-efficacy in venous thromboembolism prevention practices of Korean registered nurses' were not highly rated. Korean nurses demonstrated a lack of knowledge about venous thromboembolism, particularly in the areas of venous thromboembolism prophylaxis measures and venous thromboembolism diagnosis methods. Relevance to clinical practice Focused education on venous thromboembolism prevention and risk assessment should be considered a component of continuing education for Korean nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives The primary aim of this study was to examine the correlations between patient and caregiver characteristics with caregiver burden, anxiety and depression in Alzheimer's Disease. Secondary aim was to determine which behavioural and psychological symptoms had the greatest impact on caregiver burden, anxiety and depression in Alzheimer's Disease. Background Caregivers of individuals with Alzheimer's Disease experience high levels of burden, both psychologically and physically. Previous studies have examined caregiver burden, anxiety and depression separately. However, no paper has examined these three psychological conditions simultaneously. Design A cross-sectional design. Methods A total of 310 patients with probable Alzheimer's Disease and their primary caregivers were assessed. Cognitive impairment and neuropsychiatric symptoms were assessed with the Mini Mental State Examination, Montreal Cognitive Assessment, Clock Drawing Test and Neuropsychiatric Inventory, respectively. Caregiver burden, anxiety and depression were assessed with the ZBI, Generalised Anxiety Disorder Scale-7 and Patient Health Questionnaire-9, respectively. Results All 12 neuropsychiatric symptoms in the Neuropsychiatric Inventory were significantly correlated with caregiver burden, anxiety and depression, with the top three neuropsychiatric predictors being depression, apathy and anxiety. Furthermore, higher levels of caregiver anxiety were associated with a longer duration of being a caregiver. Within caregivers, higher levels of depression were independently associated with higher numbers of additional caregivers, lower educational background and being the spouse of the patient. Higher levels of burden were associated with a longer duration of being a caregiver and being the spouse of the patient. Caregiver burden, anxiety or depression were not significantly correlated with hours/day of caring for the patient. Conclusions Caregiver burden, anxiety and depression were significantly correlated with different neuropsychiatric symptoms in the Neuropsychiatric Inventory. Relevance to clinical practice Practitioners are able to identify caregivers at risk for burden, anxiety and depression. Understanding which Neuropsychiatric Inventory symptom is more closely associated with distress in caregivers will help practitioners to be more specific and effective in detecting caregiver distress. [ABSTRACT FROM AUTHOR]

Aims and objectives To field test a parental self-efficacy scale regarding its acceptability and feasibility and to describe parental self-efficacy in a convenience sample of parents with children aged 6 years old or less. Background Self-care within families is increasingly emphasised in health policy as a means of maximising healthcare resources. This study reports the field testing of a scale designed to measure parental self-efficacy. Design Cross-sectional survey of parents of children aged 6 years old or less. Methods Subjects were recruited through a parenting internet website ( n = 84) and local parenting and community organisations ( n = 68) and asked to complete a questionnaire containing the scale. Data collection took place between January and August 2011. Results The scale, previously validated with an expert panel of professionals, gathered information about parental self-efficacy when administered either directly or through an on-line data collection portal, although there were more missing data when administered via the Internet. Although convenience and self-selecting samples precluded parameter estimation, areas of concern highlighted were difficulties differentiating children with serious illnesses and the use of the Personal Child Health Record. Use of the Internet was widespread, as was use of community pharmacists and nursery staff. Conclusion Although the primary purpose was not to collect specific data, the data indicated the continuing concern of parents regarding serious illness and where additional investment may be required to meet parental needs and expectations. Relevance to clinical practice The previously validated scale can be used to collect information about parental self-efficacy either through a paper questionnaire or the Internet. Although there was slightly more missing data from the Internet version, the ease of its administration makes this an attractive option. Parents generally reported high levels of self-efficacy and satisfaction with services; however, the scale was able to identify areas where further investment might be useful. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of the study was to review breastfeeding support provided by Public Health Nurses in Ireland. The objectives were to identify the availability of appropriate guiding policies, educational preparation, attitude of Public Health Nurses and the availability and use of other supportive services. Background. Breastfeeding rates in Ireland are among the lowest in Europe. The main source of formal support for breastfeeding mothers in the community in Ireland is from Public Health Nurses who can make referral to other non-statutory resources. The nature of this support is determined by policies guiding clinical practice and education that increases breastfeeding confidence and competence of all personnel. Consequently, an assessment of breastfeeding resources requires an analysis of all these variables. Design. A large quantitative, cross-sectional study was conducted, involving Public Health Nurses and mothers. This paper represents the results from the perspective of Public Health Nurses. Method. Directors of Public Health Nursing ( n = 24) and Public Health Nurses ( n = 204) completed self-report questionnaires by mail and online. Data were analysed using the Statistical Package for Social Sciences and reported using descriptive and inferential statistics. Results. Public Health Nurses are well educated to support breastfeeding and have a positive attitude and a high degree of self-assessed confidence and competence. A wide variety of non-statutory support exists for breastfeeding but is not always used to their full potential. Conclusion. Standardising educational requirements for Public Health Nurses in supporting breastfeeding is an area that requires attention. Ultimately, service delivery in relation to supporting breastfeeding mothers would benefit from being more timely and responsive. Relevance to clinical practice. Awareness of support resources is necessary for Public Health Nurses to make appropriate referrals for breastfeeding mothers. Furthermore, Directors of Public Health Nursing need to encourage the breastfeeding supportive role of Public Health Nurses and facilitate continuing professional development. [ABSTRACT FROM AUTHOR]