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Aim: The present study aimed to examine the effects of a learning programme for nurse managers on connecting learning with their own experiences and fostering competence. Background: In Japan, second‐level programmes for certified nurse administrators represent the main opportunity for formal training for nurse managers. However, it is difficult for nurse managers to transfer second‐level programme learning to their workplace. Methods: This quasi‐experimental study used a two‐group pretest–posttest design with purposive sampling and non‐random assignment of 29 consenting Japanese nurse managers who were participating in a second‐level programme through a prefectural nursing association. The programme provided reflection papers and feedback from a researcher, as well as reflective group sessions. The outcome measure was the Japanese First‐Line Nurse Managers Competence Inventory (JNMCI) score. Results: The intervention group showed significant improvement in JNMCI scores after participating in the programme. A significant difference in JNMCI scores was also observed between the intervention and comparison groups. Conclusion: This learning programme led to improved competency among nurse managers. Implications for Nursing Management: Nurse manager development programmes should include reflection papers and feedback, as well as reflective group sessions, to improve competency among nurse managers. [ABSTRACT FROM AUTHOR]

Consumer-directed care (CDC) is increasingly widespread among aged care service options in Organisation for Economic Co-operation and Development (OECD) countries. However, the evidence base regarding the programmatic and contextual factors that affect the outcome of CDC interventions is surprisingly small. This paper reports on a self-directed care approach for older Australians with complex care needs. A multimethods longitudinal comparative cohort study was employed comprising 4 survey tools and 56 semi-structured interviews. Participation rates were around 20%. A total of 185 (98 in the intervention and 87 in the control group) older people and carers were recruited at baseline. Eleven months later, 109 participants (59 in the intervention and 50 in the control group) completed the repeat measure. Attrition rates were around 40%. Data collection occurred between July 2010 and April 2012. The data suggest that intervention group participants were likely to be more satisfied with the way they were treated (P = 0.013), their care options (P = 0.014), the 'say' they had in their care (P < 0.001), the information they received regarding their care (P = 0.012), what they were achieving in life (P = 0.031), that the services changed their view on what could be achieved in life (P = 0.020) and with their standard of living (P = 0.008). The evaluation suggests that while only a very small segment of older people is interested in a voucher or cash option, a substantially larger group would like to have greater say over and more direct access to their care, without, however, assuming administrative and financial responsibilities. The paper concludes that a stepped capacity-building approach to CDC may improve the acceptability of CDC to older people and generate synergies that improve older people's care outcomes. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' perceptions of their practice environment in acute care hospitals in Sharjah and North Emirates in the United Arab Emirates (UAE). Background: The health of the environment in which registered nurses' work is critical to nursing outcomes. The interest to examine the practice environment extended to the Gulf area which has a complex healthcare system including the UAE. Methods: The study used an exploratory descriptive designwith a qualitative part using two focus group interviews. The sample sizewas 450 nurses selected through a random sampling method. A self-administered questionnaire including the Practice Environment Scale of NursingWork Index (PES-NWI) was used. In addition, semi-structured interviews for two focus groups were done. Results: The results showed that UAE practicing nurses reported favorable perceptions of most aspects of their practice environment. Unfavorable perceptions were only reported for Staffing and Resource Adequacy. The analysis of focus group discussions resulted in different emerged themes such as Lack of Recognition and Career Promotion, and Nurses' Workload due to Paper and AdministrativeWork. Conclusions: The findings of this study suggest that strategic interventions are needed to secure adequate staff and resources and implement an effective system for evaluation of performance. [ABSTRACT FROM AUTHOR]

Aims This paper compares the perceptions of nurse managers and nurses about self-leadership of professional nurses while taking ownership of capacity building during unit management. Background The Nursing Strategy for South Africa states that the competency of nurses is dependent upon factors that lead to capacity building. Method A quantitative design was followed by conducting a survey. The target population included nurse managers and professional nurses working at an academic public hospital in the Gauteng Province of South Africa. Results The findings indicate shortcomings in relation to advising professional nurses about self-direction while taking ownership of their daily pressures and stresses associated with unit management. Conclusion Professional nurses should develop their confidence by focusing on their self-leadership strengths when managing a unit. Implications for nurse managers Recommendations are made to promote self-leadership while taking ownership of nurses during capacity building of unit management. [ABSTRACT FROM AUTHOR]

Background. Worldwide, hospitals are required to prioritize the culture of quality in infection prevention (CQIP) for patient safety. Assessing CQIP is crucial, but there is limited research, especially regarding nurses' perceptions. Insufficient information exists due to scarcity of validated instruments in local languages to measure CQIP internationally. Purpose. This study assessed the "Leading a Culture of Quality in Infection Prevention Scale" Russian version's (LCQ-IPS-R) validity and reliability to assess the CQIP of hospitals in Kazakhstan based on nurses' perceptions. Methods. This study utilized a methodological design and analyzed data from 204 nurses at the "National Research Center for Maternal and Child Health" in Astana City, Kazakhstan. The "cultural and linguistic adaptation" process involved a "forward-backward translation" technique. Content validity and construct validity were examined. Internal consistency reliability was explored for scale reliability. Results. The scale's mean item range was from 3.56 (SD = 1.22) to 4.40 (SD = 0.85; SD = 0.92). The corrected item-total correlation ranged from 0.321 to 0.707. Six experts rated the I-CVI from 0.83 to 1.00, with an S-CVI/Ave of 0.90. The principal component analysis with Varimax rotation produced four distinct components of the LCQ-IPS-R, explaining 69.8% of the total variance. The tests of correlation between the LCQ-IPS-R's four components revealed medium to large positive associations among the components (r = 0.25–0.55, p < 0.001). The computed α for the LCQ-IPS-R was 0.909 while α values from four subscales ranged from 0.809 to 0.921. Conclusions/Implications for Practice. This study provides evidence of the LCQ-IP-R's reliability and validity in evaluating Russian-speaking nurses' perception of their hospital's CQIP. These findings open the door for further research on CQIP in healthcare settings in Kazakhstan, Central Asia, and other Russian-speaking countries. The scale provides essential baseline information to design effective interventions for achieving hospitals' infection prevention objectives. [ABSTRACT FROM AUTHOR]

Background. The high turnover rate of new nurses is significantly impacted by the transition issue. Practice readiness has been identified as a key factor in ensuring a smooth transition, but there is currently a lack of specific instruments available in China to measure it. Aims. To translate and adapt the Casey-Fink Readiness for Practice Survey and validate its psychometric properties in senior nursing students in the Chinese cultural context. Methods. The descriptive cross-sectional study design was used. The English version of the Casey-Fink Readiness for Practice Survey was translated into Chinese according to Brislin's translation guidelines. A total of 590 senior nursing students from three nursing schools in China were surveyed with the Chinese version of the Readiness for Practice Instrument. Data analyses were performed to assess the reliability and validity of the instrument. The STROBE guidelines were used as the reporting method. Results. The validated Chinese version of the Casey-Fink Readiness for Practice Survey contained 18 items in the same four dimensions as the original English version. The internal consistency was satisfactory, with Cronbach's α and composite reliability values for all four dimensions above 0.70. The final confirmatory factor analysis model also demonstrated good fit indices, with the average variance extracted values for all dimensions above 0.50. Conclusion. The validated Chinese version of the Casey-Fink Readiness for Practice Survey is a reliable and effective instrument for measuring the readiness for practice among senior nursing students in China. Implications for Nursing Management. This study presents a valuable contribution to adapting an effective and reliable tool to assess readiness for practice among Chinese senior undergraduate nursing students. This will enable the development of specific strategies based on cultural context to optimize the readiness for practice for senior nursing students and smooth the transition of new nurses in China. [ABSTRACT FROM AUTHOR]

Aim: The aim of the current study was to examine the relationship between work engagement and perceived organisational support and self‐efficacy among registered nurses in Jordanian hospitals. Background: Nurses constitute the backbone of the health care system. Work engagement among nurses is critical due to its various positive outcomes: it enhances job satisfaction, job performance, organisation commitment and emotional health. According to the job demand–resource model, perceived organisational support and self‐efficacy increase work engagement. Method: A cross‐sectional, descriptive and correlational design and multistage cluster sampling were implemented. A total of 186 registered nurses were recruited. Self‐administered questionnaires were used to collect data from the participants. Results: Nurses showed an average level of work engagement. The dedication subscale showed the highest score among the three subscales representing work engagement. The results showed that perceived organisational support and self‐efficacy were positively correlated with work engagement (p <.01). Conclusion: Perceived organisational support and self‐efficacy correlated positively with work engagement. Implications for nursing management: An effort should be made to provide a supportive work environment by offering training programmes, sufficient job resources and positive feedback, which, in turn, improve nurses' work attitudes, self‐efficacy, perception of the work environment and intention to stay in a health organisation. This study is a descriptive study and has an IRB number 766‐2019. [ABSTRACT FROM AUTHOR]

Aim: This study examined the confidence level and perceived barriers to providing ostomy care among staff nurses in Saudi Arabia. Background: Patients with ostomies experience increased comfort and satisfaction when nurses are confident in their knowledge and skills. Design: A descriptive, cross‐sectional design was used to conduct the research. The study included a convenience sample of 214 staff nurses from five hospitals in Riyadh, Saudi Arabia. The researchers used a survey questionnaire to gauge participants' confidence in their knowledge and skills, as well as identify any perceived barriers to ostomy care. Result: Overall, 95.1% of participants worked in adult care and 82.2% worked in surgical areas. There were significant relationships between the nurses' confidence in their ostomy care knowledge and skills and their years of nursing experience and having received ostomy care training in nursing school (p <.05); however, the nurses' level of education had no correlation (p >.05). Conclusion: While the majority of nurses were confident in their ability to care for patients with ostomies, they were concerned about causing stoma problems. This suggests that improving the quality of ostomy care provided by nurses may result in fewer negative outcomes for patients with ostomies. [ABSTRACT FROM AUTHOR]

KEENEY S., MCKENNA H., FLEMING P. & MCILFATRICK S. (2010) European Journal of Cancer Care 19, 769-777 Attitudes to cancer and cancer prevention: what do people aged 35-54 years think? The aim of this study was to explore the knowledge, attitudes and behaviours of people in mid-life towards cancer prevention. The study was undertaken in Northern Ireland between 2003 and 2007. This was a mixed methods study using a sequential exploratory design. The theoretical framework was the Theory of Planned Behaviour and the methodology was based on Sutton's framework. There were three methodological stages in the study using focus groups, a large cross-sectional survey and a volunteer sample survey. This paper focuses on the findings of the cross-sectional survey relating to the attitudes of people in mid-life towards cancer and cancer prevention. Findings are considered in relation to the respondents' level of knowledge, age, gender, level of educational attainment and socio-economic status. Evidence from this study shows that attitudes towards cancer and cancer prevention are associated significantly with level of knowledge about cancer, gender, socio-economic status and level of educational attainment. In conclusion, the evidence from this study shows that men, those with a lower level of education, those with a lower level of knowledge and those in a lower socio-economic group were more likely to hold negative attitudes about cancer and cancer prevention. [ABSTRACT FROM AUTHOR]

Objective: Existing research highlights the importance of nurses' knowledge and attitudes towards the provision of artificial nutrition and hydration (ANH) for patients with advanced cancer; however, the perspectives of Arabic and Islamic nurses have not yet been investigated. Therefore, we aimed to examine Jordanian nurses' knowledge, attitudes and perceived benefits in providing ANH for patients with advanced cancer. Method: A descriptive cross‐sectional design was employed. Results: Participants comprised 183 nurses (93.5% response rate). Around 80% received no training on ANH. Nurses had poor knowledge regarding ANH, with a mean score of 5.12 (SD=2.27) out of 15. Overall, nurses had positive attitudes towards ANH care (M = 3.09, SD = 0.29); however, the subscale analysis showed that nurses held inconspicuous beliefs about ANH benefits (M = 2.67, SD = 0.71) and strongly believed that ANH places a high burden on patients (M = 3.50, SD = 0.69). Nurses from government hospitals showed significantly higher ANH knowledge, as well as positive beliefs regarding ANH benefits, compared to less educated nurses. Conclusion: Jordanian nurses have limited knowledge of ANH. Their positive attitude regarding ANH for terminally ill patients could be driven by cultural norms and beliefs, rather than education. Introducing ANH in nursing curricula and in‐hospital services could have a positive impact on nurses' knowledge. [ABSTRACT FROM AUTHOR]

Aim: To investigate Chinese nurses' views and experiences in relation to quality improvement implementation, as well as to determine the impact of contextual factors on nursing quality improvement initiatives. Background: Nurses play a major role in carrying out quality improvement initiatives. Contextual factors influence the implementation and success of quality improvement initiatives. Studies that investigated the impact of contextual factors on Chinese nurses' practice in quality improvement remain limited. Methods: A sequential explanatory mixed‐methods design was used for this study. A quantitative cross‐sectional survey was used to assess the context of quality improvement initiatives. Simple random sampling was used to recruit quality improvement teams. The sample included 356 nurses from tertiary teaching hospitals; 291 (81.7%) of them completed questionnaires. Nursing managers and nurses (n = 18) were purposively selected to participate in semi‐structured interviews; their experiences and perceptions regarding the contextual factors of quality improvement initiatives were obtained. Results: In the quantitative phase, the "microsystem" (mean=5.24) and "QI team" (mean = 4.97) contexts were reported as supportive contexts. The organizational context was weak, with a mean score of 3.92. In the qualitative phase, three themes related to the contextual challenges emerged: (1) nurses' attitudes and satisfaction, (2) team efficacy, and (3) organizational infrastructure and culture. Conclusions: Efforts to elevate organizational culture and reward systems are needed in Chinese hospitals. Further education aimed at increasing skills and knowledge should be provided, to ensure effective quality improvement implementation. Implications for Nursing Management: During quality improvement initiatives, management tasks should focus on increasing nurses' satisfaction, solving skill and knowledge deficits, and clarifying nurses' roles in relation to quality improvement. [ABSTRACT FROM AUTHOR]

Aim: To investigate the relationship between job crafting and work engagement among hospital nurses. Background: Job crafting is a relatively advanced job redesign concept, and few studies have investigated it among nurses. Methods: This is a cross‐sectional study. A total of 636 nurses were recruited from one hospital in Saudi Arabia. Of them, 608 (95.6%) completed self‐administered, online questionnaires. The questionnaire assessed participants' socio‐demographic data, job crafting and work engagement. Structured equation modelling (SEM) was used to examine the association between job crafting and work engagement. Results: Data from 549 nurses were analysed. Most of the participants (85.1%) were females, and their mean scores of job crafting and work engagement were 3.54 ± 0.5 and 4.77 ± 1.1, respectively. The SEM revealed that job crafting accounted for 57% of the variance of work engagement. Conclusions: Job crafting is a significant determinant of nurses' work engagement. Implications for nursing management: Supporting staff nurses to employ job crafting behaviours would positively improve their work engagement. This may include, but is not limited to, helping nurses to bargain a significance in their labour, reforming the work pattern in a manner that lines up with organisational objectives and employing an innovative managerial style. [ABSTRACT FROM AUTHOR]

Despite the importance of carers supporting the lives of people with mental illness, there are limited studies investigating the well‐being and needs of Malay carers in multicultural Singapore. The Malays consist of 13.4% of Singapore's population. A mixed methods qualitative dominant research approach was used to explore the well‐being and needs of Malay carers in a voluntary welfare organisation. The Kessler‐10, Friendship Scale and Carers' and Users' Expectations of Services—Carer version were used to assess the needs and well‐being of 17 Malay carers. Findings show that Malay carers experienced poor well‐being and had numerous unmet needs. Four main themes were found: (a) Concerns related to relatives with mental illness, (b) Mental health practices related to carers, (c) Holistic support for carers and (d) Preference for greater spiritual support in mental health. Recovery‐oriented mental health practice implications are discussed. Spirituality of Malay carers needs to be given greater consideration in recovery‐oriented mental health services. [ABSTRACT FROM AUTHOR]

Background: The work conditions in which the nurses provide care for older adults affect the quality of care. Study aim: (a) To describe the quality of care for older adults as perceived by the nurse; (b) to examine the relationship between occupational stress, work climate, employee development and quality of care for older people; and (c) to determine the predictors of quality of care provided for older adults. Methods: A descriptive correlational design was used in this study. A multi‐strategic sampling technique was used to recruit a sample of 500 nurses providing care for older adults in hospitals and health care centres. Results: Almost 80% of the participating nurses reported that their workplace was insufficiently staffed. Quality of care was significantly associated with occupational stress, nurses' competence and employee development. Significant predictors of quality of care were occupational stress, work climate and employee development. Conclusion: Enhancing nurses' work climate, decreasing occupational stress and increasing chances for employee development would improve the quality of care provided for older adults. Implications for nursing management: Health institutions have the opportunity to implement work environment improvements that increase support for advancing staff knowledge and skills by providing additional support for continuing education regarding the care of older adults. [ABSTRACT FROM AUTHOR]

Background: The Philippines experiences several challenges pertaining to the quality of the practice environment (PE) and nursing quality safety (NQS) among nurses. Although there is already considerable empirical data on PE effects on NQS, there is still little overall information on the association between these variables. Aim: This survey study examined the contribution of nurses' perceptions of their PE on their perception of their PE's quality of safety among hospital nurses in the Philippines. This survey was conducted in two government hospitals and two private hospitals in the Philippines. Participants: A total of 374 nurses selected from two selected government hospitals and two private hospitals in the Philippines using a convenience sample technique. Methods: Data were collected using a self‐administered questionnaire focusing on the PE and NQS among nurses. Results: The overall PE mean score of nurses is 3.07 (SD = 0.159) while the overall mean score of their NQS is 3.97 (SD = 0.702). NQS was higher in female nurses compared with male nurses (M = 2404 vs 4.16). Nurses assigned to emergency departments (F = 1.04, [df = 11], and P = .025) presented higher perceived NQS compared with those in other departments. Conclusion: Nurses report moderate PE and higher NQS. Sex and emergency room department are significantly associated with NQS. Health care services have an obligation to ensure strong PE, as an important factor in regard to nursing management and affecting the QNS. [ABSTRACT FROM AUTHOR]

Preparing healthcare students for community care has been emphasised due to the global ageing population. An instrument to measure students' community care competency is lacking. This study aimed to develop and evaluate the psychometric properties of a new scale known as Community Care Competency Scale (CCCS) for measuring nursing students' community care competency. CCCS consists of 21 items derived from literature review and community care standards. Content validity was established through a panel of seven experts in the areas of knowledge with a content validity index of 0.96. A cross‐sectional study was undertaken in a university in Singapore by using an anonymous self‐administered questionnaire to nursing students, and obtained a response rate of 87% (n = 283). Psychometric properties were explored using convergent and known‐group validity testing, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and Cronbach's alpha test. The results showed good convergent and known‐group validity. EFA and CFA showed a coherent construct of the 21 items of CCCS in a one‐factor model. The Cronbach's alpha of 0.94 indicated excellent internal consistency. The CCCS is a valid, reliable and easy‐to‐administer instrument that measures community care competency. This instrument will contribute to the empirical body of knowledge on evaluating the effectiveness of community care educational programmes for nursing students to prepare future healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Motivation is a significant concern for workforce management in healthcare organizations as it is linked to many important factors, such as performance, staff retention, and satisfaction. Aim: To assess motivation level, assess sources of motivation, and identify the difference in motivation level in relation to nurses' characteristics. Setting: The study was carried out in one major tertiary hospital in Riyadh, Kingdom of Saudi Arabia. Participants: A total convenient sample of 550 nurses were recruited. All participants are working under the umbrella of executive nursing administration. Methods: Data were collected using a self‐administered questionnaire, which consisted of 30 items that focused on assessing a nurse's motivation sources and level. Results: In general, 346 nurses (62%) fully completed the survey. The average motivation level of nurses is 3.6 ± 0.5. Additionally, internal self‐concept motivation was identified as the most predominant source of motivation (4.1 ± 0.6). Instrumental and goal internalization motivations ranked second (3.7 ± 0.6), whereas external self‐concept (3.4 ± 0.7) and intrinsic (3 ± 0.7) motivations are the lowest sources of motivation. There is a significant difference in the motivation mean between males and females (P = 0.034). Another significant difference was revealed with different years of experience (P = 0.021). Conclusion: The high percentage of internal self‐concept motivation among nurses signified that nurses needed more than enjoyment of their work atmosphere, social acknowledgment, higher salary, and good rationale to give maximum effort. Although these should be taken into consideration, more attention should be given to practices that improve a nurse's challenge, autonomy, internal value, and competency. [ABSTRACT FROM AUTHOR]

Abstract: Aim: This study aimed to investigate nurses’ perceptions of the nursing work environment in Jordanian hospitals. Background: Previous research has indicated a strong relationship between nurses’ work environment and their satisfaction at work. However, little is known about the situation in Jordan. Method: A cross‐sectional and descriptive design was used. A sample of 500 nurses was recruited. The study was conducted using the Individual Workload Perception Revised scale (IWPS‐R). Results: A sum of 382 out of 500 nurses from three health care sectors in Jordan responded to the questionnaires (response rate = 76.4%). The results indicate that nurses working in the public hospitals had significantly better perceptions about their work environment than nurses working in private and university hospitals. Older nurses with lower academic qualifications are more likely to be satisfied with their work. Furthermore, nurses who have good perceptions of support from their manager and peers, and a manageable workload are more likely to stay in their jobs. Conclusion: The public hospitals are currently considered a more suitable milieu for nurses in Jordan. Other health care sectors should work to enhance nurses’ working conditions. Implication for nurse manager: Providing a supportive work environment with a manageable workload will encourage nurses to stay in their hospitals. [ABSTRACT FROM AUTHOR]

Abstract: Problem: Strong organizational support can promote a sense of well‐being and positive work behaviors in nurses. However, despite the importance of organizational support in nursing, this topic remains unexplored in the Philippines. Purpose: The aim of this study was to examine the impact of organizational support perceptions on nurses’ work outcomes (organizational commitment, work autonomy, work performance, job satisfaction, job stress, and turnover intention). Methods: A descriptive, cross‐sectional research design was adopted in this study to collect data from one hundred eighty (180) nurses in the Philippines during the months of September 2015 to December 2015. Seven standardized tools were used: the Job Satisfaction Index, the Job Stress Scale, the Burnout Measure Scale, the Work Autonomy Scale, the Six Dimension Scale of Nursing Performance, the Turnover Intention Inventory Scale, and the Perception of Organizational Support Scale. Findings: Nurses employed in government‐owned hospitals perceived low levels of organizational support as compared to private hospitals. Significant correlations were identified between perceived organizational support (POS), hospital bed capacity, and nurses’ work status. No significant correlations were found between perceived organizational supportand the six outcomes perceived by nurses in the Philippines (organizational commitment, work performance, job autonomy, job satisfaction, job stress, and turnover intention). Conclusion: Perceptions of organizational support were low in Filipino nurses compared to findings in other international studies. Perceived organizational support did not influence job outcomes in nurses. [ABSTRACT FROM AUTHOR]

Aim: To examine reward type preferences and their relationships with the significance of rewarding perceived by registered nurses in Finland. Background: Previous studies have found relationships between nurses' rewarding and their motivation at work, job satisfaction and organisational commitment. Methods: Data were collected in a cross‐sectional, descriptive, questionnaire survey from 402 registered nurses using the Registered Nurses' Perceptions of Rewarding Scale in 2015, and analysed with descriptive and multivariate statistical methods. Results: Registered nurses assigned slightly higher values to several non‐financial than to financial rewards. The non‐financial reward types appreciation and feedback from work community, worktime arrangements, work content, and opportunity to develop, influence and participate were highly related to the significance of rewarding. Conclusions: We identified various rewards that registered nurses value, and indications that providing an appropriate array of rewards, particularly non‐financial rewards, is a highly beneficial element of nursing management. Implications for Nursing Management: It is important to understand the value of rewards for nursing management. Nurse managers should offer diverse rewards to their registered nurses to promote excellent performance and to help efforts to secure and maintain high‐quality, safe patient care. The use of appropriate rewards is especially crucial to improving registered nurses' reward satisfaction and job satisfaction globally in the nursing profession. [ABSTRACT FROM AUTHOR]

Cancer and its treatments may result in impaired fertility, which could cause long-term distress to cancer survivors. For eligible patients, fertility preservation ( FP) is available to secure future reproductive potential. Many physicians, however, feel inhibited about discussing FP. Oncology nurses may serve as an initiator for discussing the subject and provide additional support. Our aim was to investigate their knowledge about FP, the way they apply this, and possible barriers to discussing FP with patients of reproductive age. A questionnaire was administered via mail, Internet and the Dutch Oncology Nursing Congress. Four hundred and twenty-one oncology nurses participated, a third of whom (31.1%) had 'sufficient' knowledge of FP. Twenty-eight per cent of participants reported that they 'never/hardly ever' discussed FP; 32.2% 'almost always/always.' FP discussions were more frequently performed by graduate nurses, academic nurses, experienced nurses and nurses with sufficient knowledge. Reasons for not discussing FP were a 'lack of knowledge' (25.2%), 'poor prognosis' (16.4%) and 'lack of time' (10.5%). In conclusion, several obstacles may result in FP not being routinely discussed, specifically a lack of knowledge. Yet nurses feel responsible for addressing the issue, indicating that assistance with FP discussions should be encouraged. Educational training about FP is recommended. [ABSTRACT FROM AUTHOR]

The purpose was to study users' attitudes towards an electronic medical record ( EMR) closely integrated into the clinicians' cancer care workflow. The EMR, implemented in an ambulatory cancer care centre, was designed as a care pathway information system providing real-time support to the coordination of shared care processes involving all the care personnel. Mixed method pre-post study design was used. The study population consisted of all care personnel. A survey measured the quality attributes of the EMR, the clinical information it produces, the perceived usefulness of the system for supporting clinical data management tasks and the perceived impacts in terms of access and quality of care. The survey shows that users' attitudes towards the EMR (response rate of 71%) measured after the go-live were positive ranging from 3.42 to 3.95 on a 5-point scale. Besides, the content analysis of 33 pre-post interviews revealed five main themes: magnitude of the changes caused by the EMR; its innovative potential; its positive benefits; an ongoing growth in users' expectancies; and the burden associated with the time required to operate the EMR. In sum, the study shows that users can largely apply innovative uses of information technologies that automate their clinical processes. [ABSTRACT FROM AUTHOR]

Frailty causes disability and restrictions on older people's ability to engage in leisure activities and for social participation. The objective of this study was to evaluate the effects of a 1-year case management intervention for frail older people living at home in Sweden in terms of social participation and leisure activities. The study was a randomised controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to intervention (n = 80) or control groups (n = 73). The intervention group received monthly home visits over the course of a year by nurses and physiotherapists working as case managers, using a multifactorial preventive approach. Data collections on social participation, leisure activities and rating of important leisure activities were performed at baseline, 3, 6, 9 and 12 months, with recruitment between October 2006 and April 2011. The results did not show any differences in favour of the intervention on social participation. However, the intervention group performed leisure activities in general, and important physical leisure activities, to a greater extent than the control group at the 3-month follow-up (median 13 vs. 11, P = 0.034 and median 3 vs. 3, P = 0.031 respectively). A statistically significantly greater proportion of participants from the intervention group had an increased or unchanged number of important social leisure activities that they performed for the periods from baseline to 3 months (93.2% vs. 75.4%, OR = 4.48, 95% CI: 1.37-14.58). Even though statistically significant findings in favour of the intervention were found, more research on activity-focused case management interventions is needed to achieve clear effects on social participation and leisure activities. [ABSTRACT FROM AUTHOR]

Meyer D., Raffle H. & Ware L.J. (2014) Journal of Nursing Management 22, 769-778 The first year: employment patterns and job perceptions of nursing assistants in a rural setting Aim The aim of this study was to follow rural certified nursing assistants (CNAs) ( n = 123) in the United States for 1 year post-training to identify retention and turnover issues in the long-term care (LTC) setting by exploring the CNAs' perceptions of the LTC work experience. Background Turnover among CNAs impacts the quality of care, imposes a financial burden on facilities and taxpayers, and creates increased stress and workloads on those who remain. Method A longitudinal survey design was used to track individuals completing CNA training for 1 year. Results At 1 year post-training, 53.7% of respondents currently worked in LTC, 30.9% worked in LTC and left, and the remaining 15.4% never worked in LTC. Conclusion While the training site does not appear to impact retention, the first 6 months of employment appear critical. The CNAs cited pay as a reason for leaving LTC, but better pay did not characterize the jobs taken by the CNAs who left. Implications for nursing management This study highlights the importance of the first 6 months of employment to retention and provides practical information for nurse managers evaluating the resource-effectiveness of hosting training programmes. Additionally, the key issues influencing retention were identified and practical suggestions for nurse managers to improve retention are provided. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to test the norm of reciprocity by examining relationships between perceived organisational support ( POS), the quality of leader-member exchange ( LMX) and psychological contract breach ( PCB) and important nurse retention factors identified in the literature. Background A major cause of turnover among nurses is related to unsatisfying workplaces. Previous research, mainly outside the nursing setting, found that social exchange affects employees' work-related attitudes. Method A cross-sectional survey was conducted on 217 nurses and nursing assistants to test and refine a model linking POS, LMX, PCB with job satisfaction, trust and turnover intentions. Results Hierarchical multiple linear regression revealed that POS, PCB and LMX explained significant variance in all three retention factors: job satisfaction (adjusted R² = 0.502), trust (adjusted R² = 0.462) and turnover intentions (adjusted R² = 0.196). POS and PCB predicted most strongly job satisfaction ( P < 0.001) and trust ( P < 0.001 and P < 0.01, respectively). LMX predicted most strongly intention to leave ( P < 0.01). Conclusion In our study, POS, the quality of LMX and PCB were strongly related to job satisfaction, trust and turnover intentions. Implications for nursing management Nursing managers and leaders should recognize the importance of social exchange within their organisation to build trust, satisfy and retain scarce nurses and nursing assistants. [ABSTRACT FROM AUTHOR]

There is a paucity of literature regarding the daily routines of young children (4-7 years) and their perception of their performance. Research indicates that children's involvement in treatment therapy improves their self-consciousness, which contributes in return to the therapy's progress. Until recently, occupational therapists set goals for children by involving their parents in the planning. However, recent studies indicate that children are aware of their performance and can provide reliable data, given an evaluation that is adapted to their stage of development. 'Make My Day' (MMD) is a new evaluation developed for young children, which provides information regarding the child's performance with respect to their daily activities. The MMD incorporates two versions - one for the children's self-report and the other for the parent's report. Participants included 62 healthy 4- to 7-year-old children of Arab-Israeli decent and their parents. They were assessed using the MMD, Perceived Efficacy and Goal Setting (PEGS), Time Organization and Participation (TOPS) and a socio-demographic questionnaire. Correlations between the MMD and the TOPS/PEGS were examined regarding the differences between children's and parents' reports of performance in three age groups (concurrent validity). Results demonstrated that children's self-report of their occupational performance in daily tasks are reliable and valid. Thus, occupational therapists may obtain data from the child himself or herself and not only from the parents. Further research on the MMD is recommended in other clinical populations to increase our knowledge of their daily functioning and of MMD's validity. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether Black and White nurses' beliefs about causes of health disparities differ. Conclusions: Analyses reveal that overall Black nurses perceived external factors to contribute significantly more to health disparities than White nurses. Black nurses considered four specific causes dealing with physician and societal factors, such as “discrimination in society,” to be more significant contributors to health disparities than White nurses, whereas White nurses considered genetic factors to be a greater contributor. Practice Implications: Different views of the causes of health disparities are discussed, particularly in light of cultural competency training and other efforts to ameliorate health disparities. [ABSTRACT FROM AUTHOR]

This article reports a study exploring what older people believe would enable them to adjust to and gain maximum benefit from wearing a hearing aid. A mixed methods approach was employed during 2006 involving interviews with key stakeholders, a survey across three Scottish health board areas and focus groups. Nine key stakeholders from six national and local organisations were interviewed about the needs of older people being fitted with hearing aids. In total, 240 older people belonging to three different types of hearing impaired older people were surveyed: long-term users of hearing aids, new hearing aid users, and those on a waiting list from urban and rural areas (response rate = 24%). A series of eight follow-up focus groups with 31 audiology patients was held. Health professionals appeared to neglect appropriate provision of information and overly rely on technological interventions. Of 154 older people already fitted with hearing aids, only 52% of hearing aid users reported receiving enough practical help post fitting and only 41% reported receiving enough support. Approximately 40% reported not feeling confident in the use of their aids or their controls. Older people wanted more information than they received both before and after hearing aid fitting. Information provision and attention to the psychosocial aspects of care are key to enabling older people to adjust and optimise hearing aid benefit. [ABSTRACT FROM AUTHOR]

Objective This study examined the opinions of nurses about the introduction of enrolled nurse medication administration and analyzed its impact on the medication error rate. Methods Data were collected using a survey and examination of incident reports regarding nursing medication errors. Nurses (registered nurse, enrolled nurse with medication endorsement, enrolled nurse) responded to survey items regarding the introduction of enrolled nurse medication administration. Data analysis included descriptive statistics, Fischer's exact test, and chi-square analysis where appropriate. Results The majority of nurses (75.2%) supported enrolled nurse medication administration. However, differences in opinion were observed between registered nurse ( RN) and enrolled nurse with medication endorsement ( ENME) regarding clear understanding of responsibility and accountability ( RN: 47.2% vs. ENME: 77.8%; p =.033), and whether suitable education was provided ( RN: 34.7% vs. ENME: 73.7%; p =.012). Moreover, less than one-third of RNs agreed that the assessment process for EN medication endorsement clearly identified the competence of the ENME to administer medications. Nonetheless, nursing medication errors did not increase in the 12-month period after the introduction of enrolled nurse medication administration (pre: 314, post: 302). Conclusions The findings of this study suggest areas that should be addressed in the future, including assessment of competence and focused education about accountability and responsibility. [ABSTRACT FROM AUTHOR]

The objective of this study was to examine patient- and parent-perceived factors that impact adherence to inflammatory bowel disease treatment using a qualitative descriptive individual interview approach. Sixteen adolescents and their parents were recruited from May through August 2007 and interviewed about medication adherence using an open-ended semi-structured interview format. Interviews were audio recorded, transcribed, and coded into themes. Parent-child dyads identified forgetting, interfering activities, parent-child conflict and oppositional behaviour and inadequate planning for treatment as challenges to adherence. Participants reported that family support and good parent-child relationships, routines, monitoring and reminding and organisational tools such as pill boxes facilitated treatment adherence. Other issues that emerged included immediacy of treatment effects and parent-adolescent responsibility for treatment. Patients and parents experience a number of challenges related to adherence within behavioural, educational, organisational and health belief domains. Behavioural interventions should focus on these issues, reduction of perceived barriers, and effective transition of responsibility for treatment adherence. Future research considerations are discussed. [ABSTRACT FROM AUTHOR]