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Introduction: Globally, healthcare organizations have transitioned from paper-based documentation to electronic health records (EHR), including in Saudi Arabia. However, the adoption of EHR at the national level in Saudi Arabia needs more attention. Thus, this study aimed to determine the workflow integration of EHR and associated factors. Objectives: The specific aims were to examine the level of EHR use and workflow integration among nurses, to determine the differences in EHR use and workflow integration based on nurses' demographic characteristics, and to determine the association between the predictive factors and EHR workflow integration. Methods: This is a cross-sectional, correlational descriptive study. The data were collected from 293 nurses using the convenience sampling method. The participating nurses completed a questionnaire that included two measures: the Information System Use Survey and the Workflow Integration Survey (WIS). The data were analyzed using descriptive and multivariate statistics with SPSS software. Results: The nurses had a positive perception of EHR use and workflow. The EHR use scores differed based on workplace (P <.01), education level (P <.05), and area of practice (P <.001). Similarly, the EHR workflow integration scores varied according to workplace (P <.05), education level (P <.05), and area of practice (P <.001). Education level and workplace significantly predicted information system use. Furthermore, education level and information system use significantly predicted the EHR integration into nurses' workflow. Conclusion: The nurses expressed a greater perceived use of EHR regarding the integrated health information system, which was a predictor of EHR integration into nurses' workflow. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence of minor and serious cyberloafing behaviours among nurses and examine the impact of the nursing stressors on nurses' cyberloafing behaviours. Background: Cyberloafing could have a negative influence on employees' job performance, but it also has been argued that it could serve as a coping mechanism to deal with stressful work environments. Design: A cross‐sectional descriptive, correlational design. Methods: Data were collected between September and December 2020 from a convenience sample of staff nurses (N = 291) providing care at a tertiary hospital in Saudi Arabia. Sample characteristics, nursing stressors and cyberloafing behaviours information were collected using self‐reported questionnaires. Descriptive, bivariate and multivariate analyses were performed. Findings Nurses in Saudi Arabia exhibited low levels of minor and serious cyberloafing behaviours. However, they engaged more frequently in minor cyberloafing behaviours more than serious cyberloafing behaviours. Stressors and Internet usage frequency influenced the frequency of minor and serious cyberloafing behaviours. Level of education and nationality impacted serious cyberloafing behaviours only. Conclusion: Nursing stressors were associated with cyberloafing behaviours. Other studies on cyberloafing and job stress yielded inconsistent results. Efforts should be taken to avoid the adverse effects of cyberloafing by establishing a clear policy on using the advanced technology for non‐work purposes. Summary statement: What is already known about this topic? Job characteristics and stress have been linked to increased cyberloafing behaviours among employees.Cyberloafing can serve as a coping mechanism to deal with stressful work environment.No studies have been conducted to describe the association between nursing stressors and cyberloafing behaviours. What this paper adds? Nurses in Saudi Arabia exhibited low levels of cyberloafing behaviours.The frequency of minor and serious cyberloafing behaviours among nurses is influenced by their stress and Internet usage frequency.Nurses' level of education and nationality impacted serious cyberloafing behaviours only. The implications of this paper Efforts should be taken to minimize the impact of nursing stressors by creating a healthy work environment and promoting nursing practice.Establishing a clear policy regarding using the Internet and advanced technology for non‐work purposes is essential to avoid the adverse effects of cyberloafing.Providing education for nurses on cyberloafing associated risks might reduce the amount of cyberloafing during working hours. [ABSTRACT FROM AUTHOR]

Background: Nurses are at a high risk of developing abnormal eating behaviour. However, few studies have attempted to identify the factors that influence such behaviour. Aim: This study identifies factors that can predict abnormal eating behaviour in hospital nurses. Design This study adopted a cross‐sectional, descriptive correlational research design. Methods: A literature review was used to establish a hypothetical model, comprising the eight factors of shift work, job stress, depression, sleep quality, fatigue, coping strategy (active coping and passive coping) and abnormal eating behaviour. A convenience sample of 298 nurses aged less than 45 was recruited from two university hospitals, and structured questionnaire was administered between March and April 2017. The hypothesized model was tested using structural equation modelling. Results: Sleep quality and passive coping directly affect abnormal eating behaviour, which implies that poor sleep quality and increased passive coping worsens the behaviour. Shift work and depression indirectly affect abnormal eating behaviours. Conclusion: Nursing managers and health policy makers should adopt strategies such as improving the shift‐work pattern, providing adequate rest time after a night shift and enabling coping strategies by providing educational programs for hospital nurses. Summary Statement: What is already known about this topic? The prevalence of abnormal eating behaviour, a form of eating disorder, has been continually rising in recent years.Nurses may be at high risk of developing abnormal eating behaviour due to their job characteristics.Few previous studies have attempted to identify the factors that influence abnormal eating behaviour among hospital nurses. What this paper adds? In this study, 8% of the participants demonstrated clinical‐level abnormal eating behaviour.Sleep quality and passive coping were the main factors influencing abnormal eating behaviours among hospital nurses.Shift work and depression show significant indirect effects on abnormal eating behaviour among hospital nurses. The implications of this paper: Study findings could inform development of strategies to minimize the impact of nurses' job‐related health risks by verifying the relationship between sleep quality, passive coping and abnormal eating behaviours.It is necessary to examine the various health problems shift work causes for nurses and conduct research to establish strategies that can support policies to improve them.Nursing managers should adopt strategies such as improving the shift‐work pattern, ensuring adequate rest time after a night shift and enabling the use of coping strategies by providing educational programs to hospital nurses. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess compliance with standard precautions by Saudi nursing interns who were undergoing their internship training in four governmental tertiary teaching hospitals in Riyadh, Kingdom of Saudi Arabia, and to determine factors predictive of this. Background: Cross‐transmission and infection prevention when delivering care must be strictly followed by nursing interns by complying with standard precautions during internship training. Design The study employed a descriptive‐correlational and cross‐sectional design. Methods: A total of 224 nursing interns participated in the study by completing the Compliance with Standard Precautions Scale Arabic version between March 2017 and June 2017. Results/Findings A high overall compliance rate (84.8%) was observed. Nursing interns reported the highest compliance score in changing gloves between each patient contact and the lowest score in disposing of sharps boxes only when full. Nursing interns in hospital D showed the highest compliance rate over those in other hospitals. Age, sex, marital status, months in internship training and attendance of nursing interns in infection control seminars/trainings influenced their standard precautions compliance. Conclusion: The study revealed good compliance by nursing interns with standard precautions. However, regular educational and clinical interventions are still needed to improve some areas and to ensure the continuity of high levels of compliance in other areas of standard precautions among nursing interns. SUMMARY STATEMENT: What is already known about this topic? Compliance with standard precautions reduces the risk of exposure to infections and represents the minimum infection prevention measures that apply to all patient care.Nursing education ensures the safety of patients and prevents infections, thus requiring the strict compliance of health‐care workers, including nursing interns, with standard precautions during nursing practice.Compliance with Standard Precautions Scale Arabic version is a valid and reliable tool to assess the compliance rates of nursing students in Saudi Arabia. What this paper adds? Saudi nursing interns showed higher compliance rates with standard precautions than previous studies conducted in Saudi Arabia and other countries.Factors predictive of standard precautions compliance included age, sex, marital status, months in training and attendance of nursing interns in infection control trainings.Compliance of nursing interns with standard precautions significantly differed with the hospitals where they underwent their training. The implications of this paper: Strict compliance of nursing interns with standard precautions during their training must be regularly assessed to facilitate their infection control competency.Nurse preceptors must design internship plans that offer opportunities for nursing interns to perform nursing skills and procedures that impose stringent adherence to standard precautions.For clinical nursing practice, the findings can offer a basis for nurse educators to create regular educational and clinical interventions to improve and to ensure constant adherence to standard precautions among nursing interns. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to identify the nursing stress factors, which affect turnover intention in hospital nurses. Background: Nursing stress is known to be an important predictor of turnover intention in nurses. Although nurses experience various sources of stress across work environments, cultures, and generations, little is known about the stress factors affecting turnover intention in nurses. Design A descriptive cross‐sectional design was employed. Methods: A total of 329 nurses were recruited through convenience sampling from 27 hospitals in South Korea. Data were collected from May to November 2018 using a questionnaire. Results: Among the stress factors, stress from patients and their families, workload stress, stress from conflicts with supervisors, and stress from conflicts with peers were associated with turnover intention in hospital nurses. These variables explained 40.0% of the variance in turnover intention among hospital nurses. Conclusions: Stress from interpersonal relationships with patients and their families, supervisors, and peers may have a considerable impact on turnover intention. To reduce nursing turnover intention, coping strategies to reduce stress from patients and their families should be established. It is necessary to provide programmes that foster interpersonal relationship skills in the workplace. Nurse managers may encourage communication among nurses to establish positive relationships. SUMMARY STATEMENT: What is already known about the topic? Nurses' turnover continues to remain a challenging issue across work environments, cultures, and generations.Nursing stress has a great impact on turnover intention in hospital nurses. However, little is known about the stress factors that affect turnover intention in nurses. What this paper adds? Among the nursing stress factors, stress from patients and families had a strong effect on turnover intention in hospital nurses, followed by stress from workload, conflicts with supervisors, and conflicts with peers. The implications of this paper: Our findings suggest that stress from interpersonal relationships might have a considerable impact on turnover intention.Coping strategies to reduce stress from patients and family need to be first established to reduce the turnover intention in hospital nurses.Nurse managers should be aware of the effects of interpersonal relationships on turnover intention and encourage communication among nurses to establish positive relationships. [ABSTRACT FROM AUTHOR]

Aim: To examine the influence of health care provider's communication skills on the quality of care perceived by Emergency Department patients. Background: Communication between patients and health care providers in the context of Emergency Department is challenging and can potentially have a negative impact on the quality of care perceived by patients. Design Cross‐sectional descriptive study conducted in the Emergency Department at the University Clinical Hospital Virgen de la Arrixaca of Murcia, Spain. Method: Data were collected from 6 to 9 June 2016. Different instruments were used to evaluate the perception of patients on the communication skills and quality of care at the Emergency Department. Results: The sample was composed of 200 patients, with an average age of 44.1 (SD = 18.3), of which 106 (53%) were men. The multiple linear regression analysis showed the association between communication skills (respect, problem solving, and nonverbal communication) and age with the quality of care perceived by the patients. Conclusions: We found that the communication skills of the health care providers were explanatory variables of the quality of care perceived in an Emergency Department. SUMMARY STATEMENT: What is already known about this topic? The needs of patients and families seeking emergency care differ from those of other care settings.Patient‐health care provider communication in an Emergency Department are a true challenge.Effective communication between emergency professionals and patients/family has been described as a fundamental component of health care. What this paper adds? Health care provider communication skills are explanatory for the quality perceived by Emergency Department patients.Respect, problem solving, and nonverbal aspects are explanatory for the quality of care in an Emergency Department. The implications of this paper: Humanized care, in which patients feel listened to and respected, and which is concerned about their health problems, could increase the quality of care perceived in the Emergency Department.Health care providers in Emergency Departments should be encouraged to increase their level of communication skills. [ABSTRACT FROM AUTHOR]

Objective: Since Australia initiated national open disclosure standards in 2002, open disclosure policies have been adopted in all Australian states and territories. Yet, research evidence regarding their adoption is limited. The aim of the present study was to determine the frequency with which patients who report an adverse event had information disclosed to them about the incident, including whether they participated in a formal open disclosure process, their experiences of the process and the extent to which these align with the current New South Wales (NSW) policy. Methods: A cross-sectional survey about patient experiences of disclosure associated with an adverse event was administered to a random sample of 20 000 participants in the 45 and Up Study who were hospitalised in NSW, Australia, between January and June 2014. Results: Of the 18 993 eligible potential participants, completed surveys were obtained from 7661 (40% response rate), with 474 (7%) patients reporting an adverse event. Of those who reported an adverse event, a significant majority reported an informal or bedside disclosure (91%; 430/474). Only 79 patients (17%) participated in a formal open disclosure meeting. Most informal disclosures were provided by nurses, with only 25% provided by medical practitioners. Conclusions: Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents. A review of the open disclosure guidelines in relation to the types of adverse events that require formal open disclosure and those more suitable to informal bedside disclosure is indicated. Guidelines for bedside disclosure should be drafted to assist medical practitioners and other health professionals facilitate and improve their communications about adverse events. Alignment of formal disclosure with policy requirements may also be enhanced by training multidisciplinary teams in the process. What is known about the topic?: While open disclosure is required in all cases of serious adverse events, patients' experiences are variable, and lack of, or poor quality disclosures are all too common. What does this paper add?: This paper presents experiences reported by patients across New South Wales in a large cross-sectional survey. Unlike previous studies of open disclosure, recently hospitalised patients were identified and invited using data linkage with medical records. Findings suggest that most patients receive informal disclosures rather than a process that aligns with the current policy guidance. What are the implications for practitioners?: Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents. [ABSTRACT FROM AUTHOR]

ABSTRACT Children born to teen mothers may experience less responsive and supportive parenting and are at heightened risk for a range of social, developmental, and health issues. There is literature to support the positive impact of grandmothers on teen parents and their children. However, what if the teen's mother is also limited in her parenting capacities? How do parenting capacities across these two generations of mothers affect the developing child? In this ongoing study we are examining two important aspects of parenting capacities, attachment quality and executive functioning, in teen mothers (TM) and their biological, co- residing mothers or grandmothers (GM or GGM). Both are essential components of effective parenting, but little is known about their impact on young children's development when raised by two generations of parents. In a cross- sectional, descriptive design, a convenience sample of 50 TM/GM dyads with children 1 to 3 years old is being recruited from two urban teen-tot clinics. Participants complete a paper-and-pencil measure of attachment quality and a computerized measure of multiple aspects of executive function (working memory, inhibitory control, cognitive flexibility). A standardized maternal report measure is used to assess child developmental status. The biggest challenges of the study thus far include recruitment and transience of the study population. Progress to date and experiences from recruitment and data collection are discussed, as well as successful strategies to address challenges. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: AHDs in mental health are fundamental tools in advance care planning processes. It is an important method for involving mental healthcare users in clinical decisions and in providing effective healthcare based around user preferences.AHDs can be applied in situations in which the person may forfeit their legal capacity, according to the Convention on the Rights of Persons with Disabilities.However, the use of AHDs as described above is not yet a reality in Spain. What the paper adds to existing knowledge?: The present study surveys the knowledge and attitudes of mental healthcare providers towards AHDs in clinical practice.Although providers had a moderate–low level of knowledge about AHDs, they presented positive attitudes towards them. What are the implications for practice?: The use of AHDs in mental healthcare practice poses challenges to the Spanish mental healthcare system. Acquiring up‐to‐date data on the knowledge and attitudes of providers towards AHDs allows organizations to address aspects of their service that require reinforcement. This data could also be used by other countries just starting to use AHDs, as an initial step towards supporting the implementation of a multistage intervention process.More in‐depth training for providers would help improve their competence to implement or honour the statements set out in AHDs, the related legal and ethical issues, and liability issues related to their implementation.The Spanish mental healthcare system requires structural changes so that providers can embrace new ways of relating to users and to organize partnerships and a continuity of care centred on user preferences. Introduction: Advance healthcare directives (AHDs) in mental health offer important information regarding service users' preferences. However, whether AHDs are truly understood by providers is questionable. Aim: To survey the knowledge and attitudes of mental health professionals towards AHDs and examine any associations with sociodemographic and occupational variables. Method: We cross‐sectionally surveyed the knowledge and attitudes of 113 mental health professionals by using two validated questionnaires. Results: Participants showed very positive attitudes and high levels of knowledge about the conceptual definition and application of AHDs in clinical practice but their knowledge of the legalities, procedure and registration of AHDs was poor. Working in a community, having a career specializing in mental health or having personally signed an AHD was associated with enhanced knowledge about them. Moreover, female sex or employment as an auxiliary nursing‐care technician was associated with stronger positive attitudes. Discussion: Legal and structural changes will be needed to implement AHDs in Spain and to promote competence among healthcare providers in order to include AHDs in everyday practice. Implications for practice: The Spanish mental healthcare system requires legal and structural changes and must improve healthcare providers' competence in AHDs before they are implemented. [ABSTRACT FROM AUTHOR]

The need for the poor, the marginalised and socially excluded to live healthier and longer lives has in recent times become paramount in the development literature and policy discussions seeking to achieve the Millennium Development Goals (MDGs). In response to this, attempts are being made to redirect the research focus to examine socio-economic factors underpinning disease occurrence and ill health for health planning policies and practices to benefit the poor and vulnerable in society. Tliis paper explores the relationship between socio-economic conditions and health outcomes. It identifies and examines through participatory rural assessment techniques, basic socio- economic factors acting as significant pathways through which poverty increases the susceptibility of rural households to diseases. It seeks to address the reasons why the poor are poorer in health in rural communities of the Amansie West district of Ghana. This paper thus emphasises how social stratification and inequalities could affect quality of life of people in any given society, hence supporting the theory of social suffering and its implications on societal health. [ABSTRACT FROM AUTHOR]

Background: Mental disorders are largely socially determined, yet the combined impact of multidimensional social factors on the two most common mental disorders, depression and anxiety, remains unclear. Methods: We constructed a polysocial risk score (PsRS), a multidimensional social risk indicator including components from three domains: socioeconomic status, neighborhood and living environment and psychosocial factors. Supported by the UK Biobank cohort, we randomly divided 110 332 participants into the discovery cohort (60%; n = 66 200) and the replication cohort (40%; n = 44 134). We tested the associations between 13 single social factors with Patient Health Questionnaire (PHQ) score, Generalized Anxiety Disorder Scale (GAD) score and self-reported depression and anxiety. The significant social factors were used to calculate PsRS for each mental disorder by considering weights from the multivariable linear model. Generalized linear models were applied to explore the association between PsRS and depression and anxiety. Genome-wide environmental interaction study (GWEIS) was further performed to test the effect of interactions between PsRS and SNPs on the risk of mental phenotypes. Results: In the discovery cohort, PsRS was positively associated with PHQ score (β = 0.37; 95% CI = 0.35-0.38), GAD score (β = 0.27; 95% CI = 0.25-0.28), risk of self-reported depression (OR = 1.29; 95% CI = 1.28-1.31) and anxiety (OR = 1.19; 95% CI = 1.19-1.23). Similar results were observed in the replication cohort. Emotional stress, lack of social support and low household income were significantly associated with the development of depression and anxiety. GWEIS identified multiple candidate loci for PHQ score, such as rs149137169 (ST18) (Pdiscovery = 1.08 × 10-8, Preplication = 3.25 × 10-6) and rs3759812 (MYO9A) (Pdiscovery = 3.87 × 10-9, Preplication = 6.21 × 10-5). Additionally, seven loci were detected for GAD score, such as rs114006170 (TMPRSS11D) (Pdiscovery = 1.14 × 10-9, Preplication = 7.36 × 10-5) and rs77927903 (PIP4K2A) (Pdiscovery = 2.40 × 10-9, Preplication = 0.002). Conclusions: Our findings reveal the positive effects of multidimensional social factors on the risk of depression and anxiety. It is important to address key social disadvantage in mental health promotion and treatment. [ABSTRACT FROM AUTHOR]

Background: Work-family enrichment refers to the extent to which experiences in one role improve the quality of life in another role, and the bidirectionality indicates that benefits derived from work can be applied to family and vice versa. Parent nurses, that is, female nurses who are raising preschool children, play a major role at work and in the family. Thus, work-family enrichment is significant for them. The Work-Family Enrichment Scale cannot be generalized to parent nurses. This study was aimed at developing and psychometrically validating a draft Work-Family Enrichment Scale for Parent Nurses. Methods: A questionnaire survey was conducted among 1,090 parent nurses who were randomly sampled from hospitals with more than 200 beds in Japan. The survey evaluated (1) a draft Work-Family Enrichment Scale for Parent Nurses, (2) the Japanese version of the Work-Family Enrichment Scale, and (3) the Positive Spillover Scale. The scales were psychometrically evaluated for internal consistency, construct validity, and criterion-related validity. Results: Data from 503 participants (age, mean ± standard deviation [range] 35.5 ± 4.96 [23–47] years) were analyzed. Results of exploratory factor analysis, the work to family enrichment direction yielded five factors for 23 items: "emotional fulfillment," "efficiency," "ability to lead," "displaying industriousness," and "self-growth." Cronbach's alpha coefficients ranged from 0.862 to 0.914. In the family-to-work enrichment direction, there were five factors for 28 items: "help-seeking," "receptiveness," "expansion of one's horizon," "efficiency," and "emotional fulfillment." Cronbach's alpha coefficients ranged from 0.790 to 0.907. Additionally, the correlation coefficients reporting criterion-related validity were 0.685 and 0.619 with regard to the Japanese version of the Work-Family Enrichment Scale and 0.596 and 0.534 with the Positive Spillover Scale for the Work-to-Family Enrichment Scale and the Family-to-Work Enrichment Scale for Parent Nurses, respectively. Conclusions: The Work-Family Enrichment Scale for Parent Nurses has adequate reliability and validity and can be used as an effective measure to assess the positive aspects of work and family roles among female parent nurses. [ABSTRACT FROM AUTHOR]

Background: Cancer is a leading cause of morbidity and mortality globally. Dyspnea, affecting up to 60% of cancer patients, exacerbates physical and psychological distress, reducing quality of life. This study aims to explore the relationship between dyspnea and factors such as age, sex, clinical diagnosis, and treatment lines in cancer patients, with the goal of improving understanding and management of this debilitating symptom to enhance patient care and quality of life. Methods: This study employed an observational, cross-sectional, and descriptive approach to investigate patients with oncological disease at the University Hospital of Salamanca between March 2021 and April 2024. A convenience sample was selected, including patients over 18 years old with a pathological diagnosis of cancer, experiencing any degree of dyspnea, and who consented to participate by signing the informed consent. Exclusion criteria included lack of consent and clinical conditions that prevented an interview. The studied variables encompass sociodemographic (age, gender, diagnosis, tumor stage, number of treatment lines) and clinical aspects (daily activities, degree of dyspnea, functional capacity, physical performance), evaluated using the Barthel Index, the mMRC Dyspnea Scale, the ECOG Scale, and the Short Physical Performance Battery (SPPB). Data were collected through semistructured interviews and medical records, and analyzed using specialized software. This research has ethical approval CEiM Code 2023 12 1472, Reference 2024/01. Results: The mean age was 66.82 years. Lung cancer was predominant (60.2%), with most patients in stage 3 (65.7%) and receiving three treatment lines (68.7%). Higher age, advanced disease stage, and more treatment lines correlated with lower Barthel and SPPB scores, and higher ECOG and mMRC scores, indicating worse functionality, physical performance, and greater dyspnea. No significant correlations were found between gender or pathological diagnosis and the studied variables. Conclusions: Advanced age, higher disease stage, and more treatment lines are associated with decreased functionality, poorer physical performance, and increased dyspnea in cancer patients. Gender and specific cancer diagnosis do not significantly affect these relationships. Addressing dyspnea is crucial to improving the quality of life and physical performance in this population. Future studies should explore additional factors like treatment types and nutritional status. [ABSTRACT FROM AUTHOR]

Aim: To analyze the psychometric properties of the Hospital Survey on Patient Safety Culture (HSOPS) in internal care units at a specific teaching hospital in the Czech Republic. Design: The paper has the character of a cross-sectional validation study. Methods: The study was conducted between November 2015 and January 2016. The convenience sample consisted of 207 registered nurses working in internal care units at a specific faculty hospital in the Czech Republic. Analysis of the psychometric properties of the HSOPS was conducted using Principal Component Analysis (PCA) and reliability testing. Results: Acceptable psychometric properties of the HSOPS were verified in our study. We confirmed 12 components of the HSOPS, the same number stated in the original version from the Agency for Healthcare Research and Quality (AHRQ). The reliability of the instrument was evaluated using the Cronbach alpha coefficient, and is considered acceptable. Conclusion: These findings can help healthcare institutions to raise awareness of patient safety culture and to gain a comprehensive overview of the individual dimensions of patient safety culture. In the future, the instrument could help to compare the components of patient safety culture, not only at a national but also at an international level. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? People admitted to psychiatric facilities have high rates of tobacco use and hospitalizations present an opportunity for patients to have conversations about tobacco use treatment., Clinicians may believe that people with mental illnesses are not interested in quitting or that they do not understand the importance of treatment., Positive attitudes towards tobacco treatment, viewing that participating in treatment is normal care, and feeling that one is quite able to participate in such treatment predicts intentions to participate in treatment, which, in turn, predicts actual participation., What does this paper add to existing knowledge? Psychiatric patients who use tobacco use report poor prior involvement with tobacco treatment., Positive attitudes towards, encouraging opinions of other people about, and having a sense of control over taking part in tobacco treatment increases plans to engage in treatment., Having a sense of control in taking part in tobacco treatment is strongly associated with prior experiences with evidence-based treatment., What are the implications for practice? Because psychiatric hospitalizations are an opportunity for addressing tobacco use and treatment, clinicians should be prepared to support willing patients, especially those with prior substance use histories., Support should include providing them with information regarding tobacco treatment options during their hospital stay and ways that they can continue to receive care after discharge., Clinicians should be promoters of pro-tobacco treatment attitudes and supporting patients' sense of control over participating in treatment during hospitalization., Abstract Introduction Hospitalized tobacco users with mental illnesses ( MI) may face several barriers to stopping smoking. However, motivational factors that affect the intention to engage in tobacco treatment have been shown to predict actual engagement. Aim To use the Theory of Planned Behavior to assess intentions to and prior experiences of engaging in evidence-based tobacco treatment among hospitalized individuals with MI. Method A cross-sectional survey was conducted among 115 patients in a state psychiatric hospital. Multivariate analyses were used to examine associations with the intentions and prior experiences of engaging in tobacco treatment. Results After controlling for demographic and smoking history, attitudes, subjective norms and perceived behavioural control towards engaging in tobacco treatment were significantly associated with intentions towards treatment engagement. Only higher scores on perceived behavioural control and lower education levels were associated with reported prior experiences of tobacco treatment. Discussion The low prior treatment engagement scores, but relatively higher intention to engage scores among participants suggests the need for deliberate support for evidence-based tobacco treatment during psychiatric hospitalizations. Implications for practice Clinician training in tobacco treatment can promote self-efficacy to engage patients while supporting patients' control so that tobacco treatment is an expected component of psychiatric care. [ABSTRACT FROM AUTHOR]

Aim To validate the European Health Literacy Survey Questionnaire ( HLS- EU-Q47) in people with type 2 diabetes mellitus. Background The HLS- EU-Q47 latent variable is outlined in a framework with four cognitive domains integrated in three health domains, implying 12 theoretically defined subscales. Valid and reliable health literacy measurers are crucial to effectively adapt health communication and education to individuals and groups of patients. Design Cross-sectional study applying confirmatory latent trait analyses. Methods Using a paper-and-pencil self-administered approach, 388 adults responded in March 2015. The data were analysed using the Rasch methodology and confirmatory factor analysis. Results Response violation (response dependency) and trait violation (multidimensionality) of local independence were identified. Fitting the 'multidimensional random coefficients multinomial logit' model, 1-, 3- and 12-dimensional Rasch models were applied and compared. Poor model fit and differential item functioning were present in some items, and several subscales suffered from poor targeting and low reliability. Despite multidimensional data, we did not observe any unordered response categories. Conclusion Interpreting the domains as distinct but related latent dimensions, the data fit a 12-dimensional Rasch model and a 12-factor confirmatory factor model best. Therefore, the analyses did not support the estimation of one overall 'health literacy score.' To support the plausibility of claims based on the HLS- EU score(s), we suggest: removing the health care aspect to reduce the magnitude of multidimensionality; rejecting redundant items to avoid response dependency; adding 'harder' items and applying a six-point rating scale to improve subscale targeting and reliability; and revising items to improve model fit and avoid bias owing to person factors. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to analyse the effects of servant leadership on nurses' emotional failure and compliance with standard precautions and to explore the moderating effect of individual resilience. Design: A cross‐sectional survey. Methods: This descriptive cross‐sectional study was conducted from October 9 to November 1, 2022. The convenience sampling method was used to collect questionnaire data from 924 clinical nurses in a third‐class general hospital in Chongqing, China. Results: The emotional exhaustion and compliance with standard precautions were at the general level. Servant leadership mediated by emotional exhaustion had a significant positive predictive effect on compliance with standard precautions. Personal resilience played a negative moderating role in the relationship between servant leadership and emotional exhaustion. For nurses with low resilience, servant leadership had a greater impact on emotional exhaustion. Conclusion: The current compliance with standard precautions for clinical nurses is not high due to emotional exhaustion. The level of servant leadership can alleviate nurses' emotional exhaustion and improve compliance with standard precautions. Especially for nurses with low personal resilience, the care and support of department leaders are needed. Impact: We found that the compliance with standard precautions is not high, and the link between emotional exhaustion, servant leadership and compliance with standard precautions provides a basis for further patient care. No Patient or Public Contribution: There was no patient or public involvement. Impact Statement: Nurses are the key population for hospital infection prevention and control, and their level of compliance with standard precautions is of great significance for hospital infection prevention and control. However, in practice, nurses' compliance with standard precautions is generally low. Most of the previous studies on nurses' compliance with standard precautions were conducted from the perspective of individual nurses, based on the staff's 'knowledge, belief, and action' to study the current status of compliance with standard precautions and the factors affecting adherence, with less attention paid to the influence of psychological, environmental, and organizational factors. Therefore, the study focuses on the impact of servant leadership and emotional exhaustion on standard precautionary adherence, which is of great significance for good care management at the organizational level. It also explored how the impact of servant leadership on emotional exhaustion varies across levels of resilience, which is important for accurately identifying different types of nursing staff and targeting assistance. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the relationship between smartphone addiction, mental health and sleep quality among undergraduate pharmacy students in a Nigerian public university. Design/methodology/approach: A cross-sectional study was conducted among undergraduate pharmacy students in a Nigerian university. Data was collected using self-administered questionnaires, including Smartphone Addiction Scale-Short version, Patient Health Questionnaire, Generalized Anxiety Disorder Scale and Pittsburgh Sleep Quality Index. The data obtained were analyzed using descriptive statistics, the chi-square test and the Pearson correlation. Probability values less than 0.05 were considered statistically significant. Findings: A total of 410 undergraduate pharmacy students participated in the study, giving a response rate of 95.57%. The prevalence of smartphone addiction, depression and anxiety symptoms were 40.24%, 28.30% and 23.66%, respectively. Most students had poor sleep quality (96.10%). The prevalence of smartphone addiction had a moderate positive correlation with the severity of depression (r = 0.363, p < 0.01) and anxiety (r = 0.261, p < 0.01) symptoms. Nevertheless, smartphone addiction showed no connection with sleep quality (r = 0.022, p = 0.663). Research limitations/implications: The study was conducted in a single public university in Nigeria, hence this might limit its generalizability. The provision of mental health support within universities could help address the high prevalence of smartphone addiction, mental health issues and poor sleep quality. Originality/value: To the best of the authors' knowledge, this was the first study to examine smartphone addiction among pharmacy students in a resource-limited setting with multicultural and multiethnic groups. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is a serious public health issue. It is a significant but controllable factor in the emergence of cardiovascular disease. Controlling hypertension is a main target for individuals to prevent further illness. Objective: This study aims to explore the level of self-care behaviors, motivation, and self-efficacy among individuals with hypertension. Methods: A cross-sectional, descriptive, correlational design was used to recruit (n = 121) participants utilizing the Hypertension Self-Care Profile (HTN-SCP) questionnaire. Results: The analysis revealed that the mean score of self-care behavior was 49.7 (SD = 10.0) out of 20–80, which indicates that they are likely to have good self-care behavior. The mean score of motivation for self-care was 59.7 (SD = 11.8) out of 20–80, reflecting that individuals with hypertension have a good level of motivation for self-care, and the mean score of self-efficacy was 70.0 (SD = 9.8) out of 20–80, which means that individuals with hypertension have a high level of self-efficacy. Also, there was a significant positive correlation between self-care behavior and motivation for self-care (r =.527, p <.001), between motivation for self-care and self-efficacy (r =.554, p <.001), and between self-efficacy and self-care behavior (r =.572, p <.001). Conclusion: The study revealed that Jordanian patients with hypertension have good self-care practices, motivation, and high self-efficacy. Patients should therefore be strongly recommended to be compliant with self-care practices. The government should prioritize hypertensive patients by making it easier for them to receive information about self-management practices to improve their quality of care. [ABSTRACT FROM AUTHOR]

Aim: Knowledge about nurses' error perception is crucial for establishing a sustainable risk management. This paper presents categories and frequencies of errors as identified by nurses. The cross-sectional study results provide further knowledge for professional and organizational development. Subject and methods: Data from 1,100 German nurses working in 30 hospitals and 46 nursing homes were collected using a self-administered questionnaire. This paper firstly presents results from a content analysis of nurses' descriptions of errors and, secondly, results on frequencies of predefined nursing errors (closed-ended, ordinal frequency estimation). Thirdly, it compares the answers of hospital nurses with those of nurses employed in nursing homes and finally it compares answers of participant groups defined by sex or migration background. Results: In the open-ended section, errors described by 60.5 % of the participants concerned medical diagnosis/therapy. 20.7 % had experienced errors in hands-on care, while errors in communication with patients were noted by 3.7 %. In contrast, when offering predefined activities in the questionnaire's closed-ended part, indicated frequencies of errors stressed issues of hands-on care and documentation. Significant differences exist between participants from both settings regarding direct care and relationship building. Sex and migration background were related to frequency estimations. Conclusions: Findings point to shortened professional perspectives in the debates on risk and safety. This might lower nurses' compliance in risk management systems. The influence of health professionals' sex and migration background on their error perception needs further exploration. Field specific approaches for error prevention are needed. [ABSTRACT FROM AUTHOR]

This paper describes the factor analysis testing and construct validation of the Japanese version of the Caffrey Cultural Competence Health Services (J-CCCHS). The inventory, composed of 28 items, was translated using language and subject matter experts. Psychometric testing (exploratory factor, alpha reliability, and confirmatory factor analyses) was undertaken with nurses (N = 7494, 92% female, mean age 32.6 years) from 19 hospitals across Japan. Principal components extraction with varimax rotation yielded a 5-factor solution (62.31% variance explained) that was labeled: knowledge, comfort-proximal, comfort-distal, awareness, and awareness of national policy. Cronbach α for the subscales ranged from 0.756 to 0.892. In confirmatory factor analysis using the robust maximum likelihood estimator, the chi-square test was as follows: χ2(340) = 14604.44, P < .001. After correlated errors were introduced, there was evidence of improved model fit (χ2(335) = 8681.61, P < .05) but the other indices showed improvement (RMSEA = .058 [90% CI, 0.057-0.059], TLI = .891, CFI = .903, and SRMR = .059). The discriminating power of the J-CCCHS was indicated by statistically mean differences in J-CCCHS subscale scores between predefined groups. Taking into consideration that this is the first foray into construct validation for this instrument, and that fit was improved when a subsequent data driven model was tested, and it has the ability to distinguish between known groups that are expected to differ in cultural competence, the instrument can be of value to clinicians and educators alike. [ABSTRACT FROM AUTHOR]

Purpose: To create an instrument to assess attitudes toward lesbian, gay, and bisexual (LGB) patients among random samples of athletic trainers in the United States. Methods: This was a cross-sectional study using semi-structured interviews, paper-based questionnaires, and an electronic questionnaire. Development included three phases: (1) exploratory interviews and questionnaire responses, (2) construct validity and item reduction, and (3) criterion validity. Results: Six athletic trainers completed semi-structured interviews to develop themes regarding LGB patients. Additionally, 39 students in professional and post-professional athletic training programs answered questionnaires designed to elicit statements regarding LGB patients. For item reduction, 3,000 athletic trainers were emailed a questionnaire (response rate = 17%). For validation, another sample of 3,000 athletic trainers was sent the instruments (response rate = 13%). Athletic trainer emails were obtained from the National Athletic Trainers' Association. The resultant instrument was the 15-item Attitudes Toward Lesbian, Gay, and Bisexual Patients (ATLGBP) (α =.830). There were significant correlations between the ATLGBP and subscales of the Lesbian, Gay, Bisexual–Knowledge and Attitude Scale for Heterosexuals (hate: r =.464; civil rights: r = −.683; religion: r =.532; internal: r = −.612; knowledge: r = −.430; P <.001). Conclusions: The ATLGBP assesses affective, cognitive, and behavioral expressions of LGB attitudes in settings common to clinicians. The ability to assess attitudes toward LGB patients enables clinicians to identify areas on which to focus training and education. [Athletic Training & Sports Health Care. 2021;13(4):e146–e152.] [ABSTRACT FROM AUTHOR]

Purpose: Dental health care professionals (DHCP) are routinely exposed to occupational hazards, such as sharps, putting them at risk of exposure to blood borne pathogens in addition to experiencing psychological effects post-injury. The purpose of this study was to investigate the psychological effects of sharps injuries for students, faculty, and staff at the University of Minnesota School of Dentistry (UMN SOD). Methods: A mixed-mode, electronic and paper, research design was used for the 51-item survey. Participants were recruited from the UMN SOD and included students, faculty, and staff. The survey consisted of items from the Perceived Stress Scale (PSS-10) and Modified Patient Health Questionnaire (PHQ-9). Scores were compared between participants who had and those who had not experienced a sharps injury in the past year. Results: A total of 262 surveys were included in the statistical analysis for a 23.5% response rate. Fifty-six participants (21%) self-reported a sharps injury within the past year. Of those respondents, over half (67%) reported experiencing feelings of anxiety and increased stress (50%) while waiting for blood test results. Conclusion: A majority of participants who reported a sharps injury felt anxious and/or stressed during the month following the injury. While participants may have experienced overall increased stress and anxiety, these findings were not statistically significant. Further research is needed to assess the psychological effects of sharp injuries in DHCPs. [ABSTRACT FROM AUTHOR]

Background. Haematology nurses in Singapore experience a highly stressful work environment and increased workload due to the growing number of patients and complex treatment regimens. High job demands can lead to burnout and high staff turnover rates, which compromises the quality of patient care. Aims. To assess perceived work demands, levels of social support from colleagues, professional quality of life (ProQOL), and turnover intentions among haematology nurses and examine whether demographic and occupational characteristics, perceived job demands, and support were associated with ProQOL and turnover intentions. Design. A descriptive, correlational, and cross-sectional design was used in this study. Methods. A convenience sample of 60 haematology nurses working at a tertiary hospital in Singapore completed a self-administered survey. Perceived job demands, support from colleagues, ProQOL, and turnover intentions were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ III), Professional Quality of Life Scale version 5 (ProQOL5), and Turnover Intention Scale (TIS-6). Descriptive statistics, chi-square test, and multiple linear regressions were employed for data analysis. Results. Haematology nurses face high cognitive and emotional demands and receive high levels of support from colleagues at work. The majority of the participants reported moderate to high levels of compassion satisfaction (78.3%), burnout (76.7%), and secondary traumatic stress (81.7%). 53.3% of the participants expressed their intention to leave. Perceived job demands were significant predictors of haematology nurses' ProQOL and turnover intentions. Compassion fatigue also significantly predicts turnover intentions. Conclusion. The high levels of burnout and secondary traumatic stress reported by haematology nurses highlight an urgent need to implement strategies to help nurses cope with the high work demands and reduce their levels of compassion fatigue. Implications for Nursing Management. The findings in this study can help nursing leaders understand haematology nurses' perceived job demands and ProQOL, to develop strategies to improve the workplace environment and retention. [ABSTRACT FROM AUTHOR]

This study aimed to assess levels of alarm and compassion fatigue among critical care nurses, and investigate whether compassion fatigue is linked to alarm fatigue and can predict its occurrence. Descriptive correlational design was employed in this research. A total of 413 critical care nurses working in the health care network in Istanbul were selected through convenience sampling. Surveys were utilized to collect data regarding alarm fatigue, compassion fatigue, and personal characteristics of critical care nurses. Study findings revealed that participating critical care nurses experienced alarm fatigue and were at risk of compassion fatigue. A positive and statistically significant relationship was found between alarm fatigue and compassion fatigue, indicating alarm fatigue influences compassion fatigue. This study illuminated significant relationships among alarm fatigue and compassion fatigue in critical care nurses. Awareness of the existence of these phenomena may encourage clinical care nurses to seek help in coping with alarm and compassion fatigue, allowing them to provide quality care. [ABSTRACT FROM AUTHOR]

Introduction: The development of cultural sensitivity is essential for health care professionals but there are few tools to measure this quality in Japan. The purpose of this study was to develop a scale of cultural sensitivity for Japanese health care professionals and examine its reliability and validity. Method: A draft scale was created through conceptual analysis and a questionnaire was completed by 515 health care professionals and 1,322 college students. Exploratory and confirmatory factor analyses were used to determine suitable scale items and examine model fitness. Results: The four-factor 18-item scale showed acceptable model fitness. Cronbach's α coefficient exceeded.90 and correlation coefficients for criterion-related validity were over.29. Construct validity was confirmed by the significantly higher score of the cross-culturally experienced groups. The intraclass correlation coefficient was.642 (professionals) and.722 (students). Discussion: This reliable and valid scale for Japanese health professionals and college students may be used to evaluate training programs to increase their cultural sensitivity. [ABSTRACT FROM AUTHOR]

Background: Climate change, a pervasive global phenomenon, exerts discernible impacts on the physical, social, and psychological dimensions of well-being. The apprehension surrounding this complex environmental issue has reached a critical juncture, with over 76,000 individuals across more than thirty nations expressing profound levels of concern, characterizing their anxiety as either "very" or "extremely" pronounced. This surge in awareness regarding the potential consequences of climate change has given rise to an emergent and escalating challenge known as climate anxiety. This distinctive form of anxiety manifests through profound feelings of fear, helplessness, and despair elicited by the impending repercussions of climate change. Notably, the intersection of climate anxiety with occupational domains, particularly within the context of Nursing University Colleagues, suggests a nuanced relationship with job engagement, wherein the psychological responses to climate change may influence professional commitment and involvement. Aim of the study: To examine the correlation among Climate Anxiety, Environmental Attitude, and Job Engagement among Nursing University Colleagues comprising eight distinct nursing faculties. Design: A multicenter descriptive, cross-sectional research design study followed. Subject: Three hundred fifty-nine participants from the Centre, Delta, West, Suez Canal, and Upper regions of Egypt using a stratified random cluster sampling technique. Measurements: Social and health related to climate data structured questionnaire, climate anxiety scale, environmental attitude inventory, and job engagement scale. Results: The influence of demographics on climate anxiety, environmental attitude, and job involvement was not observed. Nevertheless, geographical variations emerged as a noteworthy factor. A statistically significant inverse correlation was identified between climate anxiety, job engagement dimensions, and the overall score of environmental attitudes. Conclusion: Climate anxiety was strongly associated with environmental attitudes and job engagement among nursing university colleagues. Higher climate anxiety is associated with a lower attitude towards the environment and decreased job engagement. Additionally, a higher attitude towards the environment is associated with decreased overall engagement in participants' jobs. Implications: The study's patterns make it clear how important it is to provide targeted psycho-educational interventions to help reduce climate anxiety among the group of nursing university colleagues. The imperative lies not only in alleviating the immediate psychological distress associated with heightened climate anxiety but also in fostering adaptive coping mechanisms. By doing so, these interventions serve as instrumental tools in nurturing resilience, thereby fortifying the mental well-being of nursing professionals amidst the evolving landscape of climate-related concerns. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Despite the increased interest in nursing students' happiness in South Korea, few studies have attempted to identify factors influencing their happiness. Therefore, nursing educators should consistently investigate the factors influencing happiness and develop strategies to improve happiness among Korean nursing students., What this paper adds to existing knowledge? This study confirmed that there were positive correlations between grateful disposition, social support and happiness. In addition, grateful disposition and support from intimate people were identified as predictors of happiness in Korean nursing students., What are the implications for practice? Development of intervention programmes to help nursing students increase grateful disposition and support from intimate people may be helpful for improving happiness. These programmes can include activity, such as writing a gratitude journal, and extracurricular programmes, such as mentoring programmes between seniors and juniors and/or professor and student., Abstract Introduction Happiness is very important in the training and development of nursing students as future nurses. However, nursing students experience a high level of stress and low level of happiness in South Korea. Aim This study aimed to investigate factors that affect happiness among nursing students in South Korea. Method Data were collected from a total of 241 nursing enrolled in two 4-year baccalaureate nursing programmes in South Korea, using a self-administrated questionnaire. To identify predictors of happiness, stepwise regression analysis was conducted. Results The results indicated that grateful disposition and support from intimate people significantly predict happiness among Korean nursing students. These two factors accounted for 38.0% of the variance in happiness. Discussion This study indicated grateful disposition and support from intimate people as factors promoting happiness in nursing students. The findings highlight grateful disposition and support from intimate people as important factors when developing effective interventions that foster nursing students' happiness. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Several studies have measured the general public's knowledge and attitudes towards Alzheimer's disease; however, much of this work is based on western samples. Due to cultural differences, the western findings may be difficult to generalize to the Chinese general public. In addition, the few studies conducted in China were often restricted to a relatively narrow range of knowledge and attitudes., What this paper adds to existing knowledge? The general public had little knowledge of Alzheimer's disease, especially on the causes, symptoms and risk factors. In terms of attitudes, although the general public held positive attitudes towards persons with Alzheimer's disease, most of them were not sure whether or not to share a diagnosis of Alzheimer's disease with the patient. In daily life, only a low proportion of people kept mentally active., What are the implications for practice? A popularization of a wide range of knowledge about Alzheimer's disease needs to be undertaken, especially focusing on persons with low educational level and emphasizing the causes, symptoms and risk factors. Besides, there is a significant need to draw up evidence-based dietary and lifestyle guidelines for Alzheimer's disease risk reduction. Moreover, health promotion agencies should identify priority groups for Alzheimer's disease risk reduction initiatives, especially those with lower income, a lower level of knowledge on Alzheimer's disease and with chronic diseases., Abstract Aim The purpose of this descriptive correlational cross-sectional study was to assess the current level of knowledge, attitudes and health behaviours regarding Alzheimer's disease among community residents in Tianjin, China and to identify factors related to these attributes. Method A convenience sample of 140 community-dwelling adults aged 20-75 years was selected to complete a researcher-designed questionnaire about Alzheimer's disease-related knowledge, attitudes and health behaviours. Results The findings revealed that 15.7% of the participants knew the risk factors for Alzheimer's disease. With regard to attitude, 138 participants (98.6%) believed that people with Alzheimer's disease should not be discriminated against, and 55.7% were not sure whether to share a diagnosis of Alzheimer's disease with the patient. In daily life, 28.6% of the participants pursued their interests and hobbies. A lower level of health behaviours was associated with lower income, presence of chronic diseases and a lower level of knowledge about Alzheimer's disease. Discussion These findings provide a strong case for population-level risk reduction initiatives to be undertaken, especially among people with lower income, a lower level of knowledge on Alzheimer's disease and with chronic diseases. [ABSTRACT FROM AUTHOR]

Background: Nurses working in emergency units are in direct contact with traumatic events. Trauma effects do not solely affect patients and their caregivers and, rather, extend to secondarily influence nurses themselves. Secondary exposure to trauma may result in symptoms similar to symptoms experienced by the patient themselves. No previous study investigated the secondary traumatic stress among emergency nurses in Jordan. Purpose To identify prevalence, predictors, and consequences of secondary traumatic stress among nurses working in emergency departments. Method: A descriptive correlation design was utilized to collect data using self‐report questionnaires from 202 nurses working at eight emergency departments in Jordan. Findings The study revealed that almost half of the sample reported high to severe levels of secondary traumatic stress. The analyses showed that nurses who demonstrated lower empathy (P =.016) and greater coping capacity (P <.001) tended to develop more secondary traumatic stress. Organizational factors were not significant predictors of secondary traumatic stress. Conclusion: A significant proportion of emergency nurses suffer secondary traumatic stress that is found also to be associated with psychical factors. Emergency nurses need to consider the consequences of secondary traumatic stress on their health and quality of care provided. SUMMARY STATEMENT: What is already known about this topic? Emergency nurses are susceptible to develop secondary traumatic stress due to nature of their work and being repetitively exposed to traumatic patients.No studies have examined existence of secondary traumatic stress among nurses in Jordan and in the Arab countries.The literature has contradicting findings on factors that can enhance or attenuate development of secondary traumatic stress symptoms. What this paper adds? More than half of the participants reported high to severe levels of secondary traumatic stress indicating that secondary traumatic stress is apparent among ER nurses in Jordan.Coping and empathy are important predictors of secondary traumatic stress among emergency nurses.Nurses who reported higher level of secondary traumatic stress symptoms tended to have more work‐related absenteeism and more sick days. The implications of this paper: There is a need to raise awareness of both nurses and health care leaders to existence of secondary traumatic stress among emergency nurses and to establish screening tools and referral procedures for risky nurses.Theory of secondary traumatic stress has to be revised to provide more robust view about the process by which secondary traumatic stress develops among helping professionals.Future studies have to examine factors that may contribute to secondary traumatic stress other than factors addressed in previous studies. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence and identify the predictors of breakfast skipping among 14‐ to 16‐year‐old adolescents in Jordan, focusing on mother‐related variables. Background: Breakfast is an essential meal across one's entire lifespan and especially important during the adolescent years. The practice of skipping breakfast has become so prevalent among adolescents that it is now a well‐documented nutritional problem. Design A descriptive cross‐sectional correlational design. Methods: A proportional cluster stratified sampling protocol was used to select 1896 adolescents and their mothers (1013) during the period of March to June 2016. A self‐reported questionnaire was used to collect data on breakfast‐skipping rates, the perceived reasons for this behavior, the perceived importance of consuming breakfast, and maternal encouragement of breakfast consumption. Results: The prevalence of breakfast skipping was 34.3% among adolescents and 21.5% among their mothers. A significant association was found between breakfast skipping among adolescents and their mothers (χ2 [1, n = 998] = 37.90, P =.001). Maternal encouragement of breakfast consumption, gender, and adolescent perception of the importance of this meal were found to be significant predictors of adolescent breakfast skipping. Conclusion: The findings highlight the importance of involving mothers in developing nutritional health plans aimed at promoting regular breakfast consumption among adolescents. SUMMARY STATEMENT: What is known about the topic? Regular breakfast intake has been linked to positive benefits for adolescent health, including lower risk for obesity and fewer biomarkers of chronic illness.The practice of skipping breakfast is highly prevalent among adolescents, both in Jordan and across the globe.Parental eating habits and attitudes influence adolescent eating behaviors and attitudes. What the paper adds? Female adolescents in Jordan skipped breakfast more often than male adolescents and to a significant degree. For both groups, lack of appetite was reported as the main reason (39%) for skipping breakfast.The interrelationships found between maternal and adolescent variables related to breakfast consumption highlight the pivotal role of mothers in promoting this practice. When mothers valued eating breakfast, so did their adolescent children, a relation that translated into lower rates of breakfast skipping among the adolescents.Maternal encouragement of breakfast consumption, the adolescents' perceived value of this practice, and their gender proved significant predictors of breakfast skipping behavior. The implications of this paper: Health interventions to promote breakfast consumption among adolescents are likely to be more effective if based on a better understanding of the role of mothers in this regard.Nurses should involve mothers in developing nutritional health plans to promote regular breakfast consumptions among adolescents.Nurses should educate mothers and adolescents about the health costs for adolescents associated with skipping breakfast. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice (EBP) has become of great interest to policymakers, health care practitioners, and researchers. Objective: This study aimed at assessing knowledge associated with, attitudes toward, and implementation of EBP among Jordanian registered nurses (RNs) in critical care units. Method: A descriptive, correlational, and cross-sectional study was conducted in 5 hospitals: 3 public and 2 private. A convenience sample of 200 RNs was invited. Data were collected using a paper-based and self-administered questionnaire, in 2 sections; the first section was the demographic and contextual characteristics and the second was the Evidence-Based Practice Questionnaire (J Adv Nurs. 2006; 53(4):454-458) to measure RNs' knowledge, attitudes, and EBP. Results: A total of 187 RNs were included in this study. Findings revealed that Jordanian RNs in critical care units perceived themselves as having a satisfactory level of knowledge and practice of evidence-based interventions. In addition, RNs strongly recognized the value of EBP. There were significant positive associations between EBP and knowledge associatedwith EBP (r = 0.708, P < .001) and attitude toward EBP (r = 0.490, P < .001). Conclusion: Knowledge associated with EBP, a positive attitude toward EBP, higher educational qualifications, and training in EBP all increased the implementation of EBP. It is recommended that continuing education programs on EBP for nurses be conducted. Nursing educators in clinical settings have to consider a number of strategies to improve EBP. A qualitative research design and/or including open-ended questions are encouraged to gain more in-depth views about EBP. [ABSTRACT FROM AUTHOR]

Background: Increasing compliance with isolation precautions is important in reducing hospital-acquired infections and their consequences. It is not possible to achieve and maintain nurse compliance through supervision, control, pressure, or training. Therefore, nurses must personally demand compliance with isolation precautions. This study aimed to determine the relationship between compliance with isolation precautions and the moral sensitivity levels of nurses who have just started working. Methods: This study employed a descriptive and cross-sectional research design. The study population consisted of 456 new nurses recruited during the pandemic. All of the new nurses who volunteered to participate in the study and completed the questionnaires completely were included in the study and 398 nurses constituted the sample of the study. Data were collected from 398 out of 456 novice nurses who agreed to participate in the study. The population coverage rate was 87.28%. Participants were selected using convenience sampling method. The data collection tools included an Introductory Information Form, The Isolation Compliance Precautions Scale (TIPCS), and the Moral Sensitivity Questionnaire (MSQ). Descriptive statistics, correlation analyses, and regression models were used to analyze data. Findings: The mean score of the MSQ was high (mean ± SD = 90.49 ± 25.94; median (P25-P75) = 84 (range, 74–97), and the score for TIPCS was high (mean ± SD = 79.29 ± 7.68; median (P25-P75) = 82 (range, 76–85)). No correlation was found between MSQ and TIPCS (p > 0.05). According to the regression analysis, although the MSQ did not correlate with TIPCS, compliance with isolation measures was found to increase as the conflict subscale of moral sensitivity increased (β= -0.36, CI= -0.55 to -0.16; p < 0.001). Choosing the profession willingly had a positive correlation with compliance with isolation measures (β = 5.3, CI = 2.4 to 8.3; p < 0.001). In addition, starting the profession at an early age had a positive correlation with compliance with isolation measures (β= -0.49, CI= -0.8 to -0.17; p = 0.002). Conclusion: The conflict sub-dimension of moral sensitivity is an important factor in nurses' compliance with isolation measures, and conducting necessary training and other studies to improve nurses' moral sensitivity may increase their compliance with isolation measures. [ABSTRACT FROM AUTHOR]

Introduction: Behavioral skills of people living with HIV/AIDS (PLWHA) in consuming antiretrovirals (ARV) can reduce their morbidity and mortality; however, behavioral skills in ARV therapy are still low. Motivational factor is considered to have an effect on behavior skills. The purpose of this study was to explain the influence of motivational factors on behavioral skills of PLWHA. Material and methods: Descriptive correlational cross-sectional approach was applied as study design. One hundred respondents, who met inclusion criteria were selected through simple random sampling method, and were requested to fill out a questionnaire. Results were analyzed using descriptive analysis and logistic regression test, with a significance value of p = 0.05. Results: In general, there is a significant effect of personal motivation (p = 0.000) and social motivation (p = 0.016) on behavioral skills. Personal motivation is based on attitudes towards preventive behavior, perceptions of disease susceptibility, benefits, and barriers to preventive behavior, while social motivation is a support provided by family and/ or friends as an assistance during treatment. Conclusions: Behavioral skills of PLWHA consisting of taking medication skills and managing information, are influenced by personal and social motivation. Support from family and friends is an important value that can play a role in achieving optimal motivation for treatment. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To appreciate the importance of patient safety incident reporting practices • To understand that optimal patient safety incident reporting practices require effective leadership behaviours • To be aware of the need for a positive organisational culture to improve incident reporting practices Background: Patient safety is a priority for all healthcare organisations. Enhancing patient safety incident reporting practices requires effective leadership behaviours at all levels in healthcare organisations. Aim: To explore nurses' perceptions of the influence of nurse managers' leadership behaviours and organisational culture on patient safety incident reporting practices. Method: A descriptive, cross-sectional, correlational design was adopted with a convenience sample of 325 nurses from 15 Jordanian hospitals. Results: Respondents had positive perceptions of their nurse managers' leadership behaviours and organisational culture. There was a significant positive relationship between leadership behaviours and organisational culture (r=0.423, P<0.001) and between leadership behaviours and actual incident-reporting practices (r=0.131, P<0.001). Additionally, there was a significant positive relationship between organisational culture and incident-reporting practices (r=0.250, P<0.001). Conclusion: Healthcare organisations must develop leaders who will foster a supportive and just culture that will enhance nurses' practice with regards to reporting patient safety incidents. [ABSTRACT FROM AUTHOR]

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

OBJECTIVE: The purpose of this paper is to describe the theoretical development and initial validation of the newly developed Work-Life Balance Culture Scale (WLBCS), an instrument for measuring an organizational culture that promotes the work-life balance of employees. METHODS: In Study 1 (N = 498), the scale was developed and its factorial validity tested through exploratory factor analyses. In Study 2 (N=513), confirmatory factor analysis (CFA) was performed to examine model fit and retest the dimensional structure of the instrument. To assess construct validity, a priori hypotheses were formulated and subsequently tested using correlation analyses. RESULTS: Exploratory and confirmatory factor analyses revealed a one-factor model. Results of the bivariate correlation analyses may be interpreted as preliminary evidence of the scale’s construct validity. CONCLUSION: The five-item WLBCS is a new and efficient instrument with good overall quality. Its conciseness makes it particularly suitable for use in employee surveys to gain initial insight into a company’s perceived work-life balance culture. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self-reported cross-sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health-care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to determine the dimensions used in judging the hospital services quality; to develop a tool for measuring perceived service quality for hospitals; to test the validity and reliability of the new scale; and finally to use the results of the data collected to suggest improving service quality. Design/methodology/approach – A cross-sectional field study was conducted among 400 hospital out-patients in Thailand. The researchers administered the SERVQUAL instrument in order to assess the applicability of these service quality attributes to the out-patient hospital setting in Thailand. The data collected were used to assess the psychometric properties of the SERVQUAL instrument and to analyze whether and to what extent the SERVQUAL dimensions adequately predicted overall service quality among Thai hospital out-patient respondents. The psychometric properties of the instrument were quite acceptable and the resulting five-factor structure was consistent to and confirms earlier measurement theory. The measurement model as estimated by the use of structural equation modeling further showed that the hypothesized model fit the empirical data quite well. Findings – The results indicate that SERVQUAL's five latent dimensions had a significant influence on overall service quality. Responsiveness had most influence; followed by empathy, tangibles, assurance; and finally reliability. Research limitations/implications – The results of this study demonstrate that service quality can be assessed in diverse service settings such as hospital out-patient departments. Further, SERVQUAL is robust enough to capture the critical elements used to assess overall service quality. The study was limited in its external validity and prediction was constrained due to the nature of the data collected, i.e. cross-sectional design. This study also chose to focus on one outcome variable, i.e. overall service quality. Other critical variables might be reasonably assessed, e.g. customer satisfaction, loyalty intentions, firm performance. Practical implications – The present study has several managerial implications for service quality enhancement in the hospitals in Thailand. First, given that responsiveness, was the strongest predictor of service quality, hospital out-patient employees can exercise strong influence over perceived quality by giving sincere and detailed information about service conditions, by being willing to help and by offering fast and efficient service to out-patients. Originality/value – The World Bank reports that health care and hospital care in particular is a growing portion of the economic pie, now nearly 18 percent of GDP in the USA. Global health care administrators are under pressure to not just control costs but to offer a quality health care experience This study offers insight into how the health care out-patient consumer views service quality and the relative importance of the various service quality dimensions in predicting overall service quality. [ABSTRACT FROM AUTHOR]

Purpose – This paper aimed to characterize the nutrition and health of Brazilians living in Bournemouth, England, and changes in lifestyle after migration. Design/methodology/approach – This is a descriptive study conducted with adult residents of Bournemouth for over a year, selected through a snowball sample. We obtained demographic and food data through a structured questionnaire. An anthropometric evaluation gathered weight, height and waist circumference data. Findings – The final sample consisted of 111 immigrants, 57.7 percent female, with a mean age of 33.02 (±9.58) years. We found evidence that despite the existence of the health immigrant effect, health and nutritional benefits in immigrants erode over time. They reported weight gain post migration, and changes in diet, with increased consumption of food rich in calories and low in nutrients. We found a high proportion of obesity and risk of metabolic complications, which increased with time living in England because of reduced physical activity and worsening dietary habits. Originality/value – The number of people migrating to other countries has been increasing, resulting in interference in the processes of integration and acculturation of lifestyle, including those related to diet and physical activity. But there is little about its impact on Brazilians living abroad. This study showed that health behaviors of migrants were negatively altered by migration. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine validity and diagnostic accuracy of the single‐item Faces Anxiety Scale for the purposes of preoperative anxiety screening. Background: Anxiety is common in most patients expecting surgery interfering with patients' recovery. Valid and reliable measures for situations with limited time for assessment are needed. Design A descriptive cross‐sectional design was used to collect the data from both self‐report and rating instruments. Methods: We enrolled 90 consecutive patients admitted for surgery in a university‐affiliated hospital from January 2013 to June 2013. Patients were administered the anxiety state subscale of the Spielberger State‐Trait Anxiety Inventory and the anxiety subscale of the Hospital Anxiety and Depression Scale, and they were presented the Faces Anxiety Scale. At the same time, patients' anxiety was rated by a nurse. Results: The correlations among scores of self‐report instruments, rating scale, and the Faces Anxiety Scale were high and statistically significant. Of the Faces Anxiety Scale cut‐off scores tested, the cut‐off score > 2 has an optimal combination of sensitivity and specificity. Conclusion: The Faces Anxiety Scale is valid and easy to administer. The scale is useful in settings where fast and precise screening is necessary. SUMMARY STATEMENT: What is already known about this topic? Anxiety is experienced by most preoperative patients, and if not treated, it has an adverse impact on patients' recovery.In the fast surgical environment, administration of existing self‐report instruments for preoperative anxiety assessment may be burdensome for some patients and rating of anxiety by observers may lack validity.The Faces Anxiety Scale has proved to be valid in critical care nursing. What this paper adds? The Faces Anxiety Scale is valid for screening of preoperative anxiety in various groups of patients admitted for surgery.The Faces Anxiety Scale performs well with both self‐report and clinical judgment scores of multiple‐item measures.Sensitivity and specificity analysis showed that patient who responses by indicating the third, fourth, or fifth face of five scale's response options may experience anxiety and may need clinical anxiety assessment. The implications of this paper: The Faces Anxiety Scale is using universal non‐verbal stimuli, and therefore, it is easily accessible with no need for cultural adaptation.With only one item, the Faces Anxiety Scale overcomes disadvantages of multiple‐item measures.Promising results of diagnostic accuracy analysis should inspire future research. [ABSTRACT FROM AUTHOR]

Aims: This paper is a report examining the level of professional autonomy as well as its predictors and outcomes among practicing nurses in the Philippines. Methods: This study adopted a descriptive, cross‐sectional research design. One hundred sixty‐six (n = 166) nurses participated in the study or a response rate of 83% during the months of January 2017 to May 2017. Seven self‐reported scales were used for this study: the Nurse Autonomy Scale, Job Stress Scale, Burnout Measure Scale, Job Satisfaction Index, Organizational Commitment Questionnaire, Turnover Intention Inventory Scale, and the Six Dimension Scale of Nursing Performance. Inferential and descriptive statistics were used to analyse the collected data. Results: Nurses demonstrated moderate levels of professional autonomy with education and hospital bed capacity as strong predictors. Regression analysis showed positive effects of professional autonomy on nurses' job outcomes such as organizational commitment, job satisfaction, and work performance. Conclusion: Consistent to international studies, nurses in the Philippines demonstrated moderate levels of professional autonomy. Nurses who had higher levels of autonomy tended to be high performing, satisfied, and committed in their jobs. Organizational efforts are critically important to foster autonomy in practicing nurses through adequate support, education, training, and developed policies. What is already known about the topic? Professional autonomy is an essential aspect of a positive work environment and is attributed to enhanced outcomes in patients, nurses, and organizations.The literature has identified several factors (individual and organizational) that influence nurses' ability to gaining professional autonomy.In the Philippines, the extent to which practicing nurses act, function, and practice independently according to their professional nursing role remains unexplored.What this paper adds? Results showed moderate professional autonomy among Philippine nurses with education and hospital bed capacity as important predictors.Higher perceptions of professional autonomy were linked to enhanced organizational commitment, job satisfaction, and work performance.The implications of this paper: Nursing leaders and managers are strategically positioned to enhance autonomy in practicing nurses through provision of adequate resources, organizational support, and developed policies.Professional enrichment through continuing education, training, and provision of adequate mentorship and coaching are essential to promote autonomy in nurses.By strengthening the concepts of nursing autonomy and professionalism in the curriculum, nursing education can play an essential role in preparing future nurses. [ABSTRACT FROM AUTHOR]

Aim: To assess the validity of the translated Spanish Cancer Symptom Scale. Background: Instruments to facilitate comprehensive and objective assessments of the cancer symptom experience in underrepresented populations are essential. Methods: The Cancer Symptom Scale was translated into Spanish, and a back translation was conducted. During June 2016, a sample of 121 Hispanic Puerto Rican patients with any cancer diagnosis, all undergoing cancer treatments, completed four paper surveys. A subgroup of 15 patients agreed to complete the Spanish Cancer Symptom Scale a second time after a short delay of 1 to 2 hours. Construct validity and reliability (internal consistency via Cronbach alpha and test‐retest reliability) was evaluated. Results: All the Intensity Items of the Spanish Cancer Symptom Scale correlated significantly with the matched items on the MD Anderson Symptom Inventory. In a subgroup of 77 participants, each Cancer Symptom Scale subscale total of scores correlated significantly with the total scores from the Functional Assessment of Cancer Therapy‐General. Discriminant validity was demonstrated between those receiving chemotherapy and those from post treatment. The Spanish Cancer Symptom Scale internal consistency reliability was 0.98. Conclusion: The Spanish Cancer Symptom Scale has excellent evidence of validity and reliability for assessing cancer‐therapy‐related symptoms. SUMMARY STATEMENT: What is already known about this topic? The Cancer Symptom Scale English version has proven to be useful for symptom management research and is currently being used as a method to evaluate the effectiveness of interventions or palliative treatments in ameliorating cancer‐therapy related symptoms. What this paper adds? The Spanish Cancer Symptom Scale is a valid and reliable instrument for determining the symptom profile of Hispanic Puerto Rican patients undergoing cancer treatments. The implications of this paper: The Spanish Cancer Symptom Scale is an easy to answer numeric rating instrument that has the potential to be included in clinical practice settings to achieve a more comprehensive and objective assessment of the symptom experience. [ABSTRACT FROM AUTHOR]

This paper reports on the prevalence of intimate partner violence (IPV) as well as individual, socioeconomic, and family function characteristics associated with IPV among women attending public health services in Marivan County, Iran. Multistage cluster sampling was employed to recruit 770 women to participate in the study. This descriptive, cross-sectional study took place from May to November 2009. The majority of the women (79.7 %) had experienced psychological IPV, followed by physical IPV (60 %) and sexual IPV (32.9 %). There was a positive significant relationship between IPV and education level of women and the level of religious commitment in both women and spouses. Spouse's smoking, addiction to drugs, mental illness, and weakness in religious persuasion were statistically significant predictors of IPV and accounted for 36 % of the variation. This correlational study suggests that educational programs regarding these risk factors and their associations with the outcome of IPV should be designed by healthcare providers and implemented not only in healthcare facilities, but presented from local media. Public health services and healthcare facilities can play an important role in the detection of IPV and improve responses to victims by establishing education centers and informing women of the best ways they can confront this deleterious problem. [ABSTRACT FROM AUTHOR]

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

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]

Objectives. Dissatisfaction with services has been associated with poorer child mental health outcomes, early treatment termination as well as disagreements over the nature of mental health difficulties, reasons for referral and therapy goals. The development of straightforward, reliable, and accurate methods of eliciting service users' views is essential within child and adolescent mental health care. This paper describes the development of the child and adolescent service experience (ChASE), a tool to measure children and young people's service experience Design. The study comprises a non-experimental, cross-sectional design. Methods. Participants were 132 mental health service users aged 8-18 years. Participants and their main carer completed the ChASE, Parent Satisfaction Questionnaire (PSQ) () and Strengths and Difficulties (SDQ) Impact Supplement. Clinicians completed the SDQ Impact Supplement and provided clinical activity data. A sub-sample of participants completed the ChASE on a second occasion, 6 weeks after the completion of the first questionnaire. Results. Scrutiny of ChASE data indicated high levels of completion. Principal axis factoring identified three factors within the ChASE: Relationship, Privacy, and Session Activity. The ChASE has good internal consistency and test-retest reliability. Significant correlations were found between the ChASE and carer satisfaction, service use, and youth clinical outcomes. Conclusions. The ChASE is a short, psychometrically robust tool for routine measurement of children, and young people's experience of mental health services, which users can complete easily. The results underline the importance of alliance factors to children and young people and their association with clinical improvement as well as the potential for the ChASE to be used a measure of children's therapeutic progress and alliance. [ABSTRACT FROM AUTHOR]

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

Aim: The aims of the present study are to describe the status of selfmanagement behaviors and illness perception, and explore the relationship between illness perception and self-management behaviors among Chinese diabetic foot patients. Methods: A cross-sectional study was conducted at the endocrinology department of a comprehensive tertiary hospital in Guangzhou, China. Data were collected on illness perception, self-management behaviors, and demographic and clinical characteristics over 9 months among 156 subjects. Data were analyzed using Pearson correlation analysis, univariate analysis and multiple linear regression analysis. Results: Only 3.2% of participants maintained excellent self-management behaviors. Additionally, the participants perceived diabetic foot as chronic and could be well controlled through treatment. Multiple linear regression analysis revealed that illness perception was associated with self-management behaviors. Conclusions: Patient illness perception is an important factor influencing self-management behaviors. It may be helpful to improve self-management behaviors by tailoring the content of the intervention to fit the patients' illness perceptions. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to determine the relationship between the demand for telenursing and the chronic illness resources available to patients with type 2 diabetes mellitus (T2DM), as well as the factors that affect this requirement. Design: Cross‐sectional. Methods: This study included 586 participants with T2DM. A telenursing needs questionnaire developed by the research team was used to assess the telenursing needs of patients with T2DM, and the Chinese version of the Chronic Illness Resources Survey was used to assess the participants' community chronic disease resources. A one‐way ANOVA and multiple regression analysis were used to determine the factors influencing the demand for telenursing and to estimate the relationship between chronic illness resources and the need for telenursing. The STROBE checklist was followed. Results: The patients' telenursing needs, ranked from high to low, are as follows: individualized skills and safety; basic disease care; psychological and spiritual needs; respect and social support; and high‐level health management. The chronic disease resource score was 3.47 ±.02, which suggested that patients with T2DM have relatively rich disease resources. Multiple regression analyses showed that resources for chronic diseases, the course of diabetes and complications, family income and other chronic diseases accounted for 79.6% of the variance in T2DM patients' telenursing needs. Conclusions: The telenursing needs of patients with T2DM are prominent, and primarily focus on basic nursing needs for the disease. To some extent, chronic disease resources affect the telenursing needs of patients with T2DM. Relevance to Clinical Practice: It is crucial to pay attention to research on telenursing for T2DM patients from the patients' perspective. Enhancing resources for chronic diseases may help meet the telenursing needs of T2DM patients. Patient or Public Contribution: Parents and diabetes management specialists participated in designing the telenursing needs questionnaire. [ABSTRACT FROM AUTHOR]