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Few biomarker-based validation studies have examined error in online self-report dietary assessment instruments, and food records (FRs) have been considered less than food frequency questionnaires (FFQs) and 24-hour recalls (24HRs). We investigated measurement error in online and paper-based FFQs, online 24HRs, and paper-based FRs in 3 samples drawn primarily from 3 cohorts, comprising 1,393 women and 1,455 men aged 45–86 years. Data collection occurred from January 2011 to October 2013. Attenuation factors and correlation coefficients between reported and true usual intake for energy, protein, sodium, potassium, and respective densities were estimated using recovery biomarkers. Across studies, average attenuation factors for energy were 0.07, 0.07, and 0.19 for a single FFQ, 24HR, and FR, respectively. Correlation coefficients for energy were 0.24, 0.23, and 0.40, respectively. Excluding energy, the average attenuation factors across nutrients and studies were 0.22 for a single FFQ, 0.22 for a single 24HR, and 0.51 for a single FR. Corresponding correlation coefficients were 0.31, 0.34, and 0.53, respectively. For densities (nutrient expressed relative to energy), the average attenuation factors across studies were 0.37, 0.17, and 0.50, respectively. The findings support prior research suggesting different instruments have unique strengths that should be leveraged in epidemiologic research. [ABSTRACT FROM AUTHOR]

Background: Noise exposures are associated with a host of adverse health effects, yet these exposures remain inadequately characterized in many industrial operations, including paper mills. We assessed noise at four paper mills using three measures: (i) personal noise dosimetry, (ii) area noise measurements, and (iii) questionnaire items addressing several different aspects of perceived noise exposure. Methods: We assessed exposures to noise characterized using the three measures and compared the relationships between them. We also estimated the validity of each of the three measures using a novel application of the Method of Triads, which does not appear to have been used previously in the occupational health literature. Results: We collected 209 valid dosimetry measurements and collected perceived noise exposure survey items from 170 workers, along with 100 area measurements. We identified exposures in excess of 85 dBA at all mills. The dosimetry and area noise measurements assigned to individual subjects generally showed good agreement, but for some operations within mill, large differences between the two measures were observed, and a substantial fraction of paired measures differed by >5 dB. Perceived noise exposures varied greatly between the mills, particularly for an item related to difficulty speaking in noise. One perceived noise exposure item related to difficulty hearing due to noise showed strong and significant correlations with both dosimetry and area measurements. The Method of Triads analysis showed that dosimetry measures had the highest estimated validity coefficient (0.70), and that the best performing perceived exposure measure had validity that exceeded that of area measurements (0.48 versus 0.40, respectively). Conclusions: Workers in Swedish pulp mills have the potential for exposures to high levels of noise. Our results suggest that, while dosimetry remains the preferred approach to exposure assessment, perceived noise exposures can be used to evaluate potential exposures to noise in epidemiological studies. [ABSTRACT FROM AUTHOR]

Background: Nursing interventions in the post‐operative time period including psychological and emotional support, adverse event education, and instructions for follow‐up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post‐anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post‐operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform. Aims: This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated‐measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries. Methods & Materials: The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)‐approved study was a repeated‐measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice. Results: The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post‐operative Day 1. Fifty‐nine participants (78%) completed the surveys on post‐operative Day 14. Discussion: As the frequency of outpatient treatment increases, nurses conducting post‐operative research will need to collect the data outside of the hospital setting. Conclusion: Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non‐traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process. [ABSTRACT FROM AUTHOR]

The psychometric properties of two paper-and-pencil versions of the Children’s Attributional Style Interview (i.e., CASI-I and CASI-II) were evaluated in a sample of 166 third and fourth graders and a sample of 245 sixth and seventh graders. The results demonstrated strong internal consistency reliability, convergent validity, and a factor structure that was consistent with theory in both samples. Furthermore, analyses demonstrated adequate evidence of the reliability and validity of several dimensional subscale scores and the composite measures of attributional style for both positive and negative events. These results suggest the utility of the CASI in research testing specific attributional predictions of cognitive theories of depression with the dimensional subscale scores. They further add to the literature by demonstrating item-level factor analytic support for a children’s attributional style measure and the feasibility of administration sizes larger than previously tested, which add to the utility of the CASI in large-scale research designs. [ABSTRACT FROM AUTHOR]

Background: Communication difficulties are common in people with dementia, and often present from an early stage. However, direct treatment options for people with dementia that positively influence their daily communication are scarce. Aims: To evaluate the potential impact and feasibility of a personalized logopaedic intervention. Methods & Procedures: A total of 40 community‐dwelling persons with dementia and their caregivers were recruited. Five experienced speech and language therapists (SLTs) delivered the six‐session Com‐mens intervention at home. Com‐mens aims to improve positive communication between people with dementia and their primary caregivers and comprises five elements: interactive history‐taking, dynamic observational assessment, education about the consequences of dementia on communication, development and use of personalized communication tools, use motivational, and person‐centred strategies by the SLT. We conducted a single‐group mixed‐methods pilot study with five measurements: baseline, directly after intervention, and at 3, 6 and 9 months follow‐up. Semi‐structured interviews and questionnaires for Experienced Communication in Dementia, quality of life, psychological well‐being and caregiver burden were conducted. Process evaluation was performed by interviewing participants, drop‐outs, SLTs and other stakeholders. Outcomes & Results: A total of 32 dyads completed the intervention. Repeated measures analyses revealed no significant changes over time. In the interviews, participants reported a positive impact on their feelings, increased communication skills and better coping with the diagnosis. Participants would recommend the intervention to others. Facilitators were timely delivery, personalized content and adequate reimbursement. Barriers were unfamiliarity with Com‐mens among referrers, an overburdened caregiver or disrupted family relationships. Conclusions & Implications: This newly developed logopaedic intervention is feasible and has a perceived positive impact on both people with dementia and their caregivers, which is confirmed by a stable pattern over a period of 1 year. Future comparative studies are needed to test the effectiveness of personalized interventions in this patient population. What this paper adds: What is already known on the subject?: SLTs are experts in the field of communication, but even though communication problems are common between people with dementia and their caregivers, there is a lack of logopaedic guidelines and materials for the direct treatment for this population. Interventions that are available either focus on (professional) caregivers only or aim to enhance cognitive functioning and do not target on joined communication. What this paper adds to the existing knowledge?: A newly developed intervention called Com‐mens can be provided by trained SLTs and takes an average of six 1‐h sessions. The intervention is perceived to be valuable and feasible for people with dementia and their caregivers, by the participants themselves, as well as by healthcare professionals and other stakeholders. What are the potential or actual clinical implications of this work?: Dissemination of this intervention will give SLTs skills, tools and materials to provide meaningful care to home‐dwelling persons with dementia and their caregivers. Also, persons with dementia and their caregivers will receive education and materials that can help them increase their understanding of communication problems, enhance their communication skills and better cope with the communication problems that result from dementia. We consider the Com‐mens intervention to be a valuable addition to the field of speech language therapy and dementia. [ABSTRACT FROM AUTHOR]

Mobile devices are increasingly used to administer self-report measures of mental health symptoms. There are significant differences, however, in the way that information is presented on mobile devices compared to the traditional paper forms that were used to administer such measures. Such differences may systematically alter responses. The present study evaluated if and how responses differed for a self-report measure, the PTSD Checklist (PCL), administered via mobile device relative to paper and pencil. Participants were 153 trauma-exposed individuals who completed counterbalanced administrations of the PCL on a mobile device and on paper. PCL total scores (d = 0.07) and item responses did not meaningfully or significantly differ across administrations. Power was sufficient to detect a difference in total score between administrations determined by prior work of 3.46 with a d = 0.23. The magnitude of differences between administration formats was unrelated to prior use of mobile devices or participant age. These findings suggest that responses to self-report measures administered via mobile device are equivalent to those obtained via paper and they can be used with experienced as well as naïve users of mobile devices. [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]

Aim: To explore the validity and reliability of the Missed Nursing Care Survey after translating it into the Arabic language. Methods: We employed a cross‐sectional design. We recruited 260 Jordanian nurses, and data were collected between May and July 2020. Translation, acceptability, construct, convergent, discriminant validity and reliability were investigated. Results: The factor analysis showed an adequate fit (three subscales) between the proposed missing care survey model and the observed data. This model reflected the survey's construct, convergent and discriminant validity, explaining 58.88% of the variance collectively. Confirmatory factor analyses showed adequate goodness‐of‐fit results (goodness of fit index = 0.91, comparative fit index = 0.94, increment fit index = 0.94, Tucker Lewis index = 0.92 and root mean square error of approximation = 0.06). The total Cronbach alpha and composite reliability achieved the criterion for all constructs in this survey. Conclusion: This Arabic version of the Missed Nursing Care Survey achieved the required level of validity and reliability. Measuring missed care and its reasons may help to improve quality of health services and assist nurse managers in designing appropriate interventions to reduce it. Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety. Summary statement: What is already known about this topic? The Missed Nursing Care Survey was designed to identify reasons for missed nursing care.The Missed Nursing Care Survey has been shown to be a reliable and valid measure among various populations and different languages. What this paper adds? The Arabic version of the Missed Nursing Care Survey was shown to be a valid and reliable tool.Measuring the quality and procedures of nursing care in the Arabic region will aid in understanding the differences between countries. The implications of this paper: Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety.Measuring missed care and its reasons may help to improve the quality of health services and assist nurse managers in designing appropriate interventions to reduce it. [ABSTRACT FROM AUTHOR]

Aim: We aimed to examine the frequency, reasons, correlates and predictors of missed nursing care in Turkey. Methods: This descriptive and cross‐sectional study sample consisted of 1310 nurses working in inpatient units of 10 public, university and private hospitals in Istanbul. Data were collected using the Nursing Teamwork Survey‐Turkish and the MISSCARE Survey‐Turkish between February and June 2019. Descriptive analysis, parametric comparative analysis, correlational analysis and regression analysis were used to analyse the data. Results: The total occurrence of missed nursing care was 2.93 (on a scale of 1.00–4.00), which differed across 21 nursing care elements. The most frequently missed care was turning patients every 2 hours. Multiple regression analysis determined that nurses' tenure in the profession, patient–nurse ratio, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. Nursing teamwork alone accounted for 23.6% of the variance in missed nursing care. Conclusions: The level of missed nursing care was found to be high, and labour resources issues were the most important reason. Nurse professionals should apply interventions to improve nurses' work environment factors such as patient–nurse ratio and nursing teamwork to reduce the incidence of missed nursing care. Summary statement: What is already known about this topic? Missed nursing care is a globally common patient safety issue that threatens quality nursing care.Although there are many studies from different countries in the international literature on missed nursing care, studies on this subject in Turkey have been limited. What this paper adds? Missed nursing care correlated with age, tenure in hospital, tenure in unit, weekly work hours, satisfied in current position, satisfaction with being a nurse, satisfaction with salary, technological, educational and career opportunities of the hospital, satisfaction with the level of teamwork in the unit, and satisfaction with support of first‐line nurse manager.Nurses' tenure in the profession, patient–nurse ratios, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. The implications of this paper: Strategies to improve nurses' work environment characteristics, especially teamwork, should be organized to prevent or reduce missed nursing care.Hospital administrators and nurse managers should address levels of missed nursing care through balancing patient–nurse ratios, providing adequate human and material resources, increasing technological, educational, and career opportunities of hospitals, meeting nurses' needs and providing support and performing activities to reduce absenteeism. [ABSTRACT FROM AUTHOR]

Background: The majority of children with cerebral palsy (CP) experience challenges in functional communication from a young age. A pivotal aspect of functional communication is language comprehension. A variety of classification systems and questionnaires are available to classify and describe functional communication skills in children with CP. A better understanding of the convergent validity of (subsections of) these tools, as well as their relationship with spoken language comprehension, will be valuable in both clinical practice and research. Aims: To investigate the convergent validity of (subsections of) functional communication tools and the relationship with spoken language comprehension in children with CP. Methods & Procedures: Cross‐sectional data on 138 children were subdivided into three developmental stages based on (Dutch) educational phases: ages 18 months–3;11y (n = 59), 4;0–5;11 years (n = 37) and 6;0–8;11 years (n = 42). The following functional communication tools were used to classify and describe functional communication: Communication Function Classification System (CFCS), subscales of the Caregivers Priorities and Child Health Index of Life with Disabilities—Dutch Version (CPCHILD‐DV) and the Focus on Communication Under Six‐34 (FOCUS‐34) questionnaire. Spoken language comprehension was assessed with the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT). Correlations between the functional communication tools, and with the C‐BiLLT, were calculated using Pearson's and Spearman's correlation coefficients. It was hypothesized a priori that correlations of at least 0.60 suggest good convergent validity. Outcomes & Results: At all developmental stages, a significant ordered decreasing tendency of communication outcomes was found across CFCS levels; lower CFCS levels were associated with lower scores on the CPCHILD‐DV and FOCUS‐34, and with a lower level of spoken language comprehension (C‐BiLLT). Correlation coefficients of the functional communication tools exceeded 0.60 at all developmental stages. Correlations between C‐BiLLT raw scores and the functional communication tools varied between 0.351 and 0.591 at developmental stage 18 months–3;11 years, between 0.781 and 0.897 at developmental stage 4;0–5;11 years, and between 0.635 and 0.659 at developmental stage 6;0–8;11 years. Conclusions & Implications: The functional communication tools assessed in this study showed convergent validity at all developmental stages. The CFCS, currently most widely used in paediatric rehabilitation, is adequate in the classification of functional communication. However, for more detailed clinical goal setting and evaluation of change in functional communication, the additional use of FOCUS‐34 or CPCHILD‐DV is recommended. What this paper adds: What is already known on the subject: A range of functional communication tools are available that help describe and classify functional communication in children with CP. These include the CFCS, subsections of CPCHILD‐DV and FOCUS‐34. The CFCS classifies functional communication in daily life with familiar and unfamiliar partners. Specific subsections of the CPCHILD‐DV and FOCUS‐34 include items that pertain to communicative participation. The innovative C‐BiLLT provides a standardized method to assess spoken language comprehension in children with CP and significant motor impairments. What this paper adds to existing knowledge: In the present study, convergent validity was confirmed between CFCS and specific subsections of the CPCHILD‐DV and FOCUS‐34. Correlations between these functional communication tools and the C‐BiLLT were moderate to strong. What are the potential or actual clinical implications of this work?: For clinical and research purposes (for instance, accurate prescription of augmentative and alternative communication—AAC), healthcare and educational professionals together with parents need to know how functional communication tools converge and how functional communication levels relate to the comprehension of spoken language. The CFCS provides a valid classification of functional communication abilities in children with CP. However, to measure change in functional communication and to evaluate treatment outcomes, use of additional functional communication tools such as the CPCHILD‐DV and FOCUS‐34 is recommended. When discrepancies are found between communicative abilities and spoken language comprehension, it is strongly recommended that valid tools are used in a more detailed examination of the child's spoken language comprehension skills and functional communication. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to determine predictors of COVID‐19 preventive behaviours in a sample of the Turkish population. Methods: The study was conducted with 575 individuals. COVID‐19 preventive behaviours were evaluated with a 19‐item scale scored from 19 to 95. Knowledge on COVID‐19 was evaluated with a 22‐item scale scored from 0 to 22. General health literacy was evaluated with the Turkey Health Literacy Scale (THLS), which was scored from 0 to 50. Results: The average COVID‐19 preventive behaviours score was moderately high in this sample of the Turkish population. Being female, having a higher level of education, better economic status, being a non‐smoker, having a higher level of COVID‐19 knowledge and better general health literacy score were significant predictors of COVID‐19 preventive behaviours (P < 0.05). Conclusion: Sociodemographic characteristics, knowledge of COVID‐19 and general health literacy are crucial in preventing COVID‐19 infections in a sample of the Turkish population. Summary statement: What is already known about the topic? To reduce the risk of transmission and prevent the spread of the COVID‐19, it is necessary to comply with COVID‐19 preventive behaviours.Sociodemographic characteristics, knowledge of COVID‐19 and general health literacy are crucial in preventing the COVID‐19 disease. What does this paper add? COVID‐19 preventive behaviours scored moderately high among a sample of the Turkish population.Being female, having higher level of education, better economic status, being a non‐smoker, having higher level of knowledge about COVID‐19 and better general health literacy are significant predictors of COVID‐19 preventive behaviours in a sample of the Turkish population, accounting for 22.4% of the variance in COVID‐19 preventive behaviours. The implications of this paper: Attempts should be made to increase the COVID‐19 knowledge and health literacy to increase COVID‐19 preventive behaviours among the Turkish population.In particular, attempts should be made to increase the COVID‐19 preventive behaviours for men, individuals with low education and poor economic conditions, and smokers. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted to identify and compare the levels of compassion fatigue and job satisfaction among haemodialysis nurses in public and private hospitals in China and explore explanatory factors based on sociodemographic and occupational characteristics. Methods: A descriptive study was conducted using a self‐designed demographic questionnaire, the Professional Quality of Life Scale and the Minnesota Satisfaction Questionnaire, with responses from 283 haemodialysis nurses working at six public and private hospitals in China between June and November 2018. Results: The compassion fatigue score of public hospital nurses was significantly higher than that of private hospital nurses. Univariate analysis showed that there were significant differences in compassion fatigue among nurses based on the number of years worked, nature of employment, and education level. Correlational analysis showed a negative correlation between overall job satisfaction and compassion fatigue in both public and private hospitals. Multiple regression analysis showed that compassion fatigue among haemodialysis nurses in public hospitals was associated with years worked, type of employment, and intrinsic and extrinsic satisfaction, whereas in private hospitals, education level, years worked, and intrinsic and extrinsic satisfaction were significant. Conclusion: Haemodialysis nurses in public hospitals are more likely to develop compassion fatigue than those in private hospitals. Summary Statement: What is already known about this topic? Nurses are susceptible to developing compassion fatigue (CF) due to multiple challenges and harsh environments in practice.Although previous studies have highlighted that haemodialysis nurses across the globe face issues with the work environment, stress and burnout, there are few reports of CF among haemodialysis nurses.At present, many countries have both publicly and privately funded hospitals, and it is not known whether the CF of haemodialysis nurses differs by hospital type. What this paper adds? Haemodialysis nurses have high levels of CF, and haemodialysis nurses in public hospitals have higher CF and lower job satisfaction than those in private hospitals.The main factors associated with CF among haemodialysis nurses in public hospitals were years worked, type of employment, and intrinsic and extrinsic satisfaction.The main factors associated with CF in haemodialysis nurses in private hospitals were education level, years worked, and intrinsic and extrinsic satisfaction. The implications of this paper: There is a need to raise awareness among both nurses and nursing management staff of haemodialysis units regarding the existence of CF among haemodialysis nurses, especially in public hospitals.Different targeted interventions or solutions should be considered according to various factors associated with CF in different types of hospitals (public and private). [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop and psychometrically test a competence‐based human resource management scale to improve managerial competence of first‐line nurse managers in public hospitals. Background: To ensure the high competence of the first‐line nurse managers, the competence‐based human resource management should be evaluated using the best‐fit instrument. However, no instrument has been identified in the hospital setting. Methods: This methodological study consists of three main steps: (1) generating scale items based on literature review and expert interviews, (2) pilot testing of face and content validity and (3) evaluating psychometric properties with 300 first‐line nurse managers from 16 public hospitals in Indonesia selected using a multistage sampling. Data were collected from May to December 2017. Principal component analysis and Cronbach's α were used for construct validity and internal consistency reliability. Results: The final scale consists of 30 items in five dimensions, which explained 65.48% of the total variance. The dimensions include 'training and evaluation, career planning and development, rewards scheme, recruitment and selection, and appraisal system'. Cronbach's α for the scale was.89, with a range of.85 to.88. Conclusion: The competence‐based human resource management scale is reliable and valid to use in public hospital settings. Summary statement: What is already known about this topic? The concept of competence‐based human resource management has been applied worldwide in every organization, and it is applicable to use for developing managerial competence of first‐line nurse managers. Therefore, the effectiveness of this management system should be assessed via a valid and reliable instrument.Several instruments to measure competence‐based human resource management have been developed, but no instrument has been identified to measure competence‐based human resource management specifically in hospital settings. What this paper adds? This study developed a scale designed to measure competence‐based human resource management to support improvement of first‐line nurse managers' managerial competence in public hospitals.The scale demonstrated sound psychometric properties with acceptable internal consistency reliability, content validity and construct validity.The scale consists of 30 items in five dimensions: training and evaluation, career planning and development, rewards scheme, recruitment and selection, and appraisal system. The implications of this paper: This study expands the basic knowledge of competence‐based human resource management as a concept with five dimensions that can be used in nursing organizations, and it can be used in quality assurance systems in public hospitals settings in Indonesia.The scale can be used as a feedback for first‐line nurse managers to see the impact of competence‐based human resource management framework on their competence and helps to identify which dimension of human resource management needs further improvement.With further research, the scale may be of use in other countries and settings. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to translate the Barriers to Nurses' Use of Physical Assessment Scale into Turkish and assess the new version's validity and reliability. Methods: This was a methodological study to verify the linguistic equivalence of the scale through the translation/back‐translation method. Twelve experts in health assessment confirmed the scale's content validity. Along with the Barriers to Nurses' Use of Physical Assessment Scale, an information form, including socio‐demographic features, was distributed to 380 nurses, who consented to participate in the research. Data were collected between July 2017 and April 2018. Internal consistency, factor analysis and test–retest reliability were used to determine consistency over time and intraclass correlations. Results: The content validity index of the scale (0.963) was calculated following confirmation of its language equivalence. With the confirmatory factor analysis, it was determined that the fit index values were at an acceptable level and the model was suitable. The factor analysis clustered factors in seven domains. The overall internal consistency coefficient was 0.822. All subscales and the overall scale showed high intraclass correlations. Conclusion: The Turkish version of the Barriers to Nurses' Use of Physical Assessment Scale is a valid and reliable instrument. Summary statement: What is already known about this topic? Nursing assessment is a critical step in the nursing process.A holistic and systematic approach is key to improving the quality of nursing care, which may be hindered by barriers to the performance of physical assessment.Several international studies have examined the barriers encountered by nurses; however, there is a lack of both instruments and research on this subject in Turkish literature. What this paper adds? The findings confirmed that the Turkish version of the Barriers to Nurses' Use of Physical Assessment Scale is a valid and reliable instrument and can be used to determine the barriers to nurses' ability to perform physical assessments.Nurses and clinic managers will be able to use the scale to identify the factors preventing assessment and develop strategies to overcome them.The questionnaire can help eliminate assessment barriers to create an effective and systematic assessment environment. The implications of this paper: Nurses and clinical managers should work together to identify and eliminate assessment barriers.Barriers to nurses' use of physical assessments can be objectively identified through a valid and reliable tool, providing opportunities for the elimination of such barriers and the development of nursing assessment activities. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to test the validity and reliability of a four‐item patient health questionnaire as a psychological distress screening tool for patients with type 2 diabetes in Indonesia. Methods: This cross‐cultural adaptation study was applied in five public health‐care centres in Indonesia in August–October 2018 using a four‐item patient health questionnaire. The content, convergent and factorial validity were assessed, and Cronbach's alpha coefficient was the reliability indicator. Results: A total of 147 participants were involved. Content validity resulted in acceptable outcomes (item and scale content validity indexes were 0.95 and 0.75, respectively). Anxiety and depression were associated with total score and psychological distress status (P < 0.001), supporting the convergent validity outcomes. Principal component analysis using varimax rotation revealed two factors, explaining 76.14% of variance (P < 0.001). Cronbach's alpha coefficients for anxiety, depression and total score were 0.780, 0.500 and 0.713, respectively. Conclusions: The study demonstrated adequate validity and reliability for the Indonesian version of a four‐item patient health questionnaire among patients with type 2 diabetes. Therefore, it is applicable as a screening tool for psychological distress in this population. Summary statement: What is already known about this topic? Anxiety and depression are common forms of psychological distress among patients with type 2 diabetes.Early identification of potential problems in diabetes benefits patients for prevention and treatment.A four‐item patient health questionnaire (PHQ4) is a valid tool for screening psychological distress. What this paper adds? The paper presents a psychometric evaluation of PHQ4 to assess psychological distress among patients with type 2 diabetes.Incidence of anxiety, depression and psychological distress for patients with diabetes in Indonesia was identified. The implications of this paper: Diabetes nurse specialists or nurse managers could consider using the Indonesian version of PHQ4 in their units.The availability of this screening tool in Indonesia makes identification of psychological distress possible.Further research and education related to psychological distress among patients with diabetes may use the valid PHQ4. [ABSTRACT FROM AUTHOR]

Background: Many national studies have shown that nurses have a high turnover rate. The key to maintaining the stability of nursing staff is to explore the factors that affect their turnover intention; however, no research has been performed to explore the influencing factors and mechanisms of nurses' turnover intention based on the Theory of Planned Behaviour. Aim: Based on the Theory of Planned Behaviour, examining the relationships among resilience, job satisfaction, social support and turnover intention of nurses, a structural equation model was constructed to examine the mediating role of job satisfaction and social support between resilience and turnover intention. Methods: In this descriptive cross‐sectional study, a total of 350 questionnaires were distributed to participants from three tertiary hospitals in Changchun, Jilin Province, between December 2018 and March 2019. Results: The final model fits well. Job satisfaction and social support directly influences turnover intention. Resilience indirectly influences turnover intention through job satisfaction and social support. Conclusion: Turnover intention is a complex variable, which is directly and indirectly affected by many factors. In this study, a new structural equation model was proposed, which laid a foundation for future longitudinal studies. Summary statement: What is already known about this topic? Globally, the high rate of nurse turnover is one of the major reasons for the shortage of nurses.The turnover intention of nurses is influenced by many factors.Few studies have examined the influencing factors of turnover intention based on theory or constructed a structural equation model to clarify the mechanism. What does this paper contribute? The Theory of Planned Behaviour presents the key determinants of behaviour and can guide our understanding of the behavioural mechanism of the turnover intention of nurses.Three influencing factors of turnover intention based on the Theory of Planned Behaviour (resilience, job satisfaction and social support), directly or indirectly affected turnover intention. The implications of this paper: Future interventions should consider the indirect role of resilience. A positive effect of increased social support and job satisfaction on turnover intention occurs through improved resilience.Longitudinal studies with larger samples are needed in the future to verify the effectiveness of the mediating effect. [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 study aims to examine the psychometric properties of the Pittsburgh Sleep Quality Index‐Indonesian version. Background: The Pittsburgh Sleep Quality Index has never been translated into Bahasa. Design This study employs a cross‐sectional and correlational study. Methods: Data were collected from 528 adolescents of junior high school age (13–16 years) during August to September 2014. All participants agreed on the Indonesian version of Pittsburgh Sleep Quality Index and Beck Depression Inventory‐II. Psychometric properties were examined including internal consistency, construct validity and known group validity, and the receiver operating characteristic curve was used to measure the cut‐off point. Results: The Cronbach's alpha for the Pittsburgh Sleep Quality Index‐Indonesian version was adequate. There were positive correlations between the total score and seven component scores. Construct validity revealed that the total score of the Pittsburgh Sleep Quality Index‐Indonesian version was correlated with the total score of the Indonesian version of the Beck Depression Inventory‐II. Known group validity indicated that adolescents without depression risk had better sleep quality. According to receiver operating characteristic curve analysis, the cut‐off point at a score of 6.5 indicated the best possible relationship of sensitivity and specificity. Conclusion: The Pittsburgh Sleep Quality Index‐Indonesian version has high reliability and validity for screening sleep quality among adolescents. SUMMARY STATEMENT: What is already known about this topic? The original Pittsburgh Sleep Quality Index has adequate internal consistency and favourable reliability.It is easy for patients and health‐care providers to use for interpreting sleep disturbances. What this paper adds? The results support the validity and reliability of the Pittsburgh Sleep Quality Index‐Indonesia in screening sleep quality among adolescents.The cutoff score for the Pittsburgh Sleep Quality Index‐Indonesian version for adolescents was 6.5. The implications of this paper: The cut‐off point could detect poor sleep quality among Indonesian adolescents.This simple tool is capable of quickly assessing sleep quality for health‐care providers. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to test the mediator role of patient safety behaviour between safety culture and safety performance among nurses. Methods: This cross‐sectional study was carried out between September and December 2017 in the nursing units of 10 primary hospitals, two secondary hospitals and two tertiary hospitals in Anhui Province, China. Results: The study participants comprised 79 RNs from primary hospitals, 147 RNs from secondary hospitals and 242 RNs from tertiary hospitals. Most were female (97.6%) and married (73.1%), and their ages ranged from less than 25 years to retirement age. The sample included nurses working in several departments, including medicine (27.1%), surgery (14.3%), emergency (11.5%) and ICU (9%). Structural equation model analysis results showed that espoused values directly affected safety performance, and practised values affected safety performance through safety behaviour. Conclusion: Our hypothetical model noted that safety behaviour is a positive mediating factor of practised safety values affecting safety performance, suggesting that Chinese nursing managers should construct a patient safety culture that is guided and driven by appropriate values, which will ultimately be externalized as nurses' daily behaviour. Summary statement: What is already known about this topic? Nurse‐based patient safety culture evaluation is the primary step towards building a patient safety culture.The investigation of patient safety culture in nursing has revealed that although considerable work has been accomplished towards building a patient safety culture by hospital administrators and nursing administrators, the expected results of patient safety management remain unrealized.Research on the correlation between patient safety culture and safety performance is currently lacking in China. What this paper adds? Nurses had positive self‐reported culture, behaviour and outcomes.Safety behaviour of nurses is a positive mediating factor of practised values and safety performance. The implications of this paper: The core of patient safety culture change is a fundamental shift in values. Chinese nursing managers should construct a patient safety culture that is guided and driven by appropriate values.Safety behaviour of nurses is a positive mediating factor of practised values. In management practice, we should first focus on refining espoused values and then promoting change among nurses by encouraging the adoption of specific management strategies. These strategies will then be internalized by nurses and become practised values, which will ultimately be externalized as nurses' daily habits. [ABSTRACT FROM AUTHOR]

Aim: Of the few instruments available to measure the important, positive aspects of caring, the Caregiver Reaction Assessment is regarded as the most suitable, but there is no validated Spanish version. The aim of this study was to translate the Caregiver Reaction Assessment into Spanish and assess its psychometric properties. Methods: The Caregiver Reaction Assessment was translated into Spanish and then back translated. Validation included construct validity, criterion validity and reliability: 287 interviews were conducted with informal caregivers of patients with dementia between November 2010 and April 2012. Results: Principal component analysis confirmed the original instrument's five subscales. Criterion validity showed a moderate negative correlation between the impact on health and the EQ‐5D (r = −.43), that is, a greater impact on health correlated with lower health‐related quality of life. The Caregiver Reaction Assessment showed good internal consistency, with a Cronbach alpha of.804, and good temporal stability for the distinct subscales, with intraclass correlation coefficients varying from.683 to.729 (p <.001). Conclusion: The Caregiver Reaction Assessment is a reliable, valid instrument for the measurement of the reactions of informal caregivers of patients with dementia, with good psychometric properties. SUMMARY STATEMENT: What is already known about this topic? The Caregiver Reaction Assessment is one of the few instruments that measures positive reactions in caregivers.A validated Spanish version of the instrument is required for Spain and other Spanish‐speaking countries. What this paper adds? The Caregiver Reaction Assessment was shown to be a reliable, valid instrument for the measurement of the reactions of informal caregivers of people with dementia in Spain and has good psychometric properties. The implications of this paper: Once validation is complete, the Caregiver Reaction Assessment may be used in all Spanish‐speaking informal caregivers and is suitable for home care and long‐term care institutions.The Caregiver Reaction Assessment subscales allow healthcare professionals to identify and focus on the areas that could bring about the greatest improvements in the care of people with dementia.The Caregiver Reaction Assessment permits the caregiver's state to be viewed at any stage of dementia and offers healthcare professionals the opportunity to act to avoid physical and emotional overload in caregivers. [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]

Background: Self‐assessments for adults who stutter are recommended as a primary evaluation tool for including their views on stuttering. Evaluating adults who stutter with self‐assessment scales is important. However, there is no tool in the Turkish literature that provides this measurement. Aims: To develop the Turkish version of The Wright and Ayre Stuttering Self‐Rating Profile (WASSP) in order to analyse its validity and reliability, and investigate its applicability for Turkish‐speaking individuals. Methods & Procedures: The study included 120 adults who stutter (aged 18–54 years). All the participants completed The Wright and Ayre Stuttering Self‐Rating Profile—Turkish version (WASSP‐TR) and the SF‐36 form. The reliability analysis involved the calculation of Cronbach's alphas for test–retest and the Pearson product‐moment correlation coefficient for internal consistency. The validity analysis, in turn, involved a confirmatory factor analysis for construct validity and testing correlations with the SF‐36 for criterion validity. Outcomes & Results: Internal consistency coefficients of the WASSP‐TR were reported to be high (> 0.70). The correlations between the WASSP‐TR and its subscales showed significant results (0.858–0.966) (p < 0.01). The correlation between the subscales of the WASSP‐TR and the SF‐36 was reported to be consistent (from −0.492 to 0.747). There was a positive correlation between stuttering severity groups and the WASSP‐TR scores (p < 0.01). Conclusions & Implications: The WASSP‐TR is a valid and reliable scale for Turkish‐speaking adults who stutter. What this paper addsWhat is already known on the subjectSelf‐assessment tools are recommended as a primary use when assessing adults who stutter. The WASSP is one of these measurement tools. However, the adaptation, validity and reliability study of the WASSP to Turkish has not been investigated.What this paper adds to existing knowledgeThis study shows that the Turkish version of the WASSP scale is valid and reliable and can be used with adults who stutter. Furthermore, the present adaptation study has been developed in order to evaluate social–emotional aspects of stuttering.What are the potential or actual clinical implications of this work?A tool that includes evaluating the behaviour, cognition, affect and participation areas as well as the stuttering behaviours of adults who stutter was adapted. This tool is expected to be useful for comprehensive evaluation of adults who stutter in clinics, in research and for pre/post‐therapy. [ABSTRACT FROM AUTHOR]

Background: Critical care nurses who care for postoperative cardiac surgery patients need such specialty knowledge as atrial electrograms (AEGs). An inadequate audit trail exists for psychometric performance of instruments to measure knowledge of AEGs. Objectives: The aim of this study was to revise a previously tested instrument and assess evidence for content validity (content validity index), internal consistency (Cronbach α), and stability (correlation coefficient, r) reliability against the a priori criterion of 0.80. Methods: The multiple-choice response, self-administered, paper-and-pencil instrument was revised to 20 items and named the Drake Atrial Electrogram Assessment Survey (DAEGAS). A panel of 6 AEG experts reviewed the DAEGAS for content validity evidence. The instrument was further revised to 19 items (13 knowledge and 6 AEG interpretation) and tested with 76 critical care nurses from the greater Houston metropolitan area. Results: The content validity index was 0.93. Cronbach α was.51, and test-retest r was 0.74. Cronbach α increased to.60 and r was 0.73 with removal of 3 items: 2 items with a negative item-total correlation and 1 item that was transitioned to a sample question. Discussion: Content validity evidence exceeded the a priori criterion. Internal consistency and stability reliability estimates did not meet the criterion, albeit the latter met the criterion recommended by psychometricians for a new instrument. Recommendations include further development of the DAEGAS to improve internal consistency estimates and testing for evidence of other forms of validity. Reliable and valid assessment of critical care nurse knowledge of AEGs will require improved psychometric performance of the DAEGAS. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate the validity and reliability of the modified Chronic Kidney Disease Self‐Management instrument in an English‐speaking population. Background: There is growing evidence that self‐management behaviours can improve outcomes for people with chronic kidney disease. However, there are few suitable instruments available. Design The study was cross sectional, with a test–retest protocol. Method: Adults with chronic kidney disease attending a primary health care between June and December 2015 completed the Chronic Kidney Disease Self‐Management instrument. Construct validity was determined using exploratory factor analysis, internal consistency and test–retest reliability using Cronbach's α and intraclass correlation. For convergent validity, the relationships between knowledge, self‐efficacy and self‐management were investigated. Results: The Australian version of the Chronic Kidney Disease Self‐Management instrument has 17 items grouped into four factors: self‐integration, seeking social support, adherence to lifestyle modification and problem solving. The instrument demonstrated good reliability. Self‐efficacy was positively correlated with self‐management scores, although there was no correlation between chronic kidney disease knowledge and self‐management. Conclusions: The Australian version of the Chronic Kidney Disease Self‐Management instrument was found to be a valid and reliable patient‐reported outcome measure. It can be used in clinical practice to support self‐management, as well as future research. SUMMARY STATEMENT: What is already known about this topic? The burden of chronic kidney disease is rising mostly due to the increasing prevalence of diabetes and hypertension.Chronic kidney disease progression can be slowed with effective self‐management behaviours.Patient‐reported outcome measures need testing in target populations prior to implementation in clinical settings and research. What this paper adds? The Australian version of the Chronic Kidney Disease Self‐Management instrument demonstrated good validity and reliability in the target population.The instrument is suitable to use in research testing interventions to improve self‐management of chronic kidney disease. The implications of this paper: Clinicians can use this patient‐reported outcome measure to assess for changes in CKD self‐management behaviours following patient education.The instrument can be used to identify individuals in need of support for self‐management skills. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the effect of health‐care providers' attitudes towards the medical use of cannabis, subjective norms and perceived stigma towards medicinal cannabis users on health‐care providers' intention to recommend medicinal cannabis for patients with qualifying conditions. Methods: A cross‐sectional correlational study included 221 health‐care providers (mean age, 42.2 ± 11.2; 74.2% women and 76.5% nurses) who completed a questionnaire examining theory‐based variables and stigma towards medicinal cannabis users. Results: More positive attitudes towards the medical use of cannabis were associated with lower stigma towards medicinal cannabis users, which, in turn, was associated with a higher intention of recommending medicinal cannabis for patients with qualifying conditions. The relationship between attitudes towards the medical use of cannabis and the intention to recommend medicinal cannabis varies according to subjective norms. Conclusions: Among nurses and physicians, stigma towards medicinal cannabis users mediated the relationship between attitudes towards the medical use of cannabis and the intention to recommend medicinal cannabis for patients with qualifying conditions, whereas subjective norms moderated this relationship. Effective treatment with medicinal cannabis might be compromised by health‐care providers' negative attitudes, stigma and subjective norms. SUMMARY STATEMENT: What is already known about this topic? The use of medicinal cannabis (MC) is considered controversial by health‐care providers. Patients who use MC are still the target of social discrimination.What this paper adds? Stigma towards MC users mediated the relationship between attitudes towards the medical use of cannabis and the intention to recommend MC for patients with qualifying conditions, whereas subjective norms moderated this relationship.The implications of this paper: There is a clear need for educational programmes for health‐care providers on the use of MC and the legitimacy of MC use. [ABSTRACT FROM AUTHOR]

Aims: To assess the validity and reliability of the stoma self‐efficacy scale for Turkish‐speaking individuals with stoma. Background: Self‐efficacy in stoma care is one of the most important variables requiring compliance for an increase in the quality of life and well‐being of individuals with stoma. Design A methodological study. Methods: This study used translation and back translation for the scale's language equivalence and expert opinion for the content validity. An expert panel and 10 individuals with stoma evaluated the scale for face validity. The scale's reliability was assessed by internal consistency, Pearson correlation, and test–retest reliability in a sample of 174 individuals with stomas. The scale's construct validity was tested with confirmatory factor analysis and exploratory factor analysis. Results: The content validity index was.96, and Cronbach's alpha was.95. In the test–retest analysis, the intraclass correlation coefficients were high. In the factor analysis, two factors emerged from the scale, and after the confirmatory factor analysis and scale modification, the fit indices of the model were found to provide a good level of validity. Conclusion: The Turkish version of the stoma self‐efficacy scale is a valid and reliable tool to determine the levels of self‐efficacy in individuals with stoma. SUMMARY STATEMENT: What is already known about this topic? Stoma creation is one of the most common surgical interventions.The ability to cope with the psychological, physiological and sociocultural changes experienced by individuals with stoma after surgery is related to their levels of self‐efficacy.Valid and reliable instruments are needed to determine the levels of self‐efficacy of individuals with stoma. What this paper adds? The Turkish version of the stoma self‐efficacy scale is a valid and reliable tool to determine the levels of self‐efficacy in individuals with stoma.The stoma self‐efficacy scale can be used by nurses to evaluate the self‐efficacy levels of Turkish‐speaking individuals with stoma in any part of the world. The implications of this paper: The stoma self‐efficacy scale can be used to evaluate self‐efficacy levels in individuals with stoma and for respective research.The adaptation of the stoma self‐efficacy scale into Turkish may contribute to the dissemination of self‐efficacy results of Turkish individuals with stoma internationally and to the comparative literature. [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: The aim of this work is to determine the behaviours of adolescents towards safety measures at school and in traffic and their health beliefs for injuries. Background: Adolescents are more prone to injuries, as they are more willing to try risky health behaviours. Methods: This descriptive and cross‐sectional study was conducted at high schools in Turkey. The data were collected from high school students based on the self‐report method between October 2017 and January 2018. Frequency, percentage, chi‐square, t test, and logistic regression were used to analyse the data. Results: A total of 481 adolescents participated in the study. The response rate is 96.05%. As a result of the research, 12.5% of the adolescents reported that they were injured in traffic and 18.9% of them were injured at school. Adolescents who did not have an accident had higher scores of health beliefs than those who had an accident (p < 0.05). The most important predictors of injury are being male (OR: 2.52, 95% CI [1.19, 53.00]), parents' separation (OR: 2.82, 95% CI [0.98, 8.09]), and not believing that traffic rules were safe (OR: 3.15, 95% CI [1.42, 6.97]). Conclusion: Adolescents have risky behaviours at school and in traffic, and these risk behaviours are related to demographic characteristics and health beliefs. School nurses should plan health belief model‐based injury prevention programs. SUMMARY STATEMENT: What is already known about this topic? Worldwide, the risky behaviour of adolescents in traffic and at school is an important public health problem that causes serious physical injuries and negatively affects social life.Studies on adolescents' safety behaviours and health beliefs about injuries are limited. What this paper adds? This study shows the rate of injury to school and traffic in adolescents, the reasons and type of injury, and the health belief scores of students who had an accident and did not have an accident.Sociocultural factors seem to play an important role in the injury rates of adolescents.The health belief model can be effective in preventing accidents because the adolescents who did not have an accident have a higher health belief score than those who had an accident. The implications of this paper: School health nurses should consider evidence‐based research findings in preventing injuries.Health belief model‐based education programs should be developed by nurses in the school to ensure that adolescents obtain positive health behaviours.Each school should employ school nurses to ensure that health services are accessible. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate illness perceptions and their predictors among Chinese patients with type 2 diabetes. Methods: A descriptive, correlational, and exploratory design was used. The Chinese version of the Revised Illness Perception Questionnaire was modified and used to collect data between September 2016 and February 2017. Results: On average, patients recognized fewer than five of the 14 common symptoms of type 2 diabetes. Of the six causal factors, "dietary behaviours" had the highest mean score, while "psychological factors" had the lowest score. Most patients lacked understanding of type 2 diabetes mellitus. They perceived it as a chronic and stable illness, without negative affective response, and controllable by themselves and through treatment. Gender, age, marital status, educational level, family income, employment status, diabetes duration, diabetes‐related complications, comorbid conditions, number of hospital admissions, and the level of haemoglobin A1c were predictors of illness perceptions. Conclusions: The findings of the present study suggest that the illness perceptions of Chinese patients with type 2 diabetes should be improved. This evidence may enrich the theoretical understanding of illness perceptions and be used to develop interventions for enhancing illness perceptions in such patients. SUMMARY STATEMENT: What is already known about this topic? Diabetes has become a global epidemic and poses a major risk in terms of morbidity and mortality.Illness perceptions significantly influence the lifestyle and behavioural choices of individuals; this concept has been employed as part of an effective mechanism to improve behavioural change and health outcomes.Few studies have examined illness perceptions among Chinese patients with type 2 diabetes mellitus. What this paper adds? Of the 14 common symptoms of type 2 diabetes, Chinese patients with type 2 diabetes recognized fewer than five, on average.The patients lacked understanding of their illness, frequently believing that smoking was not related to their illness.Socio‐demographic factors (including gender, age, marital status, educational level, family income, and employment status) and clinical factors (including diabetes duration, diabetes‐related complications, comorbid conditions, number of hospital admissions, and level of haemoglobin A1c) are predictors of illness perceptions among Chinese patients with type 2 diabetes mellitus. The implications of this paper: The findings provide evidence regarding illness perceptions among Chinese diabetic patients, which adds to the international understanding of diabetes care.The findings help health care professionals to understand, recognize, and address illness perceptions and their predictors among patients with diabetes. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to explore the effect of video‐mediated communication on father‐infant bonding and transition to fatherhood during and after Satogaeri Bunben. Background: Satogaeri Bunben is a Japanese perinatal tradition that results in the pregnant wife and husband living apart, which may interfere with father‐infant bonding and transition to fatherhood. Design/Methods: A mixed‐methods study was conducted from July 2012 to November 2015. Participants were divided into two groups (Treatment/Control). Quantitative data included Taiji kanjyo Hyotei Syakudo (TKHS) , communication methods, husband's visitation records and video‐mediated communication records and satisfaction of video‐mediated communication experience. Qualitative data included participants' journal entries about their experience and feelings toward their infants during Satogaeri Bunben. Results: Fourteen treatment and thirteen control dyads/couples participated in the study. There were significant differences between groups in the frequency of fathers' visitation during Satogaeri Bunben, as well as on the THKS between groups in cross‐sectional analysis and in treatment group in longitudinal analysis. Fathers' journal entries revealed the use of video‐mediated communication in both groups, specifically commenting about these experiences and the impact of additional visual cues when communicating. Conclusion: Video‐mediated communication provides a sense of virtual co‐presence, which may help support father‐infant bonding and transition to fatherhood; however, it does not completely substitute for face‐to‐face interaction. SUMMARY STATEMENT: What is already known about this topic? Father‐infant bonding and transition to fatherhood are supported by father's early involvement and ongoing sharing of time and space with his infant. What this paper adds? Virtual co‐presence in which people maintain a sense of "being there" for each other across distances may improve father‐infant bonding and transition to fatherhood when face‐to‐face contact is not possible due to geographic separation. The implications of this paper: Video‐mediated communication was explored as a way to support fathers who were separated from their wives and infants during the perinatal period by creating a sense of virtual co‐presence. This study advanced the idea that video‐mediated communication may be ideally suited when families are separated geographically during the perinatal period and early infancy (e.g. military/work deployment, hospitalization, educational opportunity and migrant/refugee families who send one parent ahead), as it provides communication context by adding visual cues and contextualizing auditory cues. [ABSTRACT FROM AUTHOR]

Emergent research has investigated the impact of abuse on the decision of match officials to leave their sport. The existing literature is largely descriptive and qualitative. Based on large surveys of football referees in France and the Netherlands, this paper investigates the factors that are associated with the verbal and physical abuse of the referees and also the association of this abuse with the intentions of referees to quit officiating. The associations are investigated by estimating the marginal effects from bivariate probit and probit models respectively. Bivariate probit estimation reveals a strong correlation between each form of abuse. Both, unsurprisingly, are also positively associated with years of experience of referees. Probit estimation reveals that both forms of abuse, as well as intimidation from refereeing certain teams, are associated with an increased consideration of referees to quit. As increased intention to quit is also associated with the experience of the referee it is likely that the effect of abuse on referee considerations of quitting increase through time. The main conclusions are that the alternative forms of abuse are not zero-sum and both should be targeted by governing bodies to reduce the decline in the number of football referees. The data show that support of referees, for example through mentoring, can offset stated intentions to quit. Highlights This study looks at the factors that are associated with verbal and physical abuse of football referees and the association of this abuse with the intentions to quit. The alternative forms of abuse are not zero-sum and both should be targeted to reduce the decline in referees. Support of referees, for example through mentoring, can offset stated intentions to quit. [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]

Student engagement within the development of learning analytics services in Higher Education is an important challenge to address. Despite calls for greater inclusion of stakeholders, there still remains only a small number of investigations into students' beliefs and expectations towards learning analytics services. Therefore, this paper presents a descriptive instrument to measure student expectations (ideal and predicted) of learning analytics services. The scales used in the instrument are grounded in a theoretical framework of expectations, specifically ideal and predicted expectations. Items were then generated on the basis of four identified themes (Ethical and Privacy Expectations, Agency Expectations, Intervention Expectations, and Meaningfulness Expectations), which emerged after a review of the learning analytics literature. The results of an exploratory factor analysis and the results from both an exploratory structural equation model and confirmatory factor analysis supported a two‐factor structure best accounted for the data pertaining to ideal and predicted expectations. Factor one refers to Ethical and Privacy Expectations, whilst factor two covers Service Feature Expectations. The 12‐item Student Expectations of Learning Analytics Questionnaire (SELAQ) provides researchers and practitioners with a means of measuring of students' expectations of learning analytics services. Lay Description: What is already known about this topic: Understanding student expectations of learning analytics is an important challenge for higher education institutions to address.Research has measured student beliefs regarding the features and ethical procedures of a learning analytics service. What this paper adds: This study builds on prior work by developing an instrument to measure student expectations of learning analytics services.This study proposes that student expectations of learning analytics can be measured using two subscales: (a) ethical and privacy expectations and (b) service expectations. Implications for practice and/or policy: Higher education institutions should understand what students expect from learning analytics services before any implementations are actioned.Higher education institutions have a validated instrument to gauge and understand student expectations of learning analytics services.Results obtained from the instrument can be used to inform the development of specific learning analytics policies for each higher education institution. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The literature shows a clear relationship between a good therapeutic relationship (TR) and the efficacy of nursing interventions.For the implementation of nursing psychotherapeutic interventions, the initial establishment of a good TR is essential.Several instruments assess the relationship established between the therapist and the patient in psychotherapy. However, no tool has been found to assess the quality of the TR established between the nurse and the patient. What this paper adds to existing knowledge?: This study allowed the development and evaluation of the psychometric properties of a scale to assess the TR between the nurse and the patient in a sample of mental health nurses.The developed scale (Therapeutic Relationship Assessment Scale‐Nurse) has psychometric properties that attest its reliability (internal consistency and test–retest) and construct validity as an instrument to assess the quality of the TR established between the nurse and the patient from the nurse's perspective. What are the implications for practice?: As the TR is crucial for providing nursing care and, in particular, for implementing nursing psychotherapeutic interventions, the scale developed is a valid tool to assess the quality of the TR established between the nurse and the patient in the perspective of the mental health nurse.The use of instruments to assess the quality of the nurse–patient TR facilitates the identification of the relationship's gaps, which can serve as a basis for improving the relationship itself and the nursing care provision. Introduction: The therapeutic relationship (TR) is essential to providing psychiatric and mental health nursing care. Nevertheless, no assessment tools exclusive for assessing nursing TR were found in the literature. Aim: To describe and evaluate the psychometric properties (reliability and construct validity) of a scale that allows assessing the quality of TR established between the nurse and the patient. Method: A survey method was adopted, using a convenience sample of 356 mental health nurses. Internal consistency was assessed by Cronbach's alpha and Omega index. Results: A total of 221 mental health nurses participated in the study (response rate = 62.08%). The scale's final structure has 25 items. Cronbach's alpha was 0.93, ranging from 0.78 to 0.88 for each of the factors. The cumulative variance explained in a four‐factor structure was 71.12%. Discussion: The Therapeutic Relationship Assessment Scale (TRAS)‐Nurse presents good psychometric properties. In the light of Benner's theory, it can be an useful tool for novice nurses to better understand what aspects they should pay attention to for establishing a successful TR. Implications for Practice: Mental health nurses can use the TRAS‐Nurse, thus having a scale available that allows them to self‐assess the quality of TR they establish with their patients. [ABSTRACT FROM AUTHOR]

During the COVID‐19 crisis, digital informal learning is important for students' academic engagement. Although scholars have highlighted the importance of students' digital competence in improving digital informal learning (DIL), the mediating role of DIL between digital competence and academic engagement has remained ambiguous. The purpose of this study is to investigate the relationship between students' digital competence and their academic engagement with the mediating role of DIL in the higher education context. This study used a descriptive correlational design, and the data were analyzed using structural equation modelling (SEM). The study sample included 308 students from Shiraz University, Iran. The results showed that digital competence positively and significantly correlated with students' DIL and their academic engagement. Furthermore, DIL, as the mediator variable, was found to mediate the relationship between students' digital competence and their academic engagement. Since higher education institutions have a key role in improving students' academic engagement, particularly in the COVID‐19 pandemic, academic administrators should pay more attention to students' digital competencies and provide them with efficient and user‐friendly DIL platforms that can increase their academic engagement. Lay Description: What is already known about this topic: One of the challenges of online learning environments is students' engagement especially in the COVID‐19 crisis.The role of digital informal learning (DIL) in the students' engagement is ambiguous.Little work has been done to support the relationship between digital competence, DIL and academic engagement. What this paper adds: The structural equation model of academic engagement, digital competence, and DIL was examined.There is a significant relationship between digital competence and DIL of students.The engagement of students will increase both with the use of digital competencies and DIL. Implications for practice and/or policy: Administrators should provide efficient DIL platforms to increase students' academic engagement.Educators should consider students' digital competencies to increase their academic engagement. [ABSTRACT FROM AUTHOR]

Digital competence is critical for university students to adapt to and benefit from digitally enhanced learning. Prior studies on its measurement mostly focus on educators and relied on factor analyses. However, there is a lack of valid and convenient tools to measure university students' digital competence. This study aimed to develop a digital competence scale for university students (DC‐US) in digitally enhanced learning with robust psychometric properties. An initial DC‐US with 23 items was proposed to measure the single latent trait of digital competence. It was validated and refined continuously through a pilot study, a main study and a predictive validity study in three datasets involving 825 participants altogether, using factor analyses, Rasch analyses and the partial least squares modelling. The final DC‐US turned out to comprise two subscales: technical literacy and digital skills, with 10 items retained, and manifested high internal consistency, unidimensionality and measurement invariance. The scale also demonstrated strong predictive validity, with technical literacy greatly predicting digital skills, which negatively predicted technostress. The DC‐US enables instructors and school administrators to conveniently obtain preliminary information of university students' digital competence, informing their digital class preparation and development of timely interventions for addressing digital deficiencies. Lay Description: What is already known about this topic?: Digital competence is critical for university students to adapt to and benefit from digitally enhanced learning (DEL).There is a lack of valid and convenient tools to measure university students' digital competence.Prior studies on its measurement mostly focus on educators and relied on factor analyses. What this paper adds?: A unidimensional, valid and unbiased digital competence scale was developed for university students.Rasch analyses and classical test theory were employed jointly for the scale development.The digital competence scale comprised two subscales: Technical literacy and digital skills. Implications for practice: University students can use the scale for a quick self‐assessment of their digital competence before joining DEL.Instructors can use the scale to gain an initial knowledge of their students' digital competence to inform digital class preparation.University administrators can rely on the scale to quickly evaluate the implementation effectiveness of DEL schemes. [ABSTRACT FROM AUTHOR]

Reflection journals (RJs) have been recognised as a vital tool in promoting student learning. However, little is known about how doctoral students use RJs to improve academic engagement. Through a mixed-method study, this paper explored how six international students from a Chinese normal university utilized RJs in their engagement in an advanced learning sciences course. This study used reflective journals, surveys, and interviews to examine doctoral students' perceptions of the effectiveness of reflective journals in their learning process in a 12-week 'Frontiers of the Learning Sciences' course. The quantitative results revealed that all items received a positive rating and were appropriate for exploring how reflective journals enhanced the participants' critical thinking, writing skills and engagement. Overall, the findings confirmed that reflective journals facilitate critical thinking, metacognition, and self-engagement. The findings of the study likewise provide information for course instructors to adjust their lesson plans in response to students' comments and suggestions. [ABSTRACT FROM AUTHOR]

Open Educational Resources (OER) aim to provide equal access to education. Yet, as the language level used in OER presents a barrier to many learners, there is a need to make these resources more comprehensible. This study combined eye‐tracking methodology and comprehension assessment to explore the effect of text simplification on English second language (L2) users, while also accounting for text organizational structure and individual predispositions. A total of 37 adult English L2 users took part in the study. They had to read either an authentic narrative, authentic expository OER or their linguistically simplified versions. The analysis showed that simplification led to better text comprehension, and text narrativity facilitated text recall, particularly at lower English proficiency levels. Eye‐tracking measures revealed that text simplification led to an increase in processing time during the initial reading of the text and a decrease in processing time during text re‐inspection. These findings have strong practical applications for online teaching with OER. Lay Description: What is already known about this topic: Open Educational Resources (OER) aim to increase access to education to all.Language level of OER in English was found to be very difficult, particularly to English L2 users.Text simplification that reduces the difficulty level of OER to English L2 users might be a potential solution.There is a lack of research that controls for the type of texts, individual predispositions and uses diverse behavioural measures to explore the effect of text simplification on English L2 users. What this paper adds: Text simplification led to better text comprehension, and text narrativity facilitated text recall, particularly at lower English proficiency levels.Text simplification slowed down processing during the initial reading of the text, and sped up processing during text re‐inspection.Final sentences, which were the likely locations for the integration of text information, received extended overall processing time in the simplified condition.Language proficiency played an important role both in text comprehension and text processing. Implications for practice and/or policy: Linguistic simplification of an OER text where possible – using higher frequency lexis, splitting long sentences, avoiding passive voice – benefits English L2 users, particularly at lower proficiency levels.There should be more narrative elements and cohesive links within and between sentences in the academic texts and OER, as these structures seem to be retained in readers' memory longer.OER publishers and material designers should be motivated to include the possibility for OER learners to access a simplified version of the OER materials [ABSTRACT FROM AUTHOR]

While the use of experiments is important for developing students' scientific knowledge and skills, challenges may arise when teachers and students are conducting experiments in class, such as non‐reusable experimental resources, safety issues and difficulties simulating some specific effects. Augmented reality (AR) technology affords an alternative approach to conducting experiments by bringing students a virtual–real mixed learning environment. In this study, taking junior high school physics knowledge on the magnetic field as an example, we designed and developed an AR‐based mobile simulated experiment tool. This study investigates the effect of the AR‐based experiment on students' knowledge improvement and cognitive load compared with 3D and traditional experiments. A sample of 122 ninth‐grade students was randomly chosen and assigned to three groups (AR, 3D and Traditional). The results demonstrate that students in the AR group performed better than those in the 3D and Traditional groups in terms of their knowledge improvement. The AR group students also experienced the lowest cognitive load among the three groups. Moreover, students had positive perceptions about AR and 3D tools. The implications of this study are discussed. Lay Description: What is already known about this topic: Experiment is an important method for students' magnetic field learning.Traditional magnetic experiment consists of various procedures that may cause some inconvenience during learning.Augmented reality (AR) provides a virtual–real fusion environment to assist teaching and learning.While some studies indicate positive impact of AR on learner's cognitive load, some do not. What this paper adds: An AR‐based mobile simulated experiment tool was proposed based on the junior high school physics knowledge, the magnetic field.A Comparison was made among AR, 3D and traditional experiment for magnetic field learning.Higher knowledge improvement and lower cognitive load were observed in the AR group.3D and Traditional groups showed similar knowledge improvement and cognitive load. Implications for practice and/or policy: The AR design with hand‐held devices has unlimited scalability of educational applications.Serving the real object as marker and using the professional algorithm to simulate some specific phenomenon were recommended in future AR studies.The findings indicated that AR experimental tool had a statistically significant effect on students' knowledge improvement and cognitive load.The similar result between 3D and Traditional groups implies that not everything virtualized is good; we must consider the actual teaching and learning situations. [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]

Designers are often faced with the challenge of following web accessibility guidelines that are complex and ambiguous, and therefore hard to use. This is evidenced by the low percentage of public websites that comply fully with web accessibility standards worldwide. Lack of engagement among designers to follow established web accessibility guidelines is often accounted for this issue. In this paper, we address designers' lack of engagement through a serious game called GATE which is based on the Web Content Accessibility Guidelines (WCAG). We followed a User-Centred approach by identifying user types of designers through an online survey. We then mapped these user types and the WCAG to relevant game mechanics. The resulting game was evaluated with designers for its perceived effectiveness, user engagement, and user satisfaction using a mixed methods approach. Our results demonstrate the potential of GATE which offers designers an innovative and engaging solution towards the wider adoption of web accessibility guidelines. [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]

Supplemental digital content is available in the text. Introduction: The ability to self-manage and problem solve effectively is an important component of managing chronic conditions. For individuals with limb loss, problem solving the fit of their prosthetic socket is crucial to being able to functionally ambulate with a prosthetic leg. This study evaluates and compares two innovative problem-solving tools designed to empower prosthesis wearers in self-managing their socket fit. Materials and Methods: Fourteen paper-based problem-solving decision trees were integrated into a mobile health app displayed on an iPad. Thirty prosthesis wearers performed a total of six trials split between the two conditions (paper-based and mobile app).Technical effectiveness, efficiency, and acceptability were assessed during and after participants used each tool to problem solve real-life scenarios. Technical effectiveness was a measure of the number of errors, whereas efficiency was a measure of the amount of time needed to complete each trial. Acceptability was measured using Likert-like questionnaires and semistructured interviews. Results: Results demonstrated significantly better efficiency (paper-based = 124.22 seconds on average, app = 108.76 seconds; P = 0.0076) and technical effectiveness (paper-based = 0.66 errors on average, app = 0.2 errors; P < 0.001) for the app. Age and education were correlated with the outcomes. Conclusions: The mobile app demonstrated significantly better outcomes as compared with the paper-based decision trees. Both the mobile app and paper-based tool had high acceptability; however, the mobile app was found to be significantly easier to use and less confusing than the paper-based version of the decision trees. Further study is required to assess the efficacy of the decision trees to manage a prosthetic fit issue in an individual who is currently having difficult managing a prosthetic socket fit issue. [ABSTRACT FROM AUTHOR]

This paper explores the prevalence and predicting factors of depression in older Korean community‐dwelling adults, giving special attention to nutrition and social support. Data from male (n = 123) and female (n = 135) older adults were collected in two senior centers in 2009. We found that depression was present in 17.1%. No significant gender difference was found in the prevalence of depression although the predicting factors were gender specific. In male participants, deficient protein intake, having more chronic diseases, and having a subjective perception of difficulties in mastication were predicting factors for depression, whereas deficient vitamin B6 intake, lower cognition, and lack of social support were predicting factors in female participants. The high prevalence of depression, regardless of gender, highlights the urgent need to screen depressed elders. The different predicting factors for depression in male and female older adults suggest a need to develop gender‐specific interventions to alleviate depressive symptoms. [ABSTRACT FROM AUTHOR]

Information technology provides the potential for polychronic learning. However, research on polychronicity in the educational field is scarce. The purposes of this study were to develop a multidimensional polychronicity scale for information technology learning and explore the relationship between polychronicity in information technology‐supported learning and personality traits. This study is divided into two phases. First, a questionnaire survey was used to develop a multidimensional polychronicity scale for information technology learning, and 602 questionnaires were included in the analysis. Second, 129 participants reported their polychronicity in information technology‐supported learning and Big Five personality traits. The first phase results showed that the scale of polychronicity in IT‐supported learning (SPITSL) contained three constructs, that is, time tangibility (α =.89), scheduling preference (α =.84) and involvement with people (α =.85) and that the total variance explained was 69.43%. The confirmatory factor analysis results indicated that the preliminary model fit, overall model fit and internal model fit were acceptable. The second phase results showed that polychronicity was related to the Big Five personality traits. This study showed that the SPITSL has a multidimensional structure that is consistent with the definition of polychronicity advocated by many scholars. Lay Description: What is already known about this topic: Multitasking has become one of the most common behaviours in student learning.Research on polychronicity in the educational field is important but scarce. What this paper adds: The study aims to develop a polychronicity scale for digital learning.The scale of polychronicity in IT‐supported learning (SPITSL) reflected the multidimensionality of polychronicity.The polychronic students in this study prefer the scheduled learning tasks. Implications for practice and/or policy: SPITSL may help to understand the multitasking learning preference of students online.It needs more research on students' polychronicity in the IT learning environment. [ABSTRACT FROM AUTHOR]

While to date job crafting has been conceptualised as consisting of behaviours aiming at seeking more resources, decreasing hindering demands, and seeking more challenges, recent research suggests that individuals may restore the fit between their demands and preferences also by optimising their demands. Accordingly, optimising demands has been introduced in the resource‐based perspective to job crafting as an additional strategy that aims at making the work processes more efficient, simplifying procedures and eliminating obstacles. In this paper, we explore and provide evidence for the validity of a four‐factor, hierarchical structure of behavioural job crafting constituted by increasing resources, seeking challenges, decreasing demands, and optimising demands. Moreover, our results provide initial evidence suggesting that overall job crafting may be more strongly characterised by effortful actions to expand the work characteristics rather than to reduce them. [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]

What is known on the subject: Healthcare assistants are untrained and unregistered frontline staff but are expected to be proactive in preventing and responding to 'untoward' incidents quickly and efficiently when working within adult acute inpatient psychiatric settings.Healthcare assistants should be trained to provide enhanced care to service users residing in acute psychiatric settings. To date, a training programme in Psychological First Aid has not been expended in such a setting with nonregistered staff. What the paper adds to existing knowledge: The study demonstrates that training healthcare assistants in Psychological First Aid is useful in improving their confidence in caring for service users, therapeutic engagement with service users and ward culture in general. What are the implications for practice: A training programme in Psychological First Aid for healthcare assistants to enhance ward culture can be implemented in different practice environments.Psychological First Aid is harmonious with nursing values and provides healthcare assistants with a relevant, useful and easily understood toolkit to apply in acute psychiatric settings. Introduction: Healthcare assistants working within adult acute inpatient psychiatric settings are untrained and unregistered, however, they can contribute to quality service if they receive some training. Psychological First Aid training has never been expended in these settings, so this study intends to fill this gap in the existing evidence with this category of healthcare personnel. Aim: The aim of this study was to introduce and evaluate first aid training for healthcare assistants. Method: A pre/post design was adopted to gather data using questionnaires and interviews. The groups of participants included 16 healthcare assistants trained in Psychological First Aid, a sample of service users and four ward managers. Results: Post‐training, (a) healthcare assistants and service users ranked the therapeutic milieu of the ward more favourably, (b) the self‐efficacy of the healthcare assistants increased, and the number of 'untoward' incidents decreased, and (c) health care assistants' confidence in their skills was high. The ward manager interviews post‐training revealed four themes: (a) staff utilization of new skills and renewed enthusiasm, (b) calmer atmosphere on the ward and staff togetherness, (c) confidence and reflection on practice and (d) therapeutic engagement. Discussion: Training healthcare assistants is useful in improving staff confidence, therapeutic engagement with service users and ward culture in general. Implications for practice: Techniques and skills learnt are relevant and useful to healthcare assistants and provide an easily understood toolkit that is harmonious with nursing values. If executed correctly, the training can enhance practice and care outcomes and the overall service user experience. [ABSTRACT FROM AUTHOR]

This paper considers the idea that moral injury may result from social workers being exposed to sustained ethical stress – the stress experienced when workers cannot base their practice on their values. It is suggested that a particularly salient feature of agency working which might contribute to the experience of ethical stress is risk aversion. This paper is based on a study of one hundred criminal justice social workers in Scotland, who were questioned on their experiences of ethical stress and risk aversion. Quantitative and qualitative data were collected and analysed using standard multiple regression and inductive thematic analysis, respectively. Findings demonstrated that how risk-averse an agency was contributed in a unique and significant way to the worker’s experience of ethical stress. Qualitative comments illustrated why this relationship might exist, but also demonstrated that a variety of views were held by social workers and that ethical stress was not experienced by all. The findings are discussed in terms of moral injury and its links with risk aversion, bureaucracy, neoliberal hegemony, notions of ‘underclass’, personal moral codes and professional integrity. Explicitly exploring these related concepts in social work education might impact on the new generation of social workers and strengthen the profession. [ABSTRACT FROM PUBLISHER]

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]