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Aim This paper is a report of the development and psychometric testing of the Swedish version of the Body Awareness Questionnaire to measure bodily focus of attention. Background The Body Awareness Questionnaire has been identified as an instrument with excellent psychometric properties within the concept of body awareness. It has been used in both research and clinical settings in different contexts. However, a validated Swedish version is not available. Method A cross-sectional design was applied for adaptation of the Body Awareness Questionnaire and psychometric validation. Data were collected between autumn 2009 and spring 2011 from 120 patients diagnosed with rheumatoid arthritis, and from 120 students. The 'concurrent think aloud' method was used in a pre-test to determine the usability of the questionnaire. Cronbach's alpha was used to test the internal consistency, and confirmatory factor analysis was performed to test the construct validity. Results According to the confirmatory factor analysis, neither the one-factor model nor the four-factor model tested in this study fulfilled the pre-specified criteria in accordance with the Comparative Fit Index, Standardized Root Mean Squared Residual and the Root Mean Square Error of Approximation. The value of Cronbach's alpha for the Swedish version of the Body Awareness Questionnaire was satisfactory. Conclusion Our results indicate that the two models tested in this study do not provide a good fit to the observed data. Further refinement and testing of the Swedish version of the Body Awareness Questionnaire is therefore required. The concept of body awareness may be useful in the management of chronic disease and can be addressed in nursing. [ABSTRACT FROM AUTHOR]

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

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

lobchuk m.m., mcpherson c.j., mcclement s.e. & cheang m. (2011) A comparison of patient and family caregiver prospective control over lung cancer. Journal of Advanced Nursing 68(5), 1122-1133. Abstract Aim. This paper is a report of our secondary analysis of patient and family caregiver prospective control in lung cancer. Background. Control beliefs underlie self-care in sickness and health. Self-care often involves 'shared' activities between the afflicted individual and caregiving family and friends. However, depending on how control is perceived, conflicts can occur in decision-making thus jeopardizing optimal self-care. We need to comprehend how control beliefs compare between patients and caregivers and how their control beliefs are linked with dealing with serious illness. Methods. Based on questionnaire data collected in our larger study between September 2005 and February 2009, we conducted exploratory comparative analyses of 304 patients' and caregivers' control beliefs in managing lung cancer. Eight 5-point response items captured prospective control. Exploratory factor analysis with promax rotation was conducted to compare dyadic perceptions on the dimensionality of prospective control. We also conducted exploratory correlations between control beliefs and smoking cessation, attributional reactions, caregiver helping and symptom reports. Results. Principal component analysis identified the same factors for patients and caregivers: factor 1, Fate control and factor 2, Team control. Patient and caregiver 'Fate' and 'Team' control sub-scales were respectively associated with hope, caregiver helping and patient smoking cessation. Conclusion. Clinicians need to support, adapt or develop a philosophy of cancer care that is inclusive of partnerships, drawing on beliefs of patients and caregivers that controlling lung cancer is a team effort which in turn is tentatively linked to patient smoking cessation, positive emotions and caregiver helping. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to examine the direct and indirect effect, through organizational identification, of workplace ostracism on nurses' silence towards patient safety. Background Employee silence in nursing has recently received attention in relation to its antecedents. Yet, very little is known about the role of workplace ostracism in generating nurses' silence. Design A cross-sectional survey was conducted in a public hospital in Cyprus. Method Data were collected from 157 nurses employed in a public hospital of Cyprus between November 2014-January 2015. To examine the present hypotheses bootstrapping analysis and Sobel test were conducted. Results Results demonstrated that workplace ostracism has an effect on nurses' silence towards patient safety. Moreover, this effect was partially mediated through organizational identification. Conclusions Workplace ostracism among nurses significantly affects both nurses' attitude and behaviour namely organizational identification and employee silence. [ABSTRACT FROM AUTHOR]

Aim To explore associations among breastfeeding duration, maternal personality and maternal attitudes and experiences of breastfeeding. Background Understanding influences on breastfeeding initiation and duration is critical to increasing breastfeeding rates and supporting new mothers. Maternal characteristics such as self-efficacy, knowledge and confidence are known to enable women to breastfeed, but little is known about the influence of maternal trait personality on breastfeeding. Design An exploratory cross-sectional survey. Method A total of 602 mothers with an infant aged 6-12 months old completed a self-report questionnaire examining maternal trait personality, breastfeeding duration and attitudes and experiences of breastfeeding. Data were collected between March-June 2009. Results Mothers who reported high levels of extraversion, emotional stability and conscientiousness were significantly more likely to initiate and continue breastfeeding for a longer duration. Attitudes and experiences significantly associated with these personality traits such as perceived difficulties and lack of support may explain these patterns. For example, characteristics associated with introversion and anxiety may prevent women from seeking support or challenging negative attitudes of others at this critical time. Conclusion Understanding the influence of maternal personality may thus be a useful tool in antenatal support to recognize women who may need extra, directed support while facilitating discussion of potential barriers to breastfeeding. [ABSTRACT FROM AUTHOR]

Aim This study is a report of the development and testing of the Work Stressor Inventory for Nurses in Oncology. Background Stressors in oncology nursing are generally assessed using generic stress scales like the Nursing Stress Scale or the Health Professions Stress Inventory. However, qualitative investigations have highlighted the specific nature of the stress to which nurses are exposed. Design The Work Stressor Inventory for Nurses in Oncology was developed using both qualitative and quantitative methodologies. Method For the item generation phase, a semi-structured interview was conducted with 59 nurses working in oncology units during 2007. A total of 51 work-related items were retained for the final survey. A convenience sample of 582 nurses working in oncology completed the survey between January 2008-June 2008. They also completed the General Health Questionnaire and the Maslach Burnout Inventory. The Work Stressor Inventory for Nurses in Oncology was further tested for theoretically supported constructs, internal consistency reliability and concurrent validity. Findings The exploratory results revealed five factors: workload, dealing with death and dying, dealing with suffering, interpersonal conflicts, dealing with patients and relatives. The internal consistency of the five subscales was satisfactory. Correlation patterns between the Work Stressor Inventory for Nurses in Oncology dimensions and both mental health and burnout variables support the criterion-related validity of the scale. Conclusion Future quantitative or qualitative studies using this scale could add knowledge about the experiences of emotional and organizational stressors related to this area of nursing. [ABSTRACT FROM AUTHOR]

Aims To examine the role of two personal resources (active, problem-focused coping; self-efficacy beliefs) in the relation between job demands and strain. Background Evidence suggests that healthcare staff in general and nurses in particular, are at a high risk of suffering from high levels of job strain. In addition to often examined job-related resources (such as control and social support), personal resources are expected to moderate (i.e. buffer) the relation between job demands and indicators of strain, particularly when there is a functional match between the type of demands and resources. Design Cross-sectional questionnaire survey. Method A cross-sectional questionnaire survey was conducted (February-April 2010) among staff members of three nursing homes of a municipal organization for residential elderly care located in an urban area of Western Germany. A total of 145 of 251 employees responded to the invitation to participate in the study (57·8% participation rate). Data were analysed by hierarchical moderated regression analyses. Results Increasing job demands (quantitative and qualitative workload) had adverse effects on emotional exhaustion, psychosomatic complaints, and turnover intentions, whereas nurses' self-efficacy beliefs exerted beneficial effects on all outcomes. Furthermore, findings revealed that active, problem-focused coping interacts with job demands in the prediction of job strain. Conclusion Both research and practice should focus on a closer match between personal resources and job demands to prevent nurses from being strained. [ABSTRACT FROM AUTHOR]

Aim To explore the level of nurses' job satisfaction and compare the differences between critical care nurses and general ward nurses in Mainland China. Background Hospitals continue to experience high nurse turnover. Job satisfaction is a key factor to retain skilled nurses. The differences in job satisfaction among critical care nurses and general ward nurses are unknown. Design A cross-sectional design was selected for this descriptive correlation study. Methods Cross-sectional study of critical care nurses ( n = 446) and general ward nurses ( n = 1118) in 9 general hospitals by means of questionnaires that included the Chinese Nurses Job Satisfaction Scale and demographic scale. The data were collected from June 2010-November 2010. Results Chinese nurses had moderate levels of job satisfaction, were satisfied with co-workers and family/work balance; and dissatisfied with pay and professional promotion. Critical care nurses were younger; less educated and had less job tenure when compared with nurses working on general wards. Critical care nurses were significantly less satisfied than general ward nurses with many aspects of their job. Conclusion Levels of nurses' job satisfaction can be improved. The lower job satisfaction of critical care nurses compared with general ward nurses should warn the healthcare administrators and managers of potentially increasing the critical care nurses turn over. Innovative and adaptable managerial interventions need to be taken to improve critical care nurse' job satisfaction and retain skilled nurse. [ABSTRACT FROM AUTHOR]

Aim To test the effect of a nurse-led intervention on weight gain in people with serious mental illness prescribed and taking second generation antipsychotic medication. Background Weight gain and obesity has reached epidemic proportions in the general population with the prevalence of Metabolic Syndrome reaching 20-25% of the global population. People with serious mental illness are at even higher risk, particularly those taking second generation antipsychotic medication. Design An experimental randomized controlled trial was undertaken. Method The control group received a 12-week healthy lifestyle booklet. In addition to the booklet, the intervention group received weekly nutrition and exercise education, exercise sessions, and nurse support. Participants ( n = 101) were assessed at baseline and 12 weeks. Data were collected between March 2008-December 2010. Seven outcome measures were used: body measurements included girth (cm), weight (kg), height (cm), and body mass index (kg/m2); questionnaires included the medication compliance questionnaire, the Drug Attitude Inventory, the Liverpool University Neuroleptic Side Effect Rating Scale, and the Medical Outcomes Study Short Form 36. Differences in primary outcome measures between baseline and 12 weeks follow-up were compared between intervention and control groups using standard bi-variate statistical tests. The study was conducted between 2008-2010. Results The analysis of outcome measures for the control group ( n = 50) and intervention group ( n = 51) was not statistically significant. There was a mean weight change of −0·74 kg at 12 weeks for the intervention group ( n = 51), while the control group ( n = 50) had a mean weight change of −0·17 kg at 12 weeks. Conclusion The results were not statistically significant. [ABSTRACT FROM AUTHOR]

Abu Hamad B.A. & Sammour H.K. (2013) Weaning practices of mothers attending United Nations Relief and Works Agency health centres in the Gaza Governorates. Journal of Advanced Nursing 69(4), 773-781. doi: 10.1111/j.1365-2648.2012.06057.x Abstract Aim. To report a study about weaning patterns and practices among Palestinian mothers attending health centres managed by the United Nations Relief and Works Agency in the Gaza Strip. Background. Although breastfeeding and weaning are important domains in child health, weaning has gained little attention from healthcare providers and researchers. In Arab culture, weaning practices are problematic and information gaps exist in relation to how and when weaning takes place. Design. A descriptive/analytical cross-sectional study. Methods. A multi-stage stratified random sample of 285 mothers of infants from 6-24 months, attending six health centres, was selected and completed an interviewed questionnaire in 2009. The Statistical Package for Social Sciences Program was used to conduct descriptive and analytical analysis. Results. The rate of exclusive breastfeeding for infants from 0-6 months of age was low. Pregnancy was reported as the main reason for weaning. The mean weaning age was 13·5 months. The vast majority of mothers used sudden weaning, from them, the majority used traditional methods. The most popular traditional methods used by mothers were putting substances with bad taste especially aloe vera (Subra Murra) on the nipples, using of alternatives as pacifiers, putting red substances, and placing coffee on the nipples. Variations were found in the use of traditional methods in reference to mothers' demographic characteristics. Conclusion. During counselling mothers, nurses should focus on promoting gradual weaning practices and abstain from using traditional methods. Also, nurses should receive training and supervision on the appropriate weaning practices. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to test the factor structure of an Italian version of the Maslach Burnout Inventory for Human Service employees. In addition we examined the reliability and construct validity of the scale. Background There is increasing evidence that nurses are at risk of experiencing burnout. Despite the vast international use of the Maslach Burnout Inventory- Human Service Survey, its factor structure and reliability are not beyond question. Method In a sample of nurses ( N = 1613) six alternative factor models of the instrument were tested using confirmatory factor analysis. Furthermore, we examined the invariance of the pattern of factor loadings of the model that better fitted the data across gender groups. To test construct validity, participants completed four subscales of Symptoms Check List 90-R. Internal consistency was evaluated computing Cronbach's alpha estimates of the scales. The study was conducted in 2007 and 2008 in Italy. Results The factor analysis provided support for a 20-item version identifying the three original dimensions. The model was found to be factorially invariant between men and women. Correlations between the latent MBI- HSS dimensions and distress variables were in line with theoretical predictions. Reliability was supported by acceptable Cronbach's alpha indexes. Conclusion The Maslach Burnout Inventory- Human Service Survey has acceptable validity and reliability for measuring burnout among nurses, and can help healthcare managers to offer interventions to reduce burnout among nurses. Limitations of the study and suggestions for further research are highlighted. [ABSTRACT FROM AUTHOR]

colbert a.m., sereika s.m. & erlen j.a. (2012) Functional health literacy, medication-taking self-efficacy and adherence to antiretroviral therapy. Journal of Advanced Nursing 69(2), 295-304. doi: 10.1111/j.1365-2648.2012.06007.x Abstract Aims. To report a study of the relationship between functional health literacy and medication adherence, as mediated by medication-taking self-efficacy, while controlling for the effect of key demographic variables (such as race, income and level of education). Background. Medication adherence is critical to successful HIV/AIDS self-management. Despite simplified regimens and the availability of tools to assist with medication-taking, adherence remains a challenge for many people living with HIV/AIDS. Design. Cross-sectional, secondary analysis. Methods. Data for this study of 302 adults living with HIV/AIDS who were taking antiretroviral medications were collected from January 2004-December 2007. Medication adherence was measured using electronic event monitors. Bivariate analyses and stepwise regression were conducted to examine the associations among functional health literacy, medication-taking self-efficacy and HIV medication adherence. Results. Overall, functional health literacy was much higher than expected; however, adherence in this sample was sub-optimal. Higher medication-taking self-efficacy was associated with higher medication adherence; however, functional health literacy was not significantly related to either medication adherence or self-efficacy beliefs. Hence, medication-taking self-efficacy did not mediate the relationship between functional health literacy and medication adherence. Conclusions. Medication adherence continues to be an issue for people living with HIV/AIDS. Additional research is needed to understand the disparate findings related to functional health literacy and medication adherence in this and other studies examining this association. [ABSTRACT FROM AUTHOR]

wang s.-c., lee l.l., wang w.-h., sung h.-c., chang h.-k., hsu m.-y., chang s.-c. & tai c.-h. (2012) Psychometric testing of the Chinese evidence-based practice scales. Journal of Advanced Nursing 68(11), 2570-2577. Abstract Aim. This article is a report of the psychometric testing of the Chinese version of Evidence-Based Practice Implementation and Beliefs, and Barriers to, and Facilitators of Research Utilization scales. Background. Investigations into the effect of evidence-based practice on clinical care could be facilitated by instruments for measuring the levels of evidence-based practice implementation; the strength of beliefs in evidence-based practice; the barriers to, and the facilitators of research utilization. An English version of the scales measuring the above constructs has been tested whereas the Chinese one has not. Design. Instrument development. Methods. Psychometric analyses of the four evidence-based scales were conducted on a sample of 361 nurses from a medical centre in Taiwan. Both the internal consistency and squared multiple correlation coefficients were used to examine reliability. The validity testing for the four scales was estimated by examining their construct and concurrent validity. Data were collected between December 2008-January 2009. Findings. Internal consistencies exist for the Chinese Evidence-Based Practice Implementation, Beliefs, and Barriers to, and Facilitator of Research Utilization scales (≥0·85); some were greater than 0·9, which may indicate redundancy in items. Construct validity of the four scales was supported by hypotheses testing. Concurrent validity of the four scales was supported by known-group analysis, in which experienced nursing researchers had higher scores compared with clinical nurses. Conclusion. These scales may have value in discrimination between implementation of EBP and perception of barriers to, and facilitators of research utilization among nurses with different education levels, research experiences or working years in clinical setting. [ABSTRACT FROM AUTHOR]

heilemann m.v., choudhury s.m., kury f.s. & lee k.a. (2012) Factors associated with sleep disturbance in women of Mexican descent. Journal of Advanced Nursing 68(10), 2256-2266. Abstract Aims. The aims were to identify the most useful parameters of acculturation in relation to self-reported sleep disturbance and describe risk factors for sleep disturbance in women of Mexican descent. Background. Little is known about acculturation as a factor for poor sleep in the context of other personal factors such as income or sense of resilience or mastery for Latinas in the United States. Design. This study was a secondary analysis of cross sectional survey data. Methods. Personal factors were incorporated into a modification of the Conceptual Framework of Impaired Sleep to guide our secondary analysis of self-reported sleep disturbance. Data were collected from a convenience sample of 312 women of Mexican descent of childbearing age (21-40 years) located in an urban California community were collected and previously analysed in relation to depressive symptoms and post-traumatic stress disorder. The General Sleep Disturbance Scale (in English and Spanish) was used to assess sleep disturbance. Data was collected in 1998 from September through December. Results. Early socialization to the United States during childhood was the most useful acculturation parameter for understanding self-reported sleep disturbance in this sample. In a multivariate regression analysis, three factors (higher acculturation, lower income and higher depressive symptoms) were statistically significant in accounting for 40% of the variance in sleep disturbance. Conclusion. When low income Latinas of Mexican descent report sleep problems, clinicians should probe for environmental sleep factors associated with low income, such as noise, over-crowding and exposure to trauma and violence, and refer the woman to psychotherapy and counselling rather than merely prescribing a sleep medication. [ABSTRACT FROM AUTHOR]

ma c., chen s., you l., luo z. & xing c. (2012) Development and psychometric evaluation of the Treatment Adherence Questionnaire for Patients with Hypertension. Journal of Advanced Nursing 68(6), 1402-1413. Abstract Aim. This article is a report of the development and psychometric testing of the Treatment Adherence Questionnaire for Patients with Hypertension. Background Hypertension is the most prevalent health problem among adult patients affecting approximately 200 million people in China and about 1 billion persons worldwide. Adherence to medication and lifestyle for hypertensive patients result in blood pressure control and reduce adverse outcomes. At present, few specific adherence instruments are available to completely evaluate medication and lifestyle for hypertensive patients. Methods. A multi-phase psychometric questionnaire development method was used to develop the instrument. The item pool was generated using literature review and focus group. Content validity was evaluated by expert panel. Then, the field testing was conducted by a convenience sampling of 278 hypertensive patients from December 2009 to May 2010 in Guangdong Province of China. Exploratory and confirmatory factor analyses were used to test construct validity. Finally, internal consistency and test-retest reliability were assessed. Results. The new measure consisted of six dimensions with 28 items, explaining 62·54% of the total variance in the data. Confirmative factor analysis supported a good overall fit of the six-factor model. Cronbach's α of the overall questionnaire was 0·86 and 0·82 for test-retest reliability. Conclusions. The questionnaire was a brief and psychometrically sound instrument to evaluate hypertensive patients' treatment adherence and to be applied in the research and clinical fields. [ABSTRACT FROM AUTHOR]

yi m. & park e.y. (2011) Effects of breast health education conducted by trained breast cancer survivors. Journal of Advanced Nursing 68(5), 1100-1110. Abstract Aims. This article is a report on a study of the effectiveness of breast health education provided by trained breast cancer survivors on knowledge, skills, performance and self-efficacy. Background. Numerous studies have been performed to assess the effects of breast health education provided by health professionals, but few studies have examined the effects of education provided by lay persons, such as breast cancer survivors. This study focused on the role of breast cancer survivors as breast health educators. Methods. A pretest and post-test quasi-experimental design was used. Trained breast cancer survivors conducted a 60-minute breast health class that was guided by self-efficacy theory to young healthy women. The data were collected in 2008 from 22 young healthy women who participated in the class. Self-report questionnaires were used to measure the breast cancer and breast self-examinations knowledge, skills, performance and self-efficacy at pre-education, and at 1 month and 3 months post-education. Results. The scores on knowledge, skills, performance and self-efficacy before breast health education were significantly increased after 1 month and 3 months post-education. Conclusion. The results of this study demonstrate that a one-time breast health class provided by trained breast cancer survivors can be useful in motivating young women to adopt behaviours that help to prevent breast cancer morbidity and mortality. [ABSTRACT FROM AUTHOR]

merrick e., duffield c., baldwin r. & fry m. (2012) Nursing in general practice: organizational possibilities for decision latitude, created skill, social support, and identity derived from role. Journal of Advanced Nursing 68(3), 614-624. Abstract Aim. This article is a report of a study to describe the factors that support organizational opportunities for practice nurse decision-making and skill development for nurses employed in general practice in New South Wales, Australia. Background. Corresponding to the availability of subsidies from the Australian universal health insurer (Medicare), there has been an increase in the number of nurses employed in general practice. Currently, there is no Australian evidence as to the organizational possibilities for these practice nurses to make decisions, develop their own skills and abilities, derive identity from their role or how their role is influenced by social support. Methods. Over a 8-month period in 2008 practice, nurses employed in general practice in the State of New South Wales were invited to complete a 26-item self-administered online questionnaire utilizing constructs from Job Content Questionnaire (valid n = 160). Results. Confirmatory Factor Analysis indicated that all scales demonstrated acceptable levels of internal consistency. Sequential regression models revealed that social support exerts a weak influence on decision latitude ( R2 = 0·07); the addition of self-identity through work significantly improved the predictive ability of the model ( R2 = 0·16). Social support and self-identity through work exerted a negative influence on created skill ( R2 = 0·347), whereas social support was effective in predicting self-identity through work ( R2 = 0·148). Conclusions. Collegial and supervisory support in the work environment predicts organizational possibilities for practice nurse decision-making. [ABSTRACT FROM AUTHOR]

ganz f.d., raanan o., khalaila r., bennaroch k., scherman s., bruttin m., sastiel z., fink n.f. & benbenishty j. (2012) Moral distress and structural empowerment among a national sample of Israeli intensive care nurses. Journal of Advanced Nursing 69(2), 415-424. doi: 10.1111/j.1365-2648.2012.06020.x Abstract Aim. The aim of this study was to determine levels of structural empowerment, moral distress, and the association between them among intensive care nurses. Background. Structural empowerment is the ability to access sources of power. Moral distress is the painful feelings experienced when a person knows the right thing to do but cannot do so due to external constraints. Several studies suggest a theoretical relationship between these concepts. Design. Cross-sectional, descriptive correlational study. Methods. Members of the Evidence Based Nursing Practice Committee of the Israeli Society for Cardiology and Critical Care Nurses recruited a convenience sample of intensive care nurses from their respective institutions and units. Nurses were asked to complete three questionnaires (demographic and work characteristics, Moral Distress Scale, and the Conditions of Work Effectiveness Questionnaire-II). Data were collected between May-September 2009. Results. Intensive Care nurses had moderate levels of structural empowerment, low levels of moral distress frequency, and moderately high moral distress intensity. A weak correlation was found between moral distress frequency and structural empowerment. No other structural empowerment component was associated with moral distress. Work characteristics as opposed to demographic characteristics were more associated with the study variables. Conclusions. This study weakly supports the association between structural empowerment and moral distress. It also provides further evidence to the theory of structural empowerment as characterized in the critical care environment. Further studies are indicated to determine what other factors might be associated with moral distress. [ABSTRACT FROM AUTHOR]