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Aim: To develop and test the psychometric properties of an expanded catheter self‐management scale for patients with in‐dwelling urinary catheters. Design: A cross‐sectional validation study. Despite the utility of the original 13‐item catheter self‐management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self‐management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self‐management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self‐management. Methods: A total of 101 adult community‐dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23‐item expanded catheter self‐management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. Results: The 23‐item expanded catheter self‐management scale yielded a 5‐factor solution, labelled as: (i) self‐monitoring of catheter function, (ii) proactive, help‐seeking behaviour function, (iii) bowel self‐care function, (iv) hygiene‐related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self‐management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self‐management scale and catheter‐related problems. Conclusion: The 5‐factor structure provided a comprehensive assessment of key aspects of urinary catheter self‐management essential to reduce the likelihood of catheter‐related hospital presentations. Implications: The expanded catheter self‐management scale can be used to assess and monitor effective patient‐centred interventions for optimal self‐management to prevent catheter‐related problems and improve the quality of life of patients. Impact: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter.The findings of this study show the correlation between catheter self‐management skills and catheter‐related problems.The expanded catheter self‐management scale (E‐CSM) assists with analysing the self‐management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. Reporting Method: STROBE checklist was used to report all aspects of this study comprehensively and accurately. Patient or Public Contribution: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co‐designing interventions. This paper reports the psychometric analysis of the expanded catheter self‐management scale (E‐CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ‐IDC Study' (Alex et al. in Collegian, 29:405–413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study. [ABSTRACT FROM AUTHOR]

Aim: To develop and validate a culturally appropriate patient‐reported outcome measure for measuring dignity for older adults during acute hospitalization. Design: A three‐phased exploratory sequential mixed‐method design was used. Methods: Domains were identified and items were generated from findings of a recent qualitative study, two systematic reviews and grey literature. Content validity evaluation and pre‐testing were undertaken using standard instrument development techniques. Two‐hundred and seventy hospitalized older adults were surveyed to test construct and convergent validity, internal consistency reliability and test–retest reliability of the measure. Analysis was performed using Statistical Package for the Social Sciences, version 25. The STROBE checklist was used to document reporting of the study. Results: We established the 15‐item Hospitalized Older Adults' Dignity Scale (HOADS) that has a 5‐factor structure: shared decision‐making (3 items); healthcare professional‐patient communication (3 items); patient autonomy (4 items); patient privacy (2 items); respectful care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability and good test–retest reliability were demonstrated. Conclusion: We established the HOADS is a valid and reliable scale to measure dignity for older adults during acute hospitalization. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may inform the development of strategies to improve dignity‐related care in the future. Impact: The development and validation of the HOADS will provide nurses and other healthcare professionals with a feasible and reliable scale for measuring older adults' dignity during acute hospitalization. The HOADS advances the conceptual understanding of dignity in hospitalized older adults by including additional constructs that have not been captured in previous dignity‐related measures for older adults (i.e. shared decision‐making and respectful care). The factor structure of the HOADS, therefore, includes five domains of dignity and offers a new opportunity for nurses and other healthcare professionals to better understand the nuances of dignity for older adults during acute hospitalization. For example, the HOADS enables nurses to identify differences in levels of dignity based on contextual factors and to use this information to guide the implementation of strategies that promote dignified care. Patient or Public Contribution: Patients were involved in the generation of items for the scale. Their perspectives and the perspectives of experts were sought in determining the relevance of each item of the scale to patients' dignity. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to develop and psychometrically test the Nurse–Patient Mutuality in Chronic Illness (NPM‐CI) scale in two versions, one for nurses and one for patients. Method: A multiphase methodological study was conducted. In the first phase, a qualitative investigation was conducted through interviews and an analysis of the content; inductively, the items of two instruments were generated, one for nurses and one for patients. In the second phase, the content and face validity were assessed through the expert consensus method. In the third phase, exploratory factor analysis (EFA), Cronbach's alpha test, intraclass correlation and Pearson correlation coefficients were conducted to estimate construct, criterion validity and instrument reliability. For each phase, the sample included nurses and patients recruited from a large hospital in Northern Italy. Data collection was conducted between June and September 2021. Results: Nurse and patient versions of the NPM‐CI scale were developed. Two rounds of consensus reduced the items from 39 to 20; content validity index ranged between 0.78 and 1, content validity ratio was 0.94. Face validity indicated clarity and comprehensibility of the items. EFA identified three latent factors for both the scales. Internal consistency was satisfactory, with Cronbach's alphas ranging between.80 and.90. Test–retest stability was suggested, with an intraclass correlation coefficient of.96 (nurse scale) and.97 (patient scale). Predictive validity was established, with a Pearson correlation coefficient of.43 (nurse scale) and 0.55 (patient scale) between the mutuality scales and satisfaction in providing and receiving care. Conclusion: The results suggest that the NPM‐CI scales are sufficiently valid and reliable for the clinical practice among chronic illness patients and the nurses caring for them. A more in‐depth exploration of this construct in the context of nursing and patient outcomes is warranted. Patient or Public Contribution: Patients were involved in all study phases. Impact: Mutuality is fundamental in the relationship between nurse and patient, based on trust, equality, reciprocity, and mutual respect. The NPM‐CI scale was developed and psychometric estimated through a multiphase study in both nurse and patient versions. The NPM‐CI scale measures the factors of 'developing and going beyond', 'being the point of reference' and 'deciding and sharing care'. The NPM‐CI scale allows us to measure mutuality in clinical practice and research. Expected outcomes and influencing factors for patients and nurses could be associated. [ABSTRACT FROM AUTHOR]

Aims: To identify associations between perceived health and treatment adherence six years after percutaneous coronary intervention. Design: A non‐experimental descriptive long‐term follow‐up study. Methods: Baseline data (n = 416) were collected in 2013, with follow‐up data collected in 2019 (n = 154), using the EuroQoL scale, EuroQoL visual analogue scale, and Adherence of Patients with Chronic Disease Instrument. Data were analysed using descriptive statistics and multivariate methods. Results: The average age of the 154 respondents was 68.5 years (SD 7.01), with a majority males (n = 118, 86.6%). Adherence to a healthy lifestyle, good perceived results of care, support from nurses, high sense of normality, low fear of complications, motivation, older age, and duration of coronary artery disease were associated with better general perceived health as well as its dimensions (mobility, self‐care, usual activities, pain/discomfort, and anxiety/depression). Conclusion: Support from nurses is a key factor to ensuring high perceived health among post‐percutaneous coronary intervention patients. This support must be continuous and motivate the patient to adhere to a healthy lifestyle. Patients should feel comfortable sharing their problems and fears. This type of relationship will allow health care professionals to assess the patient's current situation and address potential problems about mobility, pain and discomfort, as well as anxiety and depression to strengthen the patient's sense of normality and enable them to confidently lead a normal life. Impact: The research aimed to gain knowledge about how perceived health is associated with treatment adherence six years after percutaneous coronary intervention. The results emphasise that a nurse's support of patients is crucial to the care process, as adherence to treatment showed a clear positive association with perceived health in the analysed sample of post‐PCI patients. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to develop and psychometrically test a new instrument to measure the scope of school nursing practice. Design: Methodological study. Methods: Data were collected in Spring 2018. Frontline school nurses in the United States (N = 3099) completed the 39‐item Scope of School Nursing Practice Tool (SSNPT) with two domains (current practice and importance to practice). One half of sample data (N1 = 1521) were used for exploratory factor analysis, item analysis, Cronbach's alpha, and Spearman–Brown to estimate validity and reliability of the instrument. Sample data from the other half (N2 = 1578) were retained for future analysis. Results: Factor analysis resulted in a stable four‐dimension solution: (A) Using the Nursing Process; (B) Applying Evidence to Improve Practice; (C) Connecting with Community; and (D) Leveraging the School and Family Team, accounting for 50.48% (current practice) and 53.31% (importance to practice) of total variance. Cronbach's alpha and Spearman–Brown ranged from.73 to.90 and.73 to.92, respectively. Item–total correlations ranged from.36 to.82. Conclusion: Initial psychometric properties indicate the new SSNPT is valid and reliable to assess the scope of practice of frontline school nurses. Impact: School nurses play a key role in population health and frequently serve as the sole provider of healthcare in schools worldwide. However, variability in school nursing practice affects the health, safety and educational outcomes of children and youth. No instrument exists that measures the scope of practice of school nurses. Frontline school nurses can use the SSNPT to assess practice, school nurse administrators can use the tool for resource utilization and school nurse researchers can use the tool to examine school nursing practices' impact on student/community health and academic outcomes. The SSNPT may provide a template for others who wish to examine specialty nursing scope of practice. [ABSTRACT FROM AUTHOR]

Aim: To develop and psychometrically evaluate a skin tear knowledge assessment instrument (OASES). Design: Prospective psychometric instrument validation study. Method: The skin tear knowledge assessment instrument was developed based on a literature review and expert input (N = 19). Face and content validity were assessed in a two‐round Delphi procedure by 10 international experts affiliated with the International Skin Tear Advisory Panel (ISTAP). The instrument was psychometrically tested in a convenience sample of 387 nurses in 37 countries (April–May 2020). Validity of the multiple‐choice test items (item difficulty, discriminating index, quality of the response alternatives), construct validity, and test–retest reliability (stability) were analysed and evaluated in light of international reference standards. Results: A 20‐item instrument, covering six knowledge domains most relevant to skin tears, was designed. Content validity was established (CVI = 0.90–1.00). Item difficulty varied between 0.24 and 0.94 and the quality of the response alternatives between 0.01–0.52. The discriminating index was acceptable (0.19–0.77). Participants with a theoretically expected higher knowledge level had a significantly higher total score than participants with theoretically expected lower knowledge (p <.001). The 1‐week test‐retest intraclass correlation coefficient (ICC) was 0.83 (95% CI = 0.78–0.86) for the full instrument and varied between 0.72 (95% CI = 0.64–0.79) and 0.85 (95% CI = 0.81–0.89) for the domains. Cohen's Kappa coefficients of the individual items ranged between 0.21 and 0.74. Conclusion: The skin tear knowledge assessment instrument is supported by acceptable psychometric properties and can be applied in nursing education, research, and practice to assess knowledge of healthcare professionals about skin tears. Impact: Prevention and treatment of skin tears are a challenge for healthcare professionals. The provision of adequate care is based on profound and up‐to‐date knowledge. None of the existing instruments to assess skin tear knowledge is psychometrically tested, nor up‐to‐date. OASES can be used worldwide to identify education, practice, and research needs and priorities related to skin tears in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To develop and psychometrically test the Nurse Health Education Competence Instrument for assessing nurses' knowledge, skills and personal attributes concerning competent health education practice. Design: A psychometric instrument development and validation study. Methods: A four‐step approach was used: Step 1) operational definition based on an up‐to‐date concept analysis and experts' judgement; step 2) item generation and content validation by expert panel and target population; step 3) item analysis based on acceptability, internal consistency and face validity; and step 4) psychometric evaluation based on construct validity, criterion validity, internal consistency and stability, conducted from January ‐February 2019 with 458 hospital‐care nurses. Results: The operational framework and expert groups showed good content validity, resulting in the first version. From the initial 88‐item pool, 58 items were retained after item analysis. Exploratory factor analysis revealed three scales concerning the cognitive (three‐factor solution with 23 items), psychomotor (two‐factor solution with 26 items) and affective‐attitudinal (one‐factor solution with nine items) competency domains, which respectively accounted for 58%, 53% and 54% of the variance. Known‐group study demonstrated significant differences by years working in the service and training received in health education, providing evidence for the measure's sensitivity. The three scales correlated positively with the criterion variable. Overall Cronbach alphas for the cognitive, psychomotor and affective‐attitudinal scales were 0.95, 0.95 and 0.90, respectively. Intraclass correlation coefficients were >0.70. Conclusions: The newly developed Nurse Health Education Competence Instrument is an original and tested self‐reporting psychometric tool, being the first to identify nurses' knowledge, skills and attributes necessary for planning and assessing health education practice competency. Impact: The instrument permits measurable insights into nurses' perceptions regarding their health education competence and related educational needs. This study provides a valid and specific learning tool that is appropriate to use both in clinical practice and in nursing education programmes. [ABSTRACT FROM AUTHOR]

Aim: The Self‐Care Self‐Efficacy Scale (SCSES) was newly developed as a self‐report measure for self‐care self‐efficacy for chronic illness. This study investigated its measurement equivalence (ME) in different cultural groups, including United States, China (Hong Kong), Italy, and Brazil. Design: A multi‐national study for cross‐cultural validation of the Scale. Methods: From January 2015 ‐ December 2018, investigators recruited 957 patients (United State: 200; Hong Kong: 300; Italy: 285; and Brazil: 142) with chronic illness from inpatient and outpatient settings. The SCSES was administered and clinical and demographic data were collected from participants. Based on the Meredith framework, multi‐group confirmatory factor analysis evaluated the configural, metric, scalar, and strict invariance of the scale across the four populations through a series of nested models, with evaluation of reliability and coherence of the factor solution. Results: The mean ages of the groups ranged from 65–77 years, 56.4% was male. The Cronbach's alpha coefficients of the single‐factor SCSES were 0.93, 0.89, 0.92, and 0.90 for the United States, China (Hong Kong), Italy, and Brazil, respectively. Three of the four levels of ME were partially or totally supported. The highest level achieved was partial scalar invariance level (χ2 [52] = 313.4, p < 0.001; RMSEA = 0.067; 95% CI = 0.056–0.077; CFI = 0.966; TLI = 0.960, SRMR = 0.080). Conclusion: Patients from the four countries shared the same philosophical orientation towards scale items, although some of the items contributed differently to represent the concept and participants shared the same schemata for score interpretation. Impact: Self‐efficacy is important in producing effective and sustainable self‐care behavioural changes. Cultural ideation shapes the ways individuals interpret and report their self‐care self‐efficacy. The study findings support cross‐cultural and cross‐national utility of the SCSES for research on self‐care across United States, China (Hong Kong), Italy, and Brazil. [ABSTRACT FROM AUTHOR]

Aims: To study parent's levels of uncertainty related to the transfer from pediatric to adult care in adolescents with congenital heart disease (CHD) and to identify potentially correlating factors. Background: Parents acknowledge that during transition they struggle with finding ways of feeling secure in handing over the responsibility and letting go of control. Well‐prepared and informed parents who feel secure are most likely better skilled to support their adolescent and to hand over the responsibility. Design: A cross‐sectional study. Methods: Overall, 351 parents were included (35% response rate). Parental uncertainty was assessed using a Linear Analogue Scale (0–100). Data were collected between January ‐ August 2016. Potential correlates were assessed using the readiness for transition questionnaire and sociodemographic data. Results: The mean parental uncertainty score was 42.5. Twenty‐four percent of the parents had a very low level of uncertainty (score 0–10) and 7% had a very high level (score 91–100). Overall, 26% of the mothers and 36% of the fathers indicated that they had not started thinking of the transfer yet. The level of uncertainty was negatively associated with the level of perceived overall readiness. Adolescents' age, sex, CHD complexity, and parental age were not related to uncertainty. Conclusion: A wide range in the levels of uncertainty was found. Parents who were less involved in the care, or perceived their adolescent as readier for the transition, felt less uncertain. Still, thirty percent of the parents had not started to think about the transfer to adult care. [ABSTRACT FROM AUTHOR]

Aims: To identify problematic items, assess completeness and user‐friendliness, and undertake modifications to enhance face validity of the newly developed Epilepsy Monitoring Unit Comfort Questionnaire. Design: Qualitative‐descriptive cross‐sectional study. Methods: Five iterative rounds of cognitive interviewing were conducted with members of the target population between July ‐ November 2017. Think‐aloud technique, verbal probing, and observation were used, to assess how respondents understood and answered questions. Data analysis was based on the framework method; an eight‐column framework matrix was created for this purpose. Results: In 25 interviews, problems regarding completeness of the item pool, comprehension of items, retrieval of information, judgment while finding answers and reporting the appropriate responses could be detected. According to the results, 27 items remained unchanged, 11 items were reworded, and six items were added. Instructions section of the questionnaire was reworked, too. Conclusion: Although time‐consuming, cognitive interviewing turned out to be a valuable approach for revealing problems in an instrument, which would, otherwise, remain undetected and threaten validity. [ABSTRACT FROM AUTHOR]

Aim: Develop and test the validity and reliability of MISSCARE Survey‐Ped adapted from previous versions of the MISSCARE Survey, which measures omitted nursing activities and the reasons why they were left undone. Our secondary aim was to pre‐test the construct validity using Exploratory Factor Analysis (EFA). Background: Missed Nursing Care is described as "every care activity necessary for the patient that is not provided or is seriously delayed". Missed Care is correlated with negative patient outcomes, such as mortality and adverse events. Design: A mixed‐mode cross‐sectional survey. Methods: Participants included registered pediatric nurses and nurses working in pediatric wards. This study was conducted between June and September 2017 and consisted of four phases: (a) analysis of existing surveys and item construction; (b) content and face validity; (c) reliability analysis (acceptability for ease of use, Cronbach's alpha for internal consistency and test–retest to measure stability); and (d) construct validity (EFA). Results: The MISSCARE Survey‐Ped consists of two sections: Section A "Missed Nursing Care Activities" (29 items) and Section B "Reasons for Missed Nursing Care Activities" (17 items). The new survey showed good validity properties and effectively identified Missed Nursing Care activities in pediatric settings. Conclusion: The development and validation of the MISSCARE Survey‐Ped made it possible to conduct an objective and standardized study of missed nursing care activities in the field of pediatrics. This new survey offers the opportunity to collect data that enable to design and implement interventions that improve the quality and safety of pediatric nursing. [ABSTRACT FROM AUTHOR]

Abstract: Aims: The aim of this study was to develop and psychometrically evaluate a three‐dimensional questionnaire suitable for evaluating personal and organizational accountability in nurses. Background: Accountability is defined as a three‐dimensional value, directing professionals to take responsibility for their decisions and actions, to be willing to explain them (transparency), and to be judged according to society's accepted values (answerability). Despite the relatively clear definition, measurement of accountability lags well behind. Existing self‐report questionnaires do not fully capture the complexity of the concept nor do they capture the different sources of accountability (e.g., personal accountability, organizational accountability). Design: A three‐stage measure development. Methods: Data were collected during 2015–2016. In Phase 1, an initial database of items (N = 74) was developed, based on literature review and qualitative study, establishing face and content validity. In Phase 2, the face, content, construct, and criterion‐related validity of the initial questionnaires (19 items for personal and organizational accountability questionnaire) were established with a sample of 229 nurses. In Phase 3, the final questionnaires (19 items each) were validated with a new sample of 329 nurses and established construct validity. Results: The final version of the instruments comprised 19 items, suitable for assessing personal and organizational accountability. The questionnaire referred to the dimensions of responsibility, transparency, and answerability. The findings established the instrument's content, construct, and criterion‐related validity as well as good internal reliability. Conclusion: The questionnaire portrays accountability in nursing, by capturing nurses’ subjective perceptions of accountability dimensions (responsibility, transparency, answerability), as demonstrated by personal and organizational values. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to develop an assessment tool to measure the critical thinking ability of nurses. Background As an increasing number of complex patients are admitted to hospitals, the importance of nurses recognizing changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered Nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice. Currently, there is no published tool to assess critical thinking skills which is context specific to Australian nurses. Design A modified Delphi study will be used for the project. Methods This study will develop a series of unfolding case scenarios using national health data with multiple-choice questions to assess critical thinking. Face validity of the scenarios will be determined by an expert reference group of clinical and academic nurses. A Delphi study will determine the answers to scenario questions. Panel members will be expert clinicians and educators from two states in Australia. Rasch analysis of the questionnaire will assess validity and reliability of the tool. Funding for the study and Research Ethics Committee approval were obtained in March and November 2016, respectively. Discussion Patient outcomes and safety are directly linked to nurses' critical thinking skills. This study will develop an assessment tool to provide a standardized method of measuring nurses' critical thinking skills across Australia. This will provide healthcare providers with greater confidence in the critical thinking level of graduate Registered Nurses. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to develop and test the psychometric properties of the new Cultural and Linguistic Diversity scale, which is designed to be used with the newly validated Clinical Learning Environment, Supervision and Nurse Teacher scale for assessing international nursing students' clinical learning environments. Background In various developed countries, clinical placements are known to present challenges in the professional development of international nursing students. Design A cross-sectional survey. Methods Data were collected from eight Finnish universities of applied sciences offering nursing degree courses taught in English during 2015-2016. All the relevant students ( N = 664) were invited and 50% chose to participate. Of the total data submitted by the participants, 28% were used for scale validation. The construct validity of the two scales was tested by exploratory factor analysis, while their validity with respect to convergence and discriminability was assessed using Spearman's correlation. Results Construct validation of the Clinical Learning Environment, Supervision and Nurse Teacher scale yielded an eight-factor model with 34 items, while validation of the Cultural and Linguistic Diversity scale yielded a five-factor model with 21 items. Conclusion A new scale was developed to improve evidence-based mentorship of international nursing students in clinical learning environments. The instrument will be useful to educators seeking to identify factors that affect the learning of international students. [ABSTRACT FROM AUTHOR]

Aims To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery. Background The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan. Design Two-phase mixed methods sequential explanatory design and grounded theory. Setting: critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20). Methods Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis. Results Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance. Conclusion There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making. [ABSTRACT FROM AUTHOR]

Aims. The aim of this study was to determine nurses' readiness for evidence-based practice at Finnish university hospitals. Background. Although systematic implementation of evidence-based practice is essential to effectively improving patient outcomes and value of care, nurses do not consistently use evidence in practice. Uptake is hampered by lack of nurses' individual and organizational readiness for evidence-based practice. Although nurses' evidence-based practice competencies have been widely studied in countries leading the evidence-based practice movement, less is known about nurses' readiness for evidence-based practice in the non-English-speaking world. Design. A cross-sectional descriptive survey design. Methods. The study was conducted in November-December 2014 in every university hospital in Finland with a convenience sample (n = 943) of practicing nurses. The electronic survey data were collected using the Stevens' Evidence-Based Practice Readiness Inventory, which was translated into Finnish according to standardized guidelines for translation of research instruments. The data were analysed using descriptive and inferential statistics. Results. Nurses reported low to moderate levels of self-efficacy and low levels of evidence-based practice knowledge. A statistically significant, direct correlation was found between nurses' self-efficacy in employing evidence-based practice and their actual evidence-based practice knowledge level. Several statistically significant differences were found between nurses' socio-demographic variables and nurses' self-efficacy in employing evidence-based practice, and actual and perceived evidence-based practice knowledge. Conclusions. Finnish nurses at university hospitals are not ready for evidence-based practice. Although nurses are familiar with the concept of evidence-based practice, they lack the evidence-based practice knowledge and self-efficacy in employing evidence-based practice required for integrating best evidence into clinical care delivery. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the Protective Reasons against Suicide Inventory among older Chinese-speaking outpatients. Background Tools currently exist to test reasons for living among individuals of all ages in western countries, but few are available to assess older adults' protective reasons against suicide in Asia. Design A cross-sectional survey to investigate protective reasons against suicide among older Chinese-speaking outpatients. Methods The Protective Reasons against Suicide Inventory was developed based on individual interviews with 83 older outpatients in Taiwan, the literature and the authors' clinical experiences. The resulting Inventory was examined in 2013 for content validity, face validity, construct validity, criterion-related validity, internal consistency reliability and test-retest reliability. Results The Inventory had excellent content validity and face validity. Factor analysis yielded a seven-factor solution, accounting for 87·7% of the variance. Scores on the global Inventory and its subscales tended to be higher in outpatients diagnosed without suicidal ideation than in outpatients diagnosed with suicidal ideation, indicating good criterion validity. Inventory reliability and the intraclass correlation coefficient were satisfactory. Conclusions The Protective Reasons against Suicide Inventory can be completed in 5 minutes and is perceived as easy to complete. Moreover, the Inventory yielded highly acceptable parameters for validity and reliability. The Protective Reasons against Suicide Inventory can be used to assess older Chinese-speaking outpatients for factors that protect them from attempting suicide. [ABSTRACT FROM AUTHOR]