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Aims: To explore the relationship between nurse practitioner work environment and nurse practitioner outcomes (job satisfaction and intent to leave) in the United States. Design The study used a cross‐sectional survey design to collect survey data from primary care nurse practitioners in six states in the United States. Methods: We sent mail surveys to 5689 eligible nurse practitioners in Arizona, New Jersey, Washington, Pennsylvania, California and Texas. The mail also contained an online link. Participants could complete either the paper or online questionnaire. In total, 1244 participants completed the survey in 2018–2019. The work environment was measured using the Nurse Practitioner‐Primary Care Organizational Climate Questionnaire comprised of four subscales: Nurse Practitioner‐Administration Relations, Nurse Practitioner‐Physician Relations, Independent Practice and Support and Professional Visibility. Global items measured job satisfaction and intent to leave. We used mixed‐effect proportional‐odds cumulative logit models to assess the association between work environment and job satisfaction and intent to leave. Results: Overall, 90% of participants were either very satisfied or somewhat satisfied with their job and 22% reported intent to leave their job in 1 year. With a one‐unit increase in the organizational‐level Nurse Practitioner‐Administration Relations score, the odds of having a higher job satisfaction level increased by about four times and the odds of intent to leave job decreased by about 60%. A higher organizational‐level Nurse Practitioner‐Physician Relations score was significantly associated with higher job satisfaction and lower odds of intent to leave. Conclusion: Improvements in work environments may improve nurse practitioner job satisfaction and retention. Impact This study examined the relationship between work environment, job satisfaction and turnover intention of nurse practitioners. Better work environment is associated with higher job satisfaction and lower turnover intention. Findings have implications for clinical leadership who can take actions to create better work environments to increase the nurse practitioner workforce capacity. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

suhonen r., papastavrou e., efstathiou g., lemonidou c., kalafati m., da luz m.d.a., idvall e., berg a., acaroglu r., sendir m., kanan n., sousa v.d., katajisto j., välimäki m. & leino-kilpi h. (2011) Nurses' perceptions of individualized care: an international comparison. Journal of Advanced Nursing 67(9), 1895-1907. Abstract Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses ( n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to achieve profession-wide consensus on an Australian nurse practitioner specialty framework. Background Since its introduction in 1998, the Australian nurse practitioner profession has grown to over 1300 endorsed practitioners, representing over 50 different specialties. To complement better a generalist learning and teaching framework with specialist clinical education, prior research proposed a broad framework of Australian nurse practitioner specialty areas termed metaspecialties. Design This study employed an online three-round modified Delphi method. Method Recruitment using purposive sampling and snowballing techniques identified an eligible sample from a population of nurse practitioners with at least 12 months' postendorsement experience ( n = 966). Data were collected using online survey software from September 2014-January 2015 and analysed using descriptive statistics and content analysis. The Content Validity Index and McNemar's Test for Change were used to determine consensus on the nurse practitioner metaspecialties. Results One-fifth of the total eligible population completed the study. Participants achieved high consensus on four metaspecialties, including: Emergency and acute care, primary health care, child and family health care and mental health care. Two metaspecialties did not achieve consensus and require further investigation. Conclusion A large sample of nurse practitioners achieved consensus on an Australian metaspecialty framework, increasing the likelihood of widespread acceptance across the profession. This technique may be appropriate for use in jurisdictions with smaller populations of nurse practitioners. Ongoing research is needed to re-evaluate the metaspecialties as the profession grows. [ABSTRACT FROM AUTHOR]

Aims We examined the impact of workplace relationships (perceived organizational support, supervisor-nurse relationships and teamwork) on the engagement, well-being, organizational commitment and turnover intentions of nurses working in Australian and USA hospitals. Background In a global context of nurse shortages, knowledge about factors impacting nurse retention is urgently sought. We postulated, using the Social Exchange Theory, that nurses' turnover intentions would be affected by several factors and especially their relationships at work. Design Based on the literature review, data were collected via a self-report survey to test the hypotheses. Methods A self-report survey was used to gather data in 2010-2012 from 510 randomly chosen nurses from Australian hospitals and 718 nurses from US hospitals. A multi-group structural equation modelling analysis identified significant paths and compared the impact between countries. Results The findings indicate that this model was more effective in predicting the correlations between variables for nurses in Australia compared with the USA. Most paths predicted were confirmed for Australia, except for the impact of teamwork on organizational commitment and turnover, plus the impact of engagement on turnover. In contrast, none of the paths related to supervisor-subordinate relationships was significant for the USA; neither were the paths from teamwork to organizational commitment or turnover. Conclusion Our findings suggest that well-being is a predictor of turnover intentions, meaning that healthcare managers need to consider nurses' well-being in everyday decision-making, especially in the cost-cutting paradigm that pervades healthcare provision in nearly every country. This is important because nurses are in short supply and this situation will continue to worsen, because many countries have an ageing population. [ABSTRACT FROM AUTHOR]

rutledge d.n., martinez a., traska t.k. & rose d.j. (2012) Fall experiences of persons with fibromyalgia over 6 months. Journal of Advanced Nursing 69(2), 435-448. doi: 10.1111/j.1365-2648.2012.06026.x Abstract Aims. To describe circumstances and consequences of falls occurring among persons with fibromyalgia who had recent falls. Background. Fibromyalgia is a common widespread pain condition that has been linked to increased fall-risk. No published research described experiences of falling in persons with fibromyalgia. Prior to development of fall-risk reduction interventions, it is essential to understand the context of falls and fall experiences in persons with fibromyalgia. Design. Descriptive longitudinal study. Methods. The study took place during 2009; data were collected via fall diaries and interviews in 18 US women ages 21-69 years. Results. Over 6 months, 17 of 18 participants fell or had a near-fall. For the 15 women with 6-month fall-prevalence data, median number of falls was 2, with 3 near-falls. Most fall experiences contained intrinsic and extrinsic contributory factors. Participants reported engaging in various activities prior to falls/near-falls. A substantial minority (32-48%) experienced severe symptoms (pain, fatigue, stiffness) at the time. Most falls/near-falls occurred in homes during the day; one resulted in injury. Themes that were identified included the following: always being careful or generally cautious; fear of losing control of one's body, especially related to balance; desire to continue activities counterbalanced with frustration at not being able to because of fear of falling; perception of having become clumsy. Conclusions. Nurses caring for persons with fibromyalgia should assess for potential fall-risk factors and offer plans for individualized fall-prevention strategies. [ABSTRACT FROM AUTHOR]

williams j.k., skirton h., barnette j.j. & paulsen j.s. (2012) Family carer personal concerns in Huntington disease. Journal of Advanced Nursing 68(1), 137-146. Abstract Aim. To examine and compare the personal concerns of family members providing care for people with Huntington disease in the United Kingdom and the United States. Background. Family carers of people with Huntington disease may feel burdened by caregiving responsibilities and concerned about illness risk for relatives. Method. A mailed personal concerns survey was completed by 108 United Kingdom and 119 United States adult family carers of people with Huntington disease in 2006 and 2007. Survey responses included frequency and intensity of concerns, and narrative comments. Data were analysed using descriptive statistics of the products of frequency and intensity of reaction scores to identify a personal concerns index for items with the twelve highest combined scores. Factor analysis identified three factors, which were compared between respondents by factor and items within factors using t tests mean frequency by intensity scores. Narrative comments were thematically analysed. Results. Three main factors were labelled impact of role change, sense of isolation and concerns for children. Within the role change factor, United States family caregivers had significantly higher concerns about family finances and United Kingdom carers expressed significantly greater personal sadness. Both groups expressed concern about isolation from family. Although family carers in both countries expressed concern about their children, those of United States caregivers were significantly higher. Conclusion. Further studies are required to identify benefits of support services that are specific to carer concerns and consistent with national healthcare systems. [ABSTRACT FROM AUTHOR]