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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]

Aims. This paper is a report of a study of perceived levels of mental, physical and total fatigue, and also acute and chronic fatigue states, among registered nurses. Relationships between dimensions of fatigue and performance were investigated, as were differences in fatigue across levels of several demographic and work environment variables. Background. Fatigue is a factor that has been linked to performance decrements in healthcare workers. As a result of the nature of their work, nurses may be particularly susceptible to multiple dimensions of fatigue, and their performance is closely linked to patient safety. Methods. An online survey was used to measure mental, physical, and total fatigue dimensions, acute and chronic fatigue states, and performance. Participants were recruited via convenience sampling in cooperation with professional nursing organizations; 745 registered nurses completed the survey between February 2008 and April 2009. Results. Reported mental fatigue levels were higher than physical fatigue levels, and acute fatigue levels were higher than chronic fatigue levels. All fatigue dimensions and states were negatively correlated with perceived performance. Longer shift lengths and hours worked per week were associated with increases in physical and total fatigue levels. Mental, physical and total fatigue levels also differed with shift schedule. Conclusions. Fatigue levels were negatively correlated with performance, further supporting the role of fatigue in nurse performance. Work environment variables were strongly associated with differences in perceived levels of fatigue. By altering the work environment, it may thus be possible to reduce fatigue levels and the rates of medical errors. [ABSTRACT FROM AUTHOR]

Aim: We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample. Design: A cross‐sectional study using anonymous online surveys. Methods: This study was conducted with 225 American survivors of gender‐based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL‐5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help‐seeking (shame, frozen and problem management subscales: BHS‐TR Internal) and the GBV healing (GBV‐Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses. Results: The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help‐seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help‐seeking barriers; the relationship between internal help‐seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help‐seeking barriers and SOC. Conclusions: This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups. Impact: This study can help us focus on psychological interventions that enhance meaning and mitigate internal help‐seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities. [ABSTRACT FROM AUTHOR]

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Aims: The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. Background: Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes. Design: A descriptive correlational design with stratified random sampling. Method: The sample included 96 nurses from the major geographic regions of the United States. Over 9 months in 2016-2017, data were collected using a webbased survey. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function. Results: Overall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses' work function. However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function. Conclusion: Nurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care. Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress. [ABSTRACT FROM AUTHOR]

Aim To examine the relative effects of interpersonal conflict and workload on job outcomes (turnover intentions, burnout, injuries) and examine if resilience moderates the indirect effects of conflict and workload on job outcomes via job-related negative effect. Background There is interest in understanding resilience in the nursing profession. Placing resilience in the context of the Emotion-Centred Model of Occupational Stress (Spector, ) is a novel approach to understanding how resilience ameliorates the negative effects of workplace stressors. Design This study used a two-wave survey design to collect data from 97 nurses across medical units. Methods Nurses working in the US were recruited in June 2014 using Qualtrics Panels, an online survey platform service that secures participants for research. Nurses were contacted via email at two time points, two weeks apart and provided a link to an online survey. SPSS v. 23 and PROCESS v2.15 were used to analyse regressions and moderated mediation. Results/Findings Interpersonal conflict predicted turnover intentions and burnout; workload predicted injuries. Job-related negative affect mediated the relationships between stressors and job outcomes except for the direct effect of workload on injuries. Low resilience increased the magnitude of the indirect effects of conflict on job outcomes. Conclusion Job characteristics like workload predicted unique variability in self-reported physical injuries. Conflict at work, a social stressor, predicted well-being and job attitudes. Highly resilient nurses bounced back after experiencing conflict in the workplace. Resilience should be explored for its potential as a method to reduce the negative effects of social stressors. [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]

Aim To analyse critically the barriers and facilitators to new graduate nurse engagement in interprofessional collaboration. Background The acculturation of new graduate nurses must be considered in strategies that address the global nursing shortage. Interprofessional collaboration may support the transition and retention of new graduate nurses. Design Whittemore and Knafl's revised framework for integrative reviews guided the analysis. Data sources A comprehensive multi-step search (published 2000-2012) of the North American interprofessional collaboration and new graduate literature indexed in the CINAHL, Proquest, Pubmed, PsychINFO and Cochrane databases was performed. A sample of 26 research and non-research reports met the inclusion criteria. Review methods All 26 articles were included in the review. A systematic and iterative approach was used to extract and reduce the data to draw conclusions. Results The analysis revealed several barriers and facilitators to new graduate engagement in interprofessional collaboration. These factors exist at the individual, team and organizational levels and are largely consistent with conceptual and empirical analyses of interprofessional collaboration conducted in other populations. However, knowledge and critical thinking emerged as factors not identified in previous analyses. Conclusion Despite a weak-to-moderate literature sample, this review suggests implications for team and organizational development, education and research that may support new graduate nurse engagement in IPC. [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]

Aim To report the psychometric testing of the Household Risk Perception and Self-Efficacy in Environmental Risk Reduction instruments using principal components analysis. Background There are limited instruments available to test household risk perception and self-efficacy related to environmental health behaviours. The Household Risk Perception instrument was developed to measure personal perceptions of household environmental health risks. The Self-Efficacy in Environmental Risk Reduction instrument was designed to measure caregivers' confidence in taking steps to reduce household risks. Design An exploratory analysis of previous data was undertaken. Method Baseline data from 235 caregivers enrolled in a randomized clinical trial testing a healthy housing intervention were collected between 2006-2009. Principal components analysis was used to determine principal components from measured responses to each instrument. Results Components were explored and compared to constructs used to design the original instruments. A five-component structure showed the simplest solution and explained 65% of variance in the Household Risk Perception analysis. Cronbach's alpha values indicated satisfactory internal consistency for four of five identified components. Risk perception varied according to available sensory input of the specific risk. A four-component structure explained 64% of the variance in the Self-Efficacy in Environmental Risk Reduction analysis. Cronbach's alpha values were satisfactory. Items mapped to steps in an action-oriented process vs. agent-specific actions. Results from both analyses suggest that environmental tobacco smoke is perceived differently than other household risks. Conclusion Previously, both instruments relied on item reliability and content validity testing. This study provides a basis for further instrument revision and theoretical testing. [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]

gutierrez a.p., candela l.l. & carver l. (2012) The structural relationships between organizational commitment, global job satisfaction, developmental experiences, work values, organizational support, and person-organization fit among nursing faculty. Journal of Advanced Nursing 68(7), 1601-1614. Abstract Aim. The aim of this correlational study was to examine the relations between organizational commitment, perceived organizational support, work values, person-organization fit, developmental experiences, and global job satisfaction among nursing faculty. Background. The global nursing shortage is well documented. At least 57 countries have reported critical shortages. The lack of faculty is finally being recognized as a major issue directly influencing the ability to admit and graduate adequate numbers of nurses. As efforts increase to both recruit and retain faculty, the concept of organizational commitment and what it means to them is important to consider. Design. A cross-sectional correlational design was used. Methods. The present study investigated the underlying structure of various organizational factors using structural equation modelling. Data were collected from a stratified random sample of nurse faculty during the academic year 2006-2007. Results. The final model demonstrated that perceived organizational support, developmental experiences, person-organization fit, and global job satisfaction positively predicted nurse faculty's organizational commitment to the academic organization. Cross-validation results indicated that the final full SEM is valid and reliable. Conclusions. Nursing faculty administrators able to use mentoring skills are well equipped to build positive relationships with nursing faculty, which in turn, can lead to increased organizational commitment, productivity, job satisfaction, and perceived organizational support, among others. [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]