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Aim To compare home care nursing services use by community-dwelling older people from urban and rural environments in Poland. Background In the current literature, there is a lack of data based on multidimensional geriatric assessment concerning the provision of care delivered by nurses for older people from urban and rural environments. Design Cross-sectional random survey. Method Between 2006-2010, a random sample of 935 older people (over 65 years of age) from an urban environment and 812 from a neighbouring rural environment were interviewed in a cross-sectional survey. Findings The rural dwellers (82·8%) nominated their family members as care providers more often than the city inhabitants (51·2%). Home nursing care was provided to 4·1% of people in the city and 6·5% in the county. Poststroke condition, poor nutritional status, and low physical activity level, as well as low scores for activities of daily living, instrumental activities of daily living, and Mini-Mental State Examination values, were all determinants of nursing care, both in urban and rural areas. In the urban environment, additional predictors of nursing care use were age, presence of ischaemic heart disease, diabetes and respiratory disorders, number of medications taken, and a high depression score. Conclusions Poor functional status is the most important determinant of nursing care use in both environments. In the urban environment, a considerable proportion of community-dwelling elders live alone. In the rural environment, older people usually have someone available for potential care services. The main problem seems to be seeking nursing care only in advanced deterioration of functional status. [ABSTRACT FROM AUTHOR]

Aim To test the psychometric properties and evaluate the German version of the Nurse Competence Scale. Background Nursing competence is an important factor for high-quality healthcare. However, there are only few instruments available, which try to assess nurse competence and there is limited knowledge about the psychometric quality of any of these instruments. Design A cross-sectional survey of 679 nurses was used. Method Analysis of the psychometric properties of the 73-item Nurse Competence Scale was undertaken using confirmatory factor analyses and Rasch modelling with data generated in a study in 2007. Results The 7-factor model of the Nurse Competence Scale could not be confirmed. However, six scales consisting of 54 items demonstrated adequate fit to the Rasch model. The six subscales could also be combined into an overall competence scale. Conclusions There are concerns about the psychometric properties of the Nurse Competence Scale. The reduced set of items removes redundancy among items, is free from item bias and constitutes six unidimensional scales. [ABSTRACT FROM AUTHOR]

Aim This article is to report the development and psychometric testing of the Hospital Aggressive Behaviour Scale - Users. Background Workplace violence is present in many work spheres, but in the healthcare sector, nurses in particular are at more risk due to the close contact they maintain with users and clients and the special characteristics of this relationship. Design Using qualitative and quantitative methodology, an instrument was applied to a sample of 1,489 nurses from 11 public hospitals. Data collection was carried out in 2010 and 2011. Results Exploratory factor analysis yielded a 10-item instrument distributed in two factors (non-physical violence and physical violence), which was validated by means of confirmatory factor analysis. Both the resulting questionnaire and the factors identified present high internal consistency and adequate external validity, analysed by means of statistically significant correlations between the Hospital Aggressive Behaviour Scale and job satisfaction, burnout components, and psychological well-being. Conclusions The results indicate that, in nursing personnel, higher exposure to user violence leads to lower job satisfaction, more emotional exhaustion and more cynicism, and to a lower level of psychological well-being. The instrument developed in this study may be very useful in the sphere of assessment and prevention of psychosocial risks for the early detection of the problem of user violence in its two facets. [ABSTRACT FROM AUTHOR]

Aim The purpose was to examine the effects of non-commercial music on quality of sleep and relaxation indices, including heart rate, mean arterial pressure, and respiratory rate in patients in intensive care units. Background There is currently insufficient scientific knowledge for the effects of music on quality of sleep in critically ill patients. Design A randomized controlled trial. Methods Between January-December 2010, 28 patients aged 39-78 years were randomly assigned to music and control groups. Participants in the music groups listened to non-commercial music for 45 minutes at nocturnal sleep time. In the control group, participants slept with no music. Participants were assessed using vital signs monitors, standardized questionnaire, and polysomnography. Polysomnography sleep was recorded for the first 2 hours of the nocturnal sleep. General estimating equation was applied to analyse data. Findings Participants in the music group had shorter stage N2 sleep and longer stage N3 sleep in the first 2 hours of the nocturnal sleep and improved self-reported sleep quality, compared with those in the control group. The music group patients also had significantly lower heart rates than those in the control group. The intensive care units patients experienced fragmented sleep with a high frequency of awakenings and severe reduction in random eye movement sleep during the first 2 hours of the nocturnal sleep. Conclusion The findings provided evidence for nurses to use soothing music as a research-based nursing intervention for intensive care unit patients' sleep improvement. [ABSTRACT FROM AUTHOR]

Aim To report a study conducted to describe the determinants of Turkish school-aged children's dietary habits and body mass index. Background Over the past two decades, children's unhealthy dietary habits and obesity have increased rapidly. Nurses have an essential role in minimizing health-risk behaviours and promoting healthy lifestyles. Using the Interaction Model of Client Health Behavior to measure children's dietary habits and body mass index values helps to prepare health-promotion interventions. Design A descriptive, correlational study. Method The study was conducted, based on a sample of 420 fifth-grade students and their parents in one city in Turkey. The data were collected during 2007 using a questionnaire designed to assess the dietary habits and anthropometric indices. Data were analysed using quantitative analysis to identify key variables. Findings The girls scored healthier on dietary habits than did the boys. Although dietary self-efficacy was statistically significant as an explanatory variable of dietary habits for both genders, the dietary attitude was the only explanatory variable of dietary habits for the girls. No difference was detected in the prevalence of overweight between boys and girls. Conclusion Nurses are well-situated to give children dietary self-efficacy improvement, dietary attitude enhancement, and family-centred and school-based intervention programmes to reduce their unhealthy dietary habits. The model guides researchers to identify the background characteristics of children that result in the body mass index. [ABSTRACT FROM AUTHOR]

Aim To provide an overview, summary of key features and evaluation of usefulness of six evidence-based practice models frequently discussed in the literature. Background The variety of evidence-based practice models and frameworks, complex terminology and organizational culture challenges nurses in selecting the model that best fits their practice setting. Data sources The authors: (1) initially identified models described in a predominant nursing text; (2) searched the literature through CINAHL from 1998 to current year, using combinations of 'evidence', 'evidence-based practice', 'models', 'nursing' and 'research'; (3) refined the list of selected models based on the initial literature review; and (4) conducted a second search of the literature on the selected models for all available years to locate both historical and recent articles on their use in nursing practice. Discussion Authors described model key features and provided an evaluation of model usefulness based on specific criteria, which focused on facilitating the evidence-based practice process and guiding practice change. Implications for nursing The evaluation of model usefulness can be used to determine the best fit of the models to the practice setting. Conclusion The Johns Hopkins Model and the Academic Center for Evidence-Based Practice Star Model emphasize the processes of finding and evaluating evidence that is likely to appeal to nursing educators. Organizations may prefer the Promoting Action on Research Implementation in Health Services Framework, Advancing Research and Clinical Practice Through Close Collaboration, or Iowa models for their emphasis on team decision-making. An evidence-based practice model that is clear to the clinician and fits the organization will guide a systematic approach to evidence review and practice change. [ABSTRACT FROM AUTHOR]

Aim To report the moderating effects of work-related conditions and interactive family-care-giving variables, including mutuality and preparedness, on caregiver role strain and mental health for family caregivers of patients with dementia. Background Few studies have examined the interrelationships among caregivers' working conditions, care-giving dynamics and caregiver well-being. Design Cross-sectional, correlational study. Methods Data were collected by self-completed questionnaires from 176 primary family caregivers of patients with dementia in Taiwan from May 2005-January 2006. Caregiver role strain and mental health were analysed by multiple regressions using a hierarchical method to enter independent variables and two- and three-way interaction terms after controlling for caregiver age and gender, employment status, and work flexibility and the simple effect of each independent variable. Results More preparedness was associated with less role strain for family caregivers with less work/care-giving conflict. More care-giving demand was associated with poorer mental health only for caregivers with low work/care-giving conflict and with average and low preparedness, but not high preparedness. For family caregivers with less work/care-giving conflict, more preparedness decreased role strain and maintained mental health even when care-giving demand was high. Conclusion These results provide a knowledge base for understanding complex family caregiver phenomena and serve as a guide for developing interventions. Future studies with longitudinal follow-ups are suggested to explore actual causal relationships. [ABSTRACT FROM AUTHOR]

Aim The study was planned to determine the hope levels of people with cancer and the variables affecting hope. Background Hope is essential for patient well-being and positively correlated with improved coping skill. Design A descriptive and exploratory design. Methods The study sample included 240 consecutive patients treated with chemotherapy and attending the Day Chemotherapy Unit of a University Hospital in Turkey. The study was conducted between December 2009-January 2010. Personal Information Form and Herth Hope Scale were used for data collection. The determinants and subscales of hope were evaluated with univariate and multivariate regression analyses. Results These mean scores showed high levels of hope among the patients included in the study. It was found that net family income, knowledge level about the disease, feeling of improvement, perception of satisfactory family support by the patient, mouth ulcers, feeling anxious or worried and presence of fear were independently related with the total hope score. Conclusions The study results showed high levels of hope among the participating patients. It is concluded that physical, financial and psychological well-being and information and support needs are directly and independently related with hope in people with cancer. These findings support the need for clinicians to continue to practise and implement hope fostering/hindering interventions among their patients. [ABSTRACT FROM AUTHOR]

Aims To report a descriptive study of fertility-awareness knowledge, attitudes, and practice of infertile women seeking fertility assistance. Background Previous research has suggested that poor fertility-awareness may be a contributing cause of infertility among women seeking fertility assistance at assisted reproductive technology clinics. The actual practices and attitudes towards fertility-awareness in this particular group of women are unknown. Design A cross-sectional questionnaire-based survey. Methods The study was conducted over 6 months, from 2007-2008, of women on admission to two assisted reproductive technology clinics in a major city in Australia. Results Two hundred and four of 282 distributed questionnaires were completed (response rate = 72·3%). Eighty-three per cent had attempted conception for 1 year or more, 86·8% actively tried to improve their fertility-awareness from one or more sources of the information, 68·2% believed they had timed intercourse mainly within the fertile window of the menstrual cycle in their attempts at conception, but only 12·7% could accurately identify this window. Ninety-four per cent believe that a woman should receive fertility-awareness education when she first reports trouble conceiving to her doctor. Conclusions Most women seeking assistance at assisted reproductive technology clinics attempt timed intercourse within the fertile window of the menstrual cycle. However, few accurately identify this window, suggesting that poor fertility-awareness may be a contributing cause of infertility. [ABSTRACT FROM AUTHOR]

Aim This article reports an empirical study of self-transcendence in cognitively intact nursing-home patients. The aim was to investigate the interrelationships between self-transcendence and nursing-home patients' physical, social, emotional and functional well-being. Background Finding new and alternative approaches to increase well-being among nursing-home patients is highly warranted. Self-transcendence is considered a developmental process of maturity in adulthood and a vital resource for well-being at the end of life, thus self-transcendence could be a useful approach. Design Cross-sectional Method The self-transcendence scale and the Functional Assessment of Cancer Therapy General (FACT-G) Quality of Life questionnaire were used. A sample of 202 cognitively intact nursing-home patients in Mid-Norway was selected to respond to the instruments in 2008 and 2009. Analysis was applied by means of LISREL 8·8 Structural Equation Modelling. Results A two-factor construct of self-transcendence showed that intrapersonal self-transcendence directly affected functional well-being and indirectly influenced physical, emotional and functional well-being. Interpersonal self-transcendence directly affected social and emotional well-being. Additionally important influences were disclosed from functional to emotional and from emotional to physical well-being. Conclusion Finding nursing interventions to enhance both intrapersonal and interpersonal self-transcendence might benefit nursing-home patients' overall well-being. In a holistic perspective of body-mind-spirit, this research generates new-research questions about the pathways between the different dimensions of well-being in nursing-home patients, which is important to holistic nursing practice. [ABSTRACT FROM AUTHOR]

Aim To identify individual, situational and lifestyle variables related to shift work tolerance among nurses who have worked night shifts for less than 1 year and nurses who have worked night shift for more than 6 years, all engaged in rotating shift work. Background Working shifts is related to negative health consequences. Factors related to shift work tolerance may differ between nurses with little experience and nurses with extensive experience in night work. Design Cross-sectional questionnaire study. Methods A questionnaire including established instruments measuring shift work tolerance, personality, work schedule and lifestyle factors was administered between November 2008-May 2010. Randomly selected Norwegian nurses ( n = 749) participated in the study; 322 were new and 427 were experienced in night work. Results There were no statistically significant differences in shift work tolerance between the new to night work nurses and the nurses who were experienced in night work. Young age was related to higher shift work tolerance. Hardiness was positively related to shift work tolerance in both groups. For the new to night work nurses, morningness was positively related to shift work tolerance. For the experienced in night work nurses, languidity, work hours per week and caffeine consumption were negatively, but flexibility was positively, related to shift work tolerance. Conclusion Several variables were related to shift work tolerance among rotating shift working nurses, especially hardiness. Somewhat different variables were related to shift work tolerance for nurses who were new to night work than for nurses with more experience in night work. [ABSTRACT FROM AUTHOR]

Aim This article is a report of the effects of Roy's adaptation model-based patient education on physical and psychosocial adaptation of patients with chronic obstructive pulmonary disease. Background Patients with chronic obstructive pulmonary disease abound in Turkey, as they do worldwide. Patient education could help in the adaptation of patients with chronic obstructive pulmonary disease to the disease, as it has with other long-term diseases. Design The study adapted a quasi-experimental design, with a comparison between an intervention group and a control group. Methods Sixty-five patients with obstructive pulmonary disease participated in this study. The data were collected between December 2008-January 2010. The data collection tool comprised an adaptation of a Roy's adaptation model-based evaluation form and perceived social support from family and friends scale. The intervention group received oral and written education based on Roy's adaptation model, while the control group received a routine follow-up. Data were analysed with paired t-test and analysis of covariance ( ancova). Findings The results indicate that education given according to Roy's adaptation model increases adaptation to disease in three modes (physiologic, self-concept and role-function mode). In addition, taking into account interdependence mode as Roy's adaptation model's fourth mode, a statistically significant increase was observed in social support from friends but not from family. Conclusion The more intervention for improving interpersonal support - especially perceived as coming from family - the more using Roy's adaptation model to educate patients with chronic obstructive pulmonary disease could benefit them to increase adaptation to the disease. [ABSTRACT FROM AUTHOR]

Aims The current study investigated the perceived importance and the perceived met needs of family members in the medical intensive care unit and assessed family members' satisfaction with needs met. Background Studies conducted throughout the world over the past 30 years indicate that family needs are still neglected. Unmet needs of family members of patients in the intensive care unit lead to dissatisfaction with care. Design A cross-sectional study. Method A total of 70 family members of critically ill patients were included in this study conducted in a medical intensive care unit in Israel between October 2007-September 2008, using a structured interview. Three outcomes measured by the Family Satisfaction in the Intensive Care Unit Inventory were regressed separately for baseline variables and family needs met subscales as measured by the Critical Care Family Needs Inventory. Multivariate linear regression analysis was used to detect factors that could have predicted each outcome. Findings The results showed differences between the perceived importance and the perceived met needs of family members. Satisfaction with care was positively related to meeting all needs domains except the information need. However, satisfaction with information and decision-making was related only to meeting information and emotional support needs. Conclusion Continued unmet needs of family members of intensive care unit patients have a negative impact on family satisfaction. Only sweeping changes in clinical practice will succeed in meeting the unmet needs of patients' families. [ABSTRACT FROM AUTHOR]

Aim This article is a report of a study to evaluate the effectiveness of an intervention on fathering ability, perceived nurse's support and paternal stress after a preterm infant's admission to a neonatal intensive care unit. Background The birth of a premature infant who is admitted to a neonatal intensive care unit is a stressful experience. Due to the maternal postpartum practice in Taiwan, the father is the main visitor of the infant during the first few weeks, but interventions have rarely focused on the father. Design A historical comparison study. Methods Between August 2009-July 2010, 35 fathers in the comparison group received routine care; 34 fathers in the intervention group received a booklet designed for the fathers during their visits to the neonatal intensive care unit and nurses' guidance based on the contents of the booklet. Fathering ability, perceived nurse's support and paternal stress were measured. Findings The intervention group had a significantly higher fathering ability and perceived nurse support than the comparison group. In the intervention group, the increased fathering ability reduced paternal stress. After adjusting for severity of illness, an significant moderating effect of perceived nurse support on the relationship between fathering ability and paternal stress was found, accounting for 59·5% of variance. Conclusion Designing a supportive intervention which provides informational, emotional, instrumental, and esteem support for the father can effectively empower his fathering ability and reduce his stress. The intervention should be initiated from the early admission of the premature infant to the neonatal intensive care unit. [ABSTRACT FROM AUTHOR]

Kao S.-H., Hsu L.-L., Hsieh S.-I. & Huang T.-H. (2013) The effects of two educational interventions on knowledge and competence of nurses with regard to conveying gastroscopy-related information to patients. Journal of Advanced Nursing 69(4), 793-804. doi: 10.1111/j.1365-2648.2012.06062.x Abstract Aim. The study was to compare the effects of two different educational interventions on knowledge and competence of nurses regarding conveying gastroscopy-related information to patients. Background. Nurses play an important role in helping patients undergo gastroscopy and must be familiar with the procedure to provide related patient education. Design. A quasi-experimental study. Methods. This study in 2010 involved a pre-test and two post-tests. The experimental group ( n = 25) received a multimedia CD-ROM, and the comparator group ( n = 40) received a pocket booklet. The effects of the two educational interventions were measured using the Knowledge Test Gastroscopy Nursing Instruction Scale, the Self-Evaluation Gastroscopy Nursing Instruction Scale, and the Gastroscopy Nursing Instruction Learning Satisfaction Scale. Results. No overall significant difference in knowledge scores between the two groups was found, but subsequent post hoc analysis showed significantly higher scores in the experimental group than in the comparator group at week 6. A significant within-subjects effect of the self-evaluation gastroscopy nursing instruction scores from baseline-week 6 was dependent on the experimental group or the comparator group. There were significant between-subjects effects overall, at week 3 and at week 6. Conclusion. Both educational interventions improved nurses' knowledge and competence in gastroscopy-related information. However, the CD-ROM-based intervention had long-term effects on knowledge and had short-term and long-term effects on competence. [ABSTRACT FROM AUTHOR]

Thome M. & Arnardottir S.B. (2013) Evaluation of a family nursing intervention for distressed pregnant women and their partners: a single group before and after study. Journal of Advanced Nursing 69(4), 805-816. doi: 10.1111/j.1365-2648.2012.06063.x Abstract Aim. To report a study of the effects of an antenatal family nursing intervention for emotionally distressed women and their partners. Background. High levels of depressive symptoms and anxiety are common in pregnant women, and their partners are likely to suffer from a higher degree of these symptoms than those of non-distressed women. Maternal anxiety and depressive symptoms influence the development of the foetus and child negatively. Distress-reducing interventions for couples are scarce. Design. The design was a pre- and post-test single group quasi-experiment. Methods. All women distressed during the last two trimesters of pregnancy were referred by midwives to a family nursing home-visiting service in a primary care setting in Iceland. They were invited to participate in the study from November 2007-September 2009. The final sample was 39 couples. Assessment of distress was through self-reporting of depressive symptoms and anxiety, self-esteem, and dyadic adjustment. The couple received four home visits that were guided by the Calgary Family Nursing Model. Results. Women experienced a higher degree of distress than men before the intervention. Couple's distress was interrelated, and improvement was significant on all indicators after the intervention. Conclusion. Healthcare professionals who care for distressed expectant women should attend to their partners' mental health status. The Calgary Family Nursing Model is an appropriate guide for nursing care of distressed prospective couples in a primary care setting. [ABSTRACT FROM AUTHOR]

Aim To explore reasons underlying cessation of breastfeeding in mothers with uncomplicated vaginal deliveries and those experiencing complications during childbirth. Background Interventions during labour and childbirth can have a negative impact on breastfeeding. Explanations include adverse reactions to medication, delayed breastfeeding initiation, and disruption of the normal endocrinology of childbirth. However, reasons for breastfeeding cessation linked to birth experience have not been fully examined. Increasing breastfeeding duration and, consequently, improving infant and maternal health in the UK depend on understanding why women stop breastfeeding. Design An exploratory cross-sectional survey. Method Between January-May 2009, 284 mothers attending community groups in Swansea, Wales, and mothers participating in online parenting forums, who initiated breastfeeding but discontinued before 6 months postpartum, reported their birth experience, including complications and reasons for breastfeeding cessation in an internet survey. Results Mothers who experienced birth complications breastfed for a significantly shorter duration than those who did not. Specifically, caesarean deliveries, foetal distress, failure to progress, and postpartum haemorrhage were each associated with a shorter breastfeeding duration. Mothers who experienced complications were more likely to discontinue breastfeeding for reasons of pain and difficulty than mothers who did not experience complications, yet no difference was seen between groups for social reasons such as embarrassment or a lack of support. Conclusion Certain complications during labour may increase risk of specific physical difficulties with breastfeeding, possibly due to their association with medications received. Maternity health professionals should be alert to this possibility to offer enhanced attention and care to overcome these issues and prolong breastfeeding duration. [ABSTRACT FROM AUTHOR]

Aim To report a study conducted to test a model linking authentic leadership of managers with nurses' perceptions of structural empowerment, performance, and job satisfaction. Background Authentic leadership has been proposed as the root element of effective leadership needed to build healthier work environments because there is special attention to the development of empowering leader-follower relationships. Although the influence of leadership style and empowerment on job satisfaction is well documented, there are few studies examining the influence of authentic leadership on nurses' empowerment and work outcomes. Design A non-experimental, predictive survey. Method In 2008, a random sample of 600 Registered Nurses working in acute care hospitals across Ontario in Canada was surveyed. The final sample consisted of 280 (48% response rate) nurses. Variables were measured using the Authentic Leadership Questionnaire, Conditions of Work Effectiveness Questionnaire, Global Job Satisfaction Survey, and General Performance scale. The theoretical model was tested using structural equation modelling. Results/outcomes The final model fit the data acceptably. Authentic leadership significantly and positively influenced staff nurses' structural empowerment, which in turn increased job satisfaction and self-rated performance. Conclusion The results suggest that the more managers are seen as authentic, by emphasizing transparency, balanced processing, self-awareness and high ethical standards, the more nurses perceive they have access to workplace empowerment structures, are satisfied with their work, and report higher performance. [ABSTRACT FROM AUTHOR]

Aim To translate the validated measure, Self- Management of Type 1 Diabetes in Adolescents, into the Mandarin Chinese language and to test the psychometric properties of the Chinese version. Background Although research on self-management of Type 1 diabetes has been increasing over the past 20 years, few health-related instruments have been available in the Chinese language for youth with Type 1 diabetes. Design A two-phase design was used in this study, including instrument translation and psychometric testing. Methods The instrument translation, from October 2008-April 2009, included three steps: forward translation, back translation, and comparison of versions via Translation Validity Index - with multiple rounds, group discussion, and achievement of consensus at each step. Psychometric properties of the Chinese version Schilling's Self- Management of Type 1 Diabetes for Adolescents scale was assessed in a convenience sample of 136 Chinese youth (ages 8-19) with Type 1 diabetes between June 2009-August 2009. Results The internal consistency and test-retest reliabilities indicated generally good consistency and temporal stability of the Chinese version. Evidence of construct validity and criterion-related validity was obtained via correlations of subscales with established measures of diabetes adherence and quality of life and also with haemoglobin A1c. Results from hypothesis testing also supported construct validity. Conclusion The Chinese version of Self- Management of Type 1 Diabetes for Adolescents scale is sound and will facilitate cross-cultural studies, while also enabling nurses to monitor and enhance the diabetes self-management of Chinese youth with Type 1 diabetes. [ABSTRACT FROM AUTHOR]

Aims This paper tests the mediating effect of institutional peer support on the relationship between physical declines and depressive symptoms among nursing home residents. Background As the number of older adults living in nursing homes increases, peer support received from other residents in the institutions is critical to the psychological well-being of residents who face physical declines and reduction in family support. This study tested whether institutional peer support would account for the detrimental effect of physical declines on depressive symptoms of Chinese older people residing in nursing homes. Design A cross-sectional design was used. Method The study was conducted between January-March 2009 by convenience sampling. The sample consisted of 187 nursing home residents, with 54 men and 133 women. Interviews were conducted by an experienced research assistant, and responses on physical abilities and institutional peer support were collected. Geriatric Depression Scale was used to assess depressive symptoms of each participant. Results Participants with poor physical abilities reported more depressive symptoms. Institutional peer support was negatively correlated with physical declines and depressive symptoms. Results of the regression analysis showed that the effect of physical declines on depressive symptoms was no longer significant when the influence of institutional peer support was statistically controlled, indicating a full mediation of institutional peer support on depression of older people. Conclusion Findings of this study reveal that institutional peer support positively contributes to the psychological well-being of nursing home residents. [ABSTRACT FROM AUTHOR]

Aim To examine the challenges and solutions encountered in the translation and cross-cultural adaptation of an English language quality of life tool in India, China, Iran, Portugal, Brazil, and Poland. Background Those embarking on research involving translation and cross-cultural adaptation must address certain practical and conceptual issues. These include instrument choice, linguistic factors, and cultural or philosophical differences, which may render an instrument inappropriate, even when expertly translated. Publication bias arises when studies encountering difficulties do not admit to these, or are not published at all. As an educative guide to the potential pitfalls involved in the cross-cultural adaptation process, this article reports the conceptual, linguistic, and methodological experiences of researchers in six countries, who translated and adapted the Mother-Generated Index, a quality of life tool originally developed in English. Data sources Principal investigator experience from six stand-alone studies (two published) ranging from postgraduate research to citywide surveys. Discussion/implications for nursing This analysis of a series of stand-alone cross-cultural studies provides lessons about how conceptual issues, such as the uniqueness of perceived quality of life and the experience of new motherhood, can be addressed. This original international approach highlights practical lessons relating to instrument choice, and the resources available to researchers with different levels of experience. Although researchers may be confident of effective translation, conceptual and practical difficulties may be more problematic. Conclusion Instrument choice is crucial. Researchers must negotiate adequate resources for cross-cultural research, including time, translation facilities, and expert advice about conceptual issues. [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]

drach-zahavy a. & marzuq n. (2013) The weekend matters: exploring when and how nurses best recover from work stress. Journal of Advanced Nursing 69(3), 578-589. doi: 10.1111/j.1365-2648.2012.06033.x Abstract Aim. This article is a report of a comparative study examining nurses' levels of emotional exhaustion and vigour after a short respite taken on weekends as compared with two midweek days taken off. Background. Recovery from work stress - a respite experience that generates replenishing of psychological and physical resources that have been depleted by meeting effortful demands - is crucial to offset future deleterious consequences to mental and physical health. Design. Longitudinal panel survey. Method. Nurses ( n = 400) completed questionnaires during 2010-2011 on three occasions: (1) Before the respite (weekend or midweek), we measured the timing of the respite and emotional exhaustion and vigour; (2) during the respite we measured respite experiences; and (3) after the respite we re-measured emotional exhaustion and vigour. Results. Nurses' emotional exhaustion was significantly lower and their vigour significantly higher after a short weekend respite than after two-midweek-days taken off. Specific experiences during the respite can compensate for the inferior recovery process on weekdays compared with weekends: emotional exhaustion levels of nurses who experienced high relaxation during their respite did not differ whether the respite was at the midweek or weekend. Vigour levels of nurses who experienced control during their respite did not differ whether their respite was midweek or at the weekend. Conclusions. Insights gained on leisure experiences carry important practical implications for nurses and nursing managers. Staff nurses and their managers should be educated in how to recover from work during leisure time, including preferring weekend on midweek respites and engagement in relaxation and control experiences as much as possible. [ABSTRACT FROM AUTHOR]

smith c.j., sammons h.m., fakis a. & conroy s. (2013) A prospective study to assess the palatability of analgesic medicines in children. Journal of Advanced Nursing 69(3), 655-663. doi: 10.1111/j.1365-2648.2012.06050.x Abstract Aim. This study examined children's opinions on the taste of three analgesic medicines: paracetamol, ibuprofen and codeine. Background. Many medicines for children are unpleasant and unacceptable. Research has shown that children's taste preferences differ to adults, in whom palatability is often tested. Little British research exists on children's opinions on the palatability of medicines. This study aimed to address this gap in knowledge. Design. Prospective observational study. Methods. Between May-September 2008, hospital inpatients aged 5-16 years rated the taste of required analgesics on a 100-mm visual analogue scale. This incorporated a 5-point facial hedonic scale. They were also asked their favourite flavour and colour for a medicine. Results. A total of 159 children took part. Eighty-five males (53·5%) and 74 females (46·5%). The median age was 8 years (Inter-quartile range 6-11). The taste of ibuprofen was significantly preferred to paracetamol or codeine. Significant differences were observed depending if the medicine rated was taken first or second (for example pre-medication with paracetamol and ibuprofen). Younger children (5-8 years) were more likely to choose the extremes of the scale when grading than older children were. Preferred flavours on questioning were strawberry 44% and banana 17%. Favourite colours were pink 25·8% and red 20·8%, with girls more likely to choose pink and boys blue. Conclusion. Ibuprofen was the most palatable analgesic medicine tested. Children reported they preferred fruit flavours and colour was sex dependent. Nurses when administering two medicines together should consider giving the least palatable first, for example paracetamol before ibuprofen for pre-medication. [ABSTRACT FROM AUTHOR]

ballard j., mooney m. & dempsey o. (2013) Prevalence of frailty-related risk factors in older adults seen by community nurses. Journal of Advanced Nursing 69(3), 675-684. doi: 10.1111/j.1365-2648.2012.06054.x Abstract Aims. To describe the frequency of four frailty-related risk factors in a cohort of older adults visited by community nurses in Dublin, Ireland. Background. The Irish public health nursing service allows for both professional and self referral. Risk factors examined were suspected cognitive impairment, nutritional and fall risk, and activities of daily living dependence. Design. Retrospective cross-sectional clinical audit. Methods. The study incorporated a retrospective clinical audit of files ( N = 120) obtained from community nursing visits over 9 months in 2009-2010. A chi-square analysis tested for association between each risk factor and oldest age, living alone, professional referral to the nursing service, and presence of formal home support. Results. Findings revealed a cohort prevalence of suspected cognitive impairment at 16·4%. Risk of malnutrition and risk of a fall were 20·2% and 30·8%, respectively. The cohort was dependent in activities of daily living at a rate of 23·5%. Participants dependent in activities of daily living were less likely to live alone and were more likely to have referred themselves to community nursing. Associations between the four frailty-related risk factors and receiving formal home support were not significant. Conclusion. This study results suggest that dependency in activities of daily living (an outcome of frailty) is strongly associated with a decreased likelihood of living alone and increased likelihood of referring oneself to community nursing services. Further research is necessary to examine how frailty screening in the referral process may enhance identification of older adults' community nursing needs in Dublin, Ireland. [ABSTRACT FROM AUTHOR]

fang j., qiu c., xu h. & you g. (2013) A model for predicting acute and chronic fatigue in Chinese nurses. Journal of Advanced Nursing 69(3), 546-558. doi: 10.1111/j.1365-2648.2012.06029.x Abstract Aim. To explore a model designed to examine direct and indirect effects of variables on acute and chronic fatigue. Background. Although influencing factors for fatigue have been studied extensively, direct and indirect effects of predictors for acute and chronic fatigue remain poorly understood. Therefore, we proposed an original prediction model for acute and chronic fatigue in Chinese nurses based on previous studies. Design. Cross-sectional, descriptive, correlational design. Methods. We used a multi-stage sampling process to finally include 581 nurses working in the general hospitals in Chengdu, China. Data were collected between November 2007-March 2008 by using questionnaires. A path analysis was applied to test the fit of the hypothesized model and analysis of variance. Results. The final model fits the data well. A total of 44·8% of variance in acute fatigue was directly and indirectly explained by job demand, job control, support at work, exposure to hazards in work environments and sleep quality, and only indirectly influenced by intershift recovery and shift work. Moreover, 61·5% of total chronic fatigue was directly and indirectly accounted for by anxiety, depression, job dissatisfaction, intershift recovery, and acute fatigue, and only indirectly influenced by job control, support at work, exposure to hazards in work environments, shift work, and sleep quality. Conclusion. Acute and chronic fatigue is affected by different factors and nurse managers should generate specific interventions to decrease them. [ABSTRACT FROM AUTHOR]

Aim To report the development and psychometric testing of the Supportive Needs of Adolescents Breastfeeding Scale. Background Nurses worldwide can influence adolescent mothers' decisions to initiate and continue breastfeeding through understanding their social support needs in the early postpartum. Review of the literature reveals a lack of instruments that measure adolescents' perceptions of supportive nursing behaviours when initiating breastfeeding. Method An instrument development and psychometric evaluation study was conducted. In phase 1, scale items were developed from the literature using social support theory. Eight lactation consultants evaluated the scale's content validity in phase 2. During phase 3, the psychometric properties of the scale were tested using item analysis, scale reliability, and exploratory factor analysis. A convenience sample of 101 adolescents, aged 15-20 years old, was recruited during their postpartum stay at three hospitals in the USA between July 2009-July 2010. Results Content validity index was 0·82. Alpha estimate of internal consistency was 0·83. Principal components analysis resulted in a 3 factor scale that explained 48% of the total variance: Practical support, Informational support and Miscellaneous. Conclusion The findings suggest evidence of the scale's adequate internal consistency. The factor analysis suggests two clear underlying dimensions of support: instrumental/emotional/appraisal and informational/emotional/appraisal, and a third miscellaneous dimension related to immediate skin-to-skin care and mothers' support persons. Further exploration of the possible global implications of the scale's dimensions is needed. [ABSTRACT FROM AUTHOR]

Aim To interpret and synthesize stroke survivors' experiences of poststroke fatigue. Background Several studies have found fatigue to be a common and distressing difficulty experienced after stroke. This review has synthesized qualitative findings of stroke survivors' experiences of poststroke fatigue with the aim of guiding practice and further research. Data sources A computer-aided search of the PubMed, CINAHL, Psyc INFO, and Embase databases was performed up to April 2012. Design and review methods Interpretive qualitative meta-synthesis. Of 167 papers identified, 12 were included. Findings Three main themes of the experience of poststroke fatigue were identified. First, five characteristics were identified and interpreted as core characteristics of poststroke fatigue. These did not seem to be influenced by the context. Two additional, distressing characteristics were identified. These were interpreted as being more responsive to the context. Second, we found that the acknowledgement of poststroke fatigue by stroke survivors and their significant others were important for the experience of poststroke fatigue. This theme appeared to be consistent across studies and was interpreted as having a major impact on the third theme identified; coping with poststroke fatigue. Two main coping patterns appeared: one taking the fatigue into account and the other struggling to cope. Lack of acknowledgement of poststroke fatigue complicates the coping process and invokes additional emotional distress. Conclusion Poststroke fatigue is a complex phenomenon. Acknowledging its presence and impact is important to cope well with it. Lack of acknowledgement from significant others increases add to the burden. [Correction added after online publication 3 September 2012: Instances of the word 'statistically' have been removed from the Findings and Conclusion in the abstract section.] [ABSTRACT FROM AUTHOR]

hauck s., winsett r.p. & kuric j. (2013) Leadership facilitation strategies to establish evidence-based practice in an acute care hospital. Journal of Advanced Nursing 69(3), 664-674. doi: 10.1111/j.1365-2648.2012.06053.x Abstract Aim. To assess the impact of leadership facilitation strategies on nurses' beliefs of the importance and frequency of using evidence in daily nursing practice and the perception of organizational readiness in an acute care hospital. Background. Integrating evidence in practice is a prominent issue for hospital nursing as knowledge and skills, beliefs, organizational infrastructure and nursing leadership must all be addressed. Design. Prospective, descriptive comparative. Method. Three surveys were used in this prospective descriptive comparative study. Evidence-Based Practice Beliefs Scale, the Implementation Scale and Organizational Culture & Readiness for System-Wide Integration Survey measured change before and after facilitating strategies for evidence-based practice enculturation. Data were collected in December 2008 ( N = 427) and in December 2010 ( N = 469). Results. Leadership facilitated infrastructure development in three major areas: incorporating evidence-based practice outcomes in the strategic plan; supporting mentors; and advocating for resources for education and outcome dissemination. With the interventions in place, the total group scores for beliefs and organizational readiness improved significantly. Analyses by job role showed that direct care nurses scores improved more than other role types. No differences were found in the implementation scores. Conclusion. Successful key strategies were evidence-based practice education and establishing internal opportunities to disseminate findings. Transformational nursing leadership drives organizational change and provides vision, human and financial resources and time that empowers nurses to include evidence in practice. [ABSTRACT FROM AUTHOR]

gallart a., cruz f. & zabalegui a. (2013) Factors influencing burden among non-professional immigrant caregivers: a case-control study. Journal of Advanced Nursing 69(3), 642-654. doi: 10.1111/j.1365-2648.2012.06049.x Abstract Aim. To identify factors related to the burden that is experienced by untrained immigrant caregivers. Background. There is growing concern about how to provide the care required by an ageing population. Although elder care has usually been provided by family members, this role is increasingly being fulfilled by immigrant caregivers with no formal training. Design. Case-control study (burdened/non-burdened according to the Zarit Burden Interview). Methods. The study took place between May 2005-October 2009. Anonymous questionnaires were distributed to 110 immigrant caregivers and their corresponding older care recipients ( n = 110), who were receiving care in their homes in Barcelona (Spain). The questionnaires included measures of burden, social support, quality of life and social integration, and items about the physical/psychological status of the care recipient and the nature of the care tasks. Two groups of immigrant caregivers were defined according to their scores on the Zarit Burden Interview: burdened ( n = 55) and non-burdened ( n = 55). Results. Burdened caregivers reported less social support, a poorer quality of life, and problems with social integration. Furthermore, 48% said that they lacked knowledge about the care task, while 44% had difficulty performing certain care tasks, which constitutes a risk situation. Conclusion. Burden among untrained immigrant caregivers may be reduced by improving their social support systems and quality of life, thereby helping to ensure the availability of the caregiver services, which society increasingly needs. [ABSTRACT FROM AUTHOR]

logue m.d. & effken j.a. (2013) Validating the personal health records adoption model using a modified e-Delphi. Journal of Advanced Nursing 69(3), 685-696. doi: 10.1111/j.1365-2648.2012.06056.x Abstract Aim. To report the results of a preliminary test of validity of a proposed theoretical framework of electronic personal health record adoption by older adults. Background. Personal health records can assist older adults in managing or co-managing their chronic health conditions. Although there is interest by this population, their adoption of this technology has been slow. Without a comprehensive understanding of the reasons for this phenomenon, facilitating adoption will be difficult. Therefore, we developed a theoretical framework of adoption barriers and facilitators. Design. Survey. Methods. A modified e-Delphi methodology was used to validate the framework by obtaining consensus from a panel of experts in related healthcare fields. These data were collected over 3 months in 2010. Of 16 expert panellists, 13 completed Round 1, 12 completed Rounds 2 and 3, and 9 completed Round 4. Central tendencies and percent agreement were computed to establish consensus. Findings. The e-Delphi resulted in expert consensus on the concepts, variables, and empirical indicators that were retained in (or added to) the framework to describe barriers and/or facilitators to older adults' adoption of personal health records for self-management of chronic disease. Conclusion. The validated model will be used as the basis for developing an instrument to identify barriers and facilitators to personal health records adoption and use by older adults with chronic disease. With better understanding of the factors that influence personal health record adoption in this population, more effective strategies may be developed to increase adoption and thus improve chronic disease management. [ABSTRACT FROM AUTHOR]

cramm j.m., strating m.m.h. & nieboer a.p. (2013) The influence of organizational characteristics on employee solidarity in the long-term care sector. Journal of Advanced Nursing 69(3), 526-534. doi: 10.1111/j.1365-2648.2012.06027.x Abstract Aim. This article is a report of a study that identifies organizational characteristics explaining employee solidarity in the long-term care sector. Background. Employee solidarity reportedly improves organizations' effectiveness and efficiency. Although general research on solidarity in organizations is available, the impact of the organizational context on solidarity in long-term care settings is lacking. Design. Cross-sectional survey. Method. The study was carried out in Dutch long-term care. A total of 313 nurses, managers and other care professionals in 23 organizations were involved. Organizational characteristics studied were centralization, hierarchical culture, formal and informal exchange of information and leadership style. The study was carried out in 2009. Findings. All organizational characteristics significantly correlated with employee solidarity in the univariate analyses. In the multivariate analyses hierarchical culture, centralization, exchange of formal and informal information and transformational leadership appears to be important for solidarity among nurses, managers and other professionals in long-term care organizations, but not transactional and passive leadership styles. Conclusion. The study increased our knowledge of solidarity among nurses, managers and other professionals in the long-term care settings. Organizational characteristics that enhance solidarity are high levels of formal and informal information exchange, less hierarchical authority, decentralization and transformational leadership styles. [ABSTRACT FROM AUTHOR]

Bao Y, Vedina R, Moodie S & Dolan S (2013) The relationship between value incongruence and individual and organizational well-being outcomes: An exploratory study among Catalan nurses. Journal of Advanced Nursing 69(3), 631-641. doi: 10.1111/j.1365-2648.2012.06045. Abstract Aims. To report a correlational study of the relations of value incongruence to the individual and organizational well-being variables of self-rated health, turnover intention, and accident propensity, as mediated by burnout. Background. Previous literature found that value incongruence may lessen individual and organizational well-being through the psychological mechanism of burnout. Empirical investigation is needed to validate these claims. Design. A cross-sectional between-cases correlational design was used. Methods. A survey was conducted in one of the largest university hospitals in a large metropolitan city in Spain in the spring of 2009, using a cross-sectional design. A total of 234 nurses participated in the study. Stepwise regression was used to test the direct and mediation relationships. Results. Hypotheses were confirmed for certain axes of values and outcome variables. In particular, Economical and Ethical value incongruence were found to be correlated with burnout. Economical, Ethical, and Emotional value incongruence were found to be correlated with turnover intention. Ethical and Emotional value incongruence were found to be correlated with accident propensity. Burnout partially mediated the relationship between Economical and Ethical value incongruence and turnover intention and fully mediated the relationship between Ethical value incongruence and accident propensity. Conclusion. The purported mediation of burnout on the relationship between value incongruence and individual and organizational well-being outcomes is valid on certain axes of values and outcome variables. This calls for caution when discussing value incongruence in organizations. Instead of advocating broad organizational culture congruence, we should target specific axes of values. [ABSTRACT FROM AUTHOR]

Aim To report a study of the psychometric properties of the Chinese version of the Daily Record of Severity of Problems form. Background In China, the prevalence of premenstrual syndrome is not confirmed due to lack of prospective daily tools. Daily Record of Severity of Problems was a validated daily symptom chart widely used for the diagnosis of premenstrual syndrome. There is no such an instrument for Chinese women. Methods The convenience sample included 126 female students in a school of nursing from September 2010-March 2011 in China. All of them completed daily ratings for two menstrual cycles, Premenstrual Tension Syndrome Self-Rating scale and Zung Self-Rating Depression scale at the first day of menses in two cycles. Results The internal consistency coefficients of reliability for total score and the correlations of each item with the total score in two cycles were all high. The majority of the cycle to cycle test-retest reliability for total scores and the individual items for the two phases of the cycle were high. Factor analysis yielded four factors describing mood, behaviour, pain, and physical symptoms. There were moderate correlations of the total Daily Record of Severity of Problems during the late-luteal phase of both cycles with Premenstrual Tension Syndrome Self-Rating scale and Zung Self-Rating Depression scale. Conclusions The Daily Record of Severity of Problems Chinese version provides reliable and valid measures of premenstrual symptoms in Chinese women. It has satisfactory psychometric properties and is suitable for nursing implication. [ABSTRACT FROM AUTHOR]

chaboyer w., ringdal m., aitken l. & kendall e. (2012) Self-care after traumatic injury and the use of the therapeutic self-care scale in trauma populations. Journal of Advanced Nursing 69(2), 286-294 doi: 10.1111/j.1365-2648.2012.06005.x. Abstract Aims. To report a correlational study of the relationship between gender, age, severity of injury, length of hospital stay and self-care behaviour in patients with traumatic injuries. Background. This study may provide a foundation for targeted nursing intervention and education programmes to help patients better recover from their injury, which is a fundamental aspect of nursing. Design. A longitudinal cohort study. Method. This study of patients hospitalized for traumatic injury was conducted from May 2006-November 2007. The Therapeutic Self Care Scale along with demographic and clinical data, were completed at 3 and 6 months after hospital discharge. Using data from the 3-month survey, the validity and reliability of the scale was calculated. Multiple regression was used to identify predictors of self-care at 3 and 6 months. Finding. Participants ( n = 125) completed the questionnaire at 3 months and 103 participants completed it at 6 months. Self-care was high on both occasions and high self-care at 3 months was related to high self-care at 6 months. Older participants reported higher self-care at 3 months compared with younger patients. Factor analysis of the scale revealed three clear components; taking medication, recognition and managing symptoms and managing changes in health conditions, which explained a total of 59·8% of the variance. The 10-item revised scale was reliable. Conclusion. The findings indicate that self-care remains fairly high and stable in the first 6 months after trauma. The revised Therapeutic Self Care Scale was valid and reliable in the trauma population. [ABSTRACT FROM AUTHOR]

lin s.-c., tsai k.-w., chen m.-w. & koo m. (2012) Association between fatigue and Internet addiction in female hospital nurses. Journal of Advanced Nursing 69(2), 374-383. doi: 10.1111/j.1365-2648.2012.06016.x Abstract Aims. To report a study conducted to examine the association between fatigue and Internet addiction among female hospital nurses. Background. The Internet provides unprecedented convenience for social interaction and information retrieval. Although excessive Internet use has been demonstrated to correlate with fatigue in adolescents, no studies have examined whether it is associated with fatigue in nurses. Design. Cross-sectional survey. Methods. The study was conducted in August 2010. Female Registered Nurses working in a regional teaching hospital in southern Taiwan were asked to complete a paper-based questionnaire. The questionnaire included questions on demographics, the Chen Internet Addiction Scale and the Chalder Fatigue Scale. Multiple linear regression analysis was performed using Chalder fatigue scale as the dependent variable. Results. Of the 564 (79% response) valid questionnaires returned, 6 and 10% of the participants were classified as diagnostic cases and possible cases of Internet addiction, respectively. Fatigue levels, adjusting for other potential confounders including work unit, shift work, regular self-medication, and self-perceived health status, was significantly associated with both possible cases of Internet addiction and diagnostic cases of Internet addiction. Conclusion. This study is the first in reporting a statistically significant association between fatigue levels and Internet addiction in female hospital nurses. Relevance to clinical practice. Nurses should pay attention to their Internet activity and whether it adds to their fatigue levels. Addictive behaviour should promptly be dealt with to ensure that the best care is provided to patients. [ABSTRACT FROM AUTHOR]

craft m.a., davis g.c. & paulson r.m. (2012) Expressive writing in early breast cancer survivors. Journal of Advanced Nursing 69(2), 305-315. doi: 10.1111/j.1365-2648.2012.06008.x. Abstract Aims. This article is the report of a study aimed at determining whether or not expressive writing improves the quality-of-life of early breast cancer survivors. An additional aim is the investigation of whether or not the type of writing prompt makes a difference in results. Background. The risk of distress can extend well beyond the time of a breast cancer diagnosis. Emotional expression may assist in dealing with this. Design. Randomized controlled study. Methods. Participants ( n = 120) were randomized into one of four groups: a control group (no writing) or one of three expressive writing groups: breast cancer trauma, any self-selected trauma and facts related to breast cancer. Participants wrote 20 minutes a day for 4 consecutive days. Their quality-of-life was measured, using the 'Functional Assessment of Cancer Therapy-Breast Cancer Version', at baseline and at 1 month and 6 months after writing. Paired t-tests, multivariate analysis of variance and multiple regression were used to analyse the data of the 97 participants who completed the journaling assignment and at least the first assessment, collected in 2006. Intention-to-treat analysis was used. Results/findings. Expressive writing about one's breast cancer, breast cancer trauma and facts related to breast cancer, significantly improved the quality-of-life outcome. Conclusion. Expressive writing, focusing the instructions on writing about one's living and dealing with a diagnosis of breast cancer, is recommended for early breast cancer survivors as a feasible and easily implemented treatment approach to improve quality-of-life. [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]

bathe a., weisshaar e. & matterne u. (2012) Chronic pruritus - more than a symptom: a qualitative investigation into patients' subjective illness perceptions. Journal of Advanced Nursing 69(2), 316-326. doi: 10.1111/j.1365-2648.2012.06009.x Abstract Aim. This article is a report of a study exploring the subjective illness perceptions of patients with chronic pruritus (>6 weeks). Background. Pruritus is a common symptom of dermatological as well as other conditions. This pervasive symptom has a substantial impact on quality of life. Little is known about how patients with chronic pruritus construct the symptom, what causes they ascribe, consequences they endure, how they control the symptom and experience the healthcare system. Design. A qualitative design taking a constructivist inquiry perspective. Methods. Semi-structured interviews with 16 patients were conducted between September 2008-February 2009 and analysed by qualitative content analysis. Results. Many patients find it very difficult to adequately describe the symptom to others resulting sometimes in bizarre accounts of the symptom that provoke irritation in lay people and health professionals. This irritation frequently leaves the sufferer feeling misunderstood. Patients often feel their burden is not taken seriously by health professionals. This and various other reasons contribute to difficulties in accepting a given diagnosis. This can leave patients unsatisfied with their current health care and the system. They respond with frequent doctor changes and consideration of complementary and alternative therapeutic methods. Conclusion. Assisting patients with chronic pruritus in their efforts to adequately describe the symptom along with unconditional regard and empathy are key factors that can help enhance the provider-patient relationship and subsequent acceptance of a given diagnosis. A stronger emphasis on the perspectives of these patients may also improve the quality of healthcare provision. [ABSTRACT FROM AUTHOR]

lafond c.m. & van hulle vincent c. (2012) A critique of the National League for Nursing/Jeffries simulation framework. Journal of Advanced Nursing 00(0), 000-000. doi: 10.1111/j.1365-2648.2012.06048.x Abstract Aims. To present a critique of the National League for Nursing/Jeffries simulation framework. Design. Fawcett's criteria for theory analysis and evaluation are used. Background. Use of simulated learning experiences in nursing education is widespread; a sound framework to guide educators across the globe in implementing these experiences effectively is essential. The basic assertion of the National League for Nursing/Jeffries simulation framework is that student-learning outcomes are influenced by the concepts of teacher, student, educational practices, and simulation design characteristics. Data sources. A literature search was performed using Cumulative Index to Nursing and Allied Health Literature, PubMed and Google Scholar to identify studies published in the English language, between 2005-June 2011, where the National League for Nursing/Jeffries simulation framework was tested or used as a theoretical framework for research. Discussion. Sixteen publications (two articles in press) from the USA and UK were identified using the framework to guide research; outcomes included increased student satisfaction, confidence, and improved skill performance. Implications for nursing. As a newer theoretical framework, the National League for Nursing/Jeffries simulation framework offers promise to guide the construction and implementation of simulation experiences resulting in positive student outcomes. Conclusion. Empirically supported definitions of concepts would strengthen the framework and help educators to consistently produce and identify positive outcomes. Additional rigorous research is necessary to further test relationships among concepts and the associated concept variables in the framework. More studies outside of the United States are needed to confirm the framework is relevant to nursing programs in other countries. [ABSTRACT FROM AUTHOR]

Aims To synthesize outcomes from research on handoffs to guide future computerization of the process on medical and surgical units. Background Handoffs can create important information gaps, omissions and errors in patient care. Authors call for the computerization of handoffs; however, a synthesis of the literature is not yet available that might guide computerization. Data sources PubMed, CINAHL, Cochrane, Psyc INFO, Scopus and a handoff database from Cohen and Hilligoss. Design Integrative literature review. Review methods This integrative review included studies from 1980-March 2011 in peer-reviewed journals. Exclusions were studies outside medical and surgical units, handoff education and nurses' perceptions. Results The search strategy yielded a total of 247 references; 81 were retrieved, read and rated for relevance and research quality. A set of 30 articles met relevance criteria. Conclusion Studies about handoff functions and rituals are saturated topics. Verbal handoffs serve important functions beyond information transfer and should be retained. Greater consideration is needed on analysing handoffs from a patient-centred perspective. Handoff methods should be highly tailored to nurses and their contextual needs. The current preference for bedside handoffs is not supported by available evidence. The specific handoff structure for all units may be less important than having a structure for contextually based handoffs. Research on pertinent information content for contextually based handoffs is an urgent need. Without it, handoff computerization is not likely to be successful. Researchers need to use more sophisticated experimental research designs, control for individual and unit differences and improve sampling frames. [ABSTRACT FROM AUTHOR]

timmermans o., van linge r., van petegem p., van rompaey b. & denekens j. (2012) A contingency perspective on team learning and innovation in nursing. Journal of Advanced Nursing 69(2), 363-373. doi: 10.1111/j.1365-2648.2012.06014.x Abstract Aims. To report a correlational study of the relation between team learning activities and implementation-effectiveness of innovations in nursing teams. Background. Non-compliance to implementation of innovations is a problem in nursing teams. In the literature, team learning is proposed as a facilitator for change. Still, studies reporting the effects of team learning activities on the implementation of innovations in nursing teams are scarce. To address this gap in the literature, this study explored the influence of team learning on the implementation of two innovations. Design. A cross-sectional survey. Methods. The survey was conducted in 2008-2009 with a sample of 469 nurses, representing 30 nursing teams from The Netherlands and Belgium. The relationship between variables representing team learning and the use and the knowledge of an incremental ( n = 14) or a radical innovation ( n = 16) was examined by correlation and multiple regression analyses. Results. Correlation analyses revealed positive relationships between the team learning activities handling production-oriented information and implementation-effectiveness of an incremental innovation. In addition, team learning activities about development-oriented information positively affected the implementation of a radical innovation. Multiple regression yielded models that explain 83% of the variance on the use of an incremental variable, 73% on knowledge of a radical innovation, and 80% on use of a radical innovation. Conclusion. In nursing teams, team learning activities that relate to the production of nursing care affect the implementation of an incremental innovation. The implementation of a radical innovation is effected by team learning activities that relate to the development of the provided nursing care. [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]

lodewijckx c., sermeus w., panella m., deneckere s., leigheb f., troosters t., boto p.a., mendes r.v., decramer m. & vanhaecht k. (2012) Quality indicators for in-hospital management of exacerbation of chronic obstructive pulmonary disease: results of an international Delphi study. Journal of Advanced Nursing 69(2), 348-362. doi: 10.1111/j.1365-2648.2012.06013.x Abstract Aim. To report a Delphi study that was conducted to select process and outcome indicators that are relevant to study quality of care and impact of care pathways for patients hospitalized with exacerbation of chronic obstructive pulmonary disease. Background. Management of patients hospitalized with exacerbation of chronic obstructive pulmonary disease is suboptimal and outcomes are poor. To evaluate the impact of care pathways properly, relevant indicators need to be selected. Design. Delphi study. Methods. The study was conducted over 4 months in 2008, with 35 experts out of 15 countries, including 19 medical doctors, 8 nurses and 8 physiotherapists. Participants were asked to rate, for 72 process and 21 outcome indicators, the relevance for follow-up in care pathways for in-hospital management of exacerbation of chronic obstructive pulmonary disease. Consensus (agreement by at least 75% of the participants) that an indicator is relevant for follow-up was sought in two rounds. Results. Consensus was reached for 26 of 72 process indicators (36·1%) and 10 of 21 outcome indicators (47·6%). Highest consensus levels were found for the process indicators regarding oxygen therapy (100%), pulmonary rehabilitation (100%) and patient education (94·5-88·6%) and for the outcome indicators concerning understanding of therapy (91·4-85·7%) and self-management (88·6-88·2%). Conclusion. The selected indicators appear to be sensitive for improvement. Therefore, researchers and clinicians that want to study and improve the care for patients hospitalized with exacerbation of chronic obstructive pulmonary disease should primarily focus on these indicators. [ABSTRACT FROM AUTHOR]

bäckström j., ekselius l., gerdin b. & willebrand m. (2012) Prediction of psychological symptoms in family members of patients with burns 1 year after injury. Journal of Advanced Nursing 69(2), 384-393. doi: 10.1111/j.1365-2648.2012.06017.x Abstract Aim. To report a study of predictors of psychological symptoms in family members of patients with burns. Background. Family members are important as a source of social support for patients undergoing prolonged rehabilitation. Little is known about psychological symptoms of family members of patients with burns, especially in the long term. Design. The design of the study was prospective and longitudinal. Methods. Forty-four family members of adult patients treated in a burn centre between 2000-2007 completed questionnaires during care and at 3, 6, and 12 months after injury. Psychological symptoms were assessed with the Hospital Anxiety and Depression Scale. Predictors for anxiety and depression were explored in regression analyses. Results. The mean scores indicated normal to mild symptoms in general. Moderate and severe symptom levels during care and at 12 months were demonstrated on the anxiety subscale by 15/44 and 5/39, respectively, and on the depression subscale by 5/44 and 0/39 of the family members, respectively. In the final regression models, the primary predictor was psychological symptoms at the previous assessment. Other predictors were previous life events, age, and the coping strategy avoidance. Conclusion. Family members of patients with burns demonstrate normal to mild levels of psychological symptoms that decrease over time. One-third show moderate to severe anxiety symptoms during care and may benefit from counselling. Previous symptoms predict later symptoms, indicating that screening with a validated instrument is useful. The results provide guidance for nurses in assessing and planning adequate interventions for family members. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the impact of a new model for the detection and management of deteriorating patients on knowledge and confidence of nursing staff in an acute hospital. Background. International evidence shows that clinical deterioration is not always recognized or acted on by nurses. The use of physiological track and trigger scoring systems accompanied by a graded response strategy has been recommended to monitor all adult patients in acute UK hospitals. However, little is known about the impact of these new systems in practice. Design. A single centre, mixed methods before-and-after study. Methods. A mixed methods before-and-after study, set in a district general hospital in England, in 2009, including a survey ( n = 213) and qualitative interviews ( n = 15) with nursing staff. The questionnaire examined knowledge and confidence in recognition and management of deteriorating patients 6 weeks before and after an intervention which included training, new observation charts and a new track and trigger system. Interviews further explored participants' perspectives. Comparisons were made between registered and unregistered nurses. Results. Following the intervention, knowledge, and confidence to recognize and manage deteriorating patients increased; the number of concerns were reduced. Scores were higher for registered than unregistered nurses before and after the intervention. Interviews confirmed these findings and provided detail on how nurses felt the new system had improved practice. Conclusion. The new model had a positive impact on the self-assessed knowledge and confidence of registered and unregistered nurses. Similar initiatives should take into account the clinical context and tailor training packages accordingly. [ABSTRACT FROM AUTHOR]

Aims. To report a study examining the relationships among coping, anxiety and resilience and to identify predictors of anxiety and resilience in adolescents undergoing cancer treatment. Background. Anxiety is the main psychological disturbance in adolescents with cancer, but predictors in the context of anxiety related cancer treatments have not been investigated. Design. Cross-sectional study. Methods. Adolescents ( n = 131) recruited from three medical centres between 2010-2011. The eligible participants were diagnosed with cancer, without mental disease and receiving chemotherapy. Participants were assessed with the paediatric cancer coping scale, revised children's manifest anxiety scale, second edition, and the Haase adolescent resilience in illness scale. Results. Over 20% of participants scored high on worry. The most commonly used coping strategy was cognitive coping, followed by problem-oriented coping and finally by defensive coping. There was a statistically significant correlation between defensive coping and level of worry. Resilience was positively correlated with cognitive coping and problem-oriented coping. The cognitive coping and defensive coping were found to predict anxiety and resilience significantly by a step-wise multiple regression analysis and accounted for 40·9% and 46·5% of total variance, respectively. Conclusions. Cognitive coping and defensive coping are predictors for the level of anxiety and resilience in adolescents undergoing cancer treatment. Health providers should evaluate coping behaviour in patients and work towards a cognitive and problem-oriented coping style that will benefit the patient's mental health during treatment. [ABSTRACT FROM AUTHOR]

Aim. This article is a report of a study that examines the relationship between team-level learning and performance in nursing teams, and the role of beliefs about the interpersonal context in this relationship. Background. Over recent years, there has been an increasing interest in the learning processes of work teams. Researchers have investigated the impact of team learning on team performance, and the enabling conditions for this learning. However, team learning in nursing teams has been largely ignored. Design. A cross-sectional field survey design was used. Methods. The sample comprises a total of 468 healthcare professionals working in 89 nursing teams at different public hospitals throughout Spain. Members of nursing teams participated voluntarily by completing a confidential individual questionnaire. Team supervisors evaluated nursing teams' performance. Data were collected over 2007-2008. Results. The results show a mediating effect of team learning on the relationship between beliefs about interpersonal context (psychological safety, perceived task interdependence, and group potency) and team performance. Conclusion. Our findings suggest that beliefs about interpersonal context and team learning are important to effective nursing team performance. [ABSTRACT FROM AUTHOR]

Aim. To report a mixed-methods study of the development of self-confidence in Irish nursing students undertaking the first year of an undergraduate nursing programme. Background. Self-confidence underpins nurses' competence to carry out care effectively, yet there is little empirical evidence of how this attribute is fostered in pre-registration preparation. There is an assumption, however, that self-confidence develops independently and spontaneously. Design. A sequential, mixed methods three-phase design was used. Method. The design involved pretest and posttest measurements of self-confidence, focus group interviews, a student self-evaluation questionnaire and analysis of the relevant curriculum content. Data were collected between September 2007-April 2008 and sampling was from three cohorts of students at three different Institutes of Technology in Ireland. Data collection matched the nature of the data, including descriptive, non-inferential statistics and qualitative content analysis. Results. There was considerable variation in the amount and nature of theoretical preparation. Factors in clinical practice exerted the most influence. Self-confidence fluctuated during the first clinical placement and as students' self-confidence developed, simultaneously, motivation towards academic achievement increased. Conversely, self-confidence was quickly eroded by poor preceptor attitudes, lack of communication, and feeling undervalued. Conclusion. The development of self-confidence is complex and multi-factorial. This study offers further understanding of facilitators and barriers that may be relevant elsewhere in promoting student nurses' developing self-confidence. The development of self-confidence must be recognized as a central tenet for the design and delivery of undergraduate programmes. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to evaluate the self-help behaviour of individuals with eating disorders in an Internet-based self-help programme developed in the Asia-Pacific region and to determine their compliance with the programme. Background. Eating disorders represent a growing health problem affecting both Western and Asian countries. Without timely and adequate treatment, individuals with eating disorders are at risk of premature death. Self-help approaches for treating eating disorders offer therapeutic promise. Design. An open trial design was used. Method. This study, conducted from August 2006-July 2011, included 280 participants recruited from outpatient eating disorder clinics and treatment units and through a university student newspaper and Internet websites. This open trial evaluated an Internet-based self-help programme, which included components on healthy eating, family education, health assessment, motivation enhancement, self-help strategies, and psychological health promotion. The progress of participants was followed up via monthly e-mails. A tracking system was implemented to determine their compliance with the programme. Findings. A small majority of the participants (56·9%) were already undergoing treatment for their eating disorders. About 63% ( n = 176) demonstrated self-help behaviour, as manifested by their completion of health assessment questionnaires, involvement in motivation enhancement exercises, or the use of self-help strategies such as monitoring, normalizing eating behaviour, and stress management. Improvements were observed in their eating disorder psychopathology, motivational stage of change and psychological health from baseline to the 1-month follow up. Conclusion. Internet-based self-help programmes for eating disorders are helpful adjuncts to professional treatment. [ABSTRACT FROM AUTHOR]