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Background. Emergency nurses may experience various fatiguing duties and suffer more pressure, so it is necessary to promote their professional or work‐related quality of life, especially during tough periods. Aim. To describe the development of the multidimensional narrative support system and explore its effectiveness and feasibility among emergency nurses. Design. An action research was conducted in Shanghai, China, from 2022 to 2023. Methods. Two cycles of action research were adopted in the emergency departments of two tertiary general hospitals in Shanghai, China. A total of 20 and 13 emergency nurses from different posts participated in each cycle. Multiple methods and tools, such as validated instruments, self‐designed questionnaires, and individual and focus group interviews, were used to collect short‐ and long‐term data. The EQUATOR guidelines on reporting action research were used as the guideline for this study. Results. The multidimensional narrative support system was gradually modified to promote its feasibility. Involved emergency nurses actively participated in different activities and proposed relatively positive and satisfying remarks. Quantitative data showed the significantly instant or long‐lasting improvements in emergency nurses' professional and work‐related quality of life, as well as their self‐compassion, and perceived social support. Various categories were summarized about the participants' experiences, perceived long‐term effects, and suggestions on the multidimensional narrative support system. Conclusion. The multidimensional narrative support system integrates narrative methods and psychological activities and provides multidimensional support for emergency nurses. In spite of various challenges, the system shows good feasibility and significant influences on emergency nurses' well‐being and quality of life. Implications for Nursing Management. The multidimensional narrative support system may action as a novel intervention for the overall improvements of clinical emergency nurses, which can be recommended to other populations with targeted modifications and training, so as to achieve good generalization in different departments. [ABSTRACT FROM AUTHOR]

Aim. This study aims to investigate the level of organizational learning within urban Chinese Community Health Centres and reveal its potential association with primary care nurses' work performance and well‐being. Background. Globally, there is a push to establish learning healthcare systems for complex health reform challenges. Existing studies on organizational learning mainly focus on North American and European hospital settings, offering limited insights into primary care environments, particularly in developing countries. Design. Cross‐sectional study. Methods. We recruited 175 nurses from 38 community health centres in four Chinese cities (Shanghai, Shenzhen, Tianjin, and Jinan) using convenience sampling. Trained research assistants conducted face‐to‐face surveys, measuring organizational learning with the Learning Orientation Scale. Nurse‐level outcomes included self‐directed learning, quality of care, organizational commitment, and work stress. Data analysis employed multilevel linear modelling. Results. The 38 community health centres displayed a relatively high level of organizational learning, and there was a positive and significant association between organizational learning within community health centres and nurses' self‐directed learning as well as the quality of care. However, there was no significant association between organizational learning and nurses' organizational commitment or work stress. Conclusion. This study demonstrates a high‐level organizational learning capacity in urban community health centres in China. It provides a new perspective on the potential relationship between CHCs' organizational learning and primary care nurses' well‐being and work performance. Further research is needed to clarify unexpected findings and identify factors promoting organizational learning in primary care settings. Implications for Nursing Management. In China's evolving primary care system, nurses play a vital role amidst physician shortages. Policy should prioritize internal management reform alongside structural changes. This study highlights the importance of fostering organizational learning in primary care settings. Strategic interventions should promote a learning culture in CHCs, which may enhance nurses' self‐directed learning and improve the quality of care. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to evaluate the current status and related factors of practice environments of nurse managers in China. Background. Insufficient nurse staffing and poor working environment directly increase the burnout and turnover of nurse leaders. Nurse managers play a pivotal role in healthcare organizations, and their performance has been inextricably linked to achieving optimal patient, staff, and healthcare organizational outcomes. However, there are few studies exploring the influencing factors of nurse manager practice environment. Methods. A cross-sectional study was undertaken to examine a sample of 405 nursing managers who were selected from 10 hospitals located across three provinces in China. The general characteristics questionnaire, the Nurse Manager Practice Environment Scale, the Perceived Stress Scale, and the Career Growth Scale were used. Data were analyzed by descriptive statistics, univariate analysis, and multiple stepwise linear regression. Results. The total scores of the nurse manager practice environments were 236.71 ± 27.635 (with 270 being the highest possible score), which was at a generally high level. The three lowest scores were adequate budgeted resources, fair and manageable workload, and nurse manager-physician relationships. Nurse manager practice environment was predicted by hospital geographic location, having (or not) training experience in higher ranked hospitals, levels of perceived stress, and career growth scores. Conclusion. Chinese nursing managers reported a relatively favorable nursing practice environment. Policymakers should pay more attention to the practice environment of nursing managers in small city hospitals, and they could regularly evaluate, monitor, and promote practice environment determinants that are sensitive to disparities between different hospitals. In addition, hospital managers can take action by implementing diversity training programs, developing stress-reduction initiatives, and creating robust career development programs for nurse managers to support nurse managers better. Implications for nursing management: a better understanding of the current practice environment of nursing managers is beneficial for improving nursing managers' work environment, which in turn will promote the quality of care delivered and nursing management work. For nurse managers, the characteristics of the management and work environment of the small city hospitals should be benchmarked and learned against the district capital hospitals. Also, hospital administrators were required to adopt strategies to foster psychological support of nurse managers and create pathways and opportunities for professional growth to create a supportive working environment. [ABSTRACT FROM AUTHOR]

Aims and Objectives. To identify and explore assess factors that influence patients' readiness for hospital discharge (RHD) after total knee arthroplasty (TKA). Background. Evidence has suggested that most clinical staff use clinical laboratory indicators to determine discharge times, while paying little attention to patients' feelings and needs. Additional research findings have suggested a relationship between patients' self-reported readiness for hospital discharge and postdischarge complication rates, readmission rates, mortality, as well as quality of life. RHD is strongly associated with patient health outcomes. Identifying relevant influencing factors can provide guidance for early individualized interventions by healthcare professionals. Design. A cross-sectional study. Methods. During 2022, a total of 320 post-TKA patients were selected for this study. The patients were divided into the low-RHD group (<7 points) and the high-RHD group (≥7 points) according to the mean score of the Readiness for Hospital Discharge Scale (RHDS). Established scales were used to collect patients' information and to adopt univariate and binary logistic regression analysis to screen for independent factors. Results. In this study, the RHDS score of patients after TKA is 91.90 ± 7.05, of which 12.8% are in the low-RHD group (mean score <7). The binary logistic regression results reveal that age, educational level, postactivity pain, self-efficacy, and family care have to be considered risk factors generating low-RHD in TKA patients. Conclusions. The present study suggests that over 1/8 TKA patients are not ready at the time of discharge. Physicians and nurses can improve patients' RHD by reducing postactivity pain and improving self-efficacy during their rehabilitation period. Relevance to Clinical Practice. The results of this study can help physicians and nurses early identify high-risk patients with low RHD and provide them with individualized interventions. In addition to this, it is important that nurses use RHDS to assess the readiness of TKA patients before they are discharged from the hospital. [ABSTRACT FROM AUTHOR]

Objective. To identify the latent classes of personality traits among nurses in acute and critical care departments, as well as the relationship between latent classes of different personality traits and workplace bullying. Methods. A total of 245 nurses working in the acute and critical care department at a 3 A-grade hospital in Shandong Province, China, were recruited by convenient sampling. The Chinese Big Five Personality Inventory brief version was used to assess personality traits, and the Negative Acts Questionnaire was used to measure workplace bullying. Latent profile analysis was used to identify the latent classes of personality traits. Multiple linear regression analysis was used to examine the relationship between latent classes of personality traits and workplace bullying. Results. Four latent classes of personality traits among acute and critical care nurses were identified, namely, the negative group (49.0%), flexible group (16.0%), neurotic group (18.1%), and stable group (16.9%), respectively. Compared with the neurotic group, the negative group (B = −6.227, P < 0.05), stable group (B = −16.562, P < 0.001), and flexible group (B = −19.208, P < 0.001) experienced less workplace bullying. Conclusion. Our findings explore latent classes of personality traits among acute and critical care nurses, identify subgroups susceptible to workplace bullying, and suggest the development of appropriate interventions to reduce workplace bullying. Implications for Nursing Management. Hospital managers can identify nurses who are prone to workplace bullying based on their personality traits and provide them with psychological counseling services and psychological healing groups to help them establish good interpersonal relationships and maintain their mental and physical health. [ABSTRACT FROM AUTHOR]

Background. Nurses play a critical role in the medical workforce during the COVID-19 pandemic while facing various difficulties and challenges. Grit, social support, and self-esteem are important psychosocial factors influencing job performance. However, few studies have explored the relationships among these factors in nurses. Aim. This study aimed to examine the association between grit and nurses' job performance during the COVID-19 pandemic and to explore the potential chain mediation through perceived social support and self-esteem. Methods. A cross-sectional survey design was employed. From January 2021 to May 2022, a total of 709 Chinese nurses in Chengdu and Kunming completed a web-based cross-sectional survey, which included standard assessments on grit, perceived social support, self-esteem, and job performance as well as Big Five personalities. The chain mediation model was tested using the PROCESS macro program in the SPSS software. Results. There was a moderate-to-large correlation (r = 0.40, p < 0.001) between grit and job performance in Chinese nurses. Furthermore, grit was indirectly linked to job performance through the chain mediating effect of perceived social support and self-esteem (all p < 0.05). These findings persisted even when Big Five personalities were included as additional controlling variables. Conclusions. This study reveals a stable link between grit and job performance among Chinese nurses and highlights the potential role of perceived social support and self-esteem in mediating this link. Implications for Nursing Management. Nursing managers can improve nurses' grit level and provide a supportive organizational environment conducive to enhancing self-esteem and thereby promoting their job performance. [ABSTRACT FROM AUTHOR]

This study examined the current situation and relationship between missed nursing care (MNC) and job satisfaction among frontline nurses in a hospital dedicated to treating COVID-19 patients in China. Many dedicated hospitals were constructed or refurbished to centrally manage patients with COVID-19. Most nurses and doctors in these hospitals were redeployed from other departments or hospitals. This may have compromised nursing quality and job satisfaction. The omission of nursing care is a critical factor in assessing nursing quality; therefore, focusing on both MNC and job satisfaction is essential. This cross-sectional study used convenience and snowball sampling techniques to recruit frontline nurses working in a hospital for treating COVID-19 patients from November to December 2022. The questionnaires used in this study included sociodemographic information, job satisfaction, and the MISSCARE survey. Differences in job satisfaction and MISSCARE scores among participants' demographic deviations were explored using the Mann–Whitney Z test (two groups) and the Kruskal–Wallis H test (three or more groups). The correlation between participants' job satisfaction and missed nursing actions was analysed using Spearman's correlation analysis. The analysis included 306 frontline nurses. Frontline nurses' job satisfaction was high, and their MNC was low. The highest MNC was "offer rehabilitation care and guidance to patients in need every day." The most reported reasons for the MNC were "urgent patient situations." In addition, the job satisfaction scale, MNC scores, and reasons for MNC scores showed statistically significant differences among participants' demographic variables. Moreover, this study identified a negative correlation between frontline nurses' job satisfaction and MNC. Frontline nurses' job satisfaction was high, and their MNC was low. Frontline nurses' demographics were shown to affect their job satisfaction, MNC, and reported reasons. Furthermore, participants' job satisfaction can influence the MNC. Tailored interventions aimed at maintaining low levels of MNC should consider frontline nurses' demographic characteristics and job satisfaction. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to examine the effect of the length of working hours on missed nursing care, quality of nursing care, and perceptions of the nursing practice environment. Methods. A multicenter cross-sectional investigation using online questionnaires was conducted from April 2 to May 10, 2022, in twenty nine hospitals (13 Level-III hospitals and 16 Level-II hospitals). We collected data on the working hours of nurses and nurse-reported outcomes, including missed nursing care, quality of nursing care, and nursing practice environment. Restricted cubic spline (RCS) regression models were used to examine relationships between the hours per shift and nurse-reported outcomes. Results. We investigated 12,703 nurses with a response rate of 97.33%. Nurses worked on average 7.72 (SD = 1.16) hours on the day shift and 8.92 (SD = 2.20) hours on the night shift, respectively. On the day shift, working 7.5 hours shift showed minimal missed nursing care; meanwhile, working 7–7.5 hours were correlated with the highest satisfaction of the nursing practice environment and better quality of nursing care. On the night shift, the highest missed nursing care was found for a working duration of 12 hours to the working 7 hours, with the lowest satisfaction while better quality was observed. The percentage of nurses who reported working overtime was 30.33%. Nurses who worked overtime reported lower satisfaction and poorer quality of nursing care on all shifts; moreover, working overtime showed the positive correlation to missed nursing care on the day shift, while on night shift was not statistically significant. Conclusion. Positive outcomes were observed for nurses who reported working 7–7.75 hours on the day shift and 12 hours (no more than 15 hours) on the night shift. Implications of Nursing Management. The results reemphasized the need for managers to reduce the working hours, overtime work, and the frequency of the night shift. [ABSTRACT FROM AUTHOR]

Aim. To determine the relationship between transition shock and safety behavior among newly graduated nurses (NGNs) and explore the mediating role of feedback-seeking behavior. Background. The safety behavior of NGNs plays a vital role in improving patient safety in clinical situations. The direct effect of the transition shock experienced by these nurses on safety behavior remains limited, and little is known about the mediating effect of feedback-seeking behavior. Methods. A descriptive correlational research design was conducted with a cross-sectional sample of nurses in China using an online survey. A convenience sample of 575 nurses from 17 hospitals completed the questionnaires. Correlation analysis and structural equation modeling were used to examine the hypotheses. Results. The sampled NGNs' safety behavior score was 55.35 ± 5.46. Their transition shock was negatively associated with safety behavior (β = −0.225, p < 0.001). In contrast, feedback-seeking behavior was positively related to safety behavior (β = 0.502, p < 0.001). The feedback-seeking behavior partially mediated the relationship between transition shock and safety behavior, and the mediating effect was 58.29%. Conclusions. The results emphasized that the relationship between NGNs' transition shock and safety behavior is mediated by feedback-seeking behavior. Implications for Nursing Management. Interventions focusing on transition shock relief could help improve NGNs' safety behavior. This study highlights the importance of encouraging feedback-seeking behavior to improve patient safety outcomes, especially for junior nurses. It can therefore be assumed that the nursing managers' training of NGNs in special skills, such as feedback-seeking, may be conducive to their positive coping and contribute to forming safety behaviors. [ABSTRACT FROM AUTHOR]

Aims. To measure nursing clinical teachers' knowledge, attitudes, and practices about nursing students (NSs) suffering from workplace violence (WPV) in China. Background. The nursing clinical teacher is the most important person for NS during the clinical rotation. In contrast, there is a lack of investigation into the ability of nursing clinical teachers to manage NSs suffering from WPV. Method. A cross-sectional survey was conducted in Hubei province, China, between June and July 2022. Convenience sampling was employed to recruit clinical teachers in 9 tertiary hospitals who met the inclusion criteria. The survey was conducted using a self-designed questionnaire which has good reliability and validity. Questionnaires were collected through a web-based platform called Questionnaire Star in China. In July 2022, a total of 900 questionnaires were eventually distributed, and 869 valid questionnaires were returned. The software SPSS 26.0 was used to conduct descriptive and inferential statistical analyses. Result. The mean ± SD knowledge, attitudes, and practices scores of the nursing clinical teachers were 69.51 ± 12.78, 29.11 ± 4.38, and 82.84 ± 13.60, respectively. Also, the average score rate was 77.24%, 83.17%, and 87.20%, respectively. There are still deficiencies in the knowledge, attitudes, and practices index, such as knowledge about the sources of violence, perceptions about influencing factors, and behavioural practices for prevention. Factors affecting the knowledge index scores included teachers' age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, whether they had experienced WPV, whether they had witnessed NSs suffering from WPV, and whether their NSs had suffered from WPV. Factors affecting scores on the attitude index included the age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Factors influencing the score for the practice index included the working department, highest academic degree obtained, professional title, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Conclusion. Nursing clinical teachers showed moderate levels of knowledge, attitudes, and practices about NSs suffering from WPV. The deficiencies mainly focused on the sources, manifestations, influencing factors, and preventive strategies of it. Also, nursing clinical teachers should be trained to better prevent and cope with WPV suffered by NSs. At the same time, in order to better protect and teach NSs, the selection criteria for nursing clinical teachers should be stricter, with requirements on age, education, years of working experience, and titles. Implications for Nursing Management. With nursing clinical teachers as the training target, health organizations and institutions should actively develop training related to preventing and coping with NSs suffering from WPV. Also, it should be incorporated into the preservice training system for nursing clinical teachers. The content of training could focus on the sources, manifestations, influencing factors, and prevention strategies of NSs suffering from WPV. The method could be online theoretical teaching combined with offline scenario simulation exercises. At the same time, strict admission criteria for nursing clinical teachers can be helpful in protecting the safety of NSs during the clinical rotation phase. For nursing managers, they should be kept abreast of organisational policies and adopt a zero-tolerance policy towards violence. It also can be recommended that nursing clinical teachers should be proactively involved in training to improve their own ability to protect NSs. [ABSTRACT FROM AUTHOR]

Background. Burnout is a common psychological syndrome among nurses, especially in the first few years of working. However, limited studies have evaluated the factors related to burnout among junior nurses. Aims. To investigate the levels of psychological flexibility, stress, and burnout among junior nurses and examine the role of demographic and workplace relationship factors, psychological flexibility, and perceived stress on burnout among junior nurses. Materials and Methods. A convenience sample of 481 junior nurses was recruited from three tertiary hospitals in China from July 2021 to August 2022. Data were collected, including demographic data, workplace relationships, psychological flexibility (measured by experiential avoidance and cognitive fusion), perceived stress, and burnout. The Independent t-test, one-way ANOVA, Wilcoxon–Mann–Whitney test, Kruskal–Wallis test, Spearman correlation, and hierarchical regression were used to analyze the data. Results. Junior nurses had a high level of burnout in different dimensions. Nurses with an undergraduate education, nurses working in the first year, and a lack of support from supervisors and poor colleague (nurse-nurse and nurse-doctor) relationships had the lowest level of psychological flexibility and the highest level of perceived stress and burnout. Spearman correlation indicated that experiential avoidance, cognitive fusion, perceived stress, and burnout were positively associated with each other. The regression model showed that psychological flexibility (especially cognitive fusion) and perceived stress influenced burnout in junior nurses. Conclusions. Higher psychological flexibility and lower perceived stress appear to improve burnout in junior nurses. Therefore, interventions targeting these two factors may provide a viable direction for the reduction of burnout among junior nurses. Implications for Nursing Management. Hospital authorities should create a harmonious working environment and provide some psychology training programs for junior nurses. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationships between transformational leadership, psychological empowerment and innovative behaviour among nurses in China. Background: The innovative behaviour of nurses is important to adapt to the changing medical environment. However, there is currently a limited understanding of the relationship between nurses' innovative behaviour and transformational leadership and psychological empowerment during the pandemic. Methods: Convenience sampling was used to conduct an investigation involving 1317 nurses from 10 hospitals in China from January 2022 to April 2022. Data analysis was performed using correlation analysis, univariate analysis and multiple regression analysis. The STROBE checklist was followed when writing this manuscript. Results: High transformational leadership and high psychological empowerment were associated with high innovative behaviour. The results of the multiple linear regression analysis showed that physical condition, whether or not you have attended academic conferences or whether or not you have participated in fund research projects, transformational leadership and psychological empowerment were the main factors on nurses' innovative behaviour, together explaining 64.5% of the total variance. Conclusion: Promotion of transformational leadership and psychological empowerment is vital for nurses to promote innovation, thereby meeting the urgent demand for innovative nurses and the rapid development of nursing disciplines. Implications for Nursing Management: This study highlights the importance of transformational leadership in developing nurses' innovative behaviours. Understanding the role of psychological empowerment can help nurse managers formulate relevant intervention strategies and cultivate nurses' innovative behaviour. [ABSTRACT FROM AUTHOR]

Aim: This study aims to investigate the levels of organizational commitment and work engagement among clinical nurses in tertiary hospitals and explore the relationship between them. Background: The nursing literature supports the idea that organizational commitment plays an important role in positively influencing job performance. However, the relationship between organizational commitment and work engagement among clinical nurses remains unclear. Methods: This was a cross‐sectional study. A convenience sample of clinical nurses (n = 621) was selected from five tertiary hospitals in Sichuan Province of China. Survey instruments included a general information questionnaire about organizational commitment and work engagement. Univariate analysis, correlation analyses and linear regression analysis were used to examine the association between organizational commitment and work engagement. Results: The mean scores for organizational commitment and work engagement were 3.85 ± 0.59 and 4.58 ± 1.46, respectively. A moderate degree of positive correlation was found between them. Gender, monthly income and retention commitment were significantly associated with work engagement, and they accounted for 39.0% of the total variance. Conclusions: Clinical nurses had a moderate level of organizational commitment and a high level of work engagement. Organizational commitment positively influenced work engagement; that is, organizational commitment is a significant determinant of nurses' work engagement. Implications for Nursing Management: Hospital organizations should focus on assessing and strengthening nurses' organizational commitment to promote increased work engagement and, ultimately, improved quality of care. This may include, but is not limited to, increasing rest time for nurses, implementing a performance appraisal system and focusing on nurses' psychological state. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate scheduling in COVID‐19‐designated hospitals, including working hours, rest days, adverse nursing outcomes and their relationship. Background: Hospitals are at the forefront of COVID‐19 prevention and control, and nurses are the main force on the frontline of the epidemic. Nursing shift is one of the most relevant and pressing issues for frontline nurses. However, there is a lack of national, large‐sample surveys on scheduling and adverse nursing outcomes in COVID‐19‐designated hospitals. Methods: Using a cross‐sectional online survey, we used nurse‐reported data to measure the characteristics of the work setting, samples and work schedule. A descriptive analysis was performed to assess the shift status and adverse outcomes of designated hospitals and frontline nurses. Logistic regression analysis was performed to determine the association between them. Results: Basic data were collected from 217 departments of 69 COVID‐19‐designated hospitals in 31 provinces in China. Nurses in the severe isolation ward worked mainly for 4 h per shift, whereas those in the fever clinic and observation ward worked mainly for 6–8 h. Half of the nurses had only 1 day of rest per week. Long working hours, lack of adequate rest time and overtime can seriously affect the quality and safety of nurses' work, resulting in adverse outcomes. Frontline nurses hope that scheduling guarantees the time to rest while ensuring fairness. Conclusions: The current evidence showed that frontline nurses were faced with long working hours, insufficient rest and overtime, which has a negative impact on nurse satisfaction, physical and mental health and quality of care. The government, hospitals and administrators still face many problems to overcome in their nursing schedules. Implications for Nursing Management: Governments and hospitals should take these factors, such as the work setting characteristics and demographic features of the frontline nurses, into account when selecting nurses to fight COVID‐19. Nurses have different working hours in different types of coronavirus unit; therefore, nursing managers should consider the working environment and nursing schedule needs, and in the future, we should pay attention to the fairness of nurses while ensuring their rest. [ABSTRACT FROM AUTHOR]

Aims: To explore the relationships of ethical climate, physician–nurse collaboration and psychological empowerment with ethical conflict in critical care nurses. Background: Ethical conflict is a major ethical issue in nursing practice. Little research has been done on the associated factors from both organizational and personal perspectives, especially in China. Methods: From October 2021 to March 2022, we collected the data from 342 critical care nurses in three tertiary general hospitals in China via questionnaires about four variables (ethical climate, physician–nurse collaboration, psychological empowerment and ethical conflict). Data were analysed using Spearman's correlation and a structural equation model through statistical product and service solutions (SPSS) and analysis of moment structure (AMOS). Results: Critical care nurses' ethical conflict showed a negative correlation with ethical climate (r = −0.351), physician–nurse collaboration (r = −0.347) and psychological empowerment (r = −0.259) (all p < 0.001). Physician–nurse collaboration partially mediated the relationship between ethical climate and ethical conflict. Additionally, physician–nurse collaboration and psychological empowerment served as sequential mediators in the association. Conclusions: These findings suggested that negative ethical climate can lead to poor physician–nurse collaboration and ultimately ethical conflict. The intermediary role of psychological empowerment and physician–nurse collaboration was also identified. Implications for Nursing Management: Nursing managers should use the study as a fundamental basis to evaluate factors that can affect nurses' ethical conflict and develop effective strategies to mitigate this issue, which may help improve nurses' wellbeing and quality of patient care. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore and compare stress, coping, professional identity and work locus of control of new graduate nurses among Shanghai, Hong Kong and Taipei. Background: The transition from a student to a staff nurse role is recognized as a stressful experience and can be a rough journey. Many newly graduated nurses find it challenging to cope with their new roles in their first few months. Methods: A cross‐sectional research was used in the study. This study was completed in Shanghai, Hong Kong and Taipei with newly graduated nurses working in hospitals. A total of 591 graduate nurses who had worked within 1 year in hospitals were recruited using convenient sampling. Data were collected using a structured questionnaire, including demographics, the occupational stress scale, the Chinese trait coping style questionnaire, the nurse professional identity scale and the work locus of control scale (Chinese version). Results: The newly graduated nurses in Shanghai had significantly lower (p < 0.05) work stress score (2.65 ± 0.67) compared with their counterparts in Hong Kong (2.99 ± 0.69) and Taipei (2.94 ± 0.60). Newly graduated nurses in Shanghai tended to choose positive coping to deal with stressful situations, whereas those in Hong Kong would be more likely to adopt negative attitudes (p < 0.05). The newly graduated nurses in Taipei had the lowest level of professional identity (3.25 ± 0.55, p < 0.05), and their work control tended to be external (46.13 ± 6.20). In contrast, those in Shanghai (52.75 ± 6.04) and Hong Kong (59.41 ± 7.29) tended to be controlled internally. Conclusions: The study findings revealed the differences among newly graduated nurses in Shanghai, Hong Kong and Taipei with their level of stress, coping, professional identity and work locus of control. Proper leadership, mentoring for newly graduated nurses, and emphasis on first aid nursing training, emotional management and management of stress in newly graduated nurse transition programmes were suggested. Implications for Nursing Management: By comparing the results in the three regions, we recommend that nursing managers promote the right leadership style. In addition to coaching, nursing managers can assign additional mentors to newly graduated nurses to help them supplement their clinical knowledge and skills with psychological support. These mentors can come from senior nurses or nursing managers working on less demanding tasks. In addition to the existing post transfer training programmes, new graduate nurses should also focus on emergency nursing training, emotional management training and stress management training. [ABSTRACT FROM AUTHOR]

Aims: To explore whether perceived overqualification increases the risk of burnout and whether transformational leadership negatively moderates this relationship. Background: Perceived overqualification might contribute to burnout and lead to poor experience of transformational leadership, and transformational leadership might be associated with burnout. However, these relationships have not yet been confirmed. Methods: A multicentre cross‐sectional study. A total of 321 nurses from intensive care units were recruited from six tertiary hospitals. Scale of Perceived OverQualification, Transformational Leadership Questionnaire and emotional exhaustion subscale of the Maslach Burnout Inventory—General Survey were employed to collect the data. Hierarchical multiple regression and bootstrap resampling were applied to analyse the data. Results: Burnout was positively associated with perceived overqualification and negatively associated with transformational leadership (each p < 0.05). Transformational leadership significantly mediated the relationship between perceived overqualification and burnout (b = −0.6389, 95% confidence interval: −0.8706, −0.4072). Conclusion: Our findings indicated that perceived overqualification and transformational leadership directly or indirectly affect burnout among nurses from intensive care units. Implications for Nursing Managers: Personal and organizational‐oriented interventions utilizing nurses' overall qualifications and implementing transformational leadership should be employed by nurse managers to alleviate burnout and promote the work performance of nurses from intensive care units. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the compassion satisfaction and compassion fatigue among Chinese frontline nurses during the COVID‐19 pandemic in Wuhan, China and to explore the related factors. Background: Frontline nurses undertake a huge nursing workload with a risk of infection, causing great pressure on them and making them face a risk of compassion fatigue during the pandemic. Methods: A cross‐sectional online survey was conducted from 9 March to 15 March 2020. A total of 1582 nurses caring for critical patients with COVID‐19 participated. Compassion satisfaction and compassion fatigue (comprising burnout and secondary traumatic stress) were assessed with the Professional Quality of Life Scale, and resilience was measured with the Chinese 10‐item Connor‐Davidson Resilience Scale. Results: Moderate levels of compassion satisfaction (36.99 ± 6.71), burnout (24.14 ± 5.33) and secondary traumatic stress (24.53 ± 5.24) were experienced by frontline nurses. Resilience and perceived work pressure were the main predictors. Conclusions: Frontline nurses demonstrated a moderate level of compassion satisfaction and compassion fatigue. Implications for nursing management: The compassion fatigue of frontline nurses should be considered. Strategies aiming to reduce stress and enhance resilience, such as training about psychological adjustment, developing professional skills and creating a supportive workplace environment, are several options. The trial is not registered. This study is a cross‐sectional study, and according to China's clinical trial registration standards, such studies are not required to be registered. So the trial is not registered. However, oral consent was obtained from the ethics committee of the hospital before this study was conducted. [ABSTRACT FROM AUTHOR]

Aim: To determine the level of dignified care provided by critical care nurses, and explore the associated individual factors. Background: Dignity is a fundamental right of human beings. Critically ill patients are dependent on nurses. Their need for respect and dignity is liable to be neglected in intensive care unit settings. Both critically ill survivors and dying patients suffer mental anguish due to loss of dignity. Method: This was a cross‐sectional study of 526 critical care nurses working at intensive care units for adults in Zhejiang Province, China. Data were collected from February 2021 to May 2021 using the Intensive Care Unit Dignified Care Questionnaire, Wong and Law Emotional Intelligence Scale, Jefferson Scale of Empathy‐Health Professional and Nurses Professional Values Scale‐Revised. Results: The total score of dignified care was 67.37 (8.83), with the standard score as 74.07 (12.99). Participants who performed poorly in absolute and relative dignity accounted for 8.4% and 31.2% of the total sample, respectively. Emotional intelligence (β =.379, p <.001), empathy (β =.319, p <.001), professional values (β =.147, p <.001), age (β =.075, p =.003) and training in dignified care (β =.074, p =.010) were associated with dignified care, explaining 67.6% of the variance. Conclusion: The average level of participants' behaviours of maintaining patient dignity was medium. Critical care nurses need to improve their ability to maintain relative dignity of patients. Emotional intelligence, empathy, professional values, age level and training in dignified care were predictors of dignified care. Implications for Nursing Management: Improving emotional intelligence, empathy and professional values of critical care nurses and training them (especially less experienced nurses) will enhance their ability in dignified care. This study provides a novel perspective to help nursing managers develop interventions to promote humanized care in the intensive care unit. [ABSTRACT FROM AUTHOR]

Aim: To assess the influence of professional identity on work engagement among nurses working in nursing homes in China. Background: China is faced with an increasingly ageing population. There is a shortage of adequately trained nursing personnel and a high turnover rate among nurses. Work engagement is a key factor in improving nurses' performance and improving professional identity is critical to increase work productivity and satisfaction. Methods: We conducted a cross‐sectional survey of 272 nurses working in nursing homes. And the data were analysed by descriptive analyses, univariate analysis and Multiple regression analyses. Results: The overall average work engagement score was 3.99 ± 1.04. Professional identity was the only factor that significantly influenced the 'vigour' and 'absorption' of nurses. Age, ethnicity and professional identity were significant predictors of 'dedication'. Conclusions: A positive professional identity can lead to a better work engagement among nurses working in nursing homes in China. Implications for Nursing Management: To enhance the work engagement of nurses working in nursing homes, nursing leaders should create a respectful and equal work environment, create a favourable image of the industry and the profession and strengthen training to improve the professional identity. [ABSTRACT FROM AUTHOR]

Aim: To explore junior nurses' and final‐year student nurses' intention to care for COVID‐19 patients amidst the Delta COVID‐19 variant outbreak in China using the theory of planned behaviour (TPB) as a framework. Background: The COVID‐19 pandemic has intensified global nursing shortage. Junior nurses and final‐year student nurses represent the backbone of the future frontline nursing workforce. The TPB is a valid theoretical model for predicting nurses' caring behaviours. Methods: A 47‐item self‐administered questionnaire was disseminated online to a convenience sample of 547 junior nurses and final‐year student nurses located in 13 regions across mainland China. Results: Approximately 63.4% of the participants intended to care for COVID‐19 patients voluntarily and 65.6% by non‐voluntary assignment. The TPB model significantly predicted 45% of the variance in behavioural intention, subjective norms being the strongest predictor. Gender, vaccination status and ethical perceptions regarding frontline work significantly correlated with the intention to provide care. Conclusions: Our findings highlight the importance of social, organisational and family support underpinning future junior nurses' professional commitment in times of public health crisis. Implications for nursing management: Pandemic‐tailored workplace training programmes for nurses/student nurses that emphasize on self‐care and ethical issue discussions are warranted. Hospital managers should collaborate with community partners to offer additional family support for nurses in need. [ABSTRACT FROM AUTHOR]

Aims: The primary objective of this study was to determine the prevalence of workplace violence among nurses in China and its association with demographic characteristics, quality of work life and coping styles. The secondary objective was to explore how nurses deal with workplace violence and the emotional/psychological impact of workplace violence on nurses. Background: Workplace violence is a common occupational hazard that causes physical and psychological harm to nurses. Methods: A cross‐sectional study was conducted with 2769 nurses from China. A demographic information questionnaire, hospital workplace violence questionnaire, Chinese version of the work‐related quality of life scale and coping style scale were used in this study. The Chi‐squared test, Mann–Whitney U test and binary logistic regression analysis were used to investigate the effects of demographic characteristics, quality of work life and coping styles on nurses' workplace violence. Results: A total of 49.12% of the nurses (n = 1360) had experienced at least one type of workplace violence in the past 6 months. Night shifts, work department, chronic diseases (odds ratio [OR] = 1.53, p <.001), sleep disorders (OR = 1.54, p <.001), frequent overtime (OR = 1.78, p <.001), adverse nursing events (OR = 2.01, p <.001) and passive coping (OR = 1.47, p <.001) were risk factors for workplace violence. Working conditions (OR = 0.61, p <.001), general well‐being (OR = 0.65, p <.001) and positive coping (OR = 0.76, p <.001) were identified as protective factors for workplace violence. Nurses exposed to workplace violence experience various negative emotional and psychological consequences. Conclusions: Workplace violence is common among nurses in China. Good working conditions, general well‐being and positive coping may help prevent workplace violence injuries. Implications for nursing management: Efforts should be made to improve and optimize existing workplace violence prevention measures, create and maintain a good working environment for health care workers and develop various coping styles or strategies to manage stress to reduce workplace violence. The cross‐sectional study has been approved by the Ethics Committee of the First Affiliated Hospital of China Medical University, with the registration number 2019‐221‐2. Written informed consent was obtained prior to the survey. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to translate and validate the Trust in Nurses Scale (TINS) and then test and implement the tool. Background: Trust is the core feature of the nurse–patient relationship, and a simple and universal instrument to measure patients' trust in nurses in China is lacking. Methods: Exploratory and confirmatory factor analyses (EFA and CFA) were performed to verify structural validity. Content validity and reliability analyses were also conducted. Results: The Cronbach's alpha of the TINS was.817, and the test–retest reliability coefficient was.852. EFA revealed two factors and explained 59.702% of the total variation. CFA proved that all the goodness‐of‐fit indicators were acceptable. Conclusion: The TINS exhibited satisfactory reliability and validity, and it can be universally applied to survey Chinese patients' trust in nurses. Implications for Nursing Management: The TINS can be used by nursing managers to assess patients' trust in nurses, and appropriate programmes can be developed to improve patients' trust. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations between perceived overqualification, organisational commitment and work passion of nurses. Background: Few studies have considered the effects of perceived overqualification and organisational commitment on work passion of nurses, especially in developing countries. Methods: This is a multicentre cross‐sectional study. A total of 4511 nurses from eight tertiary hospitals were recruited. The Scale of Perceived OverQalification (SPOQ), the Organizational Commitment Scale (OCS) and the Work Passion Scale (WPS) were used to collect the data. Hierarchical multiple regression were employed. Results: Perceived overqualification and organisational commitment were the main predictors for both harmonious and obsessive passions (each p <.001). The unique effect of organisational commitment (βharmonious =.608, βobsessive =.556) on work passion were six to eight times larger than these of perceived overqualification (βharmonious = −.079, βobsessive =.085). Conclusion: Our findings indicate that high perceived overqualification clearly reduces nurses' harmonious passion and increases their obsessive passion, whereas high organisational commitment significantly promotes nurses' harmonious and obsessive passions. Implications for nursing management: Nurse managers should distinguish the different effects of perceived overqualification and organisational commitment on work passion. Effective intervention should be developed to release nurses' potential abilities and improve their organisational commitment and work passion. Chinese Clinical Trial Registry: ChiCTR2100047974. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe the prevalence of perceived self‐competence in palliative care among emergency care nurses and explore its predictors. Background: Emergency care nurses have a responsibility to develop palliative care competence to enhance the quality of life of dying patients and their families in the emergency department. Methods: With a convenience sample, a cross‐sectional study was conducted among 415 emergency care nurses from 22 hospitals in China. Descriptive analysis, Spearman correlation analysis and multivariate linear stepwise regression were performed. Results: Variables including marital status (single), emergency department not implementing palliative care, no palliative care training and true cooperation dimension were selected as independent predictors and explained 19.9% of variation in the regression model. Conclusions: Interventions to improve healthy work environments, offering palliative care training, advocating for policies in palliative care and offering support to unmarried nurses can advance nurses' palliative care competence. Implications for nursing management: This is the first study of emergency care nurses in China aimed at identifying predictors associated with palliative care self‐competence. It is significant in that palliative care training and a cooperative work environment are required to encourage the development of palliative care. [ABSTRACT FROM AUTHOR]

Aim: To determine the level of critical cultural competence (CCC) among Chinese clinical nurses and explore its influencing factors. Background: Previous research has only focused on the theoretical model of CCC and the development of assessment tools; however, no large‐scale study has been conducted on the level of clinical nurses' CCC and its influencing factors. Method: Clinical nurses in 14 Level A tertiary hospitals (n = 3858) were surveyed using Almutairi's critical cultural competence scale (CCCS). Descriptive, univariate and multivariate analyses were performed. Results: The mean score of CCC was 4.44 (SD = 0.33). Critical empowerment (M = 4.85, SD = 0.58) and critical awareness (M = 3.57, SD = 0.99) had the highest and lowest scores, respectively. Female nurses, nurses in the nursing department and nurses with higher positions had higher CCC. Conclusion: The CCC of clinical nurses can be strengthened through targeted training, especially considering the fact that male and low‐ranking nurses who had the lower level of CCC work in different departments. Implications for Nursing Management: Hospital administrators should pay attention to the importance of culture and cultural differences among different countries or ethnic groups. Creating an equal and fair nursing environment and encouraging nurses to provide critical cultural nursing is important. [ABSTRACT FROM AUTHOR]

Aim: To analyse junior nurses' transition shock status and its associated factors. Background: When nurses experience transition shock, turnover intentions followed by turnover behaviour are likely, which is unfavourable for the stable development of nursing teams. Methods: Using convenience sampling, 1,148 Chinese junior nurses were recruited. Those recruited completed a demographic questionnaire and the head nurses' humanistic care behaviour for nurses, feedback‐seeking behaviour and transition shock of nurses scales. Data and associated factors of transition shock were analysed using SPSS and univariate and multivariate analyses, respectively. Results: Head nurses' humanistic care behaviour and nurses' feedback‐seeking behaviour were significantly and negatively correlated with junior nurses' transition shock (mean score: 2.87 ± 0.85). Income satisfaction, head nurses' humanistic care behaviour, night shift frequency and educational background entered the regression equation. Conclusions: Transition shock exists not only in new nurses but also in junior nurses with ≤5‐year service. Those dissatisfied with their income have frequent night shifts, and higher education backgrounds have higher levels of transition shock. Implications for Nursing Management: Head nurses need to reduce transition shock of nurses with ≤5‐year service by integrating humanistic care into nursing management and creating a friendly environment to stimulate feedback‐seeking behaviour. [ABSTRACT FROM AUTHOR]

Aims: To investigate the experience and support of nurses as second victims in adverse events and explore factors. Background: Adverse events have significant negative influences on healthcare professionals. However, there is still a lack of research on the impacts of individual and event factors. Methods: A cross‐sectional survey via a self‐report electronic questionnaire was sent to approximately 6400 nurses from six tertiary comprehensive hospitals in mainland China. The socio‐demographic, adverse event‐related information and second‐victim experience and support questionnaires were used. Results: Approximately 2897 (45.26%) of nurses were involved in at least one adverse event that mainly caused psychological distress. Male nurses, Grade I adverse events, public reports and discussions of adverse events were related to the second‐victim reaction. Discussing with a respected colleague was the most strongly desired form of support. Conclusions: Chinese nurses have reported a high prevalence of psychological reactions. Follow‐up studies must consider other potential factors. Implications for Nursing Management: Nursing managers should consider the factors that affect second victims and provide support based on the expectations of nurses. Psychological first‐aid and immediate and mid‐ to long‐term support strategies should be provided to help the second victim alleviate distress. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the effect of organisational innovation climate on nurse innovation behaviour and the mediating role of psychological empowerment. Background: Encouraging nurses to generate more innovative behaviours has become an important development direction for improving the quality of nursing services. Method: We employed a self‐report questionnaire to collect data in Jinan City, China. A total of 2018 valid surveys were obtained. Hierarchical multiple regression model analysis was conducted to test the study hypothesis. Result: The mean values of innovation behaviour and organisational innovation climate were 35.29 and 83.30, respectively. Psychological empowerment was found to have partially mediating effect on the relationship between organisational innovation climate and innovation behaviour. Conclusion: Organisational innovation climate has significant impact on innovation behaviour, and it can indirectly affect innovation behaviour via the mediating role of psychological empowerment. Implications for nursing management: Nursing managers should enhance innovation climate through formal rules, procedures and training activities. They can establish resource guarantee system and information sharing platform, and strengthen work autonomy for nurses to improve their psychological empowerment. [ABSTRACT FROM AUTHOR]

Aims: To evaluate psychological well‐being and factors associated with post‐traumatic stress disorder (PTSD) among front‐line nurses during the coronavirus disease‐2019 (COVID‐19) pandemic. Background: Coronavirus disease‐2019 is a pandemic that has posed a public health emergency of international concern. Psychological well‐being of front‐line nurses is a big concern during the COVID‐19 pandemic. Methods: With a predictive study design, a same survey was sent separately at two time points (i.e. before and after nurses worked at COVID‐19 units) between January and March 2020 among 356 front‐line nurses in First Affiliated Hospital of Bengbu Medical College, Anhui, China. Results: Of a total 356 front‐line nurses, stress level and the prevalence of PTSD were significantly increased after they worked at COVID‐19 units. Nurses who had work experience less than 2 years were significantly associated with a high risk of developing PTSD. Nurses who worked in COVID‐19 inpatients wards had significantly higher odds of being PTSD (odds ratio [OR] = 21.9, 95% confidence interval [CI]: 5.08; 94.5) than those who worked in other COVID‐19‐related units. Resilience was negatively associated with PTSD (OR = 0.96, 95% CI: 0.93; 0.99). Conclusion: Nurses had significantly increased risk to develop PTSD during COVID‐19 pandemic. Implications for nursing management: Clinical and policy strategies to support front‐line nurses' psychological well‐being, particularly young nurses, in response to COVID‐19 crisis are urgently needed. [ABSTRACT FROM AUTHOR]

Aims: To investigate patient safety culture and its relationship with obstacles to adverse event reporting in Chinese nursing homes. Background: Reporting obstacles are related to high incidences and unreported rates of adverse events. Patient safety culture is also associated with adverse events. However, the relationship between reporting obstacles and patient safety culture in nursing homes is unclear. Methods: A cross‐sectional survey was conducted with a random sampling method among 549 staff members in six nursing homes using instruments of the Nursing Home Survey on Patient Safety Culture and the Adverse Event Reporting Obstacle Scale. The Pearson correlation coefficient, independent t tests, ANOVA tests and multivariate regression analysis were used. Results: Patient safety culture in nursing homes was associated with facility ownership (p <.001), facility scale (p <.001), reporting management (p <.001), whether it was an integrated care institution (p =.006), frequency of concern about patient safety (p =.001), occurrence of adverse events in departments (p =.001) and a punitive atmosphere (p =.044). Adverse event reporting obstacles were negatively correlated with patient safety culture (p <.05). Conclusion: An improvement in patient safety culture was associated with a reduction in reporting obstacles in nursing homes. Implications for Nursing Management: A barrier‐free adverse event reporting system should be built to reduce reporting obstacles and create a non‐punitive patient safety culture in nursing homes. [ABSTRACT FROM AUTHOR]

Aim: We employed the job demands–resources model to examine the impacts of job demands and resources on Chinese nurses' mental health and patient safety. Background: Employee mental health and patient safety represent important organisational goals in most hospitals. However, their relationships to insomnia, professional resources and job crafting, as related to the job demands–resources model among nurses, remain unclear. Methods: A convenience sample of 2095 registered hospital nurses was recruited from 25 provinces of mainland China from June 2019 to July 2019. Data were collected using self‐reported questionnaires that included the following instruments: the Chinese version of the Athens Insomnia Scale, the Practice Environment Scale of the Nursing Work Index, the Job Crafting Scale, the Emotional Exhaustion Scale, the Utrecht Work Engagement Scale, the General Health Questionnaire and the Safety Attitudes Questionnaire. Results: The final model confirmed our hypotheses: burnout mediated the relationship between actual job demands and mental health; work engagement mediated the relationship between perceived job resources and attitudes with regard to patient safety; and job crafting enhanced work engagement and practice environment. Conclusion: The job demands–resources model was extended based on the nurses' job characteristics and mental health, as well as patient safety. Implications for Nursing Management: These findings may contribute to nursing management strategies that encourage employees to prevent burnout, promote work engagement and job crafting, and in turn promote nurses' mental health and patient safety. [ABSTRACT FROM AUTHOR]

Background: Good general well‐being of nurses is associated with reduced burnout and improved patient safety. However, few studies explored the factors of nurses' general well‐being. Aim: The study aimed to assess general well‐being and its predictors among hospital nurses. Methods: The study recruited 573 nurses working in a tertiary Chinese hospital to complete a survey of sociodemographic characteristics, DiSC® personality profile, Self‐Rating Anxiety Scale and general well‐being. Multivariate linear regression was conducted to assess factors affecting nurses' general well‐being. Results: Marital status and clinical rank had a positive impact on general well‐being, especially when nurses were married or in the stage of assistant nursing manager. Conversely, source of stress, DiSC® profile and SAS score had a negative effect on general well‐being, especially when nurses' stress came from colleagues, nurses were characterized by steadiness and conscientiousness, and nurses had extreme anxiety. Conclusion: Marital status, clinical rank, source of stress, DiSC® profile and SAS score were main factors affecting hospital nurses' general well‐being. Implications for Nursing Management: By giving careful attention to nurses' family life, career development, personality characteristics and applying appropriate interventions, nursing managers can improve general well‐being of nurses and promote patient care. [ABSTRACT FROM AUTHOR]

Aim: To translate the instrument for measuring different types of cognitive load (MDT‐CL) into Chinese and assess the reliability and validity of the Chinese version of the MDT‐CL. Background: The MDT‐CL is needed for hospital administrators to identify which nursing staff are prone to high cognitive load and to provide tailored interventions for specific types of cognitive load. Methods: The MDT‐CL was translated into Chinese using forward and back translation, cultural adaptation and pilot tested. The reliability and validity of the instrument were assessed with intensive care unit (ICU) nurses in three tertiary hospitals in China. Results: A total of 222 ICU nurses were recruited. The scale‐content validity index of the Chinese version of the MDT‐CL was 0.966. Confirmatory factor analysis indicated that all the goodness‐of‐fit indicators were acceptable. Cronbach's α coefficient was 0.818. Test–retest reliability was 0.785. Conclusions: The Chinese version of the MDT‐CL is a valid and reliable instrument for evaluating the cognitive load of ICU nurses in China. Implications for nursing management: The validated Chinese version of the MDT‐CL is a feasible, quantitative tool for evaluating different types of cognitive load in busy clinical practice, suggesting significant clinical application value. [ABSTRACT FROM AUTHOR]

Aim: To describe the value, knowledge and implementation of evidenced‐based practice (EBP) among Chinese nurse managers and explore its influencing factors. Background: Although much of literature have reported the importance of nurse managers in pushing EBP progress and encouraged them to engage in EBP activities, the extent to which nurse managers engage in EBP is unclear. Methods: A cross‐sectional web‐based survey was applied to 1,166 nurse managers recruited from 54 hospitals in Guangdong Province, China. Descriptive statistics, t‐tests or one‐way ANOVAs, Spearman's correlation and multiple regression analysis were used to analyse the data. Results: The average scores of the Quick‐EBP‐VIK were with the mean of 2.62 (±0.56). Result showed that educational background, professional title, whether they have received EBP education or training, and EBP organisational culture and readiness are the factors influencing managers' total Quick‐EBP‐VIK score, with 43.5% of the variance explained by these factors. Conclusions: Nurse managers had positive attitudes towards EBP, but they lacked the EBP knowledge and rarely implemented EBP. Furthermore, supportive organisational environment, effective education and training can help to enhance EBP knowledge and skills of managers. Implications of nursing management: The competence of nurse managers for EBP implementation should be taken seriously. Personal and organisational strategies which can strengthen managers' EBP knowledge and skills need to be developed and conducted. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to gain a general overview of the time management disposition of clinical nursing managers in China and its related factors. Background: Effective time management is important for managers to achieve organizational goals. However, there is a lack of big‐sample research exploring the impact of psychological and socio‐demographic characteristics on time management disposition. Method: The study adopted a cross‐sectional and descriptive design; 531 nursing managers from seven regions of China were recruited. Results: The nursing managers performed best on sense of time's value, followed by time monitoring ability and sense of time efficacy. Time management disposition was predicted by self‐efficacy, SDS scores, managerial experience, the character strength of self‐control and number of children. Conclusion: The "norm" level of the Chinese clinical nursing managers' time management disposition was at a favourable level, but these managers performed poorly in the aspect of time monitoring. It is recommended that actions be taken to improve nursing managers' time management disposition in order to maximize their time‐use efficiency and enhance the quality of nursing management. Implications for Nursing Management: A greater understanding of nursing managers' time management disposition will provide a reference for subsequent actions to improve nursing managers' time management behaviour, which in turn will improve the quality and efficiency of nursing management. [ABSTRACT FROM AUTHOR]

Aim: This cross‐sectional correlation study aimed to explore the associations among patient safety culture, organisational support, second victim‐related distress, absenteeism and turnover intentions in the registered nurses (RNs) by using structural equation modelling. Background: Medical errors could cause RNs' second victim‐related distress, which may either positively or negatively impact patient safety culture. Method: The Hospital Survey on Patient Safety Culture (HSOPSC) and Second Victim Experience and Support Tool (SVEST) were used to investigate 267 RNs who were involved in direct patient care and medical errors within the previous year in China. Results: About half (45.3%) of nurses experienced psychological distress, and 26.6% of the nurses intended to leave. The model showed that 6 dimensions of patient safety culture have contributed to decreasing absenteeism and turnover intention via increased organisational supports and decreased second victim‐related distress. Conclusion: The second victim‐related distress may be relieved, and organisational support may be enhanced through improvements in patient safety culture. Implications for nursing management: Strategies are needed to establish an environment where cooperation/cooperative relationships between the supervisor and the staff nurse can be ensured. [ABSTRACT FROM AUTHOR]

Aims: To explore the relationships between work environment, value congruence and nurses' work outcomes; as well as to test the moderating effects of value congruence. Background: A poor nursing work environment in most of mainland China has negatively influenced nurses' job satisfaction, burnout and turnover intention. New insights such as improving nurses' value congruence should be proposed to better foster nurses. Methods: Cross‐sectional data were selected from the Chinese Nurses' Environment of Work Status study. In total, 19149 valid samples were collected. Hierarchical regression analyses and simple slope analyses were performed. Results: The correlation coefficients of the variables were all significant (p < .01) and in the expected direction. Value congruence moderated the relationship between nursing work environment and burnout (emotional exhaustion: β = 0.106, p < .01; depersonalization: β = 0.111, p < .01). Conclusions: Nursing work environment and value congruence were positively related to job satisfaction, and negatively related to burnout and turnover intention. The adverse impact of poor work environment on nurses' burnout can be buffered if nurses' value congruence is compatible with that of the organisation. Implications for Nursing Management: Except for improving the organisational characteristics, value congruence is a useful concept that managers can leverage to improve positive outcomes for both the organisation and its nurses. [ABSTRACT FROM AUTHOR]

Aim: To investigate the feasibility of the case mix index and compare the allocation of nursing human resources between two departments of a hospital with different case mix indexes in China. Background: The case mix index is used to assess the resource allocation of all cases in two departments of a hospital. Its values can determine the resource allocation required to diagnose and treat the patients. Methods: Clinical data were obtained from 23 different departments in 2015 and analysed retrospectively from October to November, 2016. Factors influencing the allocation of registered nurses were identified, and balanced quantities of patients with different case mix indexes were chosen from two departments. Spearman correlation analysis was performed. Results: The per capita nursing workload was significant (r = .669, p = .000). The length of hospital stay, quantity of nurses, and department case mix index were correlated with the nursing workload (t = 4.211, p = .000; t = 2.962, p = .008; t = 2.266, p = .035). Education levels (Z = −1.391, p = .164) and the professional titles (Z = −1.832, p = .067) of the nurses were not statistically significant, whereas the registered nurse level differed between two departments (Z = −2.125, p = .034). Conclusion: The case management index provides references for the efficient allocation of registered nurses in clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To explore the situation of older nurses approaching retirement with regard to their retirement planning, and the relationship of their retirement planning behaviour with the job environment and job satisfaction under their current employment arrangements and other work‐related variables. Background: Nurse shortage has become a global phenomenon that can be alleviated by retaining older nurses in service. The Chinese government proposed the “Incremental Delay Retirement Age Policy.” However, older nurses face delayed retirement but lack retirement plans. Method: A cross‐sectional questionnaire survey was conducted among a convenience sample of older retiring nurses (n = 152; 84.92% response rate) recruited from every department of four large general hospitals in Changchun, Jilin Province from June to August 2016. Result: The majority of the respondents presented poor retirement planning (n = 122, 80.3%). The independent variables of information exchange with patients, teamwork and personal growth and development explained approximately 16.6% of the variance in retirement planning. Nurse–patient communication and personal growth and development can promote retirement planning, but teamwork is negatively related to retirement planning. Conclusion: Retirement planning by Chinese older nurses is related to certain work‐related variables. However, many other work‐related variables were not associated with retirement planning and require further research. Overall, Chinese older retiring nurses must improve their retirement planning practices. [ABSTRACT FROM AUTHOR]

Aim To investigate the current nurse work environment, levels of job satisfaction and quality of patient care, and to identify intensive care units with a healthier work environment in mainland China. Background A healthy work environment is closely related to a higher nurse job satisfaction and a better patient care quality. The work environment has not been extensively explored among Chinese intensive care unit nurses. Method The Chinese version of the Essentials of Magnetism II was used to measure the nurse work environment and another two 0–10 single-item scales were used to assess nurses’ overall job satisfaction and nurse-assessed quality of care. Result The study found that the eight essentials of Chinese version of the Essentials of Magnetism II were significantly correlated with each other and also correlated with overall job satisfaction and quality of care. Nurses from medical intensive care units had a healthier work environment with higher scores of overall job satisfaction and quality of care than other intensive care units, while surgical intensive care units showed the least healthy work environment with the lowest overall job satisfaction and quality of care scores identified. The essentials of Chinese version of the Essentials of Magnetism II, overall job satisfaction and quality of care were also correlated with nurses’ work experience and their education level. Implication for nursing management Nurse administrators and health policy-makers should establish a healthy work environment for intensive care units nurses, especially for those from surgical intensive care units. [ABSTRACT FROM AUTHOR]

Aim To explore critical care nurses’ views of their job satisfaction and the relationship with job burnout, practice environment, coping style, social support, intention to stay in current employment and other work-related variables. Background Nurse shortage is a global issue, especially in critical care. Job satisfaction is the most frequently cited factor linked to nurses’ turnover. Method A convenience sample of cardiac critical care nurses (n = 215; 97.7% response rate) from 12 large general hospitals in Shanghai was surveyed from December 2010 to March 2011. Result Over half of the sample reported satisfaction with their jobs. Nurses with 10–20 years of professional experience and those who had taken all their holiday entitlement reported higher levels of job satisfaction. The independent variables of practice environment, intention to stay, emotional exhaustion, personal accomplishment and positive coping style explained about 55% of the variance in job satisfaction. Conclusion Chinese cardiac critical care nurses’ job satisfaction was related to work related variables, which are amenable to managerial action. Implications for nursing management Our findings highlight the imperative of improving intrinsic and extrinsic rewards, together with the flexibility of work schedules to promote job satisfaction and staff retention. A clinical ladder system is needed to provide promotion opportunities for Chinese nurses. [ABSTRACT FROM AUTHOR]