Search

Background. Most frontline nurses lack sufficient readiness for effective disaster response. Therefore, designing a disaster management training program (DMTP) to promote nurses' readiness for disaster response is imperative. Aim. This study aimed to evaluate the effectiveness of a structured DMTP on nurses' readiness for response to disasters. Methods. A randomized controlled trial was conducted. One hundred eligible nurses, recruited using convenience sampling from a medical centre in northern Taiwan, were randomly assigned to either the experimental (EG, n = 50) or control (CG, n = 50) group. Both groups received regular continuous nursing education. The EG received an extra two‐day (16 h) structured DMTP delivered by transdisciplinary collaborations through multiple teaching strategies (lectures, simulations, problem‐solving lessons, demonstrations, tabletop exercises, discussions, group presentations, and reflections). Readiness for disaster response, consisting of four subscales (emergency response, clinical management, self‐protection, and personal preparation), was assessed at baseline and 12 weeks after the intervention. Generalized estimating equations were used as the primary method of data analyses to evaluate the intervention effects. Results. Ninety‐four nurses (94%) completed the study, and 100 nurses were included in the intention‐to‐treat analysis. While participants in the EG had increased readiness for disaster response after training and at the 12‐week follow‐up, those in the CG exhibited no differences between baseline and 12‐week follow‐up. When the group × time interaction was examined, the EG had a greater increase in readiness for disaster response and its four domains, including emergency response, clinical management, self‐protection, and personal preparedness after 12 weeks, than the CG. Conclusion. A two‐day structured DMTP utilizing multiple teaching strategies through transdisciplinary collaborations is recommended to enhance hospital nurses' readiness for disaster response. Implications for Nursing Management. Nursing leaders should consider incorporating such a structured DMTP into ongoing nursing training as a critical component of professional development programs, thereby strengthening nurses' disaster readiness in hospital settings. [ABSTRACT FROM AUTHOR]

Aims and Objectives. The purpose of this study was to investigate the prevalence of job burnout among Taiwanese nurses, specifically exploring the mediating role of workplace social support in the association between nurses' stressors and this burnout. Background. Nurses confront high-stress, high-stakes work environments due to evolving disease patterns and growing healthcare needs. The nurse-patient ratio in Taiwan is higher than in other countries, necessitating effective strategies to mitigate nurse burnout and enhance the quality of patient care. Design. A cross-sectional study design was employed. Methods. From January to April 2019, 500 nurses were recruited from a medical center in Kaohsiung City, southern Taiwan. Participants completed a questionnaire addressing workplace social support, stressors faced by nurses, and job burnout. Data were analyzed using descriptive statistics, one-way analysis of variance, t-test evaluations, Pearson's correlation analyses, and a structural equation model with maximum likelihood estimation. Results. The findings revealed that a portion of nurses experienced high rates of personal burnout (7.20%), work-related burnout (5.00%), and client-related burnout (4.80%). The relationships among workplace social support, nurses' stressors, and job burnout were all substantial, exhibiting correlation coefficients ranging from −0.318 to 0.828. The direct effect of nurse stress on job burnout was 0.551, comprising 90.7% of the cumulative effect. In contrast, the indirect effect of nurse stress on job burnout, considering workplace social support, amounted to 9.3% of the total effect, with a value of 0.056. Conclusions. The study underscored the importance of addressing job burnout among nurses in Taiwan. Workplace social support may function as a mediating factor in the relationship between nurses' stressors and job burnout. Implications for Nursing Management. The results suggest that healthcare administrators should prioritize workplace social support initiatives. These efforts could help identify and address nurses' stressors, promote work-life balance, and reduce nurse-patient ratios and work overload. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the effectiveness of gong meditation on nurses' perceived stress and occupational burnout during the COVID‐19 pandemic. Background: Nurses play an important role in hospitals, and they currently encounter additional stress due to the COVID‐19 pandemic. Design and Methods: In this experimental study, participants were provided intervention with seven sections of gong meditation, and each session lasted for approximately 50–60 min. Data were collected from July 2020 to February 2021. Eighty nurses were randomly assigned to the experimental or control group, and 79 completed all the processes of our protocol. Generalized estimating equations (GEE) were used in data analysis. Results: Compared with the control group, the experimental group experienced significant improvements in stress and occupational burnout. Conclusions: Gong meditation can effectively alleviate stress and occupational burnout among nurses during the COVID‐19 pandemic. Implications for nursing management: Gong meditation can be provided by hospital managers to all nurses to reduce their stress, occupational burnout and subsequent mental health problems. Additionally, we suggest that gong meditation can be used as an effective intervention for individuals in other occupational fields, as it is accessible and inexpensive intervention. [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]

Aim: To examine the role of demographic factors, mindfulness, and perceived stress on resilience among nurses. Background: Resilience is an important attribute in the nursing profession although factors affecting it are very diverse. Knowing these factors may help in enhancing nurses' resilience and their subsequent quality healthcare delivery. Method: Utilizing a cross‐sectional descriptive survey, a convenience sample was recruited to answer questions assessing resilience, perceived stress, and mindfulness in Taiwan between October and November 2021. Independent t‐tests, one‐way analyses of variance (ANOVAs) and hierarchical regression were used to analyse the data. Results: A total of 816 nurses participated in the study. Postgraduate degree nurses had lower perceived stress (p =.006) and higher resilience (p =.003) compared with their college and undergraduate counterparts. Nurses working in internal medicine had significantly higher levels of perceived stress (p =.006) and lower levels of mindfulness (p =.005) compared with those in other departments. Single nurses had significantly higher levels of mindfulness (p =.04) but lower levels of resilience (p =.049) than those who were married. Educational level, perceived stress, and mindfulness were all factors that influenced nurses' resilience. Conclusion: Higher educational levels, perceived stress, and mindfulness appear to influence nurses' resilience. Nurses should therefore be encouraged to upgrade themselves academically, attend refresher courses, and learn adaptive coping strategies. Implications for Nursing Management: Hospital authorities should help nurses deal with stressful issues and offer career development opportunities to update, upgrade, and enhance their skillsets in the profession. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to examine the relationship between psychological ownership of the nursing profession and turnover intention. Background: There is a severe shortage of nurses worldwide. Research is needed to understand how nurses' intention to leave hospitals and the nursing profession can be alleviated. Methods: This study adopted a cross‐sectional design and a survey method. Proportionate random sampling was used to ensure sample representativeness. This study surveyed 430 registered nurses in a medical centre in Taiwan between December 2021 and January 2022. We used Turnover Scale and Self‐Efficacy Scale and developed Having a Place Scale. Results: Psychological ownership comprises three dimensions: self‐efficacy, nurse identity and 'having a place' in the nursing profession. This research is the first to examine how these three dimensions of psychological ownership of the nursing profession are related to the intention to leave a hospital or the nursing profession. Self‐efficacy and 'having a place' are negatively related to nurses' intention to leave a hospital (r = −.23 and −.31, p <.001). Nurse identity is negatively related to nurses' intention to leave the nursing profession (r = −.38, p <.001). Intention to leave a hospital is positively related to nurses' intention to leave the profession (r =.76, p <.001). Conclusion: The findings provide novel insights for retaining nurses. Nurse managers could use strategies such as including nurses in making workplace decisions and encouraging them to personalize their workspace. Implications for Nursing Management: Nurse managers can enhance nurses' self‐efficacy and sense of 'having a place' to retain nurses in hospitals, while enhancing nurse identity to retain nurses in the profession. [ABSTRACT FROM AUTHOR]

Aim: To explore the effectiveness of a digital learning management system in enhancing intensive care unit nurses' critical care knowledge and critical thinking tendency. Background: Learning intensive care unit knowledge and skills is essential for the continuing education of nurses, and impacts patient health outcomes. Enhancing intensive care unit nurses' critical care abilities is a medical care quality concern in clinical practice. Methods: A cross‐sectional study was conducted with 212 participants to investigate the effects of a digital learning system on care quality. Results: After the implementation of the digital learning system, intensive care unit nurses' critical care knowledge and critical thinking skills increased significantly. High‐level nurses had higher critical thinking scores. All participants associated critical care knowledge with improved quality of care. Conclusion: The digital learning management system enhanced intensive care unit nurses' critical care knowledge. Optimizing nursing care safety and quality requires that nursing staff to be at an adequate level, which improves their critical care ability. Implications for Nursing Management: A well‐designed digital learning management system with structured classes may allow intensive care unit nurses to learn effectively and can be used for continuing education. These results are of interest to nursing management staff who want to invest in the continued professional development of intensive care unit nurses to improve critical care knowledge, critical thinking skills, care quality, and health care value. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the main factors that affect nurse practitioners' (NPs) job satisfaction, especially the relationship between organisational commitment and leadership styles in acute care practices. Background: There is little known about the influence of organisational commitment and leadership on NPs' job satisfaction within acute care hospitals. Methods: A cross‐sectional design with a national online survey enrolled 1205 NPs from the Taiwan Association of Nurse Practitioners. A multiple regression model was applied to identify potential variables that associated with job satisfaction. Results: Organisational commitment (mean = 59.47), job satisfaction (mean = 173.47) and leadership style (mean ranged from 13.29 to 28) were at a moderate level. Organisational commitment, leadership style, patient load and NP advancement levels explained 63% of the variance in NPs' job satisfaction. Conclusions: Organisational commitment and leadership styles, such as idealized influence and individual consideration, are major factors that impact NPs' job satisfaction. Implications for Nursing Management: Health care organisations should develop policies targeting organisational commitment and managers' leadership styles to improve NPs' job satisfaction. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 frontline nurses' stress‐reduction programme by the cooperation of manager with the nurses is not‐well developed. Aim: This study aimed to examine the effect of an emergency nurse‐led stress‐reduction project on reducing stress levels during the COVID‐19 pandemic. Methods: The action research was conducted using online and person‐to‐person group brainstorming strategies. The online survey was used to evaluate emergency nurses' stress levels, causes of stress and needs at the 50th, 80th and 110th days of the pandemic from March to May 2020. Results: The numbers of nurses participating in three‐time survey were 160, 166 and 160, respectively. There was a decrease in the nurses' work‐related stress after implementing the improvement strategies. Stress from personal protective equipment (PPE), information about infection control and family's worry about being infected reduced across 2 months. Needs regarding PPE, COVID‐19 information and a forum for sharing experiences of COVID‐19 care decreased whereas needs of allowing more days off increased. Conclusions: The stress‐reduction project targeting at nurses' views of their needs can reduce their stress during the COVID‐19 pandemic. Implications for Nursing Management: The online and person‐to‐person group brainstorming building a good partnership between nurses and managers can be an effective nursing management. [ABSTRACT FROM AUTHOR]

Aims: This study aims to examine coronavirus disease 2019 (COVID‐19) pandemic‐related work factors for adverse effects on the mental health and whether organisational strategies attenuate these effects. Background: COVID‐19 pandemic has led to increased work burden and mental health risks for nurses. Methods: A total of 1499 Taiwanese full‐time nurses completed a web‐based questionnaire between July and December 2020. Pandemic‐related work conditions, namely, increased working hours, caring for COVID‐19 patients, occupational stigma and redeployment, were assessed. Organisational strategies to combat pandemic‐related work stressors including compensation to workers and adequate protection equipment were surveyed. Outcome measures were intention to leave, burnout and depression assessed using validated questionnaires. Results: Redeployment, increased working hours and occupational stigma were associated with adverse mental health and intention to leave in logistic regression analysis. Caring for COVID‐19 patients was negatively associated with depression. Adequate compensation for workers modified the association between redeployment and burnout. Conclusions: Pandemic‐related work conditions were associated with adverse mental health and intention to leave. Organisational strategies attenuated the adverse impact of the pandemic. Implications for Nursing Management: Efforts to decrease stigma and organisational strategies including compensation for workers and adequate protection equipment provision should be adopted to improve nurses' health during a pandemic. [ABSTRACT FROM AUTHOR]

Aims: (a) To identify the frequencies and reasons for missed care by nursing aides in long‐term care facilities and (b) to clarify the correlation between missed care and the characteristics of nursing aides and facilities. Background: Missed care by nursing aides in long‐term care facilities affects the resident's quality of care and, therefore, requires attention. Methods: A cross‐sectional study was conducted, wherein 184 nursing aides and 80 registered nurses were recruited from 10 long‐term care facilities. Results: (a) The most frequently missed item of care by nursing aides was assistance with body cleaning (30.4%). (b) Among all participants, 90.2%, 89.8% and 64% indicated poor communication, labour shortages and material resource insufficiencies, respectively, as the reason for missed care. (c) Participants who perceived staff to be insufficient missed care tasks more frequently than those who perceived staff to be sufficient (p <.05). Conclusions: Missed handover and insufficient nursing aides on duty were identified as the primary reasons for missed care. Implications for Nursing Management: Handover as a nursing process should be improved to promote accuracy and continuity. Flexibility in human resources should be maintained to respond adequately to resident's emergencies, thereby ensuring effective completion of the job. [ABSTRACT FROM AUTHOR]

Aim: To explore changes in anxiety and work stress among new nurses in the first year of a 2‐year residency programme. Background: Few studies have examined the anxiety and work stress of new nurses in a residency programme. Methods: This longitudinal study examined levels of anxiety and work stress among newly employed nurses over 1 year at 1 week and 1, 2, 3, 6, 9 and 12 months. Participants were purposively sampled from a medical centre in Taiwan. The Beck Anxiety Inventory and the Nurse Stress Checklist were used to measure anxiety and stress, respectively. Results: The nurses (N = 200) generally perceived mild levels of anxiety and moderate work stress. However, anxiety and stress peaked at the first and second months. Levels stabilized by the sixth month. General ward nurses perceived higher stress levels than did those in emergency or operating rooms. Conclusions: Stress and work anxiety for new nurses peaked at 1–2 months of employment. Implications for Nursing Management: Nurse managers, preceptors and educators must work together with newly employed nurses in individualized learning and support, doing so to improve the transition experience and reduce levels of work stress and anxiety. [ABSTRACT FROM AUTHOR]

Aims: To identify key factors influencing institutional nurses' self‐perceived competencies in spiritual care. Background: In the past decade, interest in spiritual care has been increasing; however, in long‐term care facilities, limited knowledge is available about nurses' competencies in spiritual care. Methods: The cross‐sectional study was conducted with 202 nurses in 11 long‐term care facilities. Data were collected in a survey using the Spirituality and Spiritual Care Rating Scale, the Nurse Spiritual Care Therapeutics Scale, the Spiritual Care Competence Scale and demographic questions. Data were analysed using stepwise linear regression. Results: Study findings revealed that nurses' perceptions of spirituality and spiritual care, frequency of spiritual care provision and self‐satisfaction with the spiritual care given all significantly predicted overall spiritual care competence, which together explain 58% of the total variance. Conclusions: Improving nurses' perceptions of spirituality and spiritual care and encouraging the performance of spiritual care may be an effective pathway to enhance the spiritual care competence of institutional nurses. Implications for Nursing Management: Additional continuing education on spiritual care topics and the establishment of clear guidance and support from institutional administrators are required to enable nurses to deal with spiritual issues as they arise and improve the quality of holistic care. [ABSTRACT FROM AUTHOR]

Aim: To develop a hospital‐based nursing human capital model for Taiwan. Background: Effective nursing management only becomes possible when nurse managers are able to manage and maintain the right equilibrium among human capital components. Method: We developed an analytic hierarchy process (AHP) model with 8 dimensions and 31 indicators based on extensive literature review and experts' perceptual assessment. We used expert and purposive sampling and invited 82 nursing professionals to rate the importance of these dimensions and indicators. The AHP process was performed to identify the weightage and prioritize the dimensions and indicators of the nursing human capital. Results: Our analysis showed that, for nursing human capital, health was the most important factor (weight: 34.8%), followed by employee protection (20.4%), work attitude (13.7%), employee stability (10.8%), general nursing training (6.3%), competencies (5.8%), advanced nursing training (4.3%) and clinical nursing experience (3.9%). Conclusion and Implication for Nursing Management: The model would be most useful for nurse administrators in long‐range strategic management. Specifically, the model can be used as a reference to form a rating system to analyse nursing human capital. Health promotion programs and employee protection measures targeting nurses could improve nursing human capital in hospitals. [ABSTRACT FROM AUTHOR]

Aims: This study examined the relationship among upgrades in academic qualifications, practice accreditations, self‐efficacy, outcome expectations and nurses' career interest. Background: Interest in the nursing career could help retain nurses in the nursing profession. A global nurse shortage warrants further research to understand what drives interest in the nursing career. Methods: A cross‐sectional design was employed. Data were collected in a medical centre in Northern Taiwan between February and March 2017, using employee records and a survey instrument. Proportionate random sampling was used to identify full‐time registered nurses, of whom 524 provided useable responses. Employee records were used to measure nurses' upgrades in academic qualifications and practice accreditation. Results: Upgrades in academic qualifications and upgrades in practice accreditation are positively related to outcome expectations. Both self‐efficacy and outcome expectations are positively related to career interest. Conclusion: The pursuit of upgrades in academic qualifications and practice accreditation could enhance nurses' outcome expectations, thus enhancing their interest in a nursing career. Implications for Nursing Management: Hospital managers could develop policies, procedures and programmes to encourage nurses to enhance their academic qualifications or practice accreditation, helping enhance their interest in remaining in the nursing career. [ABSTRACT FROM AUTHOR]

Aims: This study examines differences in the determinants of intention to stay (Time 1) and actual retention behaviour at follow‐up (Time 2) between younger and older nursing assistants in long‐term care facilities. Background: The shortage of nursing assistants in long‐term care is increasing, and the nursing assistant workforce is also ageing. Methods: Data were obtained from a stratified equal probability sample of 595 nursing assistants from 137 institutions over a two‐year period in Taiwan. Multilevel modelling was utilized for analyses. Results: High organisational support and low burnout were associated with high intention to stay at Time 1 for both older and younger nursing assistants. However, the retention of older nursing assistants at Time 2 was more strongly influenced by high work latitude, the use of an optimization strategy and less burnout at Time 1, while the retention of younger nursing assistants at Time 2 was more likely to be affected by personal factors such as gender and marital status at Time 1. Conclusion: Organisational factors, the use of selection, optimization, compensation strategies, and burnout were more strongly associated with retention of older nursing assistants than of younger nursing assistants. Implications for Nursing Management: Nursing assistant managers should recognize the needs of nursing assistants vary by age and stage of life. Retention programs that are designed to account for age differences will be more effective at retaining nursing assistants. [ABSTRACT FROM AUTHOR]

Aim: To understand the factors affecting willingness to use telemedicine in patients with coronary artery disease after coronary intervention. Background: Telemedicine is a relatively new service provided to discharged patients in Taiwan, therefore, public acceptance is low. Method: This mixed‐methods study conducted between January and June 2014 used convenience sampling. In total, 140 patients were offered a two‐week free trial of telemedicine services before hospital discharge. Participants completed structured questionnaires and answered semi‐structured qualitative questions related to willingness to use telemedicine services. Results: Patients' willingness to use telemedicine was not significantly correlated with experience using technology, perceived ease of use or computer self‐efficacy; instead, it was based on trust in the hospital staff, opinions of the staff and ongoing support from the case manager. Reasons for their lack of willingness to use the service were mainly related to diseases, technology/equipment and environmental factors. Conclusion: Staff support through telephonic tracking and real‐time feedback can increase willingness to use telemedicine. Implications for Nursing Management: Case managers can collect necessary personal information and offer the patients 24‐hr services as a monitor, an instructor and a companion, thereby accommodating more patients, building value and strengthening telemedicine services. [ABSTRACT FROM AUTHOR]

Aims: To examine the longitudinal effects of individual characteristics on the change pattern of insomnia and the association of occupational stress with insomnia over time in newly graduated nurses. Background: The association between individual factors and insomnia in nurses is inconclusive. Longitudinal research on insomnia in newly graduated nurses is limited. Methods: This prospective longitudinal study included 200 participants generating 800 observations of insomnia severity during their first year of nursing. We employed growth mixture modelling for data analyses. Both time‐varying covariate (occupational stress) and time‐invariant covariates (nurses' characteristics) were entered into the model simultaneously. Results: Nurses had a homogeneous insomnia trajectory during the whole year of survey. The educational level significantly predicted the growth rate of insomnia severity among nurses. Occupational stress at each time point was significantly associated with worse insomnia across time points (all p < .001). Conclusions: Nurses with a baccalaureate degree were more resilient to the development of severe insomnia. Additional studies have an opportunity to investigate the reason for the effects of the educational level on the pattern of insomnia. Implications for Nursing Management: Considering nurses' occupational stress and educational level would lead more effective management of stress and insomnia in newly graduated nurses. [ABSTRACT FROM AUTHOR]

Aim: To identify the 'positive energy' that inspires nurses' retention in the profession. Background: Previous studies focused on the negative extrinsic factors associated with nurses leaving the profession. However, scant research explored the personal intrinsic essence regarding why nurses remain in the profession. Method: This study used a qualitative descriptive design. Ten focus groups including 53 participants were recruited by purposive sampling from five hospitals in Taiwan. Data were collected between March 2015 and January 2016 through semi‐structured focus group interviews. The data were examined by content analysis. Results: Six themes were identified, including sense of mission, achievement, passion, meaning of nursing, personal characteristics and intrinsic coping. Conclusion: Findings emerged from this study characterizing 'positive energy' as a steady inner strength, not easily changed with the external environment, which inspires the retention of staff nurses. Implications for Nursing Management: The themes identified in this study can be used to develop an instrument for assessing nurses' inner attributes which may help managers recruit nurses possessing 'positive energy' of retention. Future researchers may develop an intervention programme to cultivate nurses 'positive energy' and further test its effect on nurse retention. [ABSTRACT FROM AUTHOR]

Aim: Different designs of electronic hand‐off systems might have different levels of effectiveness; this study validated the effectiveness of systems with an Identify, Situation, Background, Assessment and Recommendation (ISBAR) design to one without such a design. Background: Adverse consequences in hospital commonly occur when there are breakdowns in the transmission of information between team members. To ensure information accuracy and consistency, some Taiwan hospitals implemented electronic hand‐off systems. However, the effectiveness of such systems was not investigated. Methods: A quasi‐experiment was conducted to the nurses of two Taiwan case hospitals, one with ISBAR and the other with non‐ISBAR design systems and 200 questionnaires were used to collect data. Results: The respondent rate was 72%. Using system with ISBAR design, nurses can enhance their communication effectiveness and further increase their individual benefits at hand‐off. Using a non‐ISBAR hand‐off system, communication effectiveness depends solely on the nurses' individual cognitive and expressive ability. Conclusion: System with ISBAR design can ensure effective information transmission among nurses for care continuity and prevention of adverse events. Implications for Nursing Management: Ensuring the design of electronic systems is adequate, nursing managers can save nurses' time and effort while using the system to perform their regular work effectively and gain competitive advantage. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to (a) test the hypothesized model for hospital nurses' voluntariness of incident reporting (VIR) and (b) determine the extent to which reporting culture factors, nursing safety practices and perceptions of work predict VIR. Design and Methods: A cross‐sectional survey was applied to 1,380 frontline nurses recruited from six teaching hospitals in Taiwan. Data were collected using self‐administered questionnaires. Correlation analyses and path analyses using structured equation modelling were used. Findings: More than half of the nurses did not display a voluntary attitude towards reporting. VIR was correlated with factors of reporting culture, nursing safety practices and perceptions of work. Through path analyses, the safety practices mediated on the relationship between the reporting culture and VIR. Conclusions: Nurses still have modest willingness of reporting. The factors of reporting culture and nursing safety practices are critical determinants of VIR. Within more behavioural involvement in the safety practices, the reporting culture can support nurses to report voluntarily. Implications for Nursing Management: Strengthening nurses' engagement in safety practices can advance the reporting voluntariness and agreement with reporting culture concurrently. Nurse leaders should continue to optimize workload management and job satisfaction, which is advantageous to the safety practices enacted. [ABSTRACT FROM AUTHOR]

Aims: To examine the effects of work–family conflicts and sleep quality on the self‐perceived health status and the mediating effect of sleep quality on the relationship between work–family conflicts and self‐perceived health status among hospital nurses. Background: Studies related to hospital nurses' work–family conflicts, sleep quality and health status are noteworthy but limited. Methods: A total of 575 hospital nurses in Taiwan were recruited. Data were collected using the work–family conflicts Scale, Chinese Pittsburgh Sleep Quality Index and Chinese Health Questionnaire. Independent t‐tests, chi‐squared tests, multivariate linear regression analyses and the Sobel test were used for analysis. Results: Fifty‐six per cent of all subjects reported having good health. Significantly more nurses with good sleep reported good health than those with poor sleep (84.2% vs. 44.9%, p < 0.0001). The difference in overall work–family conflict scores between the good health group and poor health group was significant (37.3 ± 12.7 vs. 46.3 ± 14.3, p < 0.0001). The correlation between overall work–family conflicts and the self‐perceived health status was indirect, and sleep quality was a mediator (Sobel test: 5.007, p < 0.001). Conclusions and Implications for Nursing Management: Work–family conflicts and poor sleep quality of hospital nurses were associated with poor health. Shift work influences the sleep quality, which mediates the correlation between work–family conflicts and self‐perceived health status. Hospital administrators should be aware of these stressful factors and the health of hospital nurses can be better promoted. [ABSTRACT FROM AUTHOR]

Aims: This study examines how career barriers and supports (i.e., perceived discrimination, lack of advancement, human capital, and social capital) impact affective, normative, and continuance aspects of professional commitment and thus nurses' professional turnover intention. Background: Professional commitment is known to influence professional turnover intention. However, little is known about how career barriers and supports contribute to professional commitment and reduce professional turnover intention. Methods: This study adopted a cross‐sectional design and a survey to collect representative data in a major hospital in northern Taiwan. We used proportionate random sampling to ensure sample representativeness and obtained 524 responses. Results: Perceived discrimination and lack of advancement were negatively related to affective professional commitment. Human capital was positively related to affective, normative, and continuance professional commitment. Social capital was positively related to normative professional commitment. All aspects of professional commitment were negatively related to professional turnover intention. Conclusion: Career barriers and supports have an important influence on professional commitment. Reduced barriers and enhanced support may therefore help reduce nurses' professional turnover intentions. Implications for Nursing Management.: Nursing managers could aim to lessen career barriers while increasing career support for nurses, helping strengthen nurses' professional commitment and retention. [ABSTRACT FROM AUTHOR]

Aim: This study explores the impact of total quality management on patient‐safety‐culture attitudes among clinical nurses, focusing on the correlations between total quality management, work values, employee satisfaction, and patient‐safety‐culture attitudes. Background: Implementing total quality management can improve nurses' attitudes towards patient‐safety culture. Method: This hospital‐based, cross‐sectional survey used a convenience sample of 30 inpatient units and 12 intensive care units at five Taiwanese regional teaching hospitals with over 500 beds. Seven hundred questionnaires were distributed (140 to each hospital) during 25 June–5 July 2015. Data were collected using an anonymous, self‐administered, and structured questionnaire. The model was tested using structural equation modelling and serial mediation analysis. Results: Of 515 completed questionnaires (73.6% response rate), 23 were invalid and 492 were used (70.3% retrieved rate). The total effect of total quality management on patient‐safety‐culture attitudes was significant via work values, which had a direct influence on patient‐safety‐culture attitude. Total quality management affected employee satisfaction, which directly influenced patient‐safety‐culture attitudes. Conclusion: Total quality management creates a beneficial working environment and improves patient‐safety culture. Total quality management, work values, and employee satisfaction orientation are important predictors of nurses' attitudes toward patient‐safety‐culture attitudes. Implications for nursing management: Health care managers should cultivate nursing performance to achieve continuous quality improvement in nursing care. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the mediating effects of work environment and burnout on the relationship between authentic leadership and the intention of nurses to leave their job. Background: Authentic leadership can contribute to a good work environment. Burnout is a critical factor that affects nurses‧ intent to leave. The mediating roles of work environment and burnout on the relationship between authentic leadership and intent to leave is unclear. Methods: A cross‐sectional design was used, and 946 nurses from three different levels of hospital (medical center, regional, and district), defined in terms of the number of beds and type of medical care provided, responded to four self‐report questionnaires. Results: Work environment and burnout mediated the effect of authentic leadership on intent to leave among nurses. The mediating effects of burnout on authentic leadership was present both for junior (β = 0.073) and senior (β = 0.081) nurses. Conclusion: Authentic leadership can affect nurses‧ intent to leave but the work environment and burnout are important mediators of this influence. Implications for Nursing Management: Administrators should adopt authentic leadership practices and make efforts to improve the work environment and decrease burnout in order to decrease nurses‧ intent to leave. [ABSTRACT FROM AUTHOR]

Aims: To determine the moderating effect of a violence‐prevention climate and the mediating effect of work frustration on the relationship between workplace violence (WPV) and the turnover intention of nurses. Background: To maintain the stability and work quality of nurses, WPV should be studied to provide effective prevention measures. Methods: A cross‐sectional study with a convenience sample was adopted. Participants were nurses from three hospitals in Taiwan. Of 1,531 questionnaires, 973 were valid for analysis (63.6%). Results: A total mediating effect of work frustration on nurses' own experiences of WPV increased turnover intention. Witnessing WPV toward coworkers caused a significant partial mediating effect on work frustration that further increased turnover intention. A violence‐prevention climate had a significant moderating effect on the work frustration and turnover intention of nurses after they had witnessed violence against others. Conclusion: Effective policies and an incentivized reporting system can foster a safe and friendly work environment not only for nurses who experience violence but also for those who witness violence. Implications for Nursing Management: Nursing managers and leaders must create a positive consultative pipeline to ensure a safe climate and environment for both the victims of WPV and the nurses who witness violence against others. [ABSTRACT FROM AUTHOR]

Aim: To explore the associations of the professional quality of life and social support with health in nurses. Background: Physical and mental health may be associated with absence from work among nurses. Few studies have explored the associations of professional quality of life and social support on the physical and mental health of nurses. Methods: This was a cross‐sectional study. In total, 294 nurses were recruited from a hospital in Southern Taiwan. A self‐report questionnaire was used to collect data. Results: Burnout, secondary traumatic stress and social support from relatives or friends were important factors of physical and mental health. Interactions between support from relatives or friends and secondary traumatic stress are important factors in physical health. Conclusion: Reducing burnout and secondary traumatic stress is important for physical and mental health of nurses. Increasing social support from relatives or friends may be useful to reduce the negative effects of secondary traumatic stress on the physical health of nurses. Implications for Nursing Management: Nurse managers could design interventions to reduce and prevent nurses from being influenced by burnout and secondary traumatic stress. Educating nurses to build effective social networks with relatives or friends and to seek support when experiencing secondary traumatic stress may also be needed. [ABSTRACT FROM AUTHOR]

Aims The purpose of this study is to examine how the interaction between nurse openness and work experience is related to patient safety. Background No study has yet examined the interactions between these, and how openness and work experience jointly impact patient safety. Methods This study adopts a cross-sectional design, using self-reported work experience, perceived time pressure and measures of patient safety, and was conducted in a major medical centre. The sample consisted of 421 full-time nurses from all available units in the centre. Proportionate random sampling was used. Patient safety was measured using the self-reported frequency of common adverse events. Openness was self-rated using items identified in the relevant literature. Results Nurse openness is positively related to the patient safety construct ( B = 0.08, P = 0.03). Moreover, work experience reduces the relation between openness and patient safety ( B = −0.12, P < 0.01). Conclusions The relationship between openness, work experience and patient safety suggests a new means of improving patient care in a health system setting. Implications for nursing management Nurse managers may enhance patient safety by assessing nurse openness and assigning highly open nurses to duties that make maximum use of that trait. [ABSTRACT FROM AUTHOR]

Aim To examine how personality and leadership influence efficiency in the nursing service environment. Background Leadership and personality contribute to the success and failure of a unit. However, how they interact to influence performance is still understudied. Methods We used matched pairs sample design to survey 135 head nurses and 1353 registered nurses on validated instruments of demographic characteristics, leadership styles and personality during June and July of 2014. Efficiency was calculated using Data Envelopment Analysis. Tobit regression was used for analysis. Results High conscientiousness and low neuroticism were significantly associated with higher efficiency. Particularly, under the initiating structure leadership style, high conscientiousness, high extraversion, high agreeableness, high openness and low neuroticism were related to higher efficiency. Openness would improve efficiency under a low consideration leadership style. Conclusions Most personality traits were related to higher efficiency under the initiating leadership style. Only openness would improve leaders' efficiency under a high initiating structure and a low consideration leadership style. Implications for nursing management Considering personality as one factor of selecting head nurses, selecting the right person can improve the fit between individuals and organisations, which in turn, improves job performance. Training head nurses to develop better leadership styles in nurses is another way to enhance efficiency. [ABSTRACT FROM AUTHOR]

Aim We explored the impact of job content and stress on anxiety, depressive symptoms and self-perceived health status among nurse practitioners ( NPs). Background Taiwan's NP roles vary between hospitals as a result of the diverse demands and complex tasks that cause job-related stress, potentially affecting the health of the NP. Methods This study utilised a cross-sectional descriptive design with 161 NPs from regional hospitals participating. Data collection involved demographics, the Taiwan Nurse Stress Checklist, the Job Content Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, a General Health Status Checklist and salivary cortisol tests. Results NPs reported moderate job stress, similar job control to nurses, mild anxiety and depression, and below-average self-perceived health. Being a licensed NP, personal response, competence, and incompleteness of the personal arrangements subscales of job stress, and anxiety predicted self-perceived health after adjusting for other covariates. Conclusions Job stress and anxiety affect NP health. Implications for Nursing Management NPs are a valuable resource, and the healthcare system demand is growing. Reasonable NP staffing, working hours, proper promotion systems, the causes of job stress, job content clarification and practical work shift scheduling need to be considered. The occupational safety and physical and psychological health of NPs are strongly associated with the quality of patient care. [ABSTRACT FROM AUTHOR]

Aims (1) To explore the attitudes and perceived barriers to reporting medication administration errors and (2) to understand the characteristics of - and nurses' feelings - about error reports. Background Under-reporting of medication administration errors is a global concern related to the safety of patient care. Understanding nurses' attitudes and perceived barriers to error reporting is the initial step to increasing the reporting rate. Methods A cross-sectional, descriptive survey with a self-administered questionnaire was completed by the nurses of a medical centre hospital in Taiwan. Results A total of 306 nurses participated in the study. Nurses' attitudes towards medication administration error reporting were inclined towards positive. The major perceived barrier was fear of the consequences after reporting. The results demonstrated that 88.9% of medication administration errors were reported orally, whereas 19.0% were reported through the hospital internet system. Self-recrimination was the common feeling of nurses after the commission of an medication administration error. Conclusions Even if hospital management encourages errors to be reported without recrimination, nurses' attitudes toward medication administration error reporting are not very positive and fear is the most prominent barrier contributing to underreporting. Implications for nursing management Nursing managers should establish anonymous reporting systems and counselling classes to create a secure atmosphere to reduce nurses' fear and provide incentives to encourage reporting. [ABSTRACT FROM AUTHOR]

Aims To understand nurse administrators' intentions and considerations in recruiting inactive nurses and to examine predictors of intent to recruit. Background Few studies have provided insight into employer intentions and considerations in recruiting inactive nurses. Methods A census survey collected data from 392 nurse administrators via a mailing method. Results Overall, 89.0% of nurse administrators were willing to recruit inactive nurses. Stepwise regression analysis revealed that the only predictor of nurse administrators' intention to recruit was nurse turnover rate at the hospital. Nurse administrators perceived the most important recruiting considerations were inactive nurses' cooperation with alternating shifts, health status and nursing licence. The most frequent reasons for not recruiting were an inactive nurse's lack of understanding of the medical environment and poor nursing competence. Conclusions Most hospital nurse administrators were willing to recruit inactive nurses. Inactive nurses who wish to return to work should be qualified, willing to work both day and night shifts, and in good health. Implications for Nursing Management Nurse administrators can reduce the nursing shortage by recruiting inactive nurses. Re-entry preparation programmes should be implemented that will provide inactive nurses with knowledge of the current medical environment and the skills required to improve their nursing competence. [ABSTRACT FROM AUTHOR]

Aims To investigate inactive nurses' human capital, intention to return to hospital nursing and incentives for returning. Background Few studies have discussed the loss of human capital with regard to inactive nurses and how to attract them to return to clinical work. Method Systematic random sampling was used, with 328 subjects completing the mailed questionnaires, resulting in a response rate of 25.4%. Results Inactive nurses not only had moderate to high human capital (average years of nursing experience was 10.29, with moderate to high levels of nursing professional commitment and nursing competence) and were young. Forty-three percent of subjects reported intending to return to hospital nursing. Sufficient nurse staffing, greater safety in the working environment, and re-entry preparation programmes were incentives for returning. Conclusions Recruiting inactive nurses back to hospital work is vital and feasible as inactive nurses had a moderate to high degree of human capital. The most feasible way is offering reasonable working conditions, in particular, providing sufficient staffing, a safe working environment and re-entry preparation programmes. Implications for nursing management The findings confirm the human capital of inactive nurses and provide concrete directions for nursing managers to follow when recruiting inactive nurses to hospital nursing. [ABSTRACT FROM AUTHOR]

Aim This study examined the effect of underlying contextual factors on the intention to stay in nurses. Background Workplace promotion, social support, work stress, job satisfaction and organisation-based self-esteem (OBSE) are psychosocial factors influencing the intention to stay in nurses. However, few studies have analysed the relationships among these factors. Method A cross-sectional survey was conducted and a sample was recruited in convenience sampling method from a medical centre in Taiwan. A total of 791 nurses completed a self-report questionnaire over a 3-month period in 2013. Results Social support, work stress, job satisfaction and OBSE significantly affected the intention to stay in nurses. Furthermore, social support and job satisfaction showed a positive direct effect on the intention to stay and an indirect effect on the intention to stay; the indirect effect was mediated by OBSE. Conclusion Organisation-based self-esteem mediates the effects of social support and job satisfaction on the intention to stay in nurses. Implications for Nursing Management The results showing the influence of OBSE on the intention to stay in nurses can serve as insight for hospital managers to make decisions when encouraging and managing employees. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to examine the mediating effects of positive moods underlying the relationship between experiencing compassion at work and both job performance and organisational citizenship behaviour (OCB). Background Employees who have experienced compassion might have more positive moods while at work; such moods have been connected to a host of important organisational outcomes such as better job performance and OCB. Methods This study adopted a two-stage survey whose participants consisted of 269 registered nurses employed by hospitals in Taiwan. All hypotheses were tested using hierarchical regression analyses. Results The results showed that positive moods mediate completely the relationship between experiencing compassion at work and both job performance and OCB. Conclusion When nurses frequently feel that their hospital, supervisors or co-workers are willing to listen to them, the strength that arises from this compassion can effectively increase job performance and OCB though the positive moods process. Implications for nursing management It is importance to cultivate a compassionate and caring culture throughout hospitals' hierarchies, especially from the top down. Nurses will have more opportunities to experience it, witness it, or participate in it when they work within a compassionate and caring organisational culture. [ABSTRACT FROM AUTHOR]

Aim In this study, the influence of work values and personality traits on the intent to stay at work was examined among nurses in Taiwan. Background No empirical studies in this area have been conducted in the nursing industry. Methods A cross-sectional predictive study was performed during 2012 with 1246 nurses recruited from three different types of hospital located in northeastern Taiwan. A structured questionnaire based on the 5-factor model was used. Multiple regression analyses were used to investigate the various factors associated with the intent to stay at work among nurses. Results The overall response rate was 85%. The nurses who had a high level of intent to stay at work were significantly more likely to be in senior roles; exhibited positive work values, conscientiousness, emotional stability; and worked at a non-religious hospital. Conclusion Age, the role of work values, personality traits and type of hospital were crucial in enhancing the level of intent to stay at work. Implications for nursing management The study findings provide evidence for managers to develop an optimal strategy for nurses with specific personality traits and highly positive work values, which can guide the recruitment and retention of nurses. [ABSTRACT FROM AUTHOR]

Aim (a) To explore staff nurses’ actual decisional involvement and preferred level of decisional involvement, the decisional dissonance, and the attributing factors; and (b) to understand staff nurses’ perceptions about the process of decisional involvement at their work place in Taiwan. Background Research related to nurses’ decisional involvement was scarce and mainly emphasized the level of involvement without examining the possible attributing factors and the process of nurses’ decisional involvement. Method A two-phase internet mixed-method study design was used. A total of 125 staff nurses completed the internet survey using decisional involvement scale and 15 completed online forum discussion questions. Result Nurses’ actual decisional involvement was significantly lower than preferred decisional involvement. The attributing factor to nurses’ actual decisional involvement included the level of education, type of hospital, work unit and workload. There were no differences of preferred decisional involvement among different demographic data. Regarding nurses’ perceptions of decisional involvement, three themes were identified: dependent on administrators, fear of getting into trouble, and the power of consensus. Conclusions The low level of actual decisional involvement and preferred decisional involvement might be associated with workload, management style and the fear of getting into troubles. Implication The government, health care organisations, nursing leaders should reexamine the influence of work setting factors, workload and management style to nurses’ actual decisional involvement. [ABSTRACT FROM AUTHOR]

Aim This study explored the influences of transformational leadership on nurse innovation behaviour and the mediating role of organisational climate. Background Recently, global nursing experts have been aggressively encouraging nurses to pursue innovation in nursing in order to improve nursing outcomes. Nursing innovation, in turn, is affected by nursing leadership. Method We employed a questionnaire survey to collect data, and selected a sample of nurses from hospitals in Taiwan. A total of 439 valid surveys were obtained. Hierarchical multiple regression model analysis was conducted to test the study hypothesis. Result The mean values of agreement of nurse innovation behaviour and transformational leadership were 3.40 and 3.78, respectively. Patient safety climate and innovation climate were found to have full mediating effects on the relationship between transformational leadership and innovation behaviour. Conclusion Organisational climate has a significant impact on innovation behaviour. Transformational leadership has indirect effects on innovation behaviour via the mediation of patient safety climate and innovation climate. Implications for nursing management Hospitals should enhance transformational leadership by designing leadership training programmes and establishing transformational culture. In addition, nursing managers should foster nursing innovation through improvements in organisational climate. [ABSTRACT FROM AUTHOR]

Aim To develop or enhance the job satisfaction and organisational commitment of nurses by implementing job rotation and internal marketing practices. Background No studies in the nursing management literature have addressed the integrated relationships among job rotation, internal marketing, job satisfaction and organisational commitment. Method This cross-sectional study included 266 registered nurses (response rate 81.8%) in two southern Taiwan hospitals. Software used for data analysis were spss 14.0 and amos 14.0 (structural equation modelling). Results Job rotation and internal marketing positively affect the job satisfaction and organisational commitment of nurses, and their job satisfaction positively affects their organisational commitment. Conclusion Job rotation and internal marketing are effective strategies for improving nursing workforce utilisation in health-care organisations because they help to achieve the ultimate goals of increasing the job satisfaction of nurses and encouraging them to continue working in the field. This in turn limits the vicious cycle of high turnover and low morale in organisations, which wastes valuable human resources. Implications for nursing management Job rotation and internal marketing help nursing personnel acquire knowledge, skills and insights while simultaneously improving their job satisfaction and organisational commitment. [ABSTRACT FROM AUTHOR]

Aim The study investigated the three symptoms of burnout among hospital nurses and examined the buffering effects of optimism and proactive coping in relation to burnout. Background Nursing is a profession that can easily lead to burnout. Burnout has been one of the most investigated work outcomes in current research. Previous research has largely ignored the positive influence of individuals on job outcomes and has not tested a constructive framework that might facilitate interventions to prevent burnout. Method A cross-sectional survey of 314 staff nurses in general hospitals in Taiwan. Participants completed a set of questionnaires with demographic information. Finding The findings suggested that higher levels of proactive coping behaviours and optimism were associated with lower levels of burnout. Optimism was found to have the strongest relationship with the decreased personal accomplishment of burnout. Conclusion The findings of this study confirmed the importance of optimism and proactive coping in prevention of symptoms of burnout. Implications for nursing management The results of this study provided important recommendations regarding stress management interventions for health-care managers, nurses, psychologists and human resource staff in the reduction of burnout to promote mental health in an organisation. [ABSTRACT FROM AUTHOR]

Aim This study explores whether abusive supervision can effectively predict employees' counterproductive work behaviour ( CWB) and organisational citizenship behaviour ( OCB) and the role of toxic emotions at work as a potential mediator of these relationships in nursing settings. Background Workplace bullying is widespread in nursing. Despite the growing literature on abusive supervision and employees' counterproductive work behaviour and organisational citizenship behaviour, few studies have examined the relationships between abusive supervision and these work behaviours from the viewpoint of the victimed employee's emotion process. Methods This study adopted a two-stage survey of 212 nurses, all of whom were employed by hospitals in Taiwan. Hypotheses were tested through the use of hierarchical multiple regression. Results The results showed that abusive supervision was positively associated with toxic emotions. Moreover, toxic emotions could effectively predict nurses' counterproductive work behaviour and organisational citizenship behaviour. Finally, it was found that toxic emotions partially mediated the negative effects of abusive supervision on both work behaviours. Conclusion Toxic emotions at work are a critical mediating variable between abusive supervision and both counterproductive work behaviour and organisational citizenship behaviour. Hospital administrators can implement policies designed to manage events effectively that can spark toxic emotions in their employees. Implications for nursing management Work empowerment may be an effective way to reduce counterproductive work behaviour and to enhance organisational citizenship behaviour among nurses when supervisors do not promote a healthy work environment for them. [ABSTRACT FROM AUTHOR]

Aim This study examines whether higher perceived stress among female hospital workers can result in more serious work-family conflict ( WFC) and poorer mental health, and also identifies the role that person-environment ( P- E) fit plays in moderating these relationships. Background Female hospital workers with higher perceived stress tend to report greater WFC and worse mental health than others with less perceived stress. A better fit between a person and her environment may lead to lower perceived stress. As a result, she may experience less WFC and better mental health. Methods This study adopts a longitudinal design with 273 participants, all of whom are employed by hospitals in Taiwan. All hypotheses are tested using hierarchical regression analyses. Results The results show that perceived stress is an effective predictor of WFC and mental health status, whereas the P- E fit can moderate these relationships. Conclusion Hospitals should pay more attention to the negative effects of perceived high stress on the WFC levels and mental health of their female employees. The P- E fit can buffer effectively the impact of perceived stress on both WFC and mental health. Implications for nursing management If hospitals can adopt appropriate human resource management practices as well as monitor and manage the P- E fit continuously, they can better help their employees to fit into the overall hospital environment. [ABSTRACT FROM AUTHOR]

Aim This study explores the mediating effects of job satisfaction on work stress and turnover intention among long-term care nurses in Taiwan. Background Healthcare institutions face a nursing shortage, and it is important to examine the factors that influence turnover intention among nurses. Excessive levels of work stress may lead to employee dissatisfaction and a significant inverse relationship between work stress and job satisfaction, including subsequent effects on turnover among nurses. However, little is known about the mediating role of job satisfaction on work stress and turnover intention among long-term care nurses. Methods A cross-sectional survey and a correlation design were used. Multistage linear regression was used to test the mediation model. Results This study showed that job satisfaction significantly mediated the relationship between work stress and turnover intention. Thirty-eight percent of the variance in turnover intention explained by work stress was accounted for by the mediation pathway. Conclusion The results of this study showed that higher job satisfaction significantly decreased work stress and turnover intention among long-term care nurses. Implications for nursing management This study provides nursing administrators with a resource to build a supportive environment to increase nurses' job satisfaction and to decrease their stress and turnover. [ABSTRACT FROM AUTHOR]

Aims The purpose of this study was to explore the relationship between organisational support, organisational identification, and organisational citizenship behaviour and the predictors of organisational citizenship behaviour in Taiwanese male nurses. Background The turnover rate among male nurses is twice that of female nurses. Organisational citizenship behaviour is the predictor of turnover intention. Little information is available on the relationship between organisational support, organisational identification and organisational citizenship behaviour, particularly for male nurses. Methods Data were collected in 2010 from a questionnaire mailed to 167 male nurses in Taiwan. A cross-sectional survey with simple sampling was used in this study. Results The results showed that organisational identification and organisational support were correlated with organisational citizenship behaviour. Organisational distinctiveness, organisational support of work conditions and the type of organisation were the main predictors of organisational citizenship behaviour. Together they accounted for 40.7% of the total variation in organisational citizenship behaviour. Organisational distinctiveness was the most critical predictor, accounting for 29.6% of the variation. Conclusion Organisational support and organisational identification have positive relationships with organisational behaviour. Organisational distinctiveness is an important factor in explaining organisational citizenship behaviour in male nurses. Implications for nursing management This finding provides concrete directions for managers to follow when providing organisational identification, in particular, the organisational distinctiveness will help male nurses to display increasingly more organisational citizenship behaviour. [ABSTRACT FROM AUTHOR]

Aims The purpose of this study was to explore the mediating effects of work empowerment on job satisfaction for nurses in long-term care facilities in Taiwan. Background Previous research has noted that job satisfaction is an important factor that reflects upon the work environment and the characteristics of the job itself. It is important to link work empowerment to job satisfaction among nurses. Methods This research study used a cross-sectional design. A total of 65 nurses participated in the study. Regression models and Sobel tests were fitted to evaluate the relationship between work empowerment and job satisfaction. Results Structural empowerment mediated the effects of psychological empowerment on job satisfaction (standardized β = 0.46, Sobel test: z = 2.69, P = 0.007). Conclusions Both psychological and structural empowerment positively correlated with job satisfaction among nurses in long-term care facilities. The structural empowerment had a mediating effect on job satisfaction. Implications for nursing management The managers of long-term care facilities should create an empowering work environment for nurses by providing them with available resources and by involving them in the developmental goals of the facilities. The critical structural components of an empowered workplace can contribute to the psychological empowerment of nurses and increase their job satisfaction. [ABSTRACT FROM AUTHOR]

Aims To assess the level of and the differences in managerial competencies, research capability, time management, executive power, workload and work-stress ratings among nurse administrators (NAs), and to determine the best predictors of managerial competencies for NAs. Background Although NAs require multifaceted managerial competencies, research related to NAs' managerial competencies is limited. Method A cross-sectional survey was conducted with 330 NAs from 16 acute care hospitals. Managerial competencies were determined through a self-developed questionnaire. Data were collected in 2011. Results All NAs gave themselves the highest rating on integrity and the lowest on both financial/budgeting and business acumen. All scores for managerial competencies, research capability, time management and executive power showed a statistically significant correlation. The stepwise regression analysis revealed that age; having received NA training; having completed a nursing project independently; and scores for research capability, executive power and workload could explain 63.2% of the total variance in managerial competencies. Conclusion The present study provides recommendations for future administrative training programmes to increase NAs' managerial competency in fulfilling their management roles and functions. Implications for Nursing Management The findings inform leaders of hospitals where NAs need to develop additional competencies concerning the type of training NAs need to function proficiently. [ABSTRACT FROM AUTHOR]

chou h. y., hecker r. & martin a. (2012) Journal of Nursing Management 20, 502-511 Predicting nurses' well-being from job demands and resources: a cross-sectional study of emotional labour Aim The aim of the present study was to investigate the effects of job demands and resources as well as emotional labour on job satisfaction and emotional exhaustion among nurses. Background While emotional labour is a construct that has considerable significance in health care as nurses often need to express organizationally desired emotions, little research has investigated the relationships between emotional labour, job demands and resources in the prediction of nurses' well-being. Methods The questionnaire was distributed to 450 registered nurses (RN) working in a teaching hospital in Taiwan during February 2007, of which 240 valid questionnaires were returned and analysed (53.33% response rate). In addition to descriptive statistics and correlation, structural equation modelling (LISREL 8.8) was conducted. Results The findings showed that the frequency of interacting with difficult patients positively related to surface acting. Perceived organizational support (POS) positively related to deep acting and negatively to surface acting. The results also showed that surface acting related negatively, and deep acting related positively, to job satisfaction. The frequency of interactions with difficult patients related positively to emotional exhaustion, and negatively to job satisfaction. Perceived organizational support related negatively to emotional exhaustion and positively to job satisfaction. Conclusions The results suggest that job demands, resources and emotional labour can predict nurses' well-being. Implications for Nursing Management The results of the present study indicate that nurses' well-being can be predicted by job demands, resources and emotional labour. There is a need to address organizational support and training programmes to enhance job satisfaction and reduce emotional exhaustion among nurses. [ABSTRACT FROM AUTHOR]

lee h.-f., chien t.-w. & yen m. (2013) Journal of Nursing Management 21, 648-656 Examining factor structure of Maslach burnout inventory among nurses in Taiwan Aim To investigate the factorial structure of a Chinese version of the MBI-HSS for nurses in Taiwan. Background Previous studies have presented different factorial structures using the Maslach burnout inventory-human services survey (MBI-HSS). Methods Secondary data analysis was implemented to explore the factor structure of MBI-HSS using exploratory factor analysis. Confirmatory factor analysis was then performed to verify the modified structure for nurses in Taiwan. Results The EFA found that three factors explaining 57% of the variance were extracted, and 20 of the 22 items were retained. The goodness-of-fit test was performed using the CFA approach, and it was verified that the modified version of MBI-HSS is a suitable instrument for measuring burnout for nurses in Taiwan. Conclusions A nationwide sample confirmed the factorial structure of MBI-HSS for nurses in Taiwan with a three-dimension, 20-item assessment, and the variance was not diminished in this sample. Implications for nursing management These findings demonstrate that the modified version of MBI-HSS provides a suitable instrument for measuring burnout for nurses in Taiwan. Therefore, the modified version of MBI-HSS can be used to compare burnout of nurses across cultures, providing valuable information for policies or preventions in the future. [ABSTRACT FROM AUTHOR]