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Supportive counseling and facilitated referrals to support organizations have shown positive effects on mental health and coping with domestic and family violence. However, the reasons why and how such effects are significant remain unknown. The current paper used data from a randomized controlled trial of a psychosocial intervention implemented in Nepal among 140 abused pregnant women. The hypothesized mediating effects of self‐efficacy and social support on mental health and quality of life of abused pregnant women were tested using serial mediation analyses. Significance of parameter estimates and bias‐corrected 95% confidence intervals (CIs) for the indirect effects were generated using bootstrapping. The postintervention changes in self‐efficacy and social support were found to have significant mediating effects on the relationship between the intervention and changes in both mental health and quality of life of participants post intervention. The positive effects on outcomes were seen at follow‐up as well, though to a lesser extent. Further interventions should focus on enhancing abused women's self‐efficacy and social support to ensure their positive mental health and better lives. [ABSTRACT FROM AUTHOR]

Extensive research on the coronavirus disease 2019 (COVID‐19) is underway. However, there are not many studies on the use of masks, which are essential for infection prevention. This descriptive study aimed to understand the factors influencing the use of masks by Korean adults during COVID‐19. We conducted an online survey with 280 adults in South Korea between August and September 2020, analyzing the data using SPSS version 24.0. Multiple regression analyses were performed to understand the factors that influence individuals' use of masks. The participants' perceived susceptibility, perceived barriers, other people's dignity, compliance with public order, reasonable decision making, and subjective norms explained 21.6% of mask use. Mask use is expected to increase further if people perceive a personal need to wear masks, if their peers perceive the importance of mask use, and if they possess civic consciousness that considers society as a whole. This paper makes a significant contribution to the field of public health, with evidence‐based recommendations for increasing mask use, going beyond simply attributing mask use to individual preferences. [ABSTRACT FROM AUTHOR]

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Nursing and midwifery are unarguably stressful endeavors requiring high levels of psychological capital and coping strategies. The impact of the work environment on patient safety outcomes suggests that high nurse/midwife stress may be associated with more adverse patient events. The purpose of this study was to explore the psychological capital of clinical nurses and midwives and identify explanatory factors (including psychological capital, well‐being, and health‐related behaviors) contributing to attitudes to patient safety. A descriptive web‐ and paper‐based survey comprising a convenience sample of nurses and midwives in acute health facilities in Sydney, Australia, was performed (October 2018 and April 2019). Variables included psychological capital, psychological well‐being, work culture, and attitudes to patient safety. Descriptive statistics were performed and a regression model was specified (a statistical significance of P < 0.05 was set a priori). Psychological capital, depression score, and work engagement had a significant effect on patient safety perceptions when controlling for other factors. The findings suggest that nurse and midwife well‐being is an important consideration when striving to improve patient safety. [ABSTRACT FROM AUTHOR]

Shortage and turnover of registered nurses are worldwide challenges, and work motivation is one factor in retaining staff in the healthcare sector. The aim of this study was to explore registered nurses' motivation expressed in daily communication, using the basic needs in self‐determination theory as a framework. A secondary analysis of ethnographic data, collected through participant observations, informal interviews during observations, and individual interviews, was used. A total sample of all registered nurses employed at a hospital unit in Sweden (n = 10) participated. The data were analyzed thematically through the lens of the basic needs in self‐determination theory: autonomy, competence, and relatedness. Self‐regulation of learning, the possibilities to discuss work‐related challenges with colleagues, and having registered nurses lead dialogues with physicians were factors connected to autonomy. Having a registered nurse and physician solve problems together was a factor connected to competence. A sense of belonging and security in a permissive climate between registered nurses was connected to relatedness. This paper has implications for increased awareness of the three basic motivational needs, which could be used in the development of attractive workplaces. [ABSTRACT FROM AUTHOR]

This study aimed to examine the energy drink consumption pattern of Korean nurses and related factors. A descriptive cross‐sectional design was utilized, and data were collected through a self‐reporting questionnaire. Participants were Korean nurses working in hospitals. Data were analyzed by descriptive statistics, chi‐square test, and binomial logistic regression test. A total of 388 nurses participated in the study. Approximately two‐thirds of the nurses consumed energy drinks in addition to caffeinated coffee and/or tea. They usually consumed energy drinks during working hours and at the workplace. In comparison with nonconsumers, nurses who consumed energy drinks perceived that they had a stimulating effect and could replace regular drinks. Having colleagues who consume energy drinks and perceiving that energy drinks had an arousal effect were shown to be associated factors for energy drink consumption; thus, it is necessary to develop educational strategies targeting these groups of nurses. The reasons for the dependence of hospital nurses on energy drinks should be further investigated. [ABSTRACT FROM AUTHOR]

Over the last decade, the importance of Advanced Care Planning has been recognized in Japan. However, it is still difficult for healthcare providers and patients to verbalize how they want to spend the last days of their lives and what unfinished business they have left to accomplish. This study aimed to clarify how nurses intervened to assist patients with cancer at the end of life to express their thoughts and concerns. Twenty‐four nurses were interviewed regarding how they intervened for patients' thoughts and concerns, and data were analyzed qualitatively using a modified grounded theory approach. A 25‐item scale was selected, and the questionnaires, which included the scale, were distributed to nurses in general wards, palliative care units, and home visiting nurse services. A total of 1864 responses were analyzed. Factor analysis and structural equation model analysis were used, and three factors were identified: "assessment and intervention," "basic care," and "knowledge and communication," which led to the formulation of an intervention structure model for uncovering thoughts and concerns. These results indicate the importance of basic care and communication during interventions for patients. [ABSTRACT FROM AUTHOR]

Enhanced recovery after surgery protocol is a multidisciplinary and multimodal approach designed to improve perioperative outcomes for patients. This meta‐analysis aimed to identify and elaborate on the efficacy of this protocol in women undergoing gynecologic surgery. Four databases were searched for randomized controlled trials from inception to December 2021. A total of 14 studies met the inclusion criteria and were analyzed. There was a significant reduction in the length of stay, the time to first flatus and first defecation, complications, and readmission rates in patients undergoing enhanced recovery after surgery when compared to routine care. The rate of discharge on the first postoperative day significantly increased in patients from the enhanced recovery group. There was no significant difference in the surgery time and blood loss. In conclusion, the enhanced recovery after surgery protocol might have a positive effect on patients undergoing gynecologic surgery. However, there is still heterogeneity between the included studies, and we need more research to draw reliable conclusions that enhanced recovery after surgery is favorable. [ABSTRACT FROM AUTHOR]

This cross‐sectional study aimed to test the influences of social support and emotion regulation strategies (cognitive reappraisal and expression suppression) on burn survivors' posttraumatic growth. A convenience sampling method was adopted to recruit 130 burn survivors from the department of burns and plastic surgery of a public hospital in Linyi, China. Data were collected using self‐reported questionnaires on social support, emotion regulation strategies, and posttraumatic growth. Structural equation modeling was performed to explore the associations among social support, emotion regulation strategies, and posttraumatic growth in burn survivors. The results showed that social support positively affected cognitive reappraisal and negatively affected expression suppression. Furthermore, it positively affected posttraumatic growth. Moreover, social support indirectly influenced posttraumatic growth through cognitive reappraisal, which implies that cognitive reappraisal played a partial mediating effect in the relationship between social support and posttraumatic growth. These findings provide new insights into the predictors of posttraumatic growth. Cognitive reappraisal and social support should be taken into account to improve burn survivors' posttraumatic growth. [ABSTRACT FROM AUTHOR]

In health care, high-fidelity simulation has been shown to result in increased student learning outcomes when compared to low-fidelity simulation. With educational facilities investing significant amounts of money into purchasing high-fidelity simulators, it is imperative to identify if the midlevel simulator, which is less costly, will result in the same learning outcomes. In this study, we examined the effect of midlevel-fidelity simulation versus low-fidelity simulation on Bachelor of Science in Nursing nursing students' knowledge, self-confidence, and skill performance. A quasi-experimental design examined the effects of midlevel-fidelity simulation ( n = 37) versus low-fidelity simulation (case study) ( n = 37) in junior-level nursing students. There was a significant difference for both groups in knowledge and skill performance (measured with a mini Objective Structured Clinical Examination), but not between the groups. Unexpectedly, the case-study group had a higher level of self-confidence (self-reported). The results of this study indicate that further research is needed to support faculties' selection of learning strategies with the lowest cost and highest effectiveness in achieving the desired learning outcomes. [ABSTRACT FROM AUTHOR]

The activities of nursing researchers have been constrained by the COVID‐19 pandemic. Therefore, this study aimed to investigate the types of support and related factors that nursing researchers hope to receive from academic societies during the pandemic and to obtain suggestions for the role of academic societies in supporting nursing researchers and expanding research. An online survey was conducted with 1532 Japan Academy of Nursing Science members. The survey included 19 items of potential support from the society during the COVID‐19 pandemic as well as open‐ended questions. Data were analyzed statistically and qualitatively. For 9 of the 19 items, over 50% of respondents reported that they "needed" or "very much needed" support. Multivariate analysis results showed that younger respondents and those with family members requiring care were significantly more likely to report needs for some items. In the open‐ended comments, there were several suggestions for activities, including "Lobbying for revision of regulations on research implementation." Nursing researchers expressed needs for support that reflect their demographic characteristics and situations, including collaboration across organizations and securing research‐promotion and skill‐development opportunities online. [ABSTRACT FROM AUTHOR]

The turnover of new nurses is a critical issue that not only causes economic loss to hospitals but also negatively affects the quality of nursing services and patient care. This study examined the impact of workplace bullying, which is an external factor, and resilience, an internal factor, on new nurses' turnover intention. The participants of this study comprised 153 nurses from two tertiary hospitals located in Korea with more than 8 weeks but less than 12 months of work experience. The factors impacting the turnover intention of new nurses in tertiary hospitals were verbal and non‐verbal bullying (β = 0.27), tenacity (β = −0.24), not getting placement in the desired department (β = 0.17), and age group (β = 0.12). The regression model was significant (F = 9.23, p<0.001) based on hierarchical regression analysis, and the explanatory power of the model was 29%. It was concluded that reduction of verbal and non‐verbal bullying in the workplace, and programs that promote the tenacity of resilience, are necessary to reduce the turnover intention of new nurses in tertiary hospitals. [ABSTRACT FROM AUTHOR]

Providing care to methamphetamine‐related callout events in the prehospital environment is often complex and resource‐intensive, requiring staff to manage agitation and violence‐related side effects of methamphetamines. In Australia, emergency responders are increasingly required to attend events related to methamphetamines, even though reports suggest methamphetamine use across Australia has declined. The aim of the study was to explore Australian police and paramedic experiences attending methamphetamine‐related events. A qualitative descriptive phenomenology design was employed using semi‐structured interviews with employed police (10) and paramedics (8) from Australia. Data were analyzed using thematic analysis. Participants described the complexities associated with providing prehospital care to people affected by methamphetamines. Participants described associated domestic/family violence, increased levels of violence, challenges with communication, and responder emotional and psychological distress and physical injury. Violence associated with methamphetamine use is a critical factor in prehospital care. Workplace violence and family/domestic violence are important issues that require further research to ensure families and staff are well supported and have the services they need to continue responding to people affected by methamphetamine use. [ABSTRACT FROM AUTHOR]

Grit, a personality trait characterized by having passion and perseverance for long‐term goals, has been linked to increased performance, retention, and well‐being in various fields. In the 15 years since the original grit scale was published, many studies have investigated factors that promote grit. However, a scale has not yet been developed measuring characteristics that can contribute to higher levels of grit. This study aimed to develop a novel scale to measure the psychological resources of grit. The Delphi technique was used to obtain consensus from a national and international panel of academics and practitioners who are experts in grit and related constructs. A total of 30 participants rated 100 scale items over three rounds of online surveys. Experts agreed that items selected for the final scale (n = 20) were essential, with 85% rating them as important or very important. The scale, called the Grit Psychological Resources Scale, has promise as a helpful tool for practitioners involved in staff development and building capabilities that contribute to goal achievement. [ABSTRACT FROM AUTHOR]

The experience of a life‐threatening illness, such as cancer, can have an array of health impacts and social and psychological well‐being can be compromised. This study compared differences in unmet care needs, social support, and hope of Taiwanese women with either newly diagnosed (n = 72) or recurring (n = 39) gynecological cancer at baseline (T0) and three follow‐up surveys every 2 months (T1; T2; T3). Sociodemographic questions and three standardized self‐administered questionnaires were used. The generalized estimating equations (GEE) method was used to analyze data. Women with recurrent cancer reported higher levels of care needs and lower levels of hope than those with a primary diagnosis. Significant positive correlations between social support and hope scores were observed for women with recurring cancer at T1 and T2. However, these women reported less hope at T3 compared to those with a primary diagnosis. Routine assessment of women's care needs related to their medical condition and provision of different kinds of support can aim to improve well‐being and their hope for the future. [ABSTRACT FROM AUTHOR]

In response to growing evidence that student healthcare professionals find professional practicum stressful and that it negatively affects their mental health, a six‐session psychoeducation Resilience and Wellbeing Program was implemented by a professional counselor in Year 3 of the Bachelor of Nutrition and Dietetics at Griffith University, Australia. The aim of this study was to evaluate student dietitians' perceptions of whether the program improved their ability to cope with practicum stressors. The study used a longitudinal cohort design, with students completing surveys at three time points: before and after the program and after the final practicum. The study was completed with two cohorts of students between 2018 and 2020 (n = 111). Most respondents (95%) found their professional practicum to be stressful or challenging on at least some occasions, mostly due to constantly being assessed (56%), finances (40%), and being away from usual supports (38%). Almost all students rated the program as having some value (99%), with the content about stress and self‐care the most highly rated. Qualitative comments revealed the program helped students to manage stress by prioritizing their personal needs. Students used stress management skills during the practicum to achieve balance in their lives, despite pandemic conditions. [ABSTRACT FROM AUTHOR]

HIV prevalence among men who have sex with men in China has increased dramatically, and timely linkage to care after being diagnosed with HIV is important to treatment success. This cross‐sectional study aims to utilize structural equation modeling to test a hypothesized model of timely linkage to care adapted from the HIV‐related stigma framework. Data were collected from 257 men who have sex with men living with HIV. The proportion of participants with timely linkage to care within 1 month was 63.42%. The model result showed a good fit. Higher HIV‐related stigma was significantly associated with a lower level of social support, mental health, maladaptive coping (three mechanism variables), and attitude toward linkage to care. Higher CD4+ T‐cell count, disclosure of HIV positivity to sexual partners, and greater convenience of accessing care were related to timely linkage to care (p < 0.05). These model results suggest that enhancing attention to family reactions and social support are needed for further research and interventions to accelerate newly diagnosed people's access to HIV care in China. [ABSTRACT FROM AUTHOR]

This descriptive‐predictive, cross‐sectional study aimed to explore organizational commitment and to determine the predictability of years of experience, level of education, position, perceived organizational support, and work–life balance on each component of organizational commitment. The participants included 234 nurses who were randomly selected from four general hospitals in the Republic of the Union of Myanmar. The research instruments included a demographic data form, the Organizational Commitment Scale, the Survey of Perceived Organizational Support, and the Work–Life Balance Scale. The data were analyzed using descriptive statistics and stepwise multiple regression. The results revealed that the nurses perceived the three components of organizational commitment at a moderate level. Years of experience, position, perceived organizational support, and work–life balance explained 38.0% of the total variance for affective commitment, 28.3% for continuance commitment, and 35.9% for normative commitment. The findings of this study can inform administrators and policymakers regarding the development of strategies to improve organizational commitment among nurses based on four predictors. [ABSTRACT FROM AUTHOR]

This study was aimed at identifying the social determinants related to COVID‐19 infection in South Korea. This secondary analysis used data from the 2020 Community Health Survey, a nationwide sample taken to understand the health status of Korean residents. The participants were 220 970 adults 19 years of age or older. COVID‐19‐related social determinants were age, education level, marital status, household income, hypertension, eating habits, social support, and regional income. The risk of COVID‐19 infection increased in those who were under 40 years, were high school graduates or higher, were single, had a household income over US$ 4166.7, ate breakfast 5–7 times a week, had three or more helpers during COVID‐19, and lived in a region with above‐average income. Hypertension reduced the risk of COVID‐19 infection. In conclusion, adults with high socioeconomic activity showed a high risk for COVID‐19 infection, which was assumed to include only adults living in residential housing in the community. Further studies are required to include adults living in long‐term care or communal living facilities, known to be frequently infected with the corona virus. [ABSTRACT FROM AUTHOR]

Graduate entry healthcare students experience many challenges during their academic journey. The impact of these challenges needs to be considered to support students through their training and education. In this study, we examined the impact of experiencing these role conflicts (at the outset of the academic year), for example, family and caring responsibilities, activities with family/friends, and daily tasks/chores, on the academic performance (at the end of the academic year) of graduate‐entry healthcare students. We also investigated the potential of students' self‐efficacy for learning to mitigate the extent to which such role conflicts impact academic performance. Findings demonstrate that the more graduate entry healthcare students experienced conflicts between their life responsibilities and their academic responsibilities, the worse their academic performance was across the year. This negative relationship was somewhat mitigated by high self‐efficacy for learning. The practical implications of our research suggest the need to provide specific mitigation strategies to support healthcare students regarding conflicts between their life/family responsibilities and their academic work. [ABSTRACT FROM AUTHOR]

This study examined the association between adding nurse aides and patient mortality in acute care settings. We conducted a retrospective cohort study using a national healthcare administrative claims database. We identified patients who underwent planned surgery for six types of cancer from 2010 to 2017. Multivariable logistic analyses were used to examine the association between the nurse aide staffing level and patient outcomes. The primary outcomes were failure to rescue and 30‐day hospital mortality. We examined 330 666 in‐hospital patients. The median number of nurse aides per 100 occupied beds was 6.60 (interquartile range, 4.61–8.43). In the multivariable analysis, nurse aide staffing level was not significantly associated with failure to rescue or 30‐day hospital mortality. The Japanese government provides economic incentives to hospitals that hire more nurse aides, expecting that a higher nurse aide staffing level will help licensed nurses concentrate on the tasks that need their specialties. However, our findings suggest that adding nurse aides may not be associated with lower rates of failure to rescue or 30‐day hospital mortality in acute care settings. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore New Zealand registered nurses' experiences of resilience and workplace adversity. Resilience research in nursing has concentrated on quantitative and individual aspects. Contextual factors have been largely ignored. This study addresses this gap by qualitatively researching and documenting nurses' experiences of resilience and workplace adversity. An online survey of New Zealand registered nurses was conducted in 2018. Qualitative responses were analyzed using Braun and Clarke's thematic analysis method. Three themes emerged: (i) perseverance; (ii) how the past influences my present resilience; and (iii) things I do to stay strong. Nurses rely on personal resilience to overcome workplace adversity. Health service organizations must implement policies and procedures that (i) reduce workplace adversity, and (ii) encourage and develop strategies for nurses to individually and collectively face adversity with resilience. Future research needs to explore how healthcare organizations can modify existing systems and structures to align with nurses' efforts to sustain and develop resilience. [ABSTRACT FROM AUTHOR]

Current conceptualizations of patient self‐advocacy focus on women with cancer, leaving knowledge of male self‐advocacy deficient. The purpose of this study is to describe the key components of self‐advocacy among men with cancer. Adult (≥18 years old) men with a history of invasive cancer were recruited from cancer clinics and registries. Trained researchers led individual semi‐structured interviews regarding participants' challenges, how they overcame those challenges, and barriers and facilitators to their self‐advocacy. All interviews were analyzed using descriptive content analysis methods and synthesized into major themes. These themes were refined after receiving feedback from key stakeholders. Participants (N = 28) reported three major self‐advocacy themes: (i) managing through information and planning; (ii) finding the best team and falling in line; and (iii) strategic social connections. These themes are richly described with representative quotations for each theme and subtheme. Based on these findings, existing models of patient self‐advocacy should be adjusted to encompass how men self‐advocate. Clinicians should consider how gender may impact how and why patients with cancer self‐advocate so that they can best support their patients in achieving patient‐centered care. [ABSTRACT FROM AUTHOR]

The significance of patient engagement in infection prevention and control remains to be stressed as a means of improving patient safety. This study aimed to determine nurses' awareness of infection prevention and control, assess patient and family education on infection prevention and control, and examine the effect of nurses' infection prevention and control awareness on patient and family education. A multi‐site, cross‐sectional study was conducted among 566 nurses in Hungary. Nurses responded to a questionnaire of three parts: demographics, infection prevention, and control awareness; healthcare‐associated infections, hand hygiene, and standard precautions; and patient and family education. High scores were reached in overall awareness and standard precautions. Nurses educated patients and family members the most on hand hygiene and respiratory hygiene. Nurses with higher awareness educated patients more than those with lower awareness, but the differences were only significant for respiratory hygiene and the reason for isolation. Nursing leaders are encouraged to enhance the culture that is based on nurse/patient partnership and to develop reminders to emphasize the importance of engaging patients and family members in infection prevention and control. [ABSTRACT FROM AUTHOR]

Midwives significantly support women with unplanned pregnancies—promoting a shared perspective on the decision‐making process. This study aimed to develop a scale to support midwives to self‐assess their practice of this vital role. Following the derivation of scale items and pilot testing, the final version of the scale was administered to 531 midwives to establish internal consistency and construct criterion‐related validity. Through exploratory factor analysis, 35 items with a five‐factor structure were retained to form the midwifery practice self‐assessment scale to promote shared decision‐making in women with unplanned pregnancies. These factors illustrate midwives' general aptitude and competencies in understanding environmental factors, collaborating with significant others and the interprofessional group, forming rapport and problem sharing, focusing on consultation content, and promoting autonomous decision‐making. There were high and low scores on the scales after attendance of the workshops to support the decision‐making of women with unplanned pregnancies. The reliability analysis showed acceptable Cronbach's alpha values for the five factors, from 0.85 to 0.87. The scale was demonstrated to be a reliable and valid measure that would help improve the quality of midwives' practice. [ABSTRACT FROM AUTHOR]

Emergencies can negatively affect the morbidity and mortality of nursing home residents. As nurses employed at nursing homes play a key role in such situations, their conceptualizations of emergency management should be considered to improve care. Accordingly, this study aimed to identify nurses' conceptualizations of managing emergencies in nursing homes. A qualitative research design was conducted using interviews with 20 nurses working in five different nursing homes in the Republic of Korea between September 2019 and August 2020. The data were analyzed using phenomenography. This study identified two main perspectives used by nurses in nursing homes to manage emergencies, depending on the resident's condition: emergency care and daily preventive care. Nurses' conceptualizations of care provided in emergencies were organized under the frames of assessment and intervention, whereas routine care carried out during daily life activities fell under the frame of prevention. This study's findings, which elucidate nurses' complex practical and experiential knowledge, provide insights for the development of emergency management training. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of non‐alcoholic beer containing matured hop bitter acids on mood states among healthy adults older than 20 years. This study was an open‐label longitudinal intervention design in which each participant served as their control. For 3 weeks, we evaluated the effect of non‐alcoholic beer containing 35 mg of matured hop bitter acids on mood, sleep quality, and work performance. The data of 97 participants (age range: 23–72 years, median age: 42) were analyzed. After the intervention, we found that matured hop bitter acids significantly improved total mood state, including anxiety, depression, fatigue, and vigor, compared with the baseline. Furthermore, sleep quality and absolute presenteeism were significantly improved after the intervention compared with the baseline. The present exploratory study suggested that 3‐week supplementation with matured hop bitter acids improved mood and peripheral symptoms in persons of a wide range of ages. Although further investigation is needed, the findings suggested that non‐alcoholic beer in daily life might become a choice for maintaining mood states. [ABSTRACT FROM AUTHOR]

Frontline healthcare professionals during the pandemic were exposed to the risk of novel coronavirus disease 2019 (COVID‐19) worldwide. In this study, we aimed to explore the experiences of nurses who were diagnosed with COVID‐19. This qualitative, descriptive study was conducted between July 20 and September 29, 2020. A total of 17 nurses were included by using purposeful and snowball sampling methods and interviewed. Video interviews were conducted through WhatsApp using a semistructured in‐depth interview form. Data were analyzed using the content analysis method. The experiences of nurses at the time of COVID‐19 diagnosis were categorized into three main themes: (a) personal experiences, (b) thoughts on the reasons for getting infected, and (c) social experiences. In conclusion, we shed light on the experiences of frontline nurses during pandemic who were exposed to COVID‐19. Individual, organizational, and social regulations and actions are needed for the management of the pandemic. [ABSTRACT FROM AUTHOR]

The purpose of this cross‐sectional study was to examine factors associated with nurses' resilience during the COVID‐19 pandemic. Data were collected in the latter half of 2020 from 904 nurses across Japan, Republic of Korea, Republic of Turkey, and the United States. The questionnaire included the Connor‐Davidson Resilience Scale 10, plus demographics and 20 questions about practice environment, workplace safety concerning infection control, COVID‐related experience, and organizational support. Fear of becoming infected, intention to leave nursing, and having had a positive COVID‐19 test were inversely associated with resilience (p < 0.05). Regression analysis indicated that U.S. nurses had significantly greater resilience than nurses in the other countries examined (p < 0.001). Nurses reporting organization support and those who participated in policy and procedure development had higher resilience scores (p < 0.01). Organizational support, involving nurses in policy development, and country of practice were found to be important resilience factors in our research, which aligns with other findings. Further research is recommended to determine the optimal practice environment to support nurse resilience. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the resilience of nurses who cared for patients with a confirmed COVID‐19 diagnosis, as well as factors that potentially contributed to that resilience. A total of 23 frontline nurses who cared for patients with COVID‐19 were recruited from a COVID‐19–designated facility in Shanghai, China, using purposive sampling strategies. In‐depth interviews were conducted from March to May 2020. Qualitative data were transcribed verbatim and content analysis was used. Nurses exhibited psychological resilience while caring for patients with COVID‐19. They displayed an ability to bounce back from negative mental experiences and transform to a positive mindset to cope with the stress they faced. Factors that enhanced the nurses' resilience during the pandemic were their becoming familiar with infectious disease protocols, having a sense of professional achievement, receiving social support, having trust in the infection‐control response team in the hospital, and using self‐regulation strategies. This study could guide the design of future resilience‐enhancing interventions that provide positive coping strategies for nurses caring for individuals with infectious diseases during a pandemic. [ABSTRACT FROM AUTHOR]

Workplace cyberbullying has emerged as a new issue. This study aimed to explore individual and organizational factors that affect nurses' workplace cyberbullying in hospital settings. A multicenter, cross‐sectional study was conducted using a self‐report questionnaire. Three tertiary and 18 general hospitals were selected from one city in Korea. A total of 270 nurses with 6 months to 10 years of experience in the current department were enrolled. Multiple regression analysis was conducted to identify the factors associated with cyberbullying. Workplace cyberbullying was affected by self‐labeled victimization due to face‐to‐face bullying, subjective health level, years of experience as a nurse (β = 0.148, p = 0.009), and relation‐oriented nursing organizational culture. Face‐to‐face bullying must be addressed to prevent workplace cyberbullying. It is important to assist nurses to maintain good health—considering that, new nurses with less than 1 year of experience are vulnerable to being victimized. Effective prevention strategies should be prepared to control workplace cyberbullying in clinical practice. [ABSTRACT FROM AUTHOR]

Coping can buffer the effect of stress on well‐being. Information about factors predicting coping is essential knowledge for developing programs to promote effective coping among older people with dementia and serves as basic knowledge for further study. A cross‐sectional study design was employed to investigate the associated and predictive factors of coping. The factors were derived from the Stress Process Model for people with dementia. A group of 364 participants was determined by power analysis and purposively selected from out‐patient dementia clinics of hospitals in Thailand. Data were collected from interviews using questionnaires and were analyzed using Spearman's rank correlation coefficient and the enter method of multiple regression analysis. With reference to the conceptual framework of the Stress Process Model, the results revealed that three background and context factors (gender, personal income, and relationships with family members), two stressor factors (cognitive ability, and self‐esteem), and four mediator factors (optimism, hope, hardiness, and perceived social support) were significantly related to coping. Of the variation in coping scores, 47% could be explained by hope, perceived social support, cognitive ability, and gender. [ABSTRACT FROM AUTHOR]

The SARS‐CoV‐2 or COVID‐19 pandemic has raised public awareness around disease protection. The aims in this study were to recruit participants from Australia and Germany to determine their use of personal protective equipment and COVID‐19 avoidance strategies using scales designed for this study. Principal components analysis with the Australian data revealed two factors in the Protection from Infection Scale, Self‐Care and Protective Behaviors, and a single factor in the Infection Avoidance Scale, with each scale demonstrating strong internal reliability. Data from German participants were used to confirm the scales' structure using confirmatory factor analysis. A comparison of the two data sets data revealed that Australian participants scored higher overall on protection and avoidance strategies but at the item level there were several commonalities, including self‐care behaviors people adopted to avoid contracting COVID‐19. With no foreseeable end to this pandemic, it is important that follow‐up studies ascertain whether the public continues to adopt high levels of PPE use and follows government advice or if pandemic fatigue sets in. [ABSTRACT FROM AUTHOR]

The aim of this prospective cohort study was to assess the maximum intensity of postoperative pain at rest in 620 adults after an elective surgery as well as to determine demographic and clinical predictors of pain. The Hospital Anxiety and Depression Scale was used to evaluate the preoperative mental condition of the patient. Preoperative and postoperative pain were assessed at rest based on the Numeric Rating Scale (range: 0–10). The total median maximum intensity of pain was 3 (interquartile range: 1–5). The linear regression model for the maximum intensity of postoperative pain was statistically significant and very well fitted – the coefficient of determination was 62%. Preoperative anxiety, pain, cancer, a medical history of thyroid (vs abdominal) surgery, and an operation resulting in major (vs moderate) tissue injury have a positive impact on the maximum intensity of postoperative pain. Eye surgery and lower limb operations gave lower scores than abdominal surgery. The early identification of these predictors in patients at risk for postoperative pain will help in preparing an individual pain management plan. [ABSTRACT FROM AUTHOR]

This observational study investigated the relationship between mother‐infant contact time and changes in postpartum depression and mother‐infant attachment. The study population consisted of 101 mothers staying for 14 days at two postpartum care centers in Busan, Republic of Korea. Data were collected from February to March 2018 using a self‐administered questionnaire that covered postpartum depression, mother‐infant attachment, and included a contact timesheet. Data were analyzed using descriptive statistics, including means and standard deviations, Kruskal–Wallis tests, and multiple linear regression with bootstrapping estimation. The mean daily contact time was 5.31 ± 1.80 h. The mean postpartum depression decreased from 8.76 ± 7.10 points at admission to 5.16 ± 3.35 points at discharge. By increasing daily kangaroo mother care time by 1 h, postpartum depression was decreased by 4.02 points. However, changes in mother‐infant attachment were not related to contact time. Kangaroo mother care was effective in decreasing postpartum depression among the mothers at the postpartum care centers. Nurses working at the care centers should encourage mothers to participate in kangaroo mother care programs. Further studies considering various contacts, such as baby massage or bathing, are recommended. [ABSTRACT FROM AUTHOR]

Bedouin society poses challenges to attempts at modernization. Great efforts are being made to expand the number of nurses coming from the Bedouin population. This cross‐sectional study among 201 Bedouin nurses and physicians from southern Israel examined differences in their views on nursing as a profession and its relationship to the working environment, using a self‐administered questionnaire. Bedouin physicians demonstrated less positive attitudes towards the nursing profession than did nurses, but perceived the nursing work environment more positively. Compared to nurses, physicians ranked both nurses' involvement in policy practice and their clinical contribution to quality care lower, but scored nurses' dependence on physicians' orders higher. They also ranked teamwork and professional nursing development higher, and the autonomy of nurses lower. In conclusion, the perception of nursing as a profession in Bedouin society is linked to cultural fundamentals, gender, and the social status of women. Managers of multicultural teams, especially those including Bedouin‐origin healthcare workers, should be aware of the effect of cultural background and should take care to address social disparities and eliminate differences in perspectives. [ABSTRACT FROM AUTHOR]

The purpose of this study of healthcare workers who cared for COVID‐19 patients was to identify factors that affected the duration of wearing personal protective equipment (PPE). The results of this study will provide initial guidance to practicing clinicians and a foundation for further research on this topic. This cross‐sectional study examined 139 frontline healthcare professionals who worked at a single hospital in Wuhan, China, from March 16 to April 1, 2020. General and demographic data, physical and mental status, use of personal protective equipment, type of hospital work, and duration of wearing personal protective equipment were recorded. The mean duration of wearing personal protective equipment was 194.17 min (standard deviation: 3.71). Multiple linear regression analysis indicated that the duration of wearing personal protective equipment was significantly associated with the presence of a chronic disease, working hours when feeling discomfort, lack of patient cooperation and subsequent psychological pressure, prolonged continuous wearing of personal protective equipment, feeling anxious about physical strength, and the presence of fatigue when wearing personal protective equipment. These factors should be considered by practicing healthcare professionals and in future studies that examine the optimal duration of wearing personal protective equipment. [ABSTRACT FROM AUTHOR]

Empathy is an important characteristic for healthcare students and professionals that may improve the quality of healthcare interactions. Empathy has predominantly been studied within medicine, but also among various allied health personnel. Within paramedicine, empathy has previously been examined internationally, but not within Japan. This study used a descriptive, cross‐sectional methodology which aimed to examine self‐reported empathy in Japanese paramedic students using the Jefferson Scale of Empathy, and compare results with similar international cohorts. Empathy levels in the Japanese cohort were higher among females compared to males. In addition, there was a decrease in empathy with each subsequent year of the paramedic program, and a general decrease as age increased. This contrasts with comparable Australian cohorts which demonstrate no significant change in empathy levels during the undergraduate program. Empathy levels measured in the Japanese paramedic cohort were generally lower than for Australian cohorts. The reasons for the differences are unclear at present and thus further research in this area is required to fully determine and describe the contributing factors. [ABSTRACT FROM AUTHOR]

People with chronic obstructive pulmonary disease exhibit various symptoms, some of which can negatively affect their daily lives. Thus, they may adopt coping behaviors to improve their condition. This qualitative descriptive study investigated symptom distress and coping behaviors among 19 Chinese patients with chronic obstructive pulmonary disease using individual, semi‐structured, face‐to‐face interviews. We identified the following three themes for the patients' symptom distress: distressing symptoms, inescapable imprisonment, and no choice other than being a burden to the family. The various coping behaviors of the patients were categorized into the following three themes: struggle during the medical treatment process, careful maintenance of daily life, and coping with negative emotions. Although all patients experienced physical and psychological distress, they displayed a strong desire to improve their lives and health. By recognizing the patients' symptom distress and coping behaviors, tailored interventions could be developed to improve the quality of their lives. [ABSTRACT FROM AUTHOR]

Research into cardiovascular disease and its management in Indonesia, where it currently accounts for 67% of all deaths, has heavily emphasized the biomedical aspects; little is known about the individual's experience of the disease, especially for Indonesian women. This study aimed to understand how gender shapes Indonesian women's experiences of living with heart disease in their daily lives. Twenty‐six women aged 30–67 years were interviewed, and the transcriptions analyzed using a qualitative framework informed by intersectional approaches to gender and culture. Three major themes emerged: (i) the effect of cardiovascular disease on women's day‐to‐day activities, (ii) its effects on women's family relationships, and (iii) the women's coping strategies. The inability to fulfill their required social roles as mother or wife undermined the women's sense of self, a problem particularly acute in a cultural context where responsibility for maintaining harmony in the home and society is ascribed to women. Healthcare professionals should be aware of the ethnic and cultural backgrounds of women with cardiovascular disease, in order to deliver services that meet female patients' social, spiritual, and cultural needs. [ABSTRACT FROM AUTHOR]

It has been widely recognized that healthcare practices should be based on up‐to‐date high‐quality evidence; however, the implementation of evidence has been a slow process in nursing practice. It is crucial for clinical practitioners to be aware of the barriers to implementing evidence‐based nursing. The aim of this study was to describe participants' experiences and thoughts on barriers to implementing evidence‐based nursing in mainland China. Forty‐five participants came from 45 evidence‐based nursing implementation projects carried out in 16 hospitals in mainland China. Data were collected through observation and semi‐structured interviews, after which qualitative content analysis was undertaken. Then, the five themes and subthemes were extracted from the data. The five themes were evidence‐based, nurse‐related, patient‐related, setting barriers, and lack of support. In this study, a variety of barriers influencing evidence implementation in the Chinese nursing context were identified and further explored from the perspective of clarifying misunderstandings about evidence‐based nursing, the profound influence of Chinese culture on patients' preferences and attitudes, and the lack of professional knowledge of nurses. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Perspectives on Caring for Older Patients scale into Chinese, both the full and the shortened versions, and test its psychometric properties among Chinese nursing students. In this methodological research, the scale were translated and administered to 307 nursing students recruited from two universities in mainland China. The psychometric testing mainly included internal consistency reliability using Cronbachʼs alphas, 2‐week test–retest reliability using the intraclass correlation coefficient, convergent validity with Koganʼs Attitude toward Older People scale, and factorial validity using exploratory factor analysis. Cronbachʼs alphas for the full and the shortened version scales were 0.77 and 0.75, respectively. The intraclass correlation coefficient values of both versions exceeded 0.70 and their scores were moderately correlated with the Koganʼs Attitude toward Older People scaleʼs scores. While exploratory factor analyses revealed a six‐factor structure for the full version with factor loadings of five items below 0.3, the shortened version identified two factors with all factor loadings above 0.3. This study concluded that the psychometric properties of the full version scale were adequate and similar to those of the shortened version except for factorial validity. [ABSTRACT FROM AUTHOR]

Missed nursing care and physical restraint have been identified as indicators of patient safety, but no studies to date have explored their relation. To explore the relation between these two phenomena, a secondary analysis of a longitudinal study on 1464 in‐hospital patients and 314 registered nurses was performed. The use of physical restraint was assessed at the bedside on a daily basis; missed care was assessed with the MISSCARE survey. Individual, nursing care, and hospital‐level variables were measured. A total of 184 (12.6%) patients were restrained for 20.33% of their in‐hospital stay. No significant differences emerged in the occurrence of missed care between restrained and unrestrained patients. However, some common antecedents of these two phenomena emerged: in units where there is a lack of personnel, both an increase in missed care and physical restraint duration should be expected. As a consequence, patients are threatened in their right to receive the required care and they are at risk of being restrained. Moreover, a higher skill mix is a preventive factor, which suggests that the increased numbers of registered nurses on the team, may prevent routine forms of physical restraint use by analyzing the physical restraint in place critically and removing them as soon as possible, thus reducing the duration of the restraints. [ABSTRACT FROM AUTHOR]

This authors report on the findings of a study designed to establish website‐based self‐management recommendations for sickle cell disease. Google and Yahoo search engines were used to search the World Wide Web. Purposive sampling was used to select 28 websites that met the inclusion criteria. Data were manually collected from health education materials and subjected to qualitative content analysis. Self‐management was conceptualized as actions involving preventive health, self‐monitoring, self‐diagnosing, and self‐treatment. The results show that the websites recommend more self‐management actions for preventive health and self‐treatment than for self‐monitoring and self‐diagnosis. Frequent oral fluid intake, limitation of overactivity, eating a healthy diet, avoiding extreme temperatures, and infections were the most common preventive health recommendations. Daily pain monitoring and general bodily inspections were the most frequent self‐monitoring recommendations. Commonly cited self‐diagnostic indicators were fever, persistent pain, enlarged spleen, and leg ulcers. The use of analgesics and nonpharmacological measures were regularly cited for self‐treatment. Most recommendations were assessed as clinically safe as they align with standards for sickle cell management. Nurses and other professionals should teach clients how to assess the credibility of websites. [ABSTRACT FROM AUTHOR]

Thai trauma nurses play a vital role in neuroprotective nursing care of patients with moderate or severe traumatic brain injury. Nurses' knowledge of the evidence underpinning initial neuroprotective nursing care vital to safe and high‐quality patient care. However, the current state of knowledge of Thai trauma nurses is poorly understood. In this study, we investigated Thai nurses' knowledge of neuroprotective nursing care of patients with moderate or severe traumatic brain injury. Data were collected by a survey, comprising a section on participant characteristics and series of multiple‐choice questions. All registered nurses (n = 22) and nursing assistants (n = 13) from the trauma ward of a regional Thai hospital were invited to participate: the response rate was 100%. Participants had limited knowledge of carbon dioxide monitoring; causes and implications of hypercapnia; mean arterial pressure and cerebral perfusion pressure targets; management of sedatives and analgesics; and management of hyperthermia. Improving their knowledge focusing on knowledge deficits through educational training and implementation of evidence‐based practice is essential to improve the safety and quality of care for Thai patients with moderate or severe traumatic brain injury. [ABSTRACT FROM AUTHOR]

Women's delay in seeking medical advice for abnormal vaginal discharge can cause serious effects such as infertility, ectopic pregnancy, and advanced cervical cancer. Family healthcare workers are in a unique position to help in the promotion of vaginal health. A nonrandomized controlled trial was conducted among a sample of family healthcare workers in the intervention (n = 37) and a control (n = 37) group to assess the effectiveness of an educational intervention, which was a 2‐day intensive workshop combining reading materials. Data were analyzed using SPSS software (version 20), and the effectiveness of the intervention was determined using a mixed between‐within subjects analysis of variance. The total knowledge and attitude scores were significantly greater for family healthcare workers in the intervention group immediately and at 3 and 6 months after the educational intervention, compared to the control group. A substantial main effect was observed concerning the time, showing an increase in family healthcare workers' knowledge and attitude scores across the four time periods. A statistically significant difference in the median overall health education competency score across the two groups was also observed. The mean score differences in all sub‐competencies in health education were significantly higher among the intervention group, compared to the control group between second postintervention and the baseline. The educational intervention had revealed successful and sustainable improvements in family healthcare workers' knowledge, attitude on vaginal discharge, and health education competency. This can be implemented as an in‐service program for family healthcare workers to improve health education practices. [ABSTRACT FROM AUTHOR]

Factors affecting independence in basic and instrumental activities of daily living have been established in older adults, but not centenarians. The purpose of this study was to examine the state and factors affecting activities of daily living independence in centenarians who resided in Guangxi Province, China. A cross‐sectional design was used. Activities of daily living, physical activity, mobility, and physical performance were measured by the Population Study of ChINese Elderly study instruments, and demographics and cognition were assessed. Of the 228 participants, 57% were independent in basic activities of daily living and 5.7% in instrumental activities of daily living. Stepwise regression showed physical activity, cognition, calf circumference, and self‐reported health were associated with basic activities of daily living. Physical activity, mobility, cognition, and physical performance were correlated with instrumental activities of daily living. In conclusion, the Chinese centenarians showed impaired instrumental activities of daily living but mostly maintained basic functioning. Physical activity and cognition were associated with activities of daily living independence. [ABSTRACT FROM AUTHOR]

Psychological well‐being may play an important role in health behavior adherence and cardiovascular health, but there has been limited study of well‐being in patients with heart failure. In this descriptive qualitative research study, we interviewed 30 patients with heart failure to explore their psychological experiences with heart failure and the perceived associations between positive psychological constructs and adherence to physical activity, diet, and medication recommendations. Interviews were transcribed, then coded in NVivo using directed and conventional content analysis, and the Consolidated Criteria for Reporting Qualitative Research checklist was applied to report our findings. Participants spontaneously reported positive psychological constructs both during an acute phase of illness and 3 months later. Participants most commonly experienced gratitude, acceptance, connectedness, and faith in the setting of heart failure. In contrast, pride, determination, and hope were identified most frequently as playing a role in health behavior adherence. Finally, participants reported a reinforcing relationship between positive constructs and health behavior engagement. These findings suggest that interventions to boost positive constructs have the potential to improve well‐being and health behavior adherence in patients with heart failure. [ABSTRACT FROM AUTHOR]

Nurses' health literacy knowledge and communication skills are essential for improving patients' health literacy. Yet, research on nurses' health literacy knowledge and perception is limited. The study aimed to evaluate nurses' health literacy knowledge, communication techniques, and barriers to the implementation of health literacy interventions. A cross‐sectional study was used, and a total of 1697 nurses in 104 community hospitals in Thailand completed self‐report measures. Approximately 55% of the participants had heard about the concept of health literacy; 9% had received formal training specific to interaction with patients with low health literacy. About 50% of the nurses were aware of their patients' low health literacy; therefore, they applied the recommended communication techniques for them. Delivery of effective health literacy training was hampered by a lack of assessment tools, health literacy training and specialists, educational materials, and health provider time. Hospital administrators, nurse managers, health leaders should develop strategies to create environments and resources supporting health literacy interventions. [ABSTRACT FROM AUTHOR]

This study aims to determine the rates of complementary and alternative medicine methods used by mothers of children with developmental disabilities, reasons for using methods, and comparison of methods according to diagnosis groups. The cohort in this cross‐sectional and correlational study consisted of the mothers of 390 students with developmental disabilities; 77.2% of the mothers reported using at least one complementary and alternative medicine treatment. The highest level of use was found in the groups of mothers of children with cerebral palsy (100%) and autism spectrum disorder (88.5%). The most commonly used treatments were biological therapies consisting of special diets and multivitamins, manipulative and body‐based methods including massage and exercise, and mind–body interventions such as prayer, wearing amulets, and seeking help from a Muslim preacher (hodja). However, mothers never used alternative medicine treatments such as homeopathy, acupuncture, or Ayurveda, nor did they use energy‐based healing techniques such as reiki, tai chi, yoga, kinesiology, or neurofeedback exercises. Health care professionals, especially nurses as health care team members, should be knowledgeable and careful about the benefits, side effects, administration methods, and contraindications of complementary and alternative medicine treatments. [ABSTRACT FROM AUTHOR]