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Aim(s): To identify and synthesize evidence available on nurse leaders' interpersonal communication competence. Design: Systematic mixed‐methods review according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis checklist. Methods: The data were collected following predefined inclusion criteria. Two authors independently performed the study selection using Covidence software. Three authors assessed the quality using Joanna Briggs' Institute's critical appraisal tool and the mixed‐methods appraisal tool. The data‐based convergent synthesis design and narrative synthesis were used. Data Sources: CINAHL, PubMed, Scopus, Business Source Elite, Academic Search Premier, Communication & Mass Media Complete, PsycInfo, Web of Sciences, Medic and Finna.fi were searched and the screening of citations in relevant articles. The final searches were performed on 17 October 2022. Results: A total of 26 studies—15 quantitative, 9 qualitative and 1 of both mixed‐method and multi‐method—met the inclusion criteria. The nurse leaders' interpersonal communication competences described in the extant literature were categorized into three themes: message competence, relational competence and task competence. There were considerable differences in the levels of competence, as some competences were considered basic communication skills, while others required more advanced level competences. Furthermore, three competence levels were identified: novice, competent and expert. Conclusions: This study unravels a unique hierarchical description of communication skills across competence categories, supported by the assumption that communication skills are structured hierarchically. The studies reviewed herein had a narrow perception of nurse leaders' interpersonal communication competence and indicated a transmissional understanding of communication. Impact: This is the first mixed‐methods systematic review that describes and synthesizes the evidence on nurse leaders' communication competencies hierarchically and across competence levels. The study suggests that further research should focus on a broader and more analytical understanding of the cognitive and affective aspects of interpersonal communication competence. PROSPERO ID: CRD42023385058. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims Design Data Sources Results Conclusion Implications for the Profession and/or Patient Care Impact Patient and Public Contribution The purpose of this paper is to provide a conceptual overview of resistance and argue for the need to embrace resistance as a part of nurses' professional repertoire for disrupting inequities and fostering social justice in both nursing education and practice.Discursive article.Published peer reviewed literature on ‘resistance’ and ‘professional resistance’ in nursing, medicine, social work and other allied health care professions.Enhancing critical consciousness and engaging in intersectional collaboration are promising strategies to embrace resistance for collective action towards disrupting inequities and injustices in nursing education and practice.Embracing and legitimising resistance in everyday individual and social interactions in educational and practice settings is instrumental to fostering social justice in nursing. Without resistance, nurses may risk jeopardising enactment of moral and ethical responsibilities and suppressing their professional values of caring and compassion.Nurses can embrace resistance in practice to counteract social injustice and promote diversity, equity, inclusion and belonging and antiracism in clinical and educational settings.Research demonstrated that perceived and real inequities and injustices are common in nursing in the form of individual and structural racism, sex and gender discrimination, power imbalances and incivility. Nurses' engagement in resistance and increased capacity to resist injustices and incivilities can play an instrumental role in disrupting professional inequities in clinical practice and education.There was no patient or public involvement in the design or writing of this discursive article. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to identify the nature and extent of scientific research addressing continuing education for advanced practice nurses. Design: A scoping review. Review Methods: The Joanna Briggs Institute's methodology for scoping reviews. Data Sources: Electronic search was conducted on 17 September 2023 via CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Cochrane Library and the Joanna Briggs Institute's Evidence‐Based Practice Database for research articles published between 2012 and 2023. Results: Nineteen papers were included in this review. Scientific research on continuing education for advanced practice nursing roles (i.e. nurse practitioner, clinical nurse specialist) has primarily been conducted in the United States and mostly addresses online‐delivered continuing education interventions for clinical care competency. Most of the interventions targeted nurse practitioners. Conclusion: Continuing education has a pivotal role in supporting advanced practice nursing competency development. In addition to clinical care, future continuing education research should focus on other advanced practice nursing competencies, such as education, leadership, supporting organizational strategies, research and evidence implementation. Implications for the Profession and/or Patient Care: Continuing education programmes for advanced practice nurses should be rigorously developed, implemented and evaluated to support the quality and effectiveness of patient care. Impact: Continuing education for advanced practice nursing roles is an understudied phenomenon. This review highlights future research priorities and may inform the development of continuing education programmes. Reporting Method: PRISMA‐ScR. [ABSTRACT FROM AUTHOR]

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Aim: To test the psychometric properties of the Finnish version of the Dempster Practice Behaviour Scale and explore nurses' professional autonomy along with which characteristics are related to it. Design: An instrument validation and a descriptive cross‐sectional study. Methods: The web‐based survey was conducted in September 2021 at two university hospitals in Finland. Exploratory factor analysis (EFA) was used to explore the factor structure of the modified instrument, while Cronbach's α coefficients were calculated to determine the reliability of the scale. Descriptive univariate and multivariate analyses were conducted to examine Registered Nurses' professional autonomy. The study followed STROBE guidelines. Results: During the validation process, the 30 items of the Dempster Practice Behaviour Scale were reduced to 25 items. The S‐CVI/Ave for the translated scale was 0.94. When one additional item was omitted from the EFA, the results supported five factors, which explained 45.9% of the total variance. The mean overall autonomy score was 3.63 out of 5, with readiness and empowerment the subscales with the highest and lowest, respectively, mean values. The linear regression models showed that age, nursing experience, unit type, education, shift, and perceptions of the importance of professional autonomy were related to the subscales describing professional autonomy. Conclusion: The psychometric testing provided evidence that the translated instrument was reliable. Nurses assessed that they are skilled professionals who are accountable for their actions. However, they experienced rather low levels of professional autonomy in empowerment and valuation. Health care organizations should consider this through authentic leadership and, thus, possibly strengthen professional autonomy. [ABSTRACT FROM AUTHOR]

Aim. To explore and describe nurse managers' experiences of how the COVID-19 pandemic affected their leadership work. Background. As frontline leaders in healthcare, the work of nurse managers was dominated by the global COVID-19 pandemic in recent years. Method. Semistructured interviews were carried out during autumn 2021 at a Finnish university hospital. Twelve nurse managers participated in video call interviews, and the data were analysed by inductive content analysis. Results. Four main categories of COVID-19 effect on the nurse managers' leadership work were identified: increased work requirements; changes in work content; crisis communication; and human resources. The main categories included a total of 14 subcategories. Conclusion. The complexity and range of nurse managers' leadership work during the pandemic were emphasized. Nurse managers performed several important tasks that ensured ongoing delivery of healthcare services. Flexibility, ability to solve problems, capacity to tolerate uncertainty, pressure and rapidly evolving situations, excellent crisis communicational skills, and an ability to address the diverse needs of their staff were key competencies that nurse managers relied on during this period. Implications for Nursing Management. Nurse managers' experiences of COVID-19 can inform practice, policies, nursing, and nursing leadership education in relation to future crises. [ABSTRACT FROM AUTHOR]

Aims: To describe nurse managers' perceptions of nurses' professional autonomy in hospitals and their role in promoting it. Design: A qualitative descriptive approach. Methods: Fifteen nurse managers participated in semi‐structured focus group interviews in two university hospitals in Finland between May and June 2022. The data were analysed using inductive content analysis. Results: Nurses' professional autonomy in hospitals is perceived according to three themes: individual qualities behind independent actions, limited influencing opportunities in the organization and physicians' central effect. The nurse managers perceive that they enhance nurses' professional autonomy by promoting the nurses' independence at work, their sufficient and up‐to‐date competence, their expert role in multi‐professional cooperation and joint decision‐making and an open and appreciative work community. Conclusions: Nurse managers can enhance nurses' professional autonomy with shared leadership. However, there are still gaps in nurses' equal possibilities to influence multi‐professional work, especially outside of patient care. Promoting their autonomy requires commitment and support from leadership at all levels of the organization. The results advise nurse managers and the administration of the organization to maximize the potential of nurses' expertise, along with encouraging nurses towards self‐leadership. Impact: This study provides an innovative approach to nurses' roles through their professional autonomy from the perspective of nurse managers. These managers have an important role in enhancing nurses' professional autonomy, empowering and supporting them in their expertise, enabling necessary advanced training, and maintaining an appreciative work community where all have equal participation opportunities. Thus, nurse managers have the opportunity to strengthen high‐quality multi‐professional teams' ability to jointly develop the patient's care for better outcomes through their leadership. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To describe nurses' perceptions of family nursing practice and to explore the influence of their perceptions of the benefits, barriers and activities of family engagement in care on family nursing practice. Design: A cross‐sectional correlational study. Methods: In total, 460 nurses from two tertiary hospitals in the central region of Uganda participated. Quantitative and qualitative data were collected between August 2020 and January 2021 using the Family Nursing Practice Scale. Analyses included descriptive statistics, t‐test, Pearson correlation, analysis of variance and ordinal logistics regression. Quantitative content analysis was carried out on the textual data. Results: Nurses who perceived that family engagement in care improves patient and family outcomes were more likely to rate family nursing practice highly. Perceived barriers to family engagement in care particularly time constraints, work overload and family‐related conflicts have a negative and significant influence on family nursing practice. Nurse characteristics such as education, usual shift pattern and personal experience of having a family member in hospital are significantly associated with family nursing practice; nurses who work morning shifts were likely to report higher family nursing practice. Conclusion: The study reveals that several parameters (perceived barriers, perceived benefits and nurse characteristics) influence nursing practice with families. Thus, bearing in mind the diversity of healthcare contexts, the findings show that multiple interacting factors are important for advancing family nursing interventions and practice. Impact: Probabilistic factor‐specific predictions of nursing practice with families are provided in this study – this addresses a gap in the evidence regarding the elements that should be optimized when designing well‐informed policies and interventions to advance family nursing practice. A comparison of results in the literature with the present study's findings suggests a need to broaden the scope and context perspective in future research and broaden the understanding of how nurses´ perceptions influence family engagement in care. Reporting method: The study adheres to the STROBE reporting guidelines. Patient or public contribution: Family members/caregivers were involved in the design of the study particularly in assessment of validation of the tools used in the study. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has challenged nurses and healthcare systems globally and raised major concerns for nurses' wellbeing and working conditions. This cross-sectional and correlational study design aims to describe nurses' resilience, job satisfaction, intentions to leave and quality of care, and explain their relationships during the COVID-19 pandemic. Methods: Data were collected from Registered Nurses (N = 437) in Finland through an electronic survey between February 2021 and June 2021. The questionnaire covered background characteristics (seven questions), resilience (four questions), job satisfaction (one question), intention to leave nursing (two questions), quality of care (one question), and requiring factors of the work (eight questions). The background variables and dependent variables were analyzed and presented using descriptive statistics. Structural equation modeling was used to explain dependent variables relationships. The study followed procedures recommended in the STROBE Statement for cross-sectional studies in efforts to maximize the quality of reporting results. Results: The surveyed nurses evaluated their resilience by mean score 3.92, more nurses had considered leaving nursing during the pandemic (16%) than before (2%). Nurses´ mean score of requiring factors of the work was 2.56 and overall job satisfaction 5.8. Structural equation modeling revealed that resilience affected their job satisfaction, which also influenced the quality of care, that was rated moderate (7.46 out of 10). Structural equation modeling indices of goodness of fit were NFI = 0.988, RFI = 0.954, IFI = 0.992, TLI = 0.97, CFI = 0.992, and RMSEA = 0.064. No direct relationship was found between resilience and intention to leave nursing. Conclusions: Good resilience promoted delivery of high-quality care by nurses during the pandemic and enhanced their job satisfaction, which reduced their intention to leave nursing. The results indicate that it is important to develop interventions that support nurses' resilience. Impact: The study highlights the importance of nurses' resilience during the pandemic, while job satisfaction may decrease and requiring factors of the work increase. Given the number of nurses who consider leaving nursing, there are clear needs to develop effective strategies to maintain quality healthcare with resilient, committed nursing staff. [ABSTRACT FROM AUTHOR]

Aim(s): To identify, describe and assess research evidence on factors that promote working until and beyond the official retirement age among nurses. Design: A mixed‐methods systematic review. Prospero ID CRD42022303890. Data Sources: The CINAHL, PsycINFO, MEDLINE, Scopus, SocINDEX and Web of Science databases were searched in December 2021. Review Methods: The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) checklist was followed. Two researchers independently applied eligibility criteria, selected studies and conducted quality appraisals. Data‐based convergent synthesis and thematic analysis were used. Results: Eighteen studies were included, most of which were survey‐based. Eleven studies were quantitative, six were qualitative and one used mixed methods. Our results reveal that willingness to continue in work increased with age. Six factors promoted working until and beyond the official retirement age among nurses: good health and work ability, the significance of work sufficient income, meaningful relationships and support in the working community, individually tailored work arrangements, and organizational support and recognition. Conclusion: To sustain experienced nurses in working life and promote their working beyond retirement age organizations urgently need to apply throughout working lives supporting age management schemes. Interventions should target supportive relations and individual and flexible arrangements at the workplace. Scarce studies investigated factors contributing to an extension of working life among nurses. Most published evidence on this topic is based primarily on nurses' subjective opinions and preferences: no intervention studies or objective evaluations of factors affecting retirement were found. Impact The available evidence suggests the most critical factors for extending nurses' working lives are support and individual and flexible arrangements in the workplace. There is a need to test interventions and evaluate the effectiveness of measures encouraging nurses to extend their working lives. No Patient or Public Contribution: Systematic review. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine (1) the perceptions on core competencies of healthcare professionals working at clinical settings in Oman and (2) which demographic characteristics explain the overall core competency. Design: A cross‐sectional design. Methods: Healthcare Professional Core Competency Instrument, consisting of 11 sub‐scales with 81 items, was distributed to healthcare professionals (n = 1,543; 826 nurses and 717 physicians) who worked at primary, secondary and tertiary healthcare institutions. Descriptive statistics, t‐test, ANOVA and linear regression were used for data analysis. Results: Altogether 1,078 healthcare professionals (628 nurses and 450 physicians) responded representing 70% overall response rate. Healthcare professionals perceived their overall core competence as excellent, safety being the highest, and research and evidence‐based practice was the lowest. The multiple linear regression analysis revealed that ethnicity, gender and years of working experience were the characters that explained the overall core competence, where expatriate senior professionals reported higher competency levels compared with counterparts. [ABSTRACT FROM AUTHOR]

Aim: This integrative review aimed to describe the perceptions of the quality of care of older patients (aged 65 and above) living with cancer in acute‐care settings. Methods: We identified relevant research suitable for inclusion criteria through systematic searches of the PubMed®, EBSCOhost Academic Search Premier®, Scopus® and Web of Science® databases. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) framework and the Synthesis Without Meta‐analysis (SWiM) guidelines were used to conduct the research and report the results. The quality of the studies was evaluated using the modified Critical Skills Appraisal Programme (CASP) checklist. Results: A total of 24 studies met the inclusion criteria. The data analysis revealed that care quality could be described through three distinct themes: individuality, a sense of security and respectful encounters. Conclusion: The perceptions of older people living with cancer regarding the quality of acute care have not been extensively covered in the literature. Health‐ and age‐related challenges, patients' overall life situation, clear, realistic information about care and the future and respect during encounters should be given attention. Implications for practice: Patient‐centred and tailored care, considering the heterogeneity of the population and support for independence, is needed. [ABSTRACT FROM AUTHOR]

Aims: To describe how nurse leaders' work‐related well‐being is related to a superior's transformational leadership style and structural empowerment. Background: The demanding role of nurse leader means that these professionals experience emotional exhaustion and challenges with work–life balance. They can also be influenced by the leadership style of their own superiors. Methods: A cross‐sectional questionnaire using two internationally validated scales, namely, the Transformational Leadership Scale and Conditions For Work Effectiveness Questionnaire‐II, was used. Statistical methods were applied during data analysis. Results: A total of 155 nurse leaders participated completed the questionnaire. The participants' work‐related well‐being scores ranged from 8 to 10. The participants felt that their superiors employ transformational leadership. The dimension of feedback and rewards received the lowest scores, whereas the nurse leaders reported moderate overall empowerment levels. A nurse leader's work‐related well‐being was positively correlated with structural empowerment and their superior's leadership style. Conclusions: Despite the fact that nurse leaders reported relatively high levels of work‐related well‐being, more attention should be paid on the feedback and rewards and on the support of superiors as they positively influence the work‐related well‐being. Implications for Nursing Management: Transformational leadership should be supported in organisations and through education as it strengthens work‐related well‐being and structural empowerment of nurse leaders. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to describe nurse perceptions of nurse leaders' internal crisis communication during the COVID‐19 pandemic. Background: Internal communication is a vital part of nurse leaders' work, even more so during crises such as the COVID‐19 pandemic. Method: This is a cross‐sectional study design. The data were collected from 204 Finnish nurses in February 2021. A questionnaire developed in this study consisted of 29 items measuring internal crisis communication and seven demographic variables. The relationships between the variables were examined with cross‐tabulation, a chi‐squared test and non‐parametric tests. Factor structure was evaluated with exploratory factor analysis and reliability with Cronbach's alpha. Results: Nurses perceived the timeliness of communication highest and interaction the lowest. Nurses from intensive care, acute care and operative rooms gave highest evaluations for the content of communication and timeliness. Nurses working with COVID‐19 patients daily or weekly evaluated the highest level of false communication. Conclusion: Nurse leaders' internal crisis communication was timely, especially in the most critical units dealing with the pandemic. The study highlighted the importance of considering a unit's special needs for internal crisis communication. Interaction between nurse leaders and nursing staff during periods of crisis needs improvement. Implications for Nursing Management: Nurse leaders' successful and emphatic communication is important in supporting nurses in managing a crisis. [ABSTRACT FROM AUTHOR]

Aim: To explore nurse leaders' resilience and their role in supporting nurses' resilience during the COVID‐19 pandemic. Background: The COVID‐19 pandemic has challenged health care systems on a global level. Nurse leaders are tasked with ensuring high‐quality care, even during crises, which requires active problem‐solving and confidence in the future—resilience from leaders. Method: A scoping review was conducted using inductive thematic analysis and the PCC (Participants, Concept, Context) framework. The PubMed, Scopus, CINAHL, and PsycINFO databases, as well additional studies and grey literature, were searched from December 2019 to June 2021. Results: The review included 12 studies. Nurse leaders' self‐awareness, self‐reflection, and coping strategies described their resilience during the pandemic. A relational leadership style, supportive and safe work environment, and adequate communication were found to support nurses' resilience. Conclusions: There is scarce research concerning nurse leaders' resilience during the COVID‐19 pandemic. Future research needs to address nurse leaders' personal resilience due to the link with nurses' resilience. Implications for Nursing Management: A healthy work environment is essential for nurses' resilience. During crises, nurse leaders should adopt relational leadership styles and actively interact with nursing staff. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine what kind of psychosocial interventions aimed at improving the well‐being of adult cancer patient caregivers were developed, and to describe the methodological characteristics and clinical effectiveness of the interventions which could be included in the nursing care plans. Design: Systematic review Data sources A systematic search of three databases (PubMed, CINAHL, and PsycINFO) was conducted to identify peer‐reviewed papers published between years 2004–2019. Review Methods: The review was guided by the Joanna Briggs Institute manual for systematic reviews. Data were extracted and appraised by three reviewers using standardized checklists. Narrative synthesis was used to analyse the data. Results: A total of 37 studies underwent analysis. Most of the studies described psychoeducational interventions, designed for patient‐caregiver dyads, delivered face‐to‐face. There was a great variety in caregiver outcomes and measurement tools used. Even though most studies used a randomized controlled design and standardized intervention protocols, many reported problems with recruitment and attrition. Most studies reported that the intervention improved caregiver outcomes, yet the majority of them failed to report effect sizes. Conclusion: There are currently a plethora of successful interventions available for cancer patient caregivers which can be included to the nursing care plan. Psychoeducational online interventions which include a social support component may have the best potential in supporting caregivers. It is important to address specific caregiver needs at different cancer stages rather than general needs of caregivers in future interventions. Impact This review suggests that despite a large number of different interventions which can be included in the nursing care plan to improve the support offered to caregivers, some issues should be addressed while designing an intervention study. The emphasis should be placed on reporting effect sizes, focusing on specific caregiver needs and improving recruitment, retention strategies and sustainability of caregiver interventions. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe how nurses and nurse managers consider sustainable development principles in their daily work, how well they recognise these principles and how these principles are considered in decision‐making in perioperative work. Background: Sustainable development involves interpersonal social and cultural relations and long‐term economic and ecological thinking in societal decision‐making. These dimensions are well‐suited for a foundation of decision‐making in acute health care. No previous research has been performed on perioperative work from the sustainable development perspective. Design: Qualitative descriptive design was used. Data were collected from perioperative nurses (n = 20) and nurse managers (n = 6) working in five surgical departments in a Finnish university hospital. Data were analysed by content analysis. The reporting follows qualitative research checklist (COREQ). Results: The principles of sustainable development were poorly known among the participants. Nurse managers considered their opportunities to influence decision‐making were reduced by their limited economic knowledge. Resource use, individuality, and ecological viewpoints were emphasised in the decision‐making process in perioperative work. Conclusions: Findings reveal that perioperative nurses and nurse managers are aware of economic and ecological sustainability, but they do not actively consider it as part of their work. Social and cultural sustainability must be developed further in decision‐making in perioperative work. Relevance to clinical practice: Perioperative nurses and nurse managers consider that it is important to develop the principles of sustainable development in perioperative work. This research indicates that economic understanding is not guiding decision‐making, and there is a lack of knowledge about the benefits of ecological procedures. Social and cultural sustainability are not connected in perioperative work, although there is collaboration between the surgical team and the patient is essential. This study helps to organise operating room management effectively and diversely. [ABSTRACT FROM AUTHOR]