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Purpose: This study aimed to determine the validity and reliability of the electronic Compassion Competence Scale (e-CCS). Methods: A cross-sectional, randomized, two-period crossover design was used. Nursing students from four South Korean universities were surveyed between June 2017 and April 2018. The participants were randomly assigned to one of three groups-paper/paper, electronic/electronic, and paper/electronic or electronic/paper-and a test-retest procedure was implemented. The reliability and validity of the e-CCS were evaluated using linear weighted kappa coefficients and intraclass correlation coefficients (ICCs). Internal consistency reliability was verified using linear weighted kappa coefficients and ICCs. Pearson's correlation coefficients between the initial test and retest scores were all statistically significant. Results: The newly developed e-CCS was found to have good reliability and validity. We suggest that future research should increase sample heterogeneity by recruiting diverse age groups, nurses working in different nursing fields, and students from multiple colleges. Conclusion: This electronic instrument will help determine the differences in the level of compassion competence and devise interventions to improve compassion competence in nurses and nursing students. Further studies on enhancing compassion competence among nurses and nursing students may rely on the use of this electronic format. [ABSTRACT FROM AUTHOR]

Objectives Exposure of adults to secondhand smoke (SHS) has immediate adverse effects on the cardiovascular system and causes coronary heart disease. The current study evaluated brief self-report screening measures for accurately identifying adult cardiology patients with clinically significant levels of SHS exposure in need of intervention. Design and setting A cross-sectional study conducted in a university-affiliated cardiology clinic and cardiology inpatient service. Patients Participants were 118 non-smoking patients (59% male, mean age=63.6 years, SD=16.8) seeking cardiology services. Main outcome measures Serum cotinine levels and self-reported SHS exposure in the past 24 h and 7 days on 13 adult secondhand exposure to smoke (ASHES) items. Results A single item assessment of SHS exposure in one’s own home in the past 7 days was significantly correlated with serum cotinine levels (r=0.41, p<0.001) with sensitivity ≥75%, specificity >85% and correct classification rates >85% at cotinine cut-off points of >0.215 and >0.80 ng/mL. The item outperformed multiitem scales, an assessment of home smoking rules, and SHS exposure assessed in other residential areas, automobiles and public settings. The sample was less accurate at self-reporting lower levels of SHS exposure (cotinine 0.05-0.215 ng/mL). Conclusions The single item ASHES-7d Home screener is brief, assesses recent SHS exposure over a week's time, and yielded the optimal balance of sensitivity and specificity. The current findings support use of the ASHES- 7d Home screener to detect SHS exposure and can be easily incorporated into assessment of other major vital signs in cardiology. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the pesticide safety behaviours and related factors among cabbage farmers in Kalaw Township, Myanmar. Background: Unsafe chemical pesticide practices affect farmers' health and the environment. Understanding pesticide safety behaviours is necessary for healthcare providers to protect agriculture workers against unwanted adverse health effects. Methods: The cross‐sectional study was conducted among 195 cabbage farmers from March to May 2019. Safety behaviours and factors applied in the PRECEDE–PROCEDE model as a framework were assessed using questionnaires. Bivariate and multivariate logistic regression was applied to identify any associations. Results: Altogether, 72.1% of the farmers had a low level of safety behaviours. Goggles and masks were rarely used before and during pesticide applications. All of the farmers experienced adverse health effects after using pesticides. The attitudes toward pesticide poisoning; support from family, co‐workers and healthcare providers; and the availability of personal protective equipment were significantly associated with safety behaviours. Conclusion: Our data provide novel empirical evidence for an opportunity to design effective nursing interventions to promote pesticide safety behaviours among Myanmar agricultural workers. Nurses should pay more attention to promoting comprehensive interventions to reduce both exposure and health effects among agricultural workers through the involvement of supported stakeholders. Summary statement: What is already known about this topic? Farmers and agricultural workers have extensively used pesticides in all steps of cultivation and face a greater risk of pesticide exposure, which could result in adverse health effects.Owing to the lack of research on community health promotion conducted in Myanmar, the burden of the consequences and adverse effects of pesticides remains a significant health issue. What this paper adds? Findings reveal a clear framework for better understanding and assessing pesticide safety behaviours among agricultural workers and farmers in Myanmar.Findings contribute new knowledge for nursing community health promotion by enhancing understanding of multilevel factors, including international and external factors, associated with safety behaviours among agricultural workers and farmers. The implications of this paper: Nurses and other healthcare professionals should be aware of the importance of preventing adverse health effects among agricultural workers in the community and interventions aimed at promoting safety behaviours should be focused not only on individuals but also on the involvement of social supports—particularly family and co‐workers.Nursing policymakers should consider strengthening the nursing role in the recognition of pesticide risk exposure and health outcomes, management of pesticide poisoning and exposure and prevention of pesticide‐related health conditions both in nursing education and nursing practice.Local authorities and policymakers should focus their attention on health promotion and health services to promote safety behaviours when using pesticides, and treatment and extension services should be provided for cases of suspected pesticide poisoning. [ABSTRACT FROM AUTHOR]

Aim: To develop and test the psychometric properties of an expanded catheter self‐management scale for patients with in‐dwelling urinary catheters. Design: A cross‐sectional validation study. Despite the utility of the original 13‐item catheter self‐management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self‐management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self‐management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self‐management. Methods: A total of 101 adult community‐dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23‐item expanded catheter self‐management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. Results: The 23‐item expanded catheter self‐management scale yielded a 5‐factor solution, labelled as: (i) self‐monitoring of catheter function, (ii) proactive, help‐seeking behaviour function, (iii) bowel self‐care function, (iv) hygiene‐related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self‐management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self‐management scale and catheter‐related problems. Conclusion: The 5‐factor structure provided a comprehensive assessment of key aspects of urinary catheter self‐management essential to reduce the likelihood of catheter‐related hospital presentations. Implications: The expanded catheter self‐management scale can be used to assess and monitor effective patient‐centred interventions for optimal self‐management to prevent catheter‐related problems and improve the quality of life of patients. Impact: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter.The findings of this study show the correlation between catheter self‐management skills and catheter‐related problems.The expanded catheter self‐management scale (E‐CSM) assists with analysing the self‐management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. Reporting Method: STROBE checklist was used to report all aspects of this study comprehensively and accurately. Patient or Public Contribution: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co‐designing interventions. This paper reports the psychometric analysis of the expanded catheter self‐management scale (E‐CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ‐IDC Study' (Alex et al. in Collegian, 29:405–413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were as follows: (a) to examine the relationship between perceived organizational support and resilience; (b) to investigate the potential mediating role of general self‐efficacy and cognitive reappraisal among emergency nurses who have experienced workplace violence; and (c) to explore the application of Kumpfer's resilience framework to emergency department nurses. Design: A cross‐sectional study. Methods: From February 17, 2021, to March 8, 2021, 825 emergency nurses working in the emergency departments of tertiary hospitals in Shanghai, China, completed an online survey. Data on resilience, organizational support, cognitive reappraisal and general self‐efficacy were collected through questionnaires. The Spearman analysis was employed to investigate the relationship between variables, while the mediation analysis was conducted using AMOS 23.0 statistical software. Results: The findings of a study involving 825 emergency nurses who reported experiencing workplace violence reveal a positive correlation between perceived organizational support and resilience. Additionally, it has been observed that the relationship between these two factors is mediated by both cognitive reappraisal and general self‐efficacy. Furthermore, the mediating effect of cognitive reappraisal is more significant in this relationship. Conclusion: Kumpfer's resilience framework is found to apply to emergency nurses. Perceived organizational support, an environmental factor, affects resilience directly and positively. In addition, cognitive reappraisal and general self‐efficacy, which are individual factors, mediate this influence path. These findings suggest an interaction between environmental and individual factors in determining the resilience of emergency nurses. Impact: These findings have implications for developing resilience intervention strategies for emergency nurses exposed to occupational violence. Enhancing personal attributes such as general self‐efficacy and cognitive reappraisal is as significant as strengthening external organizational support environments for enhancing nurses' resilience. Patient or Public Contribution: Emergency nurses participated in the pilot test of our questionnaire survey and gave their opinions on the questionnaire design. Summary Statement: What is already known about the topic? In emergency rooms, workplace violence is prevalent, and it seriously endangers nurses' physical and mental health. Enhancing resilience can improve nurses' ability to self‐regulate after experiencing violence. However, the drivers and mechanisms of resilience among emergency nurses who have experienced workplace violence remain unidentified. What this paper adds? This study confirms the applicability of Kumpfer's resilience framework to emergency nurses who have experienced workplace violence. Nurses' self‐efficacy and cognitive reappraisal mediate the relationship between perceived organizational support and resilience after exposure to workplace violence. The resilience process for emergency nurses involves the interaction of individual and environmental factors. Implications for practice/policy. Managers and researchers should consider the interaction between individual and environmental factors when developing resilience intervention strategies for emergency nurses who have suffered workplace violence. It is essential to support emergency nurses from the dyadic dimensions of the environment and the individual. A supportive organizational environment and individual positive adjustment strategies are equally important in promoting resilience among nurses. [ABSTRACT FROM AUTHOR]

Aim: This study examined the relationships between patient‐centred care, diabetes self‐management and selected health outcomes for Omani patients with type‐2 diabetes. Methods: Cross‐sectional surveys were administered for 237 patients with type‐2 diabetes. Hierarchical regression analyses examined the relationships between the selected study variables. Results: The sample was middle‐aged (M = 48, SD = 11.0 years) with nearly a decade (M = 9.68, SD = 6.11) since being diagnosed with type‐2 diabetes, with higher than ideal glycaemic control measures (M = 8.8%, SD = 2.4%). In bivariate analyses, patient‐centred care was positively associated with diabetes self‐management but not with glycaemic control or quality of life. However, after controlling demographic and clinical characteristics, patient‐centred care was positively associated with both physical and mental aspects of health‐related quality of life. In the final regression model, controlling for demographic and clinical characteristics and patient‐centred care, diabetes self‐management significantly predicted both glycaemic control and both physical and mental aspects of health‐related quality of life. Conclusions: The findings support that providing individualized care may contribute to the self‐management of chronic conditions. For achieving optimal outcomes, it may be necessary for providers to effectively assess patients' unique challenges and motivations. Increasing diabetes self‐management may improve quality of life and reduce diabetes complications. Summary statement: What is already known about this topic? Patient‐centred care (PCC) enhances diabetes self‐management (DSM).Little is known about the primary care nurse's role in promoting DSM within a PCC model. What this paper adds? PCC contributes to DSM and improves patient health outcomes.Expecting patients with diabetes to comply with provided instructions may not be enough to change self‐management behaviours. The implications of this paper Administrators responsible for employing a PCC approach in their clinics may need to establish clear goals and expectations for each team member to achieve overall success and ensue that nurses and physicians have targeted training on specific strategies to encourage patient‐provider partnerships that support the adoption of effective DSM behaviours.As the patient‐centred model of care is implemented in Oman, medical and nursing education programmes may highlight in their curricula its potential impact upon self‐management behaviours.Observational studies and longitudinal research to monitor Oman's progress towards the transition to a PCC model of care may uncover modifiable barriers and facilitators that primary care providers encounter. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known?: The nurse–patient relationship in mental health care is an important focus of mental health nursing theories and research.There is limited evidence about which factors influence nurse‐sensitive patient outcomes of the nurse–patient relationship. This hinders the development, planning, delivering, and quality assurance of the nurse–patient relationship in nursing practice and nursing education. What this paper adds to existing knowledge?: To our best knowledge, this is the first study to examine associations between nurse‐sensitive patient outcomes of the nurse–patient relationship and a range of patient characteristics and relationship‐contextual factors.In this study, we found that gender, age, hospital characteristics, nurse availability when needed, nurse contact, and nurse stimulation were associated with the scores on the nurse‐sensitive patient outcome scale. What are the implications for practice?: Having insight into the factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship can help nurses, nursing students, nursing management and also patients to enhance the nurse–patient relationship, trying to influence outcomes of nursing care. Introduction: The lack of evidence on patient characteristics and relational‐contextual factors influencing nurse‐sensitive patient outcomes of a nurse–patient relationship is a possible threat to the quality and education of the nurse–patient relationship. Aim: To measure nurse‐sensitive patient outcomes of the nurse–patient relationship and to explore the associations between nurse‐sensitive patient outcomes and a range of patient characteristics and relational‐contextual factors. Method: In a multicenter cross‐sectional study, 340 inpatients from 30 units in five psychiatric hospitals completed the Mental Health Nurse‐Sensitive Patient Outcome Scale. Descriptive, univariate and Linear Mixed Model analyses were conducted. Results: Overall, patient‐reported outcomes were moderate to good. Female participants, nurse availability when needed, more nurse contact and nurse stimulation were associated with higher outcomes. Age differences were observed for some of the outcomes. Outcomes also varied across hospitals but were not related to the number of times patients were hospitalized or to their current length of stay in the hospital. Discussion: The results may help nurses to become more sensitive and responsive to factors associated with nurse‐sensitive patient outcomes of the nurse–patient relationship. Implications: The nurse‐sensitive results can support nurses in designing future nurse–patient relationships. [ABSTRACT FROM AUTHOR]

Aim: To explore the validity and reliability of the Missed Nursing Care Survey after translating it into the Arabic language. Methods: We employed a cross‐sectional design. We recruited 260 Jordanian nurses, and data were collected between May and July 2020. Translation, acceptability, construct, convergent, discriminant validity and reliability were investigated. Results: The factor analysis showed an adequate fit (three subscales) between the proposed missing care survey model and the observed data. This model reflected the survey's construct, convergent and discriminant validity, explaining 58.88% of the variance collectively. Confirmatory factor analyses showed adequate goodness‐of‐fit results (goodness of fit index = 0.91, comparative fit index = 0.94, increment fit index = 0.94, Tucker Lewis index = 0.92 and root mean square error of approximation = 0.06). The total Cronbach alpha and composite reliability achieved the criterion for all constructs in this survey. Conclusion: This Arabic version of the Missed Nursing Care Survey achieved the required level of validity and reliability. Measuring missed care and its reasons may help to improve quality of health services and assist nurse managers in designing appropriate interventions to reduce it. Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety. Summary statement: What is already known about this topic? The Missed Nursing Care Survey was designed to identify reasons for missed nursing care.The Missed Nursing Care Survey has been shown to be a reliable and valid measure among various populations and different languages. What this paper adds? The Arabic version of the Missed Nursing Care Survey was shown to be a valid and reliable tool.Measuring the quality and procedures of nursing care in the Arabic region will aid in understanding the differences between countries. The implications of this paper: Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety.Measuring missed care and its reasons may help to improve the quality of health services and assist nurse managers in designing appropriate interventions to reduce it. [ABSTRACT FROM AUTHOR]

Background: The majority of children with cerebral palsy (CP) experience challenges in functional communication from a young age. A pivotal aspect of functional communication is language comprehension. A variety of classification systems and questionnaires are available to classify and describe functional communication skills in children with CP. A better understanding of the convergent validity of (subsections of) these tools, as well as their relationship with spoken language comprehension, will be valuable in both clinical practice and research. Aims: To investigate the convergent validity of (subsections of) functional communication tools and the relationship with spoken language comprehension in children with CP. Methods & Procedures: Cross‐sectional data on 138 children were subdivided into three developmental stages based on (Dutch) educational phases: ages 18 months–3;11y (n = 59), 4;0–5;11 years (n = 37) and 6;0–8;11 years (n = 42). The following functional communication tools were used to classify and describe functional communication: Communication Function Classification System (CFCS), subscales of the Caregivers Priorities and Child Health Index of Life with Disabilities—Dutch Version (CPCHILD‐DV) and the Focus on Communication Under Six‐34 (FOCUS‐34) questionnaire. Spoken language comprehension was assessed with the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT). Correlations between the functional communication tools, and with the C‐BiLLT, were calculated using Pearson's and Spearman's correlation coefficients. It was hypothesized a priori that correlations of at least 0.60 suggest good convergent validity. Outcomes & Results: At all developmental stages, a significant ordered decreasing tendency of communication outcomes was found across CFCS levels; lower CFCS levels were associated with lower scores on the CPCHILD‐DV and FOCUS‐34, and with a lower level of spoken language comprehension (C‐BiLLT). Correlation coefficients of the functional communication tools exceeded 0.60 at all developmental stages. Correlations between C‐BiLLT raw scores and the functional communication tools varied between 0.351 and 0.591 at developmental stage 18 months–3;11 years, between 0.781 and 0.897 at developmental stage 4;0–5;11 years, and between 0.635 and 0.659 at developmental stage 6;0–8;11 years. Conclusions & Implications: The functional communication tools assessed in this study showed convergent validity at all developmental stages. The CFCS, currently most widely used in paediatric rehabilitation, is adequate in the classification of functional communication. However, for more detailed clinical goal setting and evaluation of change in functional communication, the additional use of FOCUS‐34 or CPCHILD‐DV is recommended. What this paper adds: What is already known on the subject: A range of functional communication tools are available that help describe and classify functional communication in children with CP. These include the CFCS, subsections of CPCHILD‐DV and FOCUS‐34. The CFCS classifies functional communication in daily life with familiar and unfamiliar partners. Specific subsections of the CPCHILD‐DV and FOCUS‐34 include items that pertain to communicative participation. The innovative C‐BiLLT provides a standardized method to assess spoken language comprehension in children with CP and significant motor impairments. What this paper adds to existing knowledge: In the present study, convergent validity was confirmed between CFCS and specific subsections of the CPCHILD‐DV and FOCUS‐34. Correlations between these functional communication tools and the C‐BiLLT were moderate to strong. What are the potential or actual clinical implications of this work?: For clinical and research purposes (for instance, accurate prescription of augmentative and alternative communication—AAC), healthcare and educational professionals together with parents need to know how functional communication tools converge and how functional communication levels relate to the comprehension of spoken language. The CFCS provides a valid classification of functional communication abilities in children with CP. However, to measure change in functional communication and to evaluate treatment outcomes, use of additional functional communication tools such as the CPCHILD‐DV and FOCUS‐34 is recommended. When discrepancies are found between communicative abilities and spoken language comprehension, it is strongly recommended that valid tools are used in a more detailed examination of the child's spoken language comprehension skills and functional communication. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to translate the Stoma‐quality of life into Chinese and evaluate its psychometric properties in Chinese patients. Background: Quality of life is an important issue for patients with colostomy, and its appropriate and precise measurement is beneficial to promoting better care. The Stoma‐quality of life questionnaire has been widely used; however, the validity and reliability of its Chinese version has not been determined. Design A cross‐sectional validation study was conducted. Methods: We translated the Stoma‐quality of life into Chinese using standardized methods. Then it was psychometrically tested on a convenience sample of 513 patients with colostomy. Construct validity was evaluated via exploratory factor analysis and confirmatory factor analysis. Reliability was measured with Cronbach's alpha and the split‐half Spearman–Brown coefficient. Results: The content validity, the Cronbach's α coefficient and the Spearman–Brown split‐half reliability coefficient indicated adequate validity and reliability. The exploratory factor analysis yielded four common factors, and the cumulative variance contribution rate was 67.5%. Moreover, the confirmatory factor analysis showed a good model fit. Conclusion: This study confirmed that the Chinese version of Stoma‐quality of life is an effective and reliable measurement for evaluating the quality of life of patients with colostomy. Summary statement: What is already known about this topic? Quality of life (QOL) is an important issue for patients with colostomy, and it is conducive to evaluate the effect of specific treatment and nursing interventions. However, a tailored instrument measuring QOL in Chinese patients with colostomy is lacking.The Stoma‐QOL is a widely used stoma‐specific instrument based on Hunt and McKennal's basic QOL demand model and has shown acceptable psychometric properties. What this paper adds? This study provides evidence of the construct validity and internal consistency reliability of the Stoma‐QOL‐C.The four‐factor structure of the scale shows the aspects and complexity of QOL of patients with colostomy.The study proves the Stoma‐QOL‐C a valid and reliable measure of assessing QOL of patients with colostomy. The implication of this paper: The Stoma‐QOL‐C could be used as a disease‐specific scale to evaluate the QOL of patients with colostomy.This study adds the knowledge of the psychometric properties regarding the inventory in diverse cultural backgrounds. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the level and influencing factors of fatigue in patients with rheumatoid arthritis. Methods: This cross‐sectional study was conducted in 243 patients with rheumatoid arthritis from April 2016 to March 2017. The Bristol Rheumatoid Arthritis Fatigue Multi‐Dimensional Questionnaire, Arthritis Self‐Efficacy Scale‐8, Visual Analogue Scale for pain, physical function subscale of Short Form 36‐Item Health Survey, Hospital Anxiety and Depression Scale, Perceived Social Support Scale, Pittsburgh Sleep Quality Index and a self‐designed demographic and disease‐related information questionnaire were used to collect the data. Stepwise linear multiple regression was used to clarify the impact of statistically significant variables (P < 0.05) in the independent sample t test, one‐way ANOVA and correlation analysis on the level of fatigue. Results: Stepwise linear multiple regression analyses showed that disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety were major factors influencing fatigue in patients with rheumatoid arthritis, which explained 59.5% of the total variance. Conclusion: Our study demonstrated a moderate level of fatigue in Chinese patients with rheumatoid arthritis. In clinical practice, nurses should explore individualized intervention programmes based on related predictors of fatigue to help patients relieve fatigue. Summary statement: What is already known about this topic? Fatigue is a common problem in patients with rheumatoid arthritis (RA).Little research has investigated what factors are associated with fatigue in patients with RA.Nurses need to understand the factors that potentially influence fatigue in patients with RA, in order to improve the quality of life. What this paper adds? Fatigue is moderate in Chinese patients with RA, which is lower than the results of western countries.Disease activity, self‐efficacy, physical function, pain, depression, duration of morning stiffness and anxiety are important factors affecting fatigue in patients with RA. The implications of this paper: Special attention should be paid to the RA patients with high level of fatigue.The findings of this study highlight the need to develop effective strategies to alleviate fatigue and eventually improve the quality of life in patients with RA. [ABSTRACT FROM AUTHOR]

To evaluate the reliability, internal consistency, and construct validity of the Swedish versions of PROMIS-29 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) instruments in patients with systemic sclerosis (SSc). In a cross-sectional study, consecutive SSc patients completed a paper-based survey. Internal consistency was assessed using Cronbach's alpha. Test–retest reliability was tested employing weighted Kappa (Kw) and intra-class correlation coefficient (ICC). Construct validity was evaluated by hypotheses testing using RAND-36, MRC Dyspnea score, Scleroderma Health Assessment Questionnaire (SHAQ) and clinical measurements. Forty-nine patients (86% female; 73% limited cutaneous SSc) completed the survey. The mean disease duration was 11 years and mean SHAQ was 0.5. Internal consistency and test–retest reliability were good with the exception of PROMIS-29 anxiety. PROMIS-29, FACIT-Dyspnea, and Functional limitation showed strong correlations to corresponding RAND-36 domains (|rs|=0.67 to −0.85). Relevant PROMIS-29 domains, FACIT-Dyspnea and Functional limitation correlated strongly to SHAQ and VAS overall disease severity (|rs|=0.60 to −0.75). Ceiling effects (>15%) were found in six PROMIS-29 domains and in both FACIT-Dyspnea and Functional limitations. Four (4/5) hypotheses were confirmed. PROMIS-29 and FACIT-Dyspnea meet the requirements for reliability and have adequate construct validity in Swedish patients with SSc. PROMIS-29v2 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) Index are patient outcome measures that gain increasing interest for the evaluation of patient with rheumatologic diseases. PROMIS-29v2 and FACIT-Dyspnea Index meet the requirements for reliability and have adequate construct validity compared to legacy measures in Swedish patients with systemic sclerosis. Translation and validation of PROMs is important for studies of rare diseases in multi-center collaborations. [ABSTRACT FROM AUTHOR]

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Accessible summary: What is known on the subject?: There is a scarcity of studies concerning violence in psychiatric outpatient settings in the 2010s in spite of the deinstitutionalization of psychiatric services.Previous research on violence in psychiatric outpatient settings has failed to consider the association between the psychological consequences of violence, exposures to violence and background factors. What the paper adds to existing knowledge?: It has been known for some time that exposures to violence are harmful for psychiatric inpatient nurses; the paper demonstrates that psychiatric outpatient nurses are also at risk.The psychological consequences of exposure to violence are highly individualized and influenced by background factors.Nurses who face harassment have a greater risk of suffering psychological symptoms. What are the implications for practice?: De‐escalation interventions should be implemented in psychiatric outpatient settings.Organizations should consider the possibility of internal violence occurring when planning preventive interventions to manage and reduce workplace violence.Education targeted at violence prevention, management and debriefing should be organized systematically in psychiatric outpatient units and be taken into consideration in the mental health nursing curriculum. Introduction: There is a scarcity of studies concerning violence and its consequences in psychiatric outpatient setting. Aim: This study aimed to explore the occurrence of workplace violence and the psychological consequences of exposure to violence among nurses working in psychiatric outpatient settings. Method: Research followed a cross‐sectional survey design. Data were collected with the VIA‐Q instrument. Results: During the 12 months prior to the study, nurses (n = 181) had most often experienced psychological violence, with fatigue being the most common consequence. Harassment most often caused feelings of violated integrity, whereas physical violence most often caused insomnia. Significant relationships between exposure to violence and psychological consequences were identified. Discussion: Workplace violence can manifest in a broad array of psychological symptoms and be harmful for nurses in psychiatric outpatient settings. It is important to discuss the subject of workplace violence and its place in the nursing curriculum and to reflect on how nurses are educated and trained to face violence in psychiatric nursing. Implications for Practice: De‐escalation interventions should be implemented in psychiatric outpatient settings. Organizations should take steps to abolish internal violence. Nurses need appropriate education in order to prepare them to manage workplace violence. [ABSTRACT FROM AUTHOR]

Aim: The awareness for the need for end‐of‐life care has increased among noncancer patients. However, studies on the topic have rarely targeted the needs of noncancer patients who want to die at home. This study assessed the end‐of‐life care needs of noncancer patients who were receiving care and wanted to die at home. Methods: A cross‐sectional study design was used and involved 200 participants who were diagnosed as noncancer patients and receiving home care nursing. Data were collected on demographics, disease, Palliative Performance Scale (PPS) scores, and end‐of‐life care needs, in April and May, 2016. Results: Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives." Multivariate analysis revealed that the duration of home care nursing held a significant association with end‐of‐life care needs. Conclusion: By reflecting on the comprehensive care needs of patients with chronic illnesses and including them in the care process, it will be possible to provide better quality palliative care to patients at home in the end‐of‐life stages. SUMMARY STATEMENT: What is already known about this topic? Noncancer patients at the end‐of‐life stage have complex needs and problems that are difficult to solve, compared with cancer patients.Noncancer patients need to receive effective symptom management or sufficient support for satisfactory care.End‐of‐life care is still mainly focused on cancer patients and attention to noncancer patients is lacking. What this paper adds? Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives."Duration of home care nursing and an income level were significantly associated with higher end‐of‐life care needs. The implications of this paper: Home care nurses must clearly assess the care needs of noncancer patients at the end‐of‐life stage and subsequently provide comprehensive patient‐centered care based on this assessment.It is important to adjust the care direction between patient, family, and medical staff from early on for patients who want to die at home.The results highlight needs for the development of interventions that focus on the duration of home care nursing of patients. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to examine the extent to which staffing adequacy predicts nursing teamwork, controlling for demographic and background variables. Background: Findings from former studies indicate that hospital, unit and staff characteristics may be related to nursing teamwork, such as type of hospital and unit, role, gender, age, work experience, type of shift worked, shift length, number of working hours per week, overtime and staffing adequacy. Teamwork as well as staffing is identified as significant contributors to patient and staff safety in hospitals. However, the contribution of staffing to the quality of nursing teamwork is scarcely studied. Design: This was a quantitative descriptive cross‐sectional study using the paper‐and‐pencil questionnaire Nursing Teamwork Survey‐Icelandic. Methods: The study was conducted in 27 inpatient units in eight hospitals in Iceland with a sample of 925 nursing staff members. Participants were 567 registered nurses, practical nurses, unit secretaries and nurse unit managers. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for this paper. Results: When controlling for unit type, role, experience on current unit and intent to leave, perceived adequacy of staffing alone explains up to 10% of overall teamwork. Unit type, role, years of experience on current unit and perceived staffing adequacy correlated significantly with overall teamwork. Conclusions: The findings of this study indicate that unit and staff characteristics, including perceived adequacy of staffing, are associated with and explain the variability in nursing teamwork on inpatient hospital units. The findings of this study provide important information for clinical nurses, nurse managers, policymakers and instructors in health care. Relevance to clinical practice: The findings underline the importance of adequate staffing for nursing teamwork in inpatient hospital units. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the nurses' knowledge, concerns, perceived impact and preparedness toward the COVID‐19 pandemic. Background: As COVID‐19 is a new disease, its spread and emergence cause fear, anxiety and confusion among the general population. Nurses are in close contact with infected persons, and their knowledge plays an important role in preventing the transmission chain. Methods: In this cross‐sectional study, 207 nurses were selected using convenience sampling from 29 March to 19 April 2020. The study used a questionnaire assessing the nurses' baseline characteristics, their source of information, knowledge, concerns, the perceived impact and their preparedness for the COVID‐19 pandemic. Results: Around half of the surveyed nurses (51.2%) reported that the Ministry of Health's and World Health Organization's websites and official pages were their main sources of information. The majority of nurses (81.6%) knew the nature of the virus, 83.6% agreed that their job puts them at risk of infection with COVID‐19 and 72% felt personally prepared for the pandemic. Conclusion: The majority of nurses had an acceptable level of knowledge regarding COVID‐19. However, psychological interventions are needed to be addressed in the planning stage before any pandemic. Summary statement: What is already known about this topic? It is well established that COVID‐19 is a highly infectious disease with a fatality rate of about 6.48% in Egypt.Studies about nursing and COVID‐19 are relatively few.There is a lack of data regarding the nurses' knowledge, concerns, perceived impact and preparedness toward COVID‐19. What does this paper add? Nurses prefer gaining their knowledge regarding COVID‐19 from the Ministry of Health's and the World Health Organization's websites and official pages rather than the social media websites.Nurses have an acceptable level of knowledge regarding COVID‐19. The majority of surveyed nurses knew the nature of the virus along with its signs and symptoms.The majority of surveyed nurses feel that their job puts them at the risk of infection with COVID‐19, and they are quite afraid of being infected. The implications of this paper: Psychological interventions are needed in the planning stage before any pandemic to enhance the protection of nurses and health care workers and to reduce the psychological impact.Sustainable awareness programmes are required for health care workers, keeping them up to date with the most recent information regarding prevention and management methods from the World Health Organization's guidelines and other instructional materials.Hospitals can hold meetings and organize regular psychological support groups to allow nurses to manage their fears and acquire stress reduction strategies. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the influence of barriers to the use of research results in the practice of nurses on patient safety perception. Background: The use of research results in clinical practice promotes safe care, increases quality and reduces the possibility of adverse events. Design This is a cross‐sectional study. Methods: The sample consisted of 207 nurses from three public university hospitals in the state of Minas Gerais, Brazil from March 2017 to November 2018. They answered a questionnaire with professional characteristics, The Barriers Scale and Safety Attitudes Questionnaire. Descriptive analysis, Student's t test, Pearson correlation and multiple linear regression were used for data analysis. Results: The findings showed most nurses had unfavourable competencies for implementing research results in practice. As barrier scores for the use of research results in practice increase, safety climate scores decrease. Taking a training course on the use of research results in clinical practice and organization characteristics, limitations of the setting were statistically significant, constituting factors that influence the perception of the safety climate. Conclusion: Investments in education are needed for health professionals to be aware of evidence‐based practice and how to use evidence to impact decision‐making outcomes, strengthening safety outcomes in health services. Summary statement: What is already known about this topic? The use of research results in clinical practice promotes safe care, increases quality and reduces the possibility of adverse events.In the health literature, there is little evidence on the factors related to the use of research results in the clinical practice of nurses and the patient safety climate.The non‐use of research results in clinical practice is a relevant problem for patient safety. What is already known about this topic? The results of the study showed that nurses do not have favourable competencies in the use of research results in clinical practice.The most significant barrier to the use of research results in clinical practice was related to the characteristics of the organization, and the negative perception of the safety climate was related to working conditions, indicating a negative view of the work environment.The results of the research indicated that the more barriers were reported by nurses to the use of research results in clinical practice, the worse the perception of patient safety.The provision of training courses for nurses on the use of research results and the characteristics of the organization were factors that influenced the perception of patient safety. The implications of this paper: The results of the study highlighted the need to strengthen the partnership between universities and health services. Nurses trained to use research results in clinical practice promote safe and quality care.The use of research results in clinical practice can benefit the safety and quality of care around the world. Additional studies are needed to understand other factors related to the use of research that influences patient safety outcomes. [ABSTRACT FROM AUTHOR]

Objective: To shorten the Patient Engagement In Research Scale (PEIRS) to its most essential items and evaluate its measurement properties for assessing the degree of patients' and family caregivers' meaningful engagement as partners in research projects. Methods: A prospective cross‐sectional web‐based survey in Canada and the USA, and also paper‐based in Canada. Participants were patients or family caregivers who had engaged in research projects within the last 3 years, were ≥17 years old, and communicated in English. Extensive psychometric analyses were conducted. Results: 119 participants: 99 from Canada, 74 female, 51 aged 17‐35 years and 50 aged 36‐65 years, 60 had post‐secondary education, and 74 were Caucasian/white. The original 37‐item PEIRS was shortened to 22 items (PEIRS‐22), mainly because of low inter‐item correlations. PEIRS‐22 had a single dominant construct that accounted for 55% of explained variance. Analysis of PEIRS‐22 scores revealed the following: (1) acceptable floor and ceiling effects (<15%), (2) internal consistency (ordinal alpha = 0.96), (3) structural validity by fit to a Rasch measurement model, (4) construct validity by moderate correlations with the Public and Patient Engagement Evaluation Tool, (5) good test‐retest reliability (ICC2,1 = 0.86) and (6) interpretability demonstrated by significant differences among PEIRS‐22 scores across three levels of global meaningful engagement in research. Conclusions: The shortened PEIRS is valid and reliable for assessing the degree of meaningful patient and family caregiver engagement in research. It enables standardized assessment of engagement in research across various contexts. Patient or public contribution: A researcher‐initiated collaboration, patient partners contributed from study conception to manuscript write‐up. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Non-pharmaceutical interventions (NPIs) decrease COVID-19 transmission. Reliability and validity of adherence to NPIs in accordance with normalization process theory (NPT) in coherent and convenient social subgroups using reflective measurement model assessment has not been evaluated. Methods In February 2021, a sample of medical students and people with substance use disorders in treatment as coherent (based on continuous probability distribution) vs. convenient groups (based on convenience, not equal probability) composed of travellers and COVID-19 suspected persons from Split-Dalmatia County (SDC) (n  = 656) in the Mediterranean completed self-administered surveys. Partial least squares structural equation modelling (PLS-SEM) was used to measure reflective model assessment of adherence to NPIs according to NPT. Results PLS-SEM reflective model assessment provided two-group specific factors in inverse relationships which determined adherence to NPIs with excellent goodness-of-fit [ χ 2 = 1.292, df = 1; P  = 0.297, CFI = 1, TLI = 0.997, RMSEA = 0.011 (90% CI 0–0.105), RMSEA P  = 0.604, SRMR = 0.008, Hoelter CN (α = 0.05) = 2322.757]. Significant negative factors covariance estimate (−0.716) revealed an inverse relationship between first (adherence to NPIs and internal locus of control (LoC) (0.640)) and second factor; young adulthood age (≤25) and highest level of education (1362). As the first factor increased the second tended to decrease. LoC is expected potential mechanism by which sex (MLsex = −0.017, SE = 0.007, P  < 0.016) and belonging to coherent subgroups (MLgroup = −0.008, SE = 0.003, P  = 0.015) can produce indirect effect of adherence to NPIs. Conclusions Coherent subgroups had a more pronounced tendency toward integration of NPIs in everyday life. Group factors that facilitate the normalization were higher educated younger adults with a tendency toward external LoC. [ABSTRACT FROM AUTHOR]

Background: Work-family enrichment refers to the extent to which experiences in one role improve the quality of life in another role, and the bidirectionality indicates that benefits derived from work can be applied to family and vice versa. Parent nurses, that is, female nurses who are raising preschool children, play a major role at work and in the family. Thus, work-family enrichment is significant for them. The Work-Family Enrichment Scale cannot be generalized to parent nurses. This study was aimed at developing and psychometrically validating a draft Work-Family Enrichment Scale for Parent Nurses. Methods: A questionnaire survey was conducted among 1,090 parent nurses who were randomly sampled from hospitals with more than 200 beds in Japan. The survey evaluated (1) a draft Work-Family Enrichment Scale for Parent Nurses, (2) the Japanese version of the Work-Family Enrichment Scale, and (3) the Positive Spillover Scale. The scales were psychometrically evaluated for internal consistency, construct validity, and criterion-related validity. Results: Data from 503 participants (age, mean ± standard deviation [range] 35.5 ± 4.96 [23–47] years) were analyzed. Results of exploratory factor analysis, the work to family enrichment direction yielded five factors for 23 items: "emotional fulfillment," "efficiency," "ability to lead," "displaying industriousness," and "self-growth." Cronbach's alpha coefficients ranged from 0.862 to 0.914. In the family-to-work enrichment direction, there were five factors for 28 items: "help-seeking," "receptiveness," "expansion of one's horizon," "efficiency," and "emotional fulfillment." Cronbach's alpha coefficients ranged from 0.790 to 0.907. Additionally, the correlation coefficients reporting criterion-related validity were 0.685 and 0.619 with regard to the Japanese version of the Work-Family Enrichment Scale and 0.596 and 0.534 with the Positive Spillover Scale for the Work-to-Family Enrichment Scale and the Family-to-Work Enrichment Scale for Parent Nurses, respectively. Conclusions: The Work-Family Enrichment Scale for Parent Nurses has adequate reliability and validity and can be used as an effective measure to assess the positive aspects of work and family roles among female parent nurses. [ABSTRACT FROM AUTHOR]

Background: The Geriatrics Health Behavior Questionnaire (GHBQ) is essential for assessing health-related behaviors among older adults populations. This study focuses on the translation, cultural adaptation, and psychometric evaluation of the Arabic version of the GHBQ to ensure its relevance and accuracy for Arabic-speaking older adults individuals. Methods: This cross-sectional study was conducted at the Cairo University Educational Hospital's outpatient clinic. The GHBQ was translated and culturally adapted through a systematic process, including initial translation, back-translation, expert review, and pilot testing. The psychometric properties of the Arabic-translated GHBQ were evaluated using a sample of 200 older adults Arabic-speaking participants. Reliability was assessed using Cronbach's alpha (α) and Intraclass Correlation Coefficient (ICC). Validity was evaluated through Content Validity Index (CVI), Exploratory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA). Results: The Arabic GHBQ demonstrated excellent reliability with Cronbach's alpha values ranging from 0.74 to 0.87 across subscales and ICC values confirming reproducibility (ICC = 0.82). The CVI indicated strong content validity (average CVI = 0.91). EFA revealed a five-factor structure, explaining 72% of the variance, with all factor loadings exceeding 0.60. CFA supported the questionnaire's structure with fit indices meeting recommended criteria: χ²/df = 2.05, NFI = 0.92, TLI = 0.94, GFI = 0.90, SRMR = 0.05, AIC = 140.35, and BIC = 160.22. Criterion validity was confirmed through significant correlations with established health behavior measures (r = 0.63, p < 0.001). Conclusions: The culturally adapted Arabic version of the GHBQ is a reliable and valid tool for assessing health behaviors in the older adults population in Egypt. This instrument can aid healthcare providers in identifying and addressing health behaviors, ultimately improving the well-being of this demographic. Future research should focus on expanding the sample and comparing the GHBQ with other similar tools used in Arabic-speaking populations. [ABSTRACT FROM AUTHOR]

Providing care to a patient with cerebral palsy can have many negative impacts upon caregivers. This study was carried out to define caregiving burden in the caregivers of cerebral palsy patients and determine the relationships between religious coping, fatalism, and burden of care. This cross-sectional and correlational study included 132 caregivers. Data were obtained using the Religious Coping Scale, the Fatalism Scale, and the Caregiver Burden Scale. It was determined that 18.9% of the participants experienced a heavy care burden. The luck and pessimism dimensions of the Fatalism Scale were positively and weakly correlated with caregiving burden (p < 0.01), while there was no correlation between caregiving burden and positive or negative religious coping styles (p > 0.05). Perception of fatalism explained 10% of the total variance in caregiving burden (R = 0.329, R2 = 0.109, F = 5.195, p = 0.002). It is recommended that caregivers be supported by religious experts to strengthen positive religious coping styles and advisable fatalism perceptions. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the mechanisms through which change-oriented leadership in hospitals influences job performance and employee job satisfaction. The authors examine the direct and the mediating effects of perceived learning demands and job involvement.Design/methodology/approach This cross-sectional study is based on a survey of four public hospitals in a regional health authority in Norway.Findings The findings illustrate how change-oriented leadership directly and indirectly influences work performance and job satisfaction. Learning demands and job involvement play mediating roles. Higher levels of change-oriented leadership decrease learning demands and increase job involvement, work performance and job satisfaction. Learning demands have a negative influence on work performance and job satisfaction. Job involvement has a positive influence on work performance and job satisfaction. The strongest relationship in the structural modelling is between change-oriented leadership and job involvement.Research limitations/implications This study is based on cross-sectional data. Future studies should therefore explore this further using a longitudinal design.Practical implications The practical implication of the study is to show how leaders by change-oriented behaviour can influence work performance and job satisfaction by reducing learning demands and increasing job involvement.Social implications This study illustrates different paths towards influencing job performance and job satisfaction from change-oriented leadership. It is important to use the potential of reducing learning demands and increasing job involvement, to improve job performance and job satisfaction.Originality/value The authors have developed and validated a new theoretical mediational model explaining variance in job performance and job satisfaction, and how this is related to change-oriented leadership, job involvement and learning demands. This knowledge can be used to increase the probability of successful change initiatives. [ABSTRACT FROM AUTHOR]

Aim: To examine the effect of nurse staffing patterns (nursing staff skill mix and patient classification system) on patient satisfaction with the nursing care received. Background: Evidence about the relationship between the nursing staff structures and patient outcomes in post‐transitional countries is limited. Methods: The research was conducted in three units of one secondary‐care regional hospital in Slovenia over 1 month. This cross‐sectional study used three main data elements exploring nursing staff levels (nursing hours per patient day and skill mix), patient needs (using a classification system), and patients' satisfaction with nursing care; 484 patients participated. Results: Significant positive correlations were found between the patients' satisfaction and the realized percentage of the registered nurse personnel requirements, the level of nursing care hours per patient day, and the proportion of registered nurses in the nursing team. Conclusions: A significant association between the actual and needed staffing levels and patient satisfaction was found. Nurse staffing patterns affect patient outcomes. Implications for Nursing Management: This paper supports a higher proportion of registered nurses and an increased number of overall nursing staff working hours. Managers should consider the results of the patient needs categorization system and the workforce structure characteristics as predictors of patient satisfaction. [ABSTRACT FROM AUTHOR]

Background: Increasingly healthcare policies emphasise the importance of person-centred, empathic care. Consequently, healthcare professionals are expected to demonstrate the 'human' aspects of care in training and in practice. The Consultation and Relational Empathy (CARE) Measure is a patient-rated measure of the interpersonal skills of healthcare practitioners. It has been widely validated for use by healthcare professionals in both primary and secondary care. This paper reports on the validity and reliability of the CARE Measure with sexual health nurses. Methods: Patient questionnaires were collected for 943 consultations with 20 sexual health nurses. Participating patients self-completed the questionnaire immediately after the encounter with the nurse. The questionnaire included the ten item CARE Measure, the Patient Enablement Index, and overall satisfaction instruments. Construct validity was assessed through Spearman's correlation and principal component analysis. Internal consistence was assessed through Cronbach's alpha and the inter-rater reliability through Generalisability Theory. Data were collected in 2013 in Scotland. Results: Female patients completed 68% of the questionnaires. The mean patient age was 28.8 years (standard deviation 9.8 years). Two of the 20 participating nurses withdrew from the study. Most patients (71.7%) regarded the CARE Measure items as very important to their consultation and the number of 'not applicable' and missing responses' were low (2.6% and 0.1% respectively). The participating nurses had high CARE Measure scores; out of a maximum possible score of 50, the overall mean CARE measure score was 47.8 (standard deviation 4.4). The scores were moderately correlated with patient enablement (rho = 0.232, p = 0.001) and overall satisfaction (rho = 0.377, p =0.001. Cronbach's alpha showed the measure's high internal consistency (Cronbach's alpha coefficient = 0.95), but the inter-rater reliability could not be calculated due to the high achieved CARE Measure scores that varied little between nurses. Conclusions: Within this clinical context the CARE Measure has high perceived relevance and face validity. The findings support construct validity and some evidence of reliability. The high CARE Measure scores may have been due to sample bias. A future study which ensures a representative sample of patients on a larger group of nurses is required to determine whether the measure can discriminate between nurses. [ABSTRACT FROM AUTHOR]

Aim and objectives: To analyse the levels of anxiety, depression, post-traumatic stress, and burnout among nursing professionals working in the Imbabura region of Ecuador during the COVID-19 pandemic and identify the contributing socio-occupational factors. Background: The high demand for care of COVID-19 patients led to increased work pressure on nurses, owing to increased demands for care and shortages of medical supplies and protective equipment. Design: A cross-sectional study was conducted from September to December 2022 using a self-administered questionnaire addressed to nursing professionals who cared for COVID-19 patients. Methods: The questionnaire included socio-demographic characteristics, the Spanish adaptation of Hospital Anxiety and Depression Scale (HADS-Spanish), Impact of Event Scale–Revised (IES-R) for the evaluation of post-traumatic stress disorder (PTSD), and the Spanish adaptation of the Maslach Burnout Inventory–Human Services Survey (MBI-HSS-Spanish) for burnout assessment. Univariate and multivariate analyses were performed. Results: Of the 782 participants, 88.6% had a high level of burnout (MBI-HSS-Spanish scale score > 27). Female nurses, nurses with eight-hour work shifts, and older professionals exhibited high levels of anxiety and depression. Prolonged working hours in COVID-19 patient care services were found to be a risk factor for burnout and post-traumatic stress. Conclusions: Participating nurses presented with a high level of chronic work stress and exhibited signs of anxiety and depression during the period under consideration. Providing nurses with psychological support measures and performing liaison consultations will alleviate the psychological burden on nurses. Relevance to clinical practice: The study has shown that accounting for the environments where the emotional impact is greatest and how to reduce it would not only reduce anxiety, depression, and burnout in nurses but also improve the quality of care, not only in pandemic. Patient or public contribution: Nurses contributed to the conduct of the study by participating in the data collection via questionaries. [ABSTRACT FROM AUTHOR]

Background and Purpose: The Acceptance and Action Diabetes Questionnaire (AADQ) is a tool for assessing the acceptance of thoughts and emotions related to diabetes in people living with the disease. This study aimed to examine the psychometric properties of the Swedish version of AADQ (Swe-AADQ) in a sample of adults with type 1 diabetes. Methods: To examine the psychometric properties of the Swe-AADQ, the Rasch model was used. Data for 120 individuals were included. Results: The Swe-AADQ showed an acceptable fit to the Rasch model. A sufficiently high value of the separation index indicated a capacity to distinguish between different levels of acceptance in the sample. The 7-point Likert scale was reduced to three categories suggesting an improvement in the ordering of the item thresholds. Conclusions: The Swe-AADQ possesses reasonable quality in terms of reliability and validity. However, there are some deficiencies regarding the categorization of the response rating that should be addressed. [ABSTRACT FROM AUTHOR]

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]

Accessible summary What is known about the subject? People with learning disability are more likely than the general population to develop schizophrenia., Personal recovery philosophies are based on positive attitudes and an optimism that recognizes and values people and their strengths and capacity to achieve goals., Little is known from previous studies about the illness perceptions of learning disability practitioners who work with people that experience both a learning disability and schizophrenia., The illness beliefs of learning disability practitioners about schizophrenia may mediate the potential for social exclusion and limit recovery outcomes., What this study/paper adds to existing knowledge? The findings show that the illness beliefs of learning disability practitioners and support workers regarding schizophrenia are pessimistic in terms of the consequences for people with schizophrenia and learning disability and their relatives as well as the chronic course of the illness., What are the implications for clinical practice? This study identifies the nature of LD practitioner perceptions about schizophrenia and provides guidance about how personal recovery philosophies can be applied to the management of LD and schizophrenia., The beliefs of learning disability practitioners and support workers regarding schizophrenia need to be reframed to support better recovery outcomes and social inclusion for this group., The findings from this study can inform the development of training in bio-psycho-social models of schizophrenia, recovery approaches, family/carer interventions, clinical supervision, mentorship and reflection on clinical practice, which could be potentially useful strategies to help facilitate a reframing of beliefs., Abstract Background and purpose of study The prevalence of schizophrenia in people with learning disability is 3-4%. This is the first study to investigate the illness perceptions of learning disability ( LD) practitioners towards people with schizophrenia. Methods Learning disability practitioners ( n = 210) that work with people with LD and schizophrenia completed a modified version of the Illness Perception Questionnaire Schizophrenia Carers Version ( IPQ- SCV). Descriptive and correlational analyses were conducted for all of the IPQ- SCV subscales. Results A significant positive correlation was found between consequences relative and consequences patient (0.495, P < 0.001), and a negative correlation was found between timeline episodic and timeline chronic (−0.243, P < 0.001) subscales. Discussion Consistent with previous evidence found regarding negative staff attitudes to schizophrenia recovery outcomes, course and chronicity, the current investigation has extended and confirmed these observations to staff working with individuals with comorbid schizophrenia and learning disability. Implications for practice This study identifies the nature of LD practitioner perceptions about schizophrenia and contributes to the development of the recovery philosophy in relation to the management of LD and schizophrenia. The findings inform the design of training modules in bio-psycho-social models of schizophrenia, recovery approaches, family intervention, clinical supervision and reflection. These can help LD practitioners to reframe their schizophrenia/ LD illness beliefs. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The effective provision of health services is affected by human resources and this renders upholding ethical principles in hospitals more urgent than in any other organization. This study aimed to determine the ethical predictability of human resources in hospitals in 2022. MATERIAL AND METHODS: This descriptive cross-sectional study was conducted in public, private, and "social security" hospitals in Mazandaran province in 2022. Data were collected through a researcher-made questionnaire designed based on Iranian national accreditation standards. The questionnaire consisted of 18 questions from 6 areas, including organizing manpower, employee evaluation, employee satisfaction and participation, employee empowerment, job promotion, and paying attention to employee motivation. The content validity was confirmed using experts' views, and its reliability was confirmed by Cronbach's alpha coefficient higher than 0.78. Data were analyzed by one-way ANOVA and Tukey's post hoc tests. RESULTS: There was a significant difference between the mentioned hospitals regarding the ethical predictability of human resources (p < 0.05), which was higher in social security hospitals (3.80 ± 0.00) compared to public hospitals (3.30 ± 0.00) and private hospitals (2.49 ± 0.00). The highest and the lowest mean ethical predictability of human resources in selected hospitals were reported for the areas of employee empowerment (3.89 ± 0.00) and employee evaluation (2.83 ± 0.00), respectively. CONCLUSIONS: In addition to exerting an impact on enhancing the satisfaction and productivity of employees, identifying ethical predictability factors will help medical and health services managers identify the priorities of human resources and adopt solutions to improve them. [ABSTRACT FROM AUTHOR]

Objectives: The Swedish Inflammatory Bowel Disease Registry (SWIBREG) includes approximately 84% of all patients with inflammatory bowel disease (IBD) treated with immunomodulators, biologics or surgery in Sweden. Data on health-related quality of life (HRQoL) have been collected using EQ-5D-5L in the registry since 2012. Nevertheless, there are few studies assessing the validity of EQ-5D-5L in this patient population. Thus, the aim of this study was to assess the construct validity of EQ-5D-5L amongst patients with IBD (ulcerative colitis and Crohn's disease). Methods: Individual-level data on EQ-5D-5L and other disease-specific measures were extracted from SWIBREG. Known-groups validity was assessed by analysing whether the EQ-5D-5L captured expected differences between patient groups with different activity levels of the disease. Convergent validity was assessed by analysing whether the reported problems in the dimensions of EQ-5D-5L, EQ VAS, and the EQ-5D-5L index value correlated, as hypothesized, with the four dimensions in the Short Health Scale, a symptom index question, and the Physician Global Assessment (PGA) score. Results: In total, 9769 patients with IBD were included in the study. Patients with active IBD reported more health problems in the EQ-5D-5L descriptive system than patients being in remission. The effect sizes for the differences in reported problems between patients with active and inactive disease were at least small (≥0.1) or medium (≥0.3) in all dimensions except self-care. Differences in the mean EQ-5D-5L index and EQ-VAS score between patients with active and inactive disease were statistically significant (p < 0.001) and larger than pre-defined cut-offs for minimally important differences (>0.08 for the index and >11.0 for EQ-VAS). The analysis of convergent validity showed that EQ-5D-5L results correlated as expected with the disease-specific measures in 16 of the 21 analyses. In total, 22 (79%) of the 28 hypotheses were supported. Conclusion: The findings support the construct validity of EQ-5D-5L amongst patients with IBD and contribute to the scarce literature on the validity of the five-level version of EQ-5D in this patient population. These findings have important implications for the choice of HRQoL measure in routine health care registries like SWIBREG as well as for future clinical or health economic studies considering using EQ-5D-5L as a measure of HRQoL. [ABSTRACT FROM AUTHOR]

Background: The quality of life of patients with advanced gastrointestinal cancer is seriously impaired, and socioeconomic deprivation often has a serious impact on their quality of life. However, little is known about the relative contribution of non-socioeconomic factors to the quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation. Aim: This study aims to investigate the situation and predictors of quality of life of patients with socioeconomic deprivation and evaluate the independent effects of some non-socioeconomic factors. Design: A retrospective study based on cross-sectional design. Methods: Data were obtained from 1075 patients with advanced gastrointestinal cancer who received family palliative treatment in the hospice ward of Zhongnan Hospital of Wuhan University from March 2010 to October 2020, including demographic and clinical questionnaires, Karnofsky Performance Status scale and Cancer Pain and Quality of Life Questionnaire of Chinese Cancer Patients. Results: The quality of life of patients with advanced gastrointestinal cancer with socioeconomic deprivation is impaired and is affected by gait, self-care ability, abdominal distension, nutritional status, weight loss, constipation and posture. Improvement in six of these factors--gait, self-care ability, abdominal distension, nutritional status, weight loss and posture--has an independent positive impact on the development of a healthy quality of life for patients. Conclusions: Gait, self-care ability, abdominal distension, nutritional status, weight loss and posture are important determinants of healthy quality of life in patients with advanced gastrointestinal cancer with socioeconomic deprivation, and early identification and strength management of these non- socioeconomic factors may neutralize the negative impact of socioeconomic factors on the quality of life. Implications for Practice: This study provides new ideas and intervention entry points for global nurses in practice innovations to improve the quality of life of socioeconomically deprived patients with advanced gastrointestinal cancer. It enables them to focus on the effectiveness of non-socioeconomic factors in the development and implementation of targeted care plans for patients with advanced gastrointestinal cancer experiencing socioeconomic deprivation globally. Reporting Method: This study was reported in strict compliance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

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Aim: To psychometrically assess the Spanish version of the Self‐Care of Chronic Illness Inventory (SC‐CII‐Sp) in community‐dwelling older adults with chronic multimorbidity. Design: A methodological study. Method: A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC‐CII‐Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC‐CII‐Sp and their scores on the Spanish Chronic Disease Self‐Efficacy scale (SCD‐SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC‐CII‐Sp's reliability was tested by computing the Cronbach's alpha. Results: The SC‐CII‐Sp showed good content and convergent validity. The CFA showed that the SC‐CII‐Sp has three sub‐scales. The 8‐item Self‐Care Maintenance sub‐scale has good internal consistency and is comprised of two dimensions: illness‐related and health‐promoting behaviour. The Self‐Care Monitoring sub‐scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6‐item Self‐Care Management sub‐scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour. Conclusion: The Spanish version of SC‐CII is a valid and reliable instrument to be used in the assessment of self‐care behaviours amongst Spanish‐speaking, community‐dwelling older adults with chronic multimorbidity. Implications for the Profession: Nurses need valid and reliable tools to assess self‐care behaviours in Spanish‐speaking community‐dwelling older adults with chronic multimorbidity. This study provides a 19‐item tool that allows for the comprehensive evaluation of self‐care behaviours in healthy and ill states. Impact: Using the SC‐CII‐Sp in clinical or research settings could help nurses to examine the effects of different interventions on self‐care behaviours amongst Spanish‐speaking, community‐dwelling older adults with chronic multimorbidity. Patient or Public Contribution: None to be reported. [ABSTRACT FROM AUTHOR]

Background: Despite the high burden of disease in younger children there are few tools specifically designed to estimate Health Related Quality of Life (HRQoL) in children younger than 3 years of age. A previous paper described the process of identifying a pool of items which might be suitable for measuring HRQoL of children aged 0–3 years. The current paper describes how the items were pruned and the final draft of the measure, Toddler and Infant (TANDI) Health Related Quality of Life, was tested for validity and reliability. Methods: A sample of 187 caregivers of children 1–36 months of age were recruited which included children who were either acutely ill (AI), chronically ill (CI) or from the general school going population (GP). The TANDI, an experimental version of the EQ-5D-Y proxy, included six dimensions with three levels of report and general health measured on a Visual Analogue Scale (VAS) from 0 to 100. The content validity had been established during the development of the instrument. The TANDI, Ages and Stages Questionnaire (ASQ), Faces, Leg, Activity, Cry, Consolabilty (FLACC) or Neonatal Infant Pain Scale (NIPS) and a self-designed dietary information questionnaire were administered at baseline. The TANDI was administered 1 week later in GP children to establish test-retest reliability. The distribution of dimension scores, Cronbach's alpha, rotated varimax factor analysis, Spearman's Rho Correlation, the intraclass correlation coefficient, Pearson's correlation, analysis of variance and regression analysis were used to explore the reliability, and validity of the TANDI. Results: Concurrent validity of the different dimensions was tested between the TANDI and other instruments. The Spearman's Rho coefficients were significant and moderate to strong for dimensions of activity and participation and significant and weak for items of body functions. Known groups were compared and children with acute illness had the lowest ranked VAS (median 60, range 0–100), indicating worse HRQoL. The six dimensions of the TANDI were tested for internal consistency and reliability and the Cronbach's α as 0.83. Test-retest results showed no variance for dimension scores of movement and play, and high agreement for pain (83%), relationships (87%), communication (83%) and eating (74%). The scores were highly correlated for the VAS (ICC = 0.76; p < 0.001). Conclusion: The TANDI was found to be valid and reliable for use with children aged 1–36 months in South Africa. It is recommended that the TANDI be included in future research to further investigate HRQoL and the impact of interventions in this vulnerable age group. It is further recommended that future testing be done to assess the feasibility, clinical utility, and cross-cultural validity of the measure and to include international input in further development. [ABSTRACT FROM AUTHOR]

Background: Adult functional literacy ensures adequate and safe engagement in daily activities. It is assessed through the Inventory of Reading Occupations-Adult (IRO-A). The instrument underwent translation with cultural adaptation and content validation to ensure relevance to the Filipino context. Method: The translation and cultural adaptation of the IRO-A to Filipino (Fil IRO-A) was guided by the process proposed by two international guidelines for cross-cultural adaptations that involves (a) forward translation and synthesis, (b) back translation, and (c) pre-panel review of the adaptation to the Filipino context. The Fil IRO-A also underwent content validation by seven experts. Item and scale content validity indices (I-CVI/S-CVI) were calculated. Qualitative feedback was summarized. Results: Eighteen out of the 22 items were further revised after the initial translation to consider the original construct, appropriateness to the Filipino culture, and comprehensibility to the target audience. Content experts rated 15 items (68%) as acceptable to highly relevant and seven items (32%) as less relevant. The probability of chance agreement for most of the items is small (.008 - 0.164). Nineteen of the 22 items were good to excellent using the kappa values. No items were discarded. Nine were retained while 13 were further revised. Conclusion: Experts agree that the Filipino IRO-A is valid for assessing the functional literacy of Filipino adults. Further validation study is needed to assess its use in determining reading participation. [ABSTRACT FROM AUTHOR]

Aims: Suicide is one of the leading causes of death in the world. It is important to evaluate its prevalence through valid tools. Among various tools, the Literacy of Suicide Scale (LOSS) has not yet been validated for Persian speaking people. Therefore, the aim of this study was to translate, evaluate and validate Batterham PJ., Calear AL et al.'s 2012 Literacy of Suicide Scale (LOSS) in the young military community. Materials & Methods: This was a cross-sectional study with a methodological approach. The sample was recruited from young military personnel who referred to counseling and psychology clinics that were chosen through convenience sampling. At first, the original version was obtained and translated into Persian by the Forward-Backward method. Then, in order to evaluate the content validity ten experts have examined the scale and content validity ratio (CVR) as well as the content validity index (CVI) of the questionnaire. Face validity was also assessed through a sample of 20 subjects from the study population. The test-retest with a two week interval along with Cronbach's alpha were utilized to examine the reliability. Finally, the questionnaire was distributed among 415 subjects to evaluate the construct and convergent validity. Findings: The results showed that based on CVR, CVI and face validity, all questions of the LOSS were at acceptable levels. The Cronbach's alpha for the subscales were estimated to be between 0.71 and 0.76, and for the total scale was 0.75. Also, all components of LOSS had a significant relationship with the total score of this questionnaire (r>0.2). Conclusion: The Persian version of LOSS has acceptable validity and reliability for use among young military personnel. However, further studies among populations with different cultures or demographics are needed. [ABSTRACT FROM AUTHOR]

Aim: To identify the determinants of self‐reported health‐related quality of life in children and adolescents with type 1 diabetes mellitus during the coronavirus pandemic. Design: A cross‐sectional study. Methods: The study sample included 182 children and adolescents who had been diagnosed with type 1 diabetes mellitus at least 3 months prior. Data collection instruments included sociodemographic and glycaemic control protocol adherence questionnaires, documentation sheet for recording clinical data, and Serbian versions of the EuroQol‐5D‐Y and KidScreen27 questionnaires, which were used to assess health‐related quality of life. Results: Glycaemic control adherence, presence of comorbidities, level of metabolic control, and type of insulin therapy were identified as key determinants of self‐reported health‐related quality of life. Patient or Public Contribution: No patient or public contributions. [ABSTRACT FROM AUTHOR]

Aim To evaluate the psychometric properties of a questionnaire addressing psychosocial consequences of false-positive mammographic screening. Background The Consequences of Screening - Breast Cancer and Lung Cancer questionnaires target psychosocial consequences of false-positive cancer screening. The Consequences of Screening - Breast Cancer questionnaire and ten items not considered lung cancer specific from the Lung Cancer questionnaire have been adapted for use in mammographic screening in Sweden, but remain psychometrically untested. Design Instrument development paper with psychometric cross-sectional and test-retest design. Methods Twelve scales of a Swedish questionnaire version were tested by the Rasch model and traditional psychometric methods. Women with false-positive (Group I, n = 640) and negative (Group II, n = 802) screening mammography responded to the study questionnaire and the Nottingham Health Profile during 2009-2011. Results Iterative analyses resulted in nine scales demonstrating Rasch model fit, but all scales exhibited poor targeting with relatively large floor effects. Corrected item-total correlations exceeded the recommended criterion. Score differences between Groups I and II and correlations with Nottingham Health Profile sections followed an expected pattern. Cronbach's α and test-retest reliability was acceptable for group-level assessments for ten and seven scales, respectively. Conclusions Five scales (Sense of dejection, Anxiety, Behavioural, Sleep and Existential values) of the Swedish questionnaire version demonstrated the best psychometric properties. Other scales should be used more cautiously. Although filling an important gap, causes of concern were identified across scales. The questionnaire should therefore be considered for group-level assessments rather than for measurement of individual degrees of psychosocial consequences. [ABSTRACT FROM AUTHOR]

Purpose To examine the perception of registered nurses and nursing assistants regarding the use of physical restraints with residents of nursing homes located in four of the regions of Spain; and to evaluate the relationship of these perceptions to the staff respondents' level of training. Design Cross-sectional multicenter and correlational study. The research was conducted in 2013 in 19 Spanish nursing homes with 2,940 residential beds. A total of 785 nurses (170 registered nurses and 615 nursing assistants) participated in the study. Methods The Perception of Restraint Use Questionnaire (PRUQ), consisting of 17 of the most cited reasons for using these devices, was used, as was a questionnaire capturing the sociodemographic characteristics and educational or experience level of staff respondents. Findings Nurses reported the most important uses for restraints as prevention of falls and avoidance of medical device interference. As indicated by an average PRUQ score of 3.47, staff respondents supported restraint use, especially nursing assistants (3.59) as compared to registered nurses (3.00). With regard to training: 83.7% had participated in little, if any, training and only 29.2% had read three or more documents related to restraint use; 66.6% believed that their training was inadequate. No correlation was found between the results of the PRUQ and the respondents´ sociodemographic characteristics or participation in training activities. No differences were found among nurses by region. Conclusions In contrast to papers published in other countries, nurses in this study still consider it necessary to apply restraints in everyday practice. The education of nursing staff regarding restraint and knowledge of alternatives is needed; they should at least be aware of international standards of care regarding physical restraint use. Clinical Relevance Most of the staff perceived their training related to the use of these devices as insufficient. Nursing assistants considered the use of restraints more important than did the registered nurses. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The purpose of this paper is to describe the theoretical development and initial validation of the newly developed Work-Life Balance Culture Scale (WLBCS), an instrument for measuring an organizational culture that promotes the work-life balance of employees. METHODS: In Study 1 (N = 498), the scale was developed and its factorial validity tested through exploratory factor analyses. In Study 2 (N=513), confirmatory factor analysis (CFA) was performed to examine model fit and retest the dimensional structure of the instrument. To assess construct validity, a priori hypotheses were formulated and subsequently tested using correlation analyses. RESULTS: Exploratory and confirmatory factor analyses revealed a one-factor model. Results of the bivariate correlation analyses may be interpreted as preliminary evidence of the scale’s construct validity. CONCLUSION: The five-item WLBCS is a new and efficient instrument with good overall quality. Its conciseness makes it particularly suitable for use in employee surveys to gain initial insight into a company’s perceived work-life balance culture. [ABSTRACT FROM AUTHOR]

Background The aim of this paper was to evaluate the reliability and validity of the Equity Perception Scale - Intellectual Disability Services (EPS-IDS), a detailed measure of staff equity perceptions in services for people with intellectual disability (ID). The EPS-IDS contains 3 relationship indices that assess staff relationships with their employing organisation, their co-workers, and service users. Method Postal questionnaires were used to collect quantitative data from a purposive sample of ID service staff. Results The EPS-IDS was found to have good internal consistency reliability. The overall test-retest reliability of the measure, however, was found to be less satisfactory. With the exception of the co-worker relationship index, the EPS-IDS indices were found to have promising validity. Conclusions The findings from the study suggest that the EPS-IDS shows some promise as a measure of the equity perceptions of ID service staff. Further refinements to the relationship indices, however, may be required. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to refine the Falling Risk Assessment Tool in Ophthalmology Inpatients (FRAT) and assess its psychometric properties. Design: A cross‐sectional design was used. Methods: A convenience sample of 730 patients in the ophthalmology department was recruited in a level A tertiary hospital in Guangdong Province from July 2021 to January 2022. Data were analysed using item analysis, interrater reliability, content validation, internal consistency reliability and exploratory factor analysis. Results: Five factors were extracted, accounting for 63.039% of the variance. The interrater reliability of the tool was 0.97. Cronbach's α was 0.658. The I‐CVI was 0.75–1.00, the S‐CVI/UA was 0.95 and the adjusted mean values of Kappa for indicators ranged from 0.72 to 1.00, as evaluated by the expert group. The FRAT showed satisfactory reliability and validity, and can be used to measure the fall risk assessment in ophthalmology inpatients. Patient or Public Contribution: After explaining the purpose, the patients received our fall risk assessment and answered the corresponding questionnaire questions. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this empirical study was to explore the current status and associated factors of lymphedema self‐management behaviours among Chinese breast cancer survivors. Background: Breast cancer‐related lymphedema is a lifetime concern for survivors and is currently incurable. Lifetime lymphedema self‐management takes a significant role in preventing development and progression of lymphedema. Understanding influencing factors of lymphedema self‐management behaviours can help to develop targeted intervention programs. Design: A multicentre cross‐sectional study. Methods: From December 2021 to April 2022, a convenience sample of 586 participants were recruited at four tertiary hospitals in four cities in China. Self‐reported questionnaires were used to measure socio‐demographic characteristics, disease‐and treatment‐related characteristics, lymphedema self‐management behaviours, lymphedema knowledge, illness perception, self‐efficacy, self‐regulation and social support. Descriptive analysis, bivariate analysis and hierarchical multiple regression were conducted. This study was registered at Chinese Clinical Trial Registry (ChiCTR2200057084), and was reported followed the STROBE checklist. Results: Breast cancer survivors reported moderate level of lymphedema self‐management behaviours. Promotion of lymph reflux management was ranked the least performed self‐management behaviours, while the affected limb protection management ranked the most. 36.2% of self‐management behaviours was explained by exercise regularly, level of attention on lymphedema prevention, unclear about the tumour stage (vs. stage I), knowledge, self‐efficacy, emotional illness representation and social support. Conclusions: Lymphedema self‐management behaviours of breast cancer survivors was insufficient. Performance of lymphedema self‐management varied with different socio‐demographic characteristics, along with different levels of knowledge, self‐efficacy, perception and social support. All these identified predictors should be reckoned in assessment and intervention of lymphedema self‐management behaviours. Relevance To Clinical Practice: This study addressed that breast cancer survivors' lymphedema self‐management behaviours should be promoted. Focusing on identified predictors, further lymphedema surveillance, knowledge education or social facilitation programs are recommended to enhance their self‐management performance and adherence. [ABSTRACT FROM AUTHOR]

Background: Low health literacy (HL) is associated with reduced disease self-management skills, worse health outcomes, an increased number of hospitalizations, more frequent use of the emergency room and less utilization of preventive services. To support patients with low HL it is crucial to identify affected patients. HL is a multidimensional construct, which covers different skills and abilities to make informed health decisions. Validated brief screening tools to assess health-literacy-related skills or abilities in primary care settings are currently not available in German. This study aimed to validate a single item screener developed in the US for the German primary care setting. Methods: Our study used cross-sectional data from a survey among mainly chronically ill patients (n = 346) conducted in family practices in the state of North Rhine-Westphalia. We explored the convergent validity between a single item literacy screener (SILS) and the HLS-EU-Q16. The SILS measures functional HL by asking patients about their need for help when reading information materials. The HLS-EU-Q16 is a multidimensional HL measure frequently used for research purposes in Germany. Associations between the two instruments were examined using Spearman's correlations and regression analyses. The diagnostic performance of the SILS relative to the HLS-EU-Q16 was assessed using receiver operator curves (ROC). Results: The SILS had a statistically significant correlation with the HLS-EU-Q16 (Spearman ρ: 0.35) and explained 26% of its total variance. Stratified analyses of the convergent validity between both instruments by age, sex, migration background, education level and chronic disease status showed moderate statistically significant correlations in all subgroups (range: 0.223 to 0.428). With an area under the curve of 0.66, the receiver operator curve indicated a satisfactory diagnostic performance of the SILS relative to the HLS-EU-Q16. Conclusions: The SILS provided an acceptable initial assessment of HL limitations among a heterogeneous population of mainly chronically ill patients in a primary care setting. With only one item, the SILS can be a short and effective tool for routine use in primary care and specialized care settings. Future research should test the SILS in other populations and pilot applications of the SILS in routine care. [ABSTRACT FROM AUTHOR]

Dysphagia Handicap Index (DHI) is a clinically effective, concise, and user-friendly tool for assessing the functional impact of dysphagia in clinical populations. The present study aims to trans-adapt the DHI in the Telugu language and assesses its psychometric properties. The present study was conducted in two phases. The first phase includes translating and adapting the DHI tool into Telugu (T-DHI). The second phase includes an analysis of the psychometric properties of the trans-adapted Telugu version of the DHI. The DHI was translated into the Telugu language using the forward–backward translation method. The psychometric analysis was done on 100 participants. All the participants underwent a detailed clinical swallow examination after filling the T-DHI. The overall internal consistency and Guttmann split-half reliability for the Telugu version of the DHI were good. The correlation between the T-DHI subscales and the self-perceived severity of dysphagia was found to be high. The comparison of the T-DHI scores of the control and experimental groups revealed a significant difference. The T-DHI is a reliable and valid tool to assess the quality of life of the Telugu-speaking dysphagia population. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine knowledge, attitude, and practice regarding postoperative delirium and the relationships among cardiac surgery nurses in China. Background: Postoperative delirium is a prevalent and devastating complication following cardiac surgery. Nurses play a part in multi‐disciplinary collaboration for preventing and managing postoperative delirium, of whom knowledge, attitude, and practice are essential. Design: A cross‐sectional multi‐centre study. Methods: Nurses from cardiac surgery wards and intensive care units of five tertiary hospitals in Wuhan, Hubei Province, China were enrolled. Data were gathered online using a self‐administered questionnaire. Student's t‐test, or analysis of variance, or non‐parametric tests were performed to compare differences across groups. Bootstrapping mediation analysis was conducted to examine the relationship between knowledge, attitude, and practice. The STROBE checklist was used for the reporting of this study. Results: Of 429 nurses, a moderate level of knowledge and high levels of attitude and practice regarding postoperative delirium were revealed. Nurses with higher education, higher academic title, 5–10 years of practice in nursing and cardiac surgery nursing exhibited increased knowledge. With advanced age, practice in a specialised hospital, and training experience, nurses reported a better degree of practice. Attitude played a full mediating effect in the relationship between knowledge and practice, accounting for 81.82% of the total effects. Conclusions: Knowledge, attitude, and practice regarding postoperative delirium are promising among Chinese cardiac surgery nurses, with knowledge of screening tools and perioperative nonpharmacological interventions and practice of screening in need of enhancement. Attitudes act as an intermediary between knowledge and practice regarding postoperative delirium. Relevance to Clinical Practice: Innovative and stratified in‐service education is warranted to address knowledge enhancement. Meanwhile, organisations are suggested to make efforts to foster nurses' positive attitudes, particularly in creating a favourable culture and developing institutional protocols for postoperative delirium management to improve practice. No Patient or Public Contribution: This study is focused on cardiac surgery nurses' knowledge, attitude, and practice regarding postoperative delirium, and the research questions and design are from clinical nursing practice, literature review, and expert panel review, in which the patient or public is temporarily not involved. [ABSTRACT FROM AUTHOR]

To develop and explore underlying dimensions of the Self-Regulation Assessment (SeRA) and psychometric features of potential components. Further, to identify associations between the SeRA and disability-management self-efficacy, type of diagnosis, and type of rehabilitation. Based on a previously developed model of self-regulation, expert and patient opinions, and cognitive interviews, a list of 22 items on self-regulation (the SeRA) was constructed. The SeRA was included in a cross-sectional survey among a multi-diagnostic group of 563 former rehabilitation patients. Exploratory analyses were conducted. Respondents had a mean age of 56.5 (SD 12.7) years. The largest diagnostic groups were chronic pain disorder and brain injury. Four components were found within the SeRA, labelled as "insight into own health condition," "insight into own capabilities," "apply self-regulation," and "organization of help." Cronbach's alpha was high (total scale: 0.93, subscales: range 0.85–0.89). Only scores on the first subscale showed a ceiling effect. Subscale three showed the highest correlation with a self-efficacy measure. Small differences in SeRA total scores (range 71.6–78.1) were found between different diagnostic groups. The SeRA is a new self-regulation measure with four subscales. Further research is needed to establish the validity and reliability of the SeRA. The Self-Regulation Assessment (SeRA) was developed to provide a comprehensive measurement of self-regulation among rehabilitation populations. The SeRA could potentially be used to identify persons with self-regulation problems at the start of rehabilitation treatment and measure outcomes of rehabilitation for self-regulation. The SeRA could potentially be used to help analyse outcomes of rehabilitation practice as well as evaluate interventions on self-regulation. [ABSTRACT FROM AUTHOR]