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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]

Aims and objectives. This paper is a report of a study conducted to investigate differences between nurse practitioners' perceptions of the importance of required competencies and their self-evaluated existing competencies, and the main factors influencing these differences. Background. The difference between nurse practitioners' perceptions of required competencies and their existing competencies has never been investigated. Therefore, it is still uncertain whether these two competencies differ. Design. A nationwide survey study was authorised by the Department of Health (DOH) in Taiwan. Methods. For this nationwide survey study, the Questionnaire of Competencies in the Nurse Practitioner's Role was mailed to all nurse practitioners who qualified for the first annual national NP licence exam in Taiwan. Of 582 questionnaires distributed, 374 valid questionnaires were returned for a response rate of 64·2%. Results. The scores for required competencies were all higher than existing competencies. The competencies with largest differences were (in increasing order) clinical research, direct care, and leadership and reform. The competencies with smallest differences were (in ascending order) medical assistance, communication and coordination, and ethical decision-making. Differences in the total score between required and existing competencies were significantly influenced by nurse practitioners' age, seniority as nurse practitioner, whether the nurse practitioners' institution had a nurse practitioner advancement system, and the number of patients under their care. Conclusions. Nurse practitioners' perceptions of the importance of their expected role competencies were significantly greater in most cases than their actual competencies. Relevance to clinical practice. These findings could serve as a reference to improve cultivation of the NP system in Taiwan, to strengthen professional competencies in NP training programs. [ABSTRACT FROM AUTHOR]

meyer k., bjørk i.t. & eide h. (2012) Intensive care nurses' perceptions of their professional competence in the organ donor process. Journal of Advanced Nursing 68(1), 104-115. Abstract Aims. This paper is a report of a study that explored Norwegian intensive care nurses' perceptions of their professional competence to identify educational needs in the organ donor process. Background. Intensive care professionals are requested to consider organ donation each time they care for patients with severe cerebral lesion to ensure donor organs for transplantation. The donor process challenges intensive care nurses' professional competence. Nurses' knowledge and experience may influence their professional competence in caring for organ donors and their relatives. Methods. A cross-sectional survey was conducted in all 28 Norwegian donor hospitals between October 2008 and January 2009. Intensive care nurses ( N = 801) were invited to participate and the response rate was 71·4%. Dimensions of professional competence, learning needs and contextual and demographic variables were explored. Data were analysed using descriptive and inferential statistics. Findings. Few intensive care nurses had extensive experience of or competence and training in organ donation. Nurses working at university hospitals had more experience, but lesser training than nurses in local hospitals. Experience of donor acquisition had an impact on intensive care nurses' perceptions of their professional competence in the donor process. Discussions on the ward and educational input were seen as important for the further development of professional competence. Conclusion. Training provided by experienced colleagues and a culture that encourages discussion about aspects of the donor process can develop nurses' professional competence and communally defined professional practice. Educational input that cultivates various types of knowledge can be beneficial in organ donation. [ABSTRACT FROM AUTHOR]

dickinson t. & hurley m. (2012) Exploring the antipathy of nursing staff who work within secure healthcare facilities across the United Kingdom to young people who self-harm. Journal of Advanced Nursing 68(1), 147-158. Abstract Aims. This paper is a report of a study that compared relevant attitudinal dimensions of Registered Nurses and nursing aides working within a Young Offenders' Institute and two young people's forensic units in the United Kingdom towards young people in their care who self-harm. Background. Nurses caring for young people within secure environments may engage at some point with patients who harm themselves. These staff often experience strong negative emotional reactions which can lead to antipathy and alienation. Methods. Forty seven Registered Nurses and 22 nursing aides completed the Self-Harm Antipathy Scale, which consists of 30 attitudinal self-report items. The data were collected between June 2008 and December 2008, and analysed using spss version 17. Results. Results displayed that age per se, length of service with self-harming clients, and whether the participant was a Registered Nurse or nursing aide, and number of self-harming clients worked with did not influence the Self-Harm Antipathy Scale score or any of its component sub-scores. However, field of nursing the nurse was registered under, previous study of self-harm, year first registered and gender showed significant effects. Conclusions. Given that responses reflect a degree of both empathy and apathy it seems that there is a need to promote greater therapeutic alliances and communication; for example, the use of positive regard to help reduce the incidence of labelling and the negative effects this has upon relationships. There is a significant need for nursing staff working with young people who self-harm to have access to relevant educational programmes. A focus on harm minimization could be key areas for further development. [ABSTRACT FROM AUTHOR]

Aims and objective. The goal of this paper was to evaluate the reliability and validity of the Nursing Work Index-Revised - Brazilian version (B-NWI-R). Background. Some instruments evaluate the presence of certain characteristics in the professional practice environment of nurses. Among them, the B-NWI-R, often cited in the literature and which is examined in the present study. This instrument is composed of 57 items and four subscales: autonomy, control over the work environment, nurse-physician relationships and organisational support. Design. A cross-sectional research design was carried out in three public university hospitals in the State of São Paulo, Brazil. Methods. The sample was composed of 278 nurses. The reliability of the instrument was evaluated through its homogeneity, using the Cronbach's alpha coefficient. The validity of the subscales of the B-NWI-R was evaluated through divergent construct validity and criterion-related validity. For the divergent construct validity, the Brazilian version of the Maslach Burnout Inventory (MBI) was employed, while for the criterion-related validity, variables such as 'satisfaction at work', 'perception of quality of care' and 'nurses' intention to leave work in the following year' were considered. Results. The results showed satisfactory consistency for the total of the items ( α = 0·95) and for the subscales of the B-NWI-R: 'control over practice settings' ( α = 0·75); 'nurse-physician relationships' ( α = 0·75); 'organisational support' ( α = 0·75) and 'autonomy' ( α = 0·63). The divergent validity resulted in significant correlation between the adapted instrument subscales and those of the MBI. In addition, a significant correlation was obtained between the subscales of the B-NWI-R and the variables 'perception of quality of care', 'satisfaction at work' and 'intention to leave work in the following year'. Conclusion. The reliability and validity of the B-NWI-R have been established. Relevance to clinical practice. The B-NWI-R subscales can be used to assess the nurses' perceptions of the work environment. [ABSTRACT FROM AUTHOR]

salanova m., lorente l., chambel m.j. & martínez i.m. (2011) Linking transformational leadership to nurses' extra-role performance: the mediating role of self-efficacy and work engagement. Journal of Advanced Nursing 67(9), 2256-2266. Abstract Aims. This paper is a report of a social cognitive theory-guided study about the link between supervisors' transformational leadership and staff nurses' extra-role performance as mediated by nurse self-efficacy and work engagement. Background. Past research has acknowledged the positive influence that transformational leaders have on employee (extra-role) performance. However, less is known about the psychological mechanisms that may explain the links between transformational leaders and extra-role performance, which encompasses behaviours that are not considered formal job requirements, but which facilitate the smooth functioning of the organization as a social system. Methods. Seventeen supervisors evaluated nurses' extra-role performance, the data generating a sample consisting of 280 dyads. The nurses worked in different health services in a large Portuguese hospital and the participation rate was 76·9% for nurses and 100% for supervisors. Data were collected during 2009. A theory-driven model of the relationships between transformation leadership, self-efficacy, work engagement and nurses' extra-role performance was tested using Structural Equation Modelling. Results. Data analysis revealed a full mediation model in which transformational leadership explained extra-role performance through self-efficacy and work engagement. A direct relationship between transformational leadership and work engagement was also found. Conclusion. Nurses' supervisors with a transformational leadership style enhance different 'extra-role' performance in nurses and this increases hospital efficacy. They do so by establishing a sense of self-efficacy but also by amplifying their levels of engagement in the workplace. [ABSTRACT FROM AUTHOR]

suhonen r., papastavrou e., efstathiou g., lemonidou c., kalafati m., da luz m.d.a., idvall e., berg a., acaroglu r., sendir m., kanan n., sousa v.d., katajisto j., välimäki m. & leino-kilpi h. (2011) Nurses' perceptions of individualized care: an international comparison. Journal of Advanced Nursing 67(9), 1895-1907. Abstract Aim. This paper is a report of a study of internationally-based differences in nurses' perceptions of individualized care in orthopaedic surgical in-patient wards. Background. Individualized care is valued in healthcare policy, practice and ethical statements as an indicator of care quality. However, nurses' assessments of individualized care are limited and comparative cross-cultural studies on individualized nursing care are lacking. Methods. A descriptive comparative survey was used to sample orthopaedic surgical nurses ( n = 1163) working in 91 inpatient wards in 34 acute hospitals in Finland, Cyprus, Greece, Portugal, Sweden, Turkey and the United States of America. Data were collected between March and November 2009 using the Individualized Care Scale-Nurse and analysed using descriptive and inferential statistics. Results. Nurses in different countries perceived that they supported patients' individuality generally and provided individualized care during nursing activities. Although the highest scores were in support of patients' individuality in the clinical situation both through nursing provision and nurses' perceptions of individuality, there were between-country differences within these scores. Generally, the Greek and American nurses gave the highest scores and the Turkish, Cypriot and Portuguese nurses the lowest. Conclusions. Between-country differences found may be attributed to differing roles of nurses, care processes, healthcare systems and/or the ways nursing care is defined and organized. As this was the first time the Individualized Care Scale-Nurse was used in an international context, the results are formative and indicate the need to continue studies in this area. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a descriptive study of nurses' and midwives' clinical leadership development needs. Background. Nurses and midwives are expected to fulfil a leadership role at all levels, yet efforts to strategically support them are often unfocused. An analysis of clinical leadership development needs can provide the foundation for leadership initiatives to support staff. Method. A mixed methods design was used. A questionnaire was sent to 911 nurses and midwives and 22 focus groups comprising 184 participants were conducted. Data were collected between March and June 2009 across all promotional grades of nurses and midwives in Ireland. Repeated measures ANOVA with Greenhouse-Geisser adjustment was used for post hoc pair wise comparisons of the subscale dimensions of clinical leadership. ANOVA with Tukey's post hoc method was used for comparison between grades on each individual subscale. Thematic analysis was undertaken on the focus group data. Results. Results reveal that needs related to development of the profession were the highest for all grades. The staff grade expressed a higher need in relation to 'managing clinical area', 'managing the patient care' and 'skills for clinical leadership' than managers. Qualitative analysis yielded five themes; (1) clinical leadership and leaders from a nursing and midwifery perspective; (2) quality service from a nursing and midwifery perspective; (3) clinical leaders' roles and functions; (4) capital and (5) competences for clinical leaders and leadership and the context of clinical leadership. Conclusion. Clinical leadership concerns quality, safety and effectiveness. Nurses and midwives are ideally placed to offer the clinical leadership that is required to ensure these patient care outcomes. Development initiatives must address the leader and leadership competencies to support staff. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study of psychometric properties of the Problem-Focused Style of Coping-Chinese version questionnaire. Background. Coping with stress is an important topic in the 21th century, which deserves further attention. Although a variety of instruments have emerged to assess an individual's coping responses to stress, research suggests that numerous problems are associated with the current measurements. Since most coping scales are criticized as lacking valid estimates across occupational samples and cultures, there is an immediate need to develop a reliable and valid coping-style scale. Method. The study used a convenience sample and a sampling frame consisting of 307 nurses from different medical units in two regional hospitals in Taiwan. The data collection period was from May 2009 to June 2009. Exploratory factor analyses and reliability estimates were calculated. Results. The factor analysis revealed three coping factors: reflective, suppressive and reactive. All reliability and validity estimates were satisfactory. Conclusion. The Problem-Focused Style of Coping-Chinese version questionnaire is a valid and reliable measure of nurses' dispositional coping style and can be used for educational training programmes to enhance nurses' stress management skills. [ABSTRACT FROM AUTHOR]

This paper presents the preliminary descriptive findings from an online survey commissioned by the Royal College of Nursing to ascertain members' perceptions of spirituality and spiritual care. There is a professional requirement for nurses to achieve competence in the delivery of spiritual care and to assess and meet the spiritual needs of their patients. Recently, the area of spirituality has come under criticism bringing into question the role of the nurse with regard to the provision of spiritual care. A descriptive online survey was conducted with all Royal College of Nursing members to obtain their perceptions of spirituality and spiritual care in an attempt to identify what action they feel is required with regard to this aspect of nursing practice. An online survey consisting of a five-part questionnaire was developed incorporating the Spirituality and Spiritual Care Rating Scale. Members were asked to complete the survey during a three-week period in March 2010. Overall, 4054 Royal College of Nursing members responded, making this probably the largest UK survey ascertaining nurses' perceptions of spirituality and spiritual care. Descriptive statistics, frequencies and percentages were used to identify key findings. A Cronbach's alpha of 0·80 was obtained for the Spirituality and Spiritual Care Rating Scale. The preliminary analysis confirms that nurses across the full health economy in the United Kingdom consider spirituality to be a fundamental aspect of nursing. The findings indicate that nurses recognise that attending to the spiritual needs of patients enhances the overall quality of nursing care. However, despite all the attention given to the spiritual dimension, the majority of nurses still feel that they require more guidance and support from governing bodies to enable them to support and effectively meet their patients' spiritual needs. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a descriptive comparative pilot study of use of a method that simultaneously tests the content validity and quality of translation of English-to-Chinese translations of two patient satisfaction questionnaires: the La Monica-Oberst Patient Satisfaction Scale and Hospital Consumer Assessment of Healthcare Providers and Systems. Background. Patient satisfaction is an important indicator of the quality of healthcare services. In China, however, few good translations of patient satisfaction instruments sensitive to nursing services exist. Methods. The descriptive pilot study took place in 2009 and used content validity indexing techniques to evaluate the content, context and criterion relevance of a survey question. The expert raters were 10 nursing faculty and 10 patients who evaluated the two patient satisfaction questionnaires. The experts evaluated the relevance of each item on a scale of 1-4 and the research team compared their responses to choose the most appropriate. Only the nurse faculty experts, who were bilingual, evaluated the quality of the translation using a binary rating. Results. The 'Nurse Rater' relevance scores of the LaMonica-Oberst Patient Satisfaction Scale and the Hospital Consumer Assessment of Healthcare Providers and Systems were 0.96 and 0.95 respectively, whereas the patient's overall relevance scores were 0.89 and 0.95. A Mann-Whitney U-test demonstrated that results between the two groups were statistically significantly different (P = 0.0135). Conclusions. Using content validity indexing simultaneously with translation processes was valuable for selecting and evaluating survey instruments in different contexts. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to (a) to compare hospitalized patients' and nurses' perceptions of the hospital environment, nurse--physician relationships and quality of care; (b) to determine which factors best predict the quality of care from hospitalized patients' and nurses' perspectives; and (c) to assess the relationships among all variables. Background. Quality of care is a function of many factors and includes elements of the hospital environment and nurse--physician relationships. However, comparisons between patients' and nurses' perceptions are relatively limited. Methods. This was a cross-sectional study, and 575 patients and 220 nurses across 13 units completed questionnaires. Data were collected in 2009 and analysed using descriptive statistics, independent t-tests, stepwise regression and path analysis. Results. Overall, patients' mean scores were statistically significantly higher than those of nurses on perception of hospital environment (3.05 vs. 2.65 points), nurse--physician relationships (7.88 vs. 6.53 points) and quality of care (7.91 vs. 6.63 points) (P < 0.001). Both the hospital environment and nurse--physician relationships were statistically significant predictors of quality of care. Path analysis showed that quality of care was affected by the hospital environment, nurse--physician relationships and years of education for patients (P < 0.05). However, for nurses, quality of care was only directly affected by the hospital environment and nurse--physician relationships (P < 0.05). Conclusion. These findings may help nursing leaders to ensure future excellent patient care by helping them to see which areas need improvement. They may also help nursing leaders to develop strategies to meet patients' and nurses' expectations. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an evaluation of the implementation of nurse prescribing in an acute care hospital in England. Background. At the time of the study, evaluation of nurse prescribing had taken place in community settings, but little was known about its impact and effectiveness in acute care. Although nurse prescribing has permitted doctor-nurse substitution in acute episodic care, some doctors have expressed concerns about patient safety in relation to nurse prescribing. Methods. A mixed methods single-case study was conducted in 2005-06, using purposive sampling. Semi-structured interviews were carried out with 18 hospital staff, non-participant observation of two nurses and two doctors undertaking 52 patient-prescriber consultations with 47 patients, and a questionnaire survey with 122 patients (response rate 61%: n = 74). Results. Nurse prescribing was found to benefit patients through service delivery improvement and using staff skills differently. Nurse prescribers and their colleagues were positive about role and service changes and their impact on patient care. No differences were found between the ways in which nurses and doctors performed prescribing roles, but there was a statistically significant difference between the medication-related information satisfaction ratings of patients who had seen a nurse prescriber, compared to those seen by a doctor. Conclusion. Nurses and doctors were found to provide equivalent care. Shared vision, local champions, action learning and peer support were the enabling factors that helped to embed the new prescribing roles within the study site. [ABSTRACT FROM AUTHOR]

rochefort c.m. & clarke s.p. (2010) Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units. Journal of Advanced Nursing 66(10), 2213–2224. Aim. This paper is a report of a study of the relationship between work environment characteristics and neonatal intensive care unit nurses’ perceptions of care rationing, job outcomes, and quality of care. Background. International evidence suggests that attention to work environments might improve nurse recruitment and retention, and the quality of care. However, comparatively little attention has been given to neonatal care, a specialty where patient and nurse outcomes are potentially quite sensitive to problems with staffing and work environments. Methods. Over a 6-month period in 2007–2008, a questionnaire containing measures of work environment characteristics, nursing care rationing, job satisfaction, burnout and quality of care was distributed to 553 nurses in all neonatal intensive care units in the province of Quebec (Canada). Results. A total of 339 nurses (61·3%) completed questionnaires. Overall, 18·6% were dissatisfied with their job, 35·7% showed high emotional exhaustion, and 19·2% rated the quality of care on their unit as fair or poor. Care activities most frequently rationed because of insufficient time were discharge planning, parental support and teaching, and comfort care. In multivariate analyses, higher work environment ratings were related to lower likelihood of reporting rationing and burnout, and better ratings of quality of care and job satisfaction. Conclusion. Additional research on the determinants of nurse outcomes, the quality of patient care, and the impact of rationing of nursing care on patient outcomes in neonatal intensive care units is required. The Neonatal Extent of Work Rationing Instrument appears to be a useful tool for monitoring the extent of rationing of nursing care in neonatal units. [ABSTRACT FROM AUTHOR]

gardner g., gardner a., middleton s., della p., kain v. & doubrovsky a. (2010) The work of nurse practitioners. Journal of Advanced Nursing 66(10), 2160–2169. Aim. This paper is a report of a study of variations in the pattern of nurse practitioner work in a range of service fields and geographical locations, across direct patient care, indirect patient care and service-related activities. Background. The nurse practitioner role has been implemented internationally as a service reform model to improve the access and timeliness of health care. There is a substantial body of research into the nurse practitioner role and service outcomes, but scant information on the pattern of nurse practitioner work and how this is influenced by different service models. Methods. We used work sampling methods. Data were collected between July 2008 and January 2009. Observations were recorded from a random sample of 30 nurse practitioners at 10-minute intervals in 2-hour blocks randomly generated to cover 2 weeks of work time from a sampling frame of 6 weeks. Results. A total of 12,189 individual observations were conducted with nurse practitioners across Australia. Thirty individual activities were identified as describing nurse practitioner work, and these were distributed across three categories. Direct care accounted for 36·1% of how nurse practitioners spend their time, indirect care accounted for 32·0% and service-related activities made up 31·9%. Conclusion. These findings provide useful baseline data for evaluation of nurse practitioner positions and the service effect of these positions. However, the study also raises questions about the best use of nurse practitioner time and the influences of barriers to and facilitators of this model of service innovation. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study to investigate the relationships among bone mineral density, demographics, knowledge of osteoporosis, beliefs concerning osteoporosis and preventive behaviours of at-risk females with family histories of osteoporosis. Background. Strong evidence demonstrates that genetics is a significant determinant of peak bone mass, with a heritability of 50–90%. However, few studies have examined the bone mineral density of at-risk females with family histories of osteoporosis, particularly in an Asian population. Design. Telephone survey. Methods. The study population ( n = 2890) was recruited from a radiology department at a national university medical centre in northern Taiwan during 2005–2006. In total, 886 females completed a questionnaire via the telephone; the participation rate was 30·7%. Results. The bone mineral density of at-risk females was close to osteopenia status (T score of −1 to −2·49). Most subjects were aware of osteoporosis-related information; however, few clearly understood osteoporosis. Furthermore, subjects reported difficult implementing strategies to improve bone mineral density. Variation in bone mineral density was correlated with self-rated health ( r = 0·56, p < 0·05), knowledge of osteoporosis ( r = 0·66, p < 0·05) and preventive behaviours ( r = 0·68, p < 0·05). Conclusions. This study is to examine risk factors associated with bone mineral density of females with family histories of osteoporosis. Early identification of risk factors for osteoporosis and development of prevention programmes are required to halt the increasing in the incidence of osteoporosis and improve the bone mineral density of at-risk females. Relevance to clinical practice. Nursing care professionals, who emphasise primary, secondary and tertiary prevention with individuals and families, should develop effective prevention strategies for women with family the history of osteoporosis to protect the health of these vulnerable populations at-risk for osteoporosis. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper describes a study that aimed to identify research priorities for the care of infants, children and adolescents at the sole tertiary referral hospital for children in Western Australia. The secondary aim was to stimulate nurses to explore clinical problems that would require further inquiry. Background. Planning for research is an essential stage of research development; involving clinicians in this exercise is likely to foster research partnerships that are pertinent to clinical practice. Nursing research priorities for the paediatric population have not previously been reported in Australia. Design. Delphi study. Method. Over 12 months in 2005–2006, a three-round questionnaire, using the Delphi technique, was sent to a randomly selected sample of registered nurses. This method was used to identify and prioritise nursing research topics relevant to the patient and the family. Content analysis was used to analyse Round I data and descriptive statistics for Round II and III data. Results. In Round I, 280 statements were identified and reduced to 37 research priorities. Analysis of data in subsequent rounds identified the top two priority research areas as (1) identification of strategies to reduce medication incidents (Mean = 6·47; SD 0·88) and (2) improvement in pain assessment and management (Mean = 6; SD 1·38). Additional comments indicated few nurses access the scientific literature or use research findings because of a lack of time or electronic access. Conclusions. Thirty-seven research priorities were identified. The identification of research priorities by nurses provided research direction for the health service and potentially other similar health institutions for children and adolescents in Australia and internationally. Relevance to clinical practice. The nurse participants showed concern about the safety of care and the well-being of children and their families. This study also enabled the identification of potential collaborative research and development of pain management improvement initiatives. [ABSTRACT FROM AUTHOR]

Aims and objectives: To develop and psychometrically test a food frequency questionnaire for adults at risk of coronary heart disease (Cardio‐FFQ). Background: Comprehensive dietary assessment is critical for the prevention of cardiovascular disease, but appropriate instruments to perform this work are lacking. Design: A sequential mixed‐methods study followed the COREQ and STROBE guidelines. Methods: This study was conducted between April 2016 and November 2017. It started with dietary history interviews (Phase 1) to identify candidate food items of the Cardio‐FFQ, which validity and reliability were assessed (Phase 2) through expert consultation and four seasonal measurements, including test and retest with a 2‐week gap every season. Physical activity and blood glucose and lipids were assessed seasonally, while another FFQ was administered during the fourth measurement. Content analysis was used to analyse verbatim interview transcripts, while descriptive and inferential analyses were used to simplify the Cardio‐FFQ and examine its psychometric properties. Results: Phase I involved 34 participants during their first onset of acute coronary syndrome and generated 176 candidate food items (consumed by at least three participants) under 12 food categories. These food items were simplified to form the 133‐item Cardio‐FFQ after discarding items with trivial contributions to food commonalities or between‐person variance. Further analysis showed that the simplified questionnaire had satisfactory content validity, concurrent validity, convergent validity, predictive validity, known‐group validity and test–retest reliability. Conclusion: The 133‐item Cardio‐FFQ is a valid and reliable tool for a comprehensive dietary assessment appropriate for adults at risk of coronary heart disease. Relevance to clinical practice: Nurses may use the Cardio‐FFQ to conduct a dietary assessment to better support people to commit to healthy diets, aiming to reduce the risk of coronary heart disease. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore hospital healthcare professionals' knowledge and attitudes towards dementia care in China. Background: Hospital healthcare professionals deliver most diagnosis and treatment for people with dementia in China. Literature shows that healthcare professionals' knowledge and attitudes are of great importance in providing optimum dementia care. However, there is limited research of healthcare professionals' dementia knowledge and attitudes within hospital contexts in China. Design: A cross‐sectional survey was conducted between April and December 2019. Methods: A self‐report questionnaire composed of demographics and knowledge and attitude scales related to dementia was used for doctors and registered nurses working in settings where people with dementia are cared for in eleven public tertiary hospitals in Hebei Province, China. The STROBE checklist was adhered to in this study. Results: In total, 603 healthcare professionals completed the study. The majority of respondents were registered nurses (71.3%). The overall mean knowledge score was 20.7 (SD = 2.9) out of a maximum possible score of 30. The overall mean score for attitudes was 91.3 (SD = 15.9) out of a maximum possible score of 140. Standard multiple linear regression analysis revealed that the highest level of education, the experience of searching for dementia‐related information and willingness to receive dementia training or education were significant predictors of knowledge scores. The department, the experience of working with people with dementia, length of dementia care, interest in dementia care and training type were significant predictors of attitude scores. Conclusions: Deficits in the knowledge of dementia and a low level of positive attitude were identified among the healthcare professionals who work in hospital settings where people with dementia are cared for in China. Relevance to clinical practice: Education and training in dementia care should be integrated into undergraduate nursing and medical programmes and provided for healthcare professionals after commencing employment. [ABSTRACT FROM AUTHOR]

senneseth m., alsaker k. & natvig g.k. (2012) Health-related quality of life and post-traumatic stress disorder symptoms in accident and emergency attenders suffering from psychosocial crises: a longitudinal study. Journal of Advanced Nursing 68(2), 402-413. Abstract Aims. This paper is a report of a study of health-related quality of life and post-traumatic stress disorder symptoms in patients attending an Accident and Emergency department because of psychosocial crises. Background. Psychosocial crises are commonplace globally, but there is little knowledge about patients attending Accident and Emergency departments because of psychosocial crises. Methods. Data were collected at an Accident and Emergency department in Norway from September 2008 to June 2009. A total of 99 adults participated in the baseline study and 41 of these participated at 2 months follow-up. The Short Form-36 Health Survey and the Post Traumatic Symptom Scale were used to obtain data. Findings. Participants reported significantly lower scores in all health-related quality of life domains at baseline compared with the general Norwegian population. The mental health score was two standard deviations below the norm. Health-related quality of life scores were improved and post-traumatic stress disorder symptoms were reduced after 2 months. High levels of post-traumatic stress disorder symptoms were reported by 78% of the participants at baseline and 59% at follow-up. Participants with high levels of post-traumatic stress disorder symptoms at follow-up also reported low health-related quality of life scores. Conclusion. This study suggests a need for an acute psychosocial intervention and an opportunity to receive follow-up support at Accident and Emergency departments. [ABSTRACT FROM AUTHOR]

wang x., chontawan r. & nantsupawat r. (2012) Transformational leadership: effect on the job satisfaction of Registered Nurses in a hospital in China. Journal of Advanced Nursing 68(2), 444-451. Abstract Aim. The aim of this study was to describe the relationship between the transformational leadership of nurse managers and job satisfaction among clinical Registered Nurses at a tertiary care hospital in China. Background. The healthcare system is changing rapidly. Research in Western countries has shown that transformational leadership affects job satisfaction. However, very little research related to this subject has been conducted in healthcare settings in China. Methods. The sample consisted of 238 nurses who work at a tertiary care hospital in China. Data were collected from April to August 2006. Research instruments included a demographic data form, a Leadership Practice Inventory and a Job Satisfaction Scale for clinical registered nurses. Findings. Both the transformational leadership of nurse managers and job satisfaction among clinical Registered Nurses were at a moderate level. There was a statistically significant positive correlation between the transformational leadership of nurse managers and job satisfaction ( r = 0·556, P < 0·001). Conclusion. The findings indicate that the transformational leadership of nurse managers could have an effect on the job satisfaction of clinical Registered Nurses. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the effects of a simulation-based education programme on critical care nurses' knowledge, confidence, competence and clinical performance in providing delirium care. Design: Single-blinded randomized controlled trial. Methods: Registered nurses who work in intensive care units were recruited from a university-affiliated acute major metropolitan teaching hospital. The intervention group received: (i) five online-learning delirium care videos, (ii) one face-to-face delirium care education session and (iii) a simulation-based education programme with a role-play scenario-based initiative and an objective structured clinical examination. The control group received only online videos which were the same as those provided to the intervention group. Delirium care knowledge, confidence, competence, and clinical performance as outcomes were collected at: baseline, immediately after intervention, and within 6 weeks post-intervention to test whether there were any changes and if they were sustained over time. Data were collected between 2 October and 29 December 2020. The repeated-measures analysis of variance was used to examine for changes in delirium care knowledge, confidence, and competence within groups. Results: Seventy-two critical care nurses participated with 36 each allocated to the intervention group and control group. No statistically significant difference was observed between the two groups in outcome variables at 6 weeks post-intervention. In the intervention group, significant within-group changes were observed in terms of delirium care knowledge, confidence, and competence over time. By contrast, no significant changes were observed in outcome measures over time in the control group. Conclusion: The simulation-based education programme is an effective and feasible strategy to improve delirium care by enhancing the knowledge, confidence, competence and clinical performance of critical care nurses. Impact: Our findings provide evidence regarding the development and implementation of a simulation-based education programme in hospitals for health professional education in Taiwan. [ABSTRACT FROM AUTHOR]

Aims and objectives: To assess the level of nurse‐to‐nurse collaboration during the transfer of older people between hospital and primary health care and to evaluate the psychometric properties of the newly developed Nurse‐to‐Nurse Collaboration Between Sectors Instrument. Background: Nurse‐to‐nurse collaboration is required when older people transfer between hospital and primary health care to enhance the safety and continuity of care to patients. There is a lack of evidence about the nature and level of this collaboration. Design: A cross‐sectional survey design was used. This study adhered to the STROBE checklist. Methods: A sample of 443 nurses (university hospital n = 240, primary health care n = 203) participated in the study from October 2017 to June 2018. Nurses completed the Nurse‐to‐Nurse Collaboration Between Sectors Instrument (86 items, 7–point Likert‐type scale), the Nurse‐Nurse Collaboration Scale and the Patient‐Centred Competency Scale. Results: Nurses rated the overall level of nurse‐to‐nurse collaboration moderately high (mean=4.49, standard deviation=0.83, maximum 7.00). Nurses considered collaboration an important and confidential process, gaining older people's trust in their care. Lower scores were given to the agreement of mutual objectives, policies and guidelines in collaboration, opportunities for job rotation and interacting and networking during the collaboration process. The internal consistency reliability of the newly developed instrument was acceptable. Conclusions: Nurses collaborate with competence and confidentiality during the transfer of older people between care settings. However, there is a need for more opportunities to collaborate, to obtain mutual agreement about objectives, policies and practices, and better understand other nurse's roles and responsibilities in collaboration. The reliability and validity of the Nurse‐to‐Nurse Collaboration Between Sectors Instrument were acceptable though the number and wording of items will be reviewed and further tested. Relevance to clinical practice: Nurses need opportunities to collaborate, and there is a need to develop agreed objectives, practices, roles and responsibilities in this collaboration. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. 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.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. 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.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. 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.)

sun t., zhao x.w., yang l.b. & fan l.h. (2012) The impact of psychological capital on job embeddedness and job performance among nurses: a structural equation approach. Journal of Advanced Nursing 68(1), 69-79. Abstract Aims. The objective of this study was to provide empirical evidence on the relationships between psychological capital, job embeddedness and performance. This paper also seeks to present the theoretical development of psychological capital and job embeddedness in nursing research and their application to nursing practices. Background. Psychological capital was recently identified as a core construct in the literature of positive psychology. However, there is considerably less evidence on its positive effects on job embeddedness and performance among nursing personnel. Methods. Questionnaires were distributed to approximately 1000 nurses employed in five university hospitals in Heilongjiang province in China. Data were collected in November 2009. The response rate was 73·3%. Structural equation modelling was employed to test the proposed relationships. Findings. The results support the hypothesized model. This research outlined a strong relationship between the self-reported psychological capital, job embeddedness and performance of the nurses. The study findings suggest that improving the individual-accumulated psychological state of nurses will have a positive impact on their retention intention and job performance. Conclusions. These findings suggest that higher psychological capital increases the self-reported job embeddedness and performance of these nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives: To measure the professional values of registered nurses and determine whether these values are significantly related to postlicensure ethics education and years of experience. Background: Nursing guilds in many countries reference the American Nurses Association's code of ethics to define expected professional nursing values. Strong professional values contribute to high‐quality patient care and are influenced by complex practice environments. Design: Causal‐comparative design. Methods: A convenience sample of actively licensed registered nurses in Washington State, United States of America, participated in an electronically administered survey (N = 2,439). Analyses were conducted using descriptive statistics, analysis of variance and correlation. Reporting utilised the STROBE checklist. Results: Results suggested values of highest and lowest importance to nurses. Scores varied significantly based on years of nursing experience; a higher score indicated stronger orientation toward professional nursing values. Nurses with experience of 10 years or more had the highest scores. There was a modest, positive relationship between professional values and amount of time spent in postlicensure ethics education. Conclusions: Professional values of Washington State nurses are similar to other nurses in national and global workforces. Results suggest key areas of strength in nurses' professional values and areas needing additional focus and support. Professional values are highest among nurses with longer practice experience and among nurses who have had increased ethics education. Relevance to clinical practice: Knowledge of nurses' priority values can assist leaders and educators to identify areas of needed support among nursing staff members. Organisational commitment to support of nurses' professional values through investment in ethics education may produce positive enduring consequences, such as workplace retention and high‐quality patient care. Healthcare leaders and clinical educators who promote ethics education may help to mitigate negative effects of morally challenging situations, such as moral distress and work leaving. [ABSTRACT FROM AUTHOR]

Aims To assess the reliance on intuitive and analytical approaches during clinical decision-making among novice clinicians and whether that reliance is associated with accurate decision-making. Background Nurse educators and managers tend to emphasize analysis over intuition during clinical decision-making though nurses typically report some reliance on intuition in their practice. We hypothesized that under certain conditions, reliance on intuition would support accurate decision-making, even among novices. Design This study utilized an experimental design with clinical complication (familiar vs. novel) and decision phase (cue acquisition, diagnosis and action) as within-subjects' factors, and simulation role (observer, family, auxiliary nurse and primary nurse) as between-subjects' factor. Methods We examined clinical decision-making accuracy among final semester pre-licensure nursing students in a simulation experience. Students recorded their reasoning about emerging clinical complications with their patient during two distinct points in the simulation; one point involved a familiar complication and the other a relatively novel complication. All data were collected during Spring 2015. Results Although most participants relied more heavily on analysis than on intuition, use of intuition during the familiar complication was associated with more accurate decision-making, particularly in guiding attention to relevant cues. With the novel complication, use of intuition appeared to hamper decision-making, particularly for those in an observer role. Conclusion Novice clinicians should be supported by educators and nurse managers to note when their intuitions are likely to be valid. Our findings emphasize the integrated nature of intuition and analysis in clinical decision-making. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether definable profiles existed in a cohort of nursing staff with regard to demographic characteristics, job satisfaction, acculturation, work environment, stress, cultural values and coping abilities. A survey was conducted in one hospital in Singapore from June to July 2012, and 814 full-time staff nurses completed a self-report questionnaire (89% response rate). Demographic characteristics, job satisfaction, acculturation, work environment, perceived stress, cultural values, ways of coping and intention to leave current workplace were assessed as outcomes. The two-step cluster analysis revealed three clusters. Nurses in cluster 1 ( n = 222) had lower acculturation scores than nurses in cluster 3. Cluster 2 ( n = 362) was a group of younger nurses who reported higher intention to leave (22.4%), stress level and job dissatisfaction than the other two clusters. Nurses in cluster 3 ( n = 230) were mostly Singaporean and reported the lowest intention to leave (13.0%). Resources should be allocated to specifically address the needs of younger nurses and hopefully retain them in the profession. Management should focus their retention strategies on junior nurses and provide a work environment that helps to strengthen their intention to remain in nursing by increasing their job satisfaction. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the impact of an educational programme focused on social behaviours and relationships on organisational learning culture in the residential aged care context. Background The number of aged care homes will continue to rise as the frail older elderly live longer, requiring more formal care and support. As with other small- to medium-sized health services, aged care homes are faced with the challenge of continuous development of the workforce and depend upon registered nurses to lead staff development. Design A mixed-method evaluation research design was used to determine the impact of an educational programme focused on social aspects of learning on organisational learning culture. Methods One hundred and fifty-nine (pre) and 143 (post) participants from three aged care homes completed the Clinical Learning Organisational Culture survey, and three participant-researcher registered nurse clinical educators provided regular journal entries for review. Results While each site received the same educational programme over a six-month period, the change in organisational learning culture at each site was notably different. Two aged care homes had significant improvements in affiliation, one in accomplishment and one in recognition. The educators' journals differed in the types of learning observed and interventions undertaken, with Eucalyptus focused on organisational change, Grevillea focused on group (student) change and the Wattle focused on individual or situational change. Conclusion Clinical educator activities appear to have a significant effect on organisational learning culture, with a focus on the organisational level having the greatest positive effect on learning culture and on individual or situational level having a limited effect. Relevance to clinical practice Clinical educator facilitation that is focused on organisational rather than individual interests may offer a key to improving organisational learning culture. [ABSTRACT FROM AUTHOR]

Aim To determine the attitudes of emergency care staff towards young people (aged 12-18 years) who self-harm and to gain an understanding of the basis of attitudes that exist. Background Young people frequently attend emergency services following self-harm; it is unclear whether being a young person influences attitudes held. Design Mixed methods using a triangulation convergent design. Methods Survey of 143 staff members from four accident & emergency departments and one ambulance service. Semi-structured interviews with seven children's A&E nurses and five ambulance personnel from the same locality. Data were collected during 2010. Results/Findings Pearson's product moment correlation coefficient confirmed a strong positive correlation between scores on the two scales used to measure attitudes; paired samples t-test revealed a statistically significant difference in scores across the scales; practitioners held more positive attitudes towards young people who self-harmed than young people per se. Both data sets confirmed the presence of ambivalence and ambiguity in attitudes held. The qualitative data revealed that because of their age and immaturity young people were not held responsible for their self-harming behaviours. Being young did though influence subsequent admission, with particular difficulty in securing admission for those aged 16-17 reported. Conclusion Age is a factor in shaping practitioners' attitudes; age also directs and influences a young person's journey through emergency care, although due to ambiguity there is inconsistency in determining where those aged 16-17 years of age fit. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop and test the content and face validity, and reliability of the quality clinical placement evaluation tool. Background The importance of clinical experience during undergraduate nursing degrees is undisputed. To date, tools available to measure quality of clinical placements have focused on single perspectives, that of the undergraduate or that of the supervising nurse. The quality clinical placement evaluation tool was proposed to provide an assessment of clinical placement experiences informed by supervising ward nurses and undergraduate stakeholders. Design The study employed a cross-sectional design. Methods The internal validity of an existing instrument was evaluated by an expert panel and modified for use in the acute care sector. Surveys were completed by undergraduate students ( n = 48) and supervising ward nurses ( n = 47). Factor analysis was used to identify themes drawn from the literature and explore redundancy of items. Reliability was assessed using Cronbach's alpha for internal consistency and test-retest (five to seven days apart). Results Reliability testing showed good internal consistency for the tool; test-retest reliability testing results were moderate to good for students and fair to moderate for nurses. Factor analysis identified three core themes related to supervising ward nurse responses that could also be applied to undergraduate nurses. The domains identified were the following: welcome and belonging; support to meet learning needs; and confidence and competence: reflections on learning. Conclusions The quality clinical placement evaluation has shown statistically acceptable levels of reliability and validity for measuring the quality of clinical placement from perspectives of undergraduates and supervising ward nurses. Relevance to clinical practice The tool provides tertiary institutions, acute care facilities, wards and individuals with the means to capture views of the quality of clinical placement which can also be used to undertake comparisons over time and between sites. [ABSTRACT FROM AUTHOR]

Aims To integrate existing theoretical perspectives on change management, subjective fit and occupational stress to better understand the effects of change on employee adjustment. Background Although subjective fit with organizational goals and objectives has been shown to have positive effects on employee adjustment, its role in the organizational change-occupational stress context is not understood. This represents a caveat in research when considering the notion that those who feel that they fit with the organization's goals may be better equipped to reconcile and deal with change. Design A cross-sectional survey of nurses from public and non-profit sector hospitals was conducted. Method Data were collected from 252 public and non-profit sector nurses via online surveys. Data were collected from June-October in 2010. Structural equation modelling was used to test the direct and indirect effects among the focal variables. Results The results showed that public and non-profit nurses experience flexibility-limiting and flexibility-promoting change initiatives and that these are differentially related to the perception of administrative stressors and adjustment with these relationships directly and indirectly influenced by perceptions of subjective fit. Flexibility-limiting change initiatives led to lower levels of subjective fit, higher levels of administrative stressors and less favourable adjustment. On the other hand, flexibility-promoting change practices led to higher levels of subjective fit, lower levels of administrative stressors and ultimately better adjustment. Conclusion The results further the theoretical understanding of the role of subjective fit in organizational change and occupational stress theories. [ABSTRACT FROM AUTHOR]

Aims and objectives To assess Malaysian nurses' perceived job satisfaction and to determine whether any association exists between job satisfaction and intention to leave current employment. Background There is currently a shortage of qualified nurses, and healthcare organisations often face challenges in retaining trained nurses. Job satisfaction has been identified as a factor that influences nurse turnover. However, this has not been widely explored in Malaysia. Design Cross-sectional survey. Methods Registered nurses in a teaching hospital in Malaysia completed a self-administered questionnaire. Of the 150 questionnaires distributed, 141 were returned (response rate = 94%). Results Overall, nurses had a moderate level of job satisfaction, with higher satisfaction for motivational factors. Significant effects were observed between job satisfaction and demographic variables. About 40% of the nurses intended to leave their current employment. Furthermore, age, work experience and nursing education had significant associations with intention to leave. Logistic regression analysis revealed that job satisfaction was a significant and independent predictor of nurses' intention to leave after controlling for demographic variables. Conclusion The results suggest that there is a significant association between job satisfaction and nurses' intention to leave their current employment. It adds to the existing literature on the relationship between nurses' job satisfaction and intention to leave. Relevance to clinical practice Methods for enhancing nurses' job satisfaction are vital to promote the long-term retention of nurses within organisations. Attention must be paid to the needs of younger nurses, as they represent the majority of the nursing workforce and often have lower satisfaction and greater intention to leave than older nurses do. Strategies to nurture younger nurses, such as providing opportunities for further education, greater management decision-making capabilities and flexible working environment, are essential. [ABSTRACT FROM AUTHOR]

Aim To report a study designed comparing the roles, responsibilities, and perceived outcomes of Clinical Nurse Specialists, Clinical Midwife Specialists, and Advanced Nurse Practitioners in Ireland. Background A clinical career pathway that encompasses progression from staff nurse or midwife through clinical specialist to advanced practitioner level was introduced in Ireland in 2000. Such roles are common internationally, but little evaluation has been conducted and few comparisons have been made between roles. Design A mixed-method case-study design was used. Methods Following Research Ethics Committee Approval, data were collected in 2009-2010, using non-participant observation (92 hours) of 23 Clinical Specialists and Advanced Practitioners, interviews with 21 clinicians and 13 Directors of Nursing or Midwifery. A survey was completed by 154 service-users. Results A clear difference was seen between Clinical Specialist and Advanced Practitioners, with advanced practice roles providing improved service delivery, greater clinical and professional leadership, increased research, and a clear governance and accreditation structure. Clinical Midwife Specialists were rated at a similar level to Advanced Nurse Practitioners for certain aspects and rated more highly for 'continuity of care and carer'. Conclusion Advanced Practitioners do give a higher level of care, particularly at a strategic level. Existing Clinical Specialists should therefore be encouraged to develop their skills and education to achieve advanced practice level and more specialist and advanced practice posts should be instituted. [ABSTRACT FROM AUTHOR]

Thome M. & Arnardottir S.B. (2013) Evaluation of a family nursing intervention for distressed pregnant women and their partners: a single group before and after study. Journal of Advanced Nursing 69(4), 805-816. doi: 10.1111/j.1365-2648.2012.06063.x Abstract Aim. To report a study of the effects of an antenatal family nursing intervention for emotionally distressed women and their partners. Background. High levels of depressive symptoms and anxiety are common in pregnant women, and their partners are likely to suffer from a higher degree of these symptoms than those of non-distressed women. Maternal anxiety and depressive symptoms influence the development of the foetus and child negatively. Distress-reducing interventions for couples are scarce. Design. The design was a pre- and post-test single group quasi-experiment. Methods. All women distressed during the last two trimesters of pregnancy were referred by midwives to a family nursing home-visiting service in a primary care setting in Iceland. They were invited to participate in the study from November 2007-September 2009. The final sample was 39 couples. Assessment of distress was through self-reporting of depressive symptoms and anxiety, self-esteem, and dyadic adjustment. The couple received four home visits that were guided by the Calgary Family Nursing Model. Results. Women experienced a higher degree of distress than men before the intervention. Couple's distress was interrelated, and improvement was significant on all indicators after the intervention. Conclusion. Healthcare professionals who care for distressed expectant women should attend to their partners' mental health status. The Calgary Family Nursing Model is an appropriate guide for nursing care of distressed prospective couples in a primary care setting. [ABSTRACT FROM AUTHOR]

lafond c.m. & van hulle vincent c. (2012) A critique of the National League for Nursing/Jeffries simulation framework. Journal of Advanced Nursing 00(0), 000-000. doi: 10.1111/j.1365-2648.2012.06048.x Abstract Aims. To present a critique of the National League for Nursing/Jeffries simulation framework. Design. Fawcett's criteria for theory analysis and evaluation are used. Background. Use of simulated learning experiences in nursing education is widespread; a sound framework to guide educators across the globe in implementing these experiences effectively is essential. The basic assertion of the National League for Nursing/Jeffries simulation framework is that student-learning outcomes are influenced by the concepts of teacher, student, educational practices, and simulation design characteristics. Data sources. A literature search was performed using Cumulative Index to Nursing and Allied Health Literature, PubMed and Google Scholar to identify studies published in the English language, between 2005-June 2011, where the National League for Nursing/Jeffries simulation framework was tested or used as a theoretical framework for research. Discussion. Sixteen publications (two articles in press) from the USA and UK were identified using the framework to guide research; outcomes included increased student satisfaction, confidence, and improved skill performance. Implications for nursing. As a newer theoretical framework, the National League for Nursing/Jeffries simulation framework offers promise to guide the construction and implementation of simulation experiences resulting in positive student outcomes. Conclusion. Empirically supported definitions of concepts would strengthen the framework and help educators to consistently produce and identify positive outcomes. Additional rigorous research is necessary to further test relationships among concepts and the associated concept variables in the framework. More studies outside of the United States are needed to confirm the framework is relevant to nursing programs in other countries. [ABSTRACT FROM AUTHOR]

wang s.-c., lee l.l., wang w.-h., sung h.-c., chang h.-k., hsu m.-y., chang s.-c. & tai c.-h. (2012) Psychometric testing of the Chinese evidence-based practice scales. Journal of Advanced Nursing 68(11), 2570-2577. Abstract Aim. This article is a report of the psychometric testing of the Chinese version of Evidence-Based Practice Implementation and Beliefs, and Barriers to, and Facilitators of Research Utilization scales. Background. Investigations into the effect of evidence-based practice on clinical care could be facilitated by instruments for measuring the levels of evidence-based practice implementation; the strength of beliefs in evidence-based practice; the barriers to, and the facilitators of research utilization. An English version of the scales measuring the above constructs has been tested whereas the Chinese one has not. Design. Instrument development. Methods. Psychometric analyses of the four evidence-based scales were conducted on a sample of 361 nurses from a medical centre in Taiwan. Both the internal consistency and squared multiple correlation coefficients were used to examine reliability. The validity testing for the four scales was estimated by examining their construct and concurrent validity. Data were collected between December 2008-January 2009. Findings. Internal consistencies exist for the Chinese Evidence-Based Practice Implementation, Beliefs, and Barriers to, and Facilitator of Research Utilization scales (≥0·85); some were greater than 0·9, which may indicate redundancy in items. Construct validity of the four scales was supported by hypotheses testing. Concurrent validity of the four scales was supported by known-group analysis, in which experienced nursing researchers had higher scores compared with clinical nurses. Conclusion. These scales may have value in discrimination between implementation of EBP and perception of barriers to, and facilitators of research utilization among nurses with different education levels, research experiences or working years in clinical setting. [ABSTRACT FROM AUTHOR]

Aims and objectives. This study was designed to examine the applicability of World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in adolescents in China for internal consistency and factorial validity. Background. The conceptualisation of impairments, activity limitation and participation restriction as disability underpins WHODAS 2.0. Available evidence is mainly about the use of WHODAS 2.0 in adults with little attention to adolescents. Design. Survey design. Methods. A total 314 adolescent inpatients were recruited using a purposive sampling strategy and self-measured with a range of scales related to puberty development, family function, 36-item WHODAS 2.0, extended version of Strength and Difficulties Questionnaire (Ext-SDQ). The same amount of junior high school student data was randomly selected to facilitate the model invariance examination through confirmatory factor analysis with the assistance of amos 19 and spss 19. Results. Adolescents (mean, 14·07; SD, 2·866) varied greatly in demography, health conditions, body mass index, puberty development, family function, disability and difficulties as well as prosocial status. After the removal of the item on sexual activity, the internal consistency for the 35-item WHODAS is satisfactory, overall and dimensional. The six-factor WHODAS model was found to be a good model fit, moderately correlated with the overall difficulty measured by the 20-item four-factor SDQ, with the ability to differentiate the group of adolescent inpatients and junior high school students. Conclusion. The 35-item WHODAS is useful with adolescents with satisfactory internal reliability and factorial validity. Relevance to clinical practice. This study supports the use of 35-item WHODAS in adolescents with or without health conditions in school and hospital settings, which paves the way for a better understanding about and health service delivery to adolescents during the transition from childhood to adulthood. [ABSTRACT FROM AUTHOR]

itzhaki m., bar-tal y. & barnoy s. (2012) Reactions of staff members and lay people to family presence during resuscitation: the effect of visible bleeding, resuscitation outcome and gender. Journal of Advanced Nursing 68(9), 1967-1977. Abstract Aim. This article is a report on a study conducted to examine the views of healthcare professionals and lay people regarding the effect of family presence during resuscitation on both the staff performing the resuscitation and the relatives who witness it. Background. Family presence during resuscitation is controversial. Although many professional groups in different countries have recently issued position statements about the practice and have recommended new policy moves, the Israel Ministry of Health has not issued guidelines on the matter. Methods. Study design is factorial within-between subjects. Data were collected in Israel in 2008 from a convenience sample of 220 lay people and 201 healthcare staff (52 physicians and 149 nurses) using a questionnaire based on eight different resuscitation scenarios and manipulating blood involvement and resuscitations outcome. Data were analysed using one-way analysis of variance. Findings. Overall, both staff and lay people perceived family presence during resuscitation negatively. Visible bleeding and an unsuccessful outcome significantly influenced both staff's and lay people's perceptions. Female physicians and nurses reacted more negatively to family presence than did male physicians and nurses; lay men responded more negatively than lay women. Conclusions. Changing the current negative perceptions of family presence at resuscitation requires (a) establishing a new national policy, (b) educating healthcare staff to the benefits of the presence of close relatives and (c) training staff to support relatives who want to be present. [ABSTRACT FROM AUTHOR]

Aims. To explore nurses' attitudes and level of satisfaction in using the Hospital Information System in clinical practice. Background. Application of the Hospital Information System is increasing and there is substantial evidence suggesting that the successful implementation of Hospital Information System is significantly related to nurses' attitudes. However, little information is currently available on the factors influencing those attitudes and their level of satisfaction in Hospital Information System use. Design. Cross-sectional survey. Methods. A stratified, random sampling of 342 nurses working in a Hong Kong private hospital and using Hospital Information System was recruited. A questionnaire was used to collect data on perceptions, level of satisfaction and attitudes towards Hospital Information System usage. Correlations and linear regressions were used to analyse the data. Results. Multiple linear regression analysis showed that work units, perceived usefulness and information technology support are the three predictors of nurses' attitudes and level of satisfaction with the system. In addition, nurses who have higher perceived ease of use and better satisfaction towards using the system are associated with positive attitude. Conclusion. The study results serve to guide the nurse managers to develop information systems based on the nurses' needs. Previous studies regarded nurses' level of satisfaction as a part of nurses' attitude. What is of interest in this study is that nurses' satisfaction level can be viewed as an individual factor affecting nurses' attitudes. With a user-friendly system, nurses tend to be more satisfied and therefore potentially more engaged in its use. This may indirectly improve patient care by saving time on documentation and enhancing communication among departments. Relevance to clinical practice. The nurse managers should promote an institutional culture to motivate staff towards positive acceptance of innovation. An effective collaboration with the information technology team would enhance a more efficient exchange of information to understand the complex factors of IT implementation. [ABSTRACT FROM AUTHOR]

Aim. To assess the discriminative and construct validity of the Multidrug-Resistant Bacteria Attitude Questionnaire and to study registered nurses' knowledge of, behaviour toward and emotional responses to patients with multidrug-resistant bacteria in relation to how they understand their own, managers' and politicians' responsibility for adherence to preventive measures for infection control. Background. Multidrug-resistant organisms are a global problem and an essential topic in healthcare regarding patient safety improvement. Design. Descriptive and correlational cross-sectional survey. Method. Data were collected in a non-random sample consisting of 397 registered nurses; district, haematology or infection registered nurses. One-way analysis of variance and independent t-tests were used for comparisons and a principal component analysis was performed. Results. Discriminative and construct validity were supported, as the infection registered nurses generally had higher scores on knowledge, behaviour and emotional response, compared with district registered nurses and haematology registered nurses and the three-factor solution was confirmed. Registered nurses with higher scores on knowledge and emotional response attributed greater responsibility to themselves and to politicians. The Multidrug-Resistant Bacteria Attitude Questionnaire was translated using a forward-back translation process. Conclusion. The questionnaire has adequate psychometric properties. Insufficient knowledge of, behaviour toward and emotional response to patients with multidrug-resistant bacteria were described, but the registered nurses did estimate their own responsibility for adherence to preventive measures for infection control as being great or very great. Relevance to clinical practice. There is a considerable need to improve knowledge, behaviour and emotional response regarding infection prevention measures among healthcare workers. The hospital management are responsible for such improvements and the Multidrug-Resistant Bacteria Attitude Questionnaire is useful in identifying such needs, as it has adequate psychometric properties and is able to discriminate between groups. Evaluation among healthcare workers may indicate where to situate additional training, as this is of clinical significance for safe care. [ABSTRACT FROM AUTHOR]

tsai y. & wu s.-w. (2011) Using internal marketing to improve organizational commitment and service quality. Journal of Advanced Nursing 67(12), 2593-2604. Abstract Aim. The purpose of this article was to explore the structural relationships among internal marketing, organizational commitment and service quality and to practically apply the findings. Background. Internal marketing is a way to assist hospitals in improving the quality of the services that they provide while executing highly labour-intensive tasks. Through internal marketing, a hospital can enhance the organizational commitment of its employees to attain higher service quality. Method. This research uses a cross-sectional study to survey nursing staff perceptions about internal marketing, organizational commitment and service quality. The results of the survey are evaluated using equation models. The sample includes three regional hospitals in Taiwan. Three hundred and fifty questionnaires were distributed and 288 valid questionnaires were returned, yielding a response rate of 82·3%. The survey process lasted from 1 February to 9 March 2007. The data were analysed with spss 12·0, including descriptive statistics based on demographics. In addition, the influence of demographics on internal marketing, organizational commitment and service quality is examined using one-way anova. Results. The findings reveal that internal marketing plays a critical role in explaining employee perceptions of organizational commitment and service quality. Organizational commitment is the mediator between internal marketing and service quality. Conclusion. The results indicate that internal marketing has an impact on both organizational commitment and service quality. Internal marketing should be emphasized to influence frontline nursing staff, thereby helping to create better organizational commitment and service quality. [ABSTRACT FROM AUTHOR]

phillips n.m. & endacott r. (2011) Medication administration via enteral tubes: a survey of nurses' practices. Journal of Advanced Nursing 67(12), 2586-2592. Abstract Aim. This article is a report of a study examining the practices of acute care nurses when administering medication via enteral tubes. Background. Administering medication via enteral tubes is predominantly a nursing responsibility across countries. It is important to establish what nurses actually do when giving enteral medication to inform policy and continuing education development. Method. In 2007, a survey was conducted using a random sample of acute care nurses at two large metropolitan hospitals in Melbourne, Australia. There were 181 Registered Nurses who participated in the study; 92 (50·8%) practised in intensive care units, 52 (28·7%) in surgical areas, 30 (16·6%) in medical areas and 7 (3·9%) were from combined medical-surgical areas. The questionnaire was developed by the researchers and a pilot study was conducted in August 2006 to test reliability, face validity and user-friendliness of the tool. Results. Nurses reported using a range of methods to verify enteral tube position prior to administering enteral medication; some were unreliable methods. A majority reported administering enteric-coated and slow or extended release forms of medication, and giving solid forms of medication when liquid form was available. Nearly all (96%) reported flushing a tube after giving medication, 28% before, and 12% always flushed between each medication. Conclusion. Enteral medication administration practices are inconsistent. Some nurses are using unsafe practices and may therefore compromise patient care. [ABSTRACT FROM AUTHOR]

van hecke a., goeman c., beeckman d., heinen m. & defloor t. (2011) Development and psychometric evaluation of an instrument to assess venous leg ulcer lifestyle knowledge among nurses. Journal of Advanced Nursing 67(12), 2574-2585. Abstract Aim. Development and psychometric testing of an instrument to assess venous leg ulcer lifestyle knowledge. Background. Nurses often lack knowledge to provide adequate leg ulcer advice. No valid and reliable instruments are available to assess knowledge on venous leg ulcer advice among nurses. Methods. The instrument was developed based on a literature review and patient cases. Content validity was evaluated in a Delphi procedure by nine leg ulcer experts. Item-analysis, construct validity and stability were assessed. A sample of 350 nurses and student nurses participated. Data collection took place between February and April 2009. Results. The instrument included four topics: (1) Compression therapy, (2) Physical activity/leg exercises, (3) Leg elevation and (4) Pain management. Multiple-choice questions were developed to assess factual knowledge. Patient cases were developed to assess more complex cognitive skills. Content validity was established. The quality of the response alternatives varied between 0·01 and 0·68. The difficulty index for questions evaluating factual knowledge ranged from 0·12 to 0·78. Patient cases' questions had a difficulty index between 0·07 and 0·60. The score of participants with (theoretically expected) more expertise was significantly higher than the score of participants with (theoretically expected) less expertise. The intraclass correlation coefficients ranged between 0·71 and 0·77. Eleven questions had moderate kappa-values (0·41-0·60), and in eight questions, there was fair agreement (0·30-0·40). Conclusion. An instrument with an acceptable content validity and construct validity was developed. The instrument can be applied in nursing education, nursing practice and nursing research to evaluate venous leg ulcer advice knowledge. [ABSTRACT FROM AUTHOR]

Aims. The aim of this study was to establish and evaluate the effectiveness of a care map for total knee replacement patients. Background. Bureau of National Health Insurance in Taiwan is about to launch a diagnosis-related group. This major reform has seriously affected the running of medical institutions, which are facing unprecedented management pressure. Design. A quasi-experimental control group design was carried out. Methods. Eighty-three patients were recruited, with 39 experimental group patients received nursing care based on a care map, while 44 patients who were in control group received routine nursing care. An interdisciplinary team designed the care map, which included items required for patient care from outpatient to postdischarge. Results. (1) The mean age of patients was 72·73 (SD 8·42) years. Mean length of stay was 4·92 (SD 0·77) days for the experimental group and 7·09 (SD = 1·09) for the control group. Difference between groups was significant ( t = −10·285, p < 0·001). The medical cost for the experimental group was less than that for the control group ( t = −6·03, p < 0·001). (2) The self-care efficacy score before discharge for the experimental group was higher than that for the control group ( t = 5·90, p < 0·001). (3) Significant improvements were observed in activities of daily living for both groups with the passage of time after discharge ( F = 229·034, p < 0·001), and the experimental group was better than the control group ( F = 40·895, p < 0·001). The instrumental activities of daily living abilities of both groups were also significant improvements with the passage of time after discharge ( F = 46·568, p < 0·001), and the experimental group was better than the control group ( F = 32·163, p < 0·001). Conclusions. A care map for total knee replacement patient can shorten length of stay, save medical cost and improve patient's functional recovery. Relevance to clinical practice. Results of this study can be used as a basis for practical implementation of care map in total knee replacement patients. [ABSTRACT FROM AUTHOR]

Aims and objective. To investigate emotional responses of nurses and perceived senior staff responses to errors, error-coping strategies used by nurses and how these are associated with constructive or defensive changes in nursing practice. Background. Healthcare professionals have generally reported distressing emotional responses to errors and fear concerns about their consequences. However, errors can also be part of a developmental process, by offering opportunities for learning and leading to constructive changes in clinical practice. Design. Prospective, correlational, multicentre study. Methods. Five hundred and thirty-six structured questionnaires completed from nurses employed in various hospital departments were considered eligible for data extraction. The revised questionnaire used was evaluated for content validity. Results. Data analysis indicated that positive perceived senior staff responses ( p = 0·030), accepting error responsibility ( p = 0·031) and seeking social support ( p = 0·019) predicted constructive changes in nursing practice, while negative perceived senior staff responses ( p = 0·040) and error escape-avoidance ( p = 0·041) predicted defensive changes. Conclusions. Errors promote constructive changes in clinical practice when nurses are encouraged to use adaptive error-coping strategies within a supportive, non-blaming culture. Relevance to clinical practice. These findings highlight the role of senior staff in the establishment of a supportive, trustful ward climate, so that nurses can learn from errors, prevent their recurrence and improve patient safety. [ABSTRACT FROM AUTHOR]

Aims. To determine individual and work environment characteristics associated with the occurrence of errors in Korean public hospitals. Background. Medical errors are affected by individual and work environment characteristics. Few studies have examined the factors influencing medical errors, including perceptions of safety climate and individual and organisational characteristics. Design. A survey. Methods. A questionnaire was distributed to 2358 nurses in 33 public hospitals to collect information on the frequency of errors, perceptions of safety climate and general characteristics of the participants. Data on hospital characteristics were obtained from the Regional Public Hospital Profile. The response rate was 89·7%. Multiple logistic regression analysis was performed to determine the factors influencing the occurrence of errors. Results. Of the participants, 19% reported having made at least one error in the previous year. Nurses with better perceptions of workgroup- (OR = 0·73) and organisation- (OR = 0·69) level safety climate were less likely to make errors. Nurses with less than 3 years of nursing experience (OR = 2·05) were more likely to make errors than those with ten years or more. Nurses working at Red Cross hospitals (OR = 1·63) and in rural areas (OR = 2·04) were more likely to make errors than those at Regional Medical Centres and in urban areas, respectively. Conclusion. The factors associated with the occurrence of errors were perceived safety climate, years of nursing experience and hospitals' ownership and location. Relevance to clinical practice. Public hospital executives and nurse managers should be actively involved in creating a strong safety climate. Furthermore, training programmes and managerial support focussed on improving patient safety and directed at less experienced nurses, especially those working at Red Cross hospitals in rural areas, need to be emphasised to prevent errors. [ABSTRACT FROM AUTHOR]

Aim. This article is a report of the development and psychometric testing of the Spiritual Care Inventory. Background. Research supporting the positive association between spirituality and health has lead to interest in providing spiritual care in healthcare settings. Few instruments exist that measure the provision of spiritual care. Method. In February/March 2007, a convenience sample of 298 adult and paediatric acute care, ambulatory, home health, hospice staff and rehab nurses at two hospitals ( n = 248) and graduate students at a school of nursing ( n = 50) completed a 48-item initial version of the Spiritual Care Inventory. In study 2 from July through August 2007, 78 staff nurses at one hospital ( n = 30) and a different cohort of graduate students at a school of nursing ( n = 48) completed the 18-item second version of the Spiritual Care Inventory. Results. Exploratory factor analysis in study 1 supported a 3-factor solution (spiritual care interventions, meaning making and faith rituals) with internal consistency measures for the subscales above 0·80. In study 2, internal consistency remained high. Conclusion. Factor structures identify that spiritual care is a process of intervention, meaning making and faith rituals. [ABSTRACT FROM AUTHOR]