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Intercultural relations benefit from the social psychological study of arguments made by different groups about joint projects of mutual concern. This focus allows researchers to map representations of the project in question, among communities in different cultural milieus. This paper presents a study looking at Arabs' views on the project of integration. Arabs' perspectives revolved around six argumentative themes: cultural, economic, psychological, religio‐cultural, socio‐political or stigma‐related. After comparing all claims on integration across the communities involved (the Arab minority and the Maltese majority), we describe Arabs' positive, negative and mixed/ambivalent socio‐political claims in detail, complementing a previous study on majority views. This enables a discussion of Arabs' perspectives in view of the semiotic resources relevant to localised intercultural relations. Arabs' argumentative themes clearly reflect three key patterns: (a) social representation of integration as difficult but necessary, (b) minority representation of the majority group as being resistant to integration and (c) de‐essentialism of ingroup and outgroup. These patterns contrast with the majority members' arguments in significant ways. Findings are discussed theoretically in view of how minority arguments re‐present social processes to advance or resist intercultural projects, and substantively in terms of the application of these findings for ameliorating intercultural relations in local communities. [ABSTRACT FROM AUTHOR]

Individuals with adult or juvenile Huntington disease can be cared for within psychiatric hospitals. In this paper, nurses' perceptions about the appropriateness of a psychiatric setting for these patients were explored. Semistructured interviews were conducted with 10 Maltese nurses involved in the care of these individuals. Their responses were analyzed using thematic analysis. Three main themes were identified from this study: (i) Huntington disease is not a mental illness; (ii) the lack of specialized staff and equipment within a psychiatric setting; and (iii) a need for alternative care options. The findings provide an insight into the perceptions of nurses, as they play a key role in the care and management of individuals with Huntington disease in a psychiatric setting. The findings demonstrated the need to provide alternative residential options in the community, and to improve the care and support provided both within psychiatric hospitals and the community through staff education and the provision of necessary facilities and equipment. [ABSTRACT FROM AUTHOR]

Aim: To understand the meaning of surviving out of hospital cardiac arrest and its aftereffects among Greek‐speaking survivors. Design: Hermeneutical phenomenological method based on Martin Heidegger's philosophy. Methods: Eight Greek‐speaking out of hospital cardiac arrest survivors were recruited using purposive sampling method. Data collection and analysis using the seven stages of hermeneutic analysis described by Diekelman. Data were collected through semi‐structured personal interviews with open‐ended questions. Results: Analysis revealed five themes: 'The unexpected attack', 'Experiencing a different world: Transformation of Body, Time, Emotion and Sensation', 'Restoration of the re‐embodied self', 'Life transformation' and 'Personal transformation'. The themes are commensurate with transcultural components of Near‐Death Experiences. Surviving out of hospital cardiac arrest was perceived as a 'divine gift' and a chance to continue 'living in a more conscious and meaningful way'. Despite participants' physical and psychosocial challenges, the narratives highlighted a newly acquired deep appreciation for the joy of life, living and others. Construction of meaning and a heightened spirituality seem central in reconstructing life after out of hospital cardiac arrest survivors. Patient or Public Contribution: Out of hospital cardiac arrest survivors reflected and described in‐depth on their lived experiences of out of hospital cardiac arrest through a 60‐ to 90‐min interview. In addition, the participants provided their feedback on the interpretation of the findings, confirmed the study findings, and ensured that the analysis reflected aspects of their individual experiences and were true to them. [ABSTRACT FROM AUTHOR]

Aim: Nurse leaders influence workplace culture; however, little is known about ethnic cultural influences on nurse leader development. This research aims to identify personal strategies promoting effective leadership by nurse leaders from European small island countries. Design: Descriptive qualitative study. Methods: In 2017, nineteen semi‐structured interviews with nurse leaders from England, Greece, Republic of Ireland and Malta explored leadership journeys, strategies employed to support their growth and development, and how cultural identity played a role. Transcripts were analysed using reflexive thematic analysis. Results: Four main themes and 12 subthemes captured the strategies and approaches of the nurse leaders: (1) Influences, (2) Communication, (3) Process and (4) Relationships. These findings reflect and validate the five transformational leadership practices of the Exemplary Leadership Model. While cultural island identity was discussed, there was a shared cultural identity within the role of "nurse leader" that spanned all islands. Patient or Public Contributions: Nineteen nurse leaders contributed to this study. [ABSTRACT FROM AUTHOR]

DECOLA P., BENTON D., PETERSON C., & MATEBENI D. (2012) Nurses' potential to lead in non-communicable disease global crisis. International Nursing Review 59, 321-330 Background: The incidence and projected rise of non-communicable diseases (NCDs) are a significant global public health threat. Nurses as health educators are well positioned to support health promotion and prevention efforts. The intent was to understand nurses' interest, challenges and enabling factors in carrying out this important role in addressing the NCD crisis. Method: A stratified representative survey of 1600 nurses in eight countries was conducted to better understand how nurses perceive their role in addressing risk factors associated with NCDs, as well as the types of supports required in order to facilitate this work. The study also explores nurses' changing views of the profession and their practice environment. The structured survey was administered via telephone and face-to-face interviews composed primarily of multiple choice closed-ended questions. Results: Key findings included that 95% of nurses wanted to use their knowledge, skills and time to educate individuals on the threat and prevention of NCDs. They expressed their belief that they should be spending significantly more time, on average almost twice the amount as they currently are able to devote, on preventing the development or escalation of NCDs. However, nurses' potential to do this is diluted by heavy workloads; over one third reported that their workload had worsened over the last 5 years, and 95% of nurses are experiencing time pressures. Nurses believe these constraints, almost unanimously (98%), keep them from being able to spend more time with patients in an educational capacity. Conclusions: Nurses are interested in spending more time addressing NCD prevention, but workload, time constraints and their perception towards the job of nursing hinder them from achieving their potential. Unhealthy lifestyle choices are a risk factor for NCDs; through awareness and education, positive behaviour change is possible. Research has demonstrated that nurses are effective at supporting individuals to make behaviour change, administering disease management programmes and enabling self-care as well as self-management. Practice environment issues that prevent nurses from fully reaching their potential in addressing the NCD crisis need to be addressed. [ABSTRACT FROM AUTHOR]

Background: Approximately, 20% of intensive care unit (ICU) survivors develop post‐traumatic stress disorder (PTSD) symptoms. Although Davidson Trauma Scale (DTS) provides a comprehensive approach to PSTD symptoms, there is no evidence on DTS‐I‐M use in ICU survivors. Aims and objectives: To validate the modified intensity Davidson Trauma Scale (DTS‐I‐M) (wherein the frequency and severity subscales are combined to express symptoms intensity) in a convenience sample of ICU survivors in Cyprus, and to explore the prevalence of PTSD symptoms and related predictors. Design: An instrument validation design, along with a cross‐sectional, correlational study design was employed. Methods: Translation and cultural adaptation of the instrument were achieved through a group of experts and pilot testing. The DTS‐I‐M was administered via telephone. Participants' clinical data (length of ICU stay [LOS], mechanical ventilation duration [MVD], admission diagnosis, medication history) and demographics (age, gender) were collected. Non‐parametric comparisons, and regression analyses to identify predictors of DTS‐I‐M scores and PTSD symptoms were employed. Results: The Cypriot DTS‐I‐M version demonstrated high test‐retest (Pearson's r = 0.928, P <.001) and internal consistency (Cronbach's [α] alpha =.97) reliability in a sample of 69 ICU survivors (62.7% response). About 36.2% of participants reported PTSD symptoms. Factor analysis confirmed the construct validity of the DTS‐I‐M, and a 3‐factor structure (encompassing intrusive, avoidance, hyperarousal, mood, and cognitive symptoms). In a multiple regression, MVD (B = −3.11, OR [95% CI] = 22.58 [3.07‐166.09, P =.002]) and LOS (r2 = 0.302, P =.002) were statistically significant predictors of DTS‐I‐M score. Conclusion: We confirm the applicability of the DTS‐I‐M for the assessment of PTSD symptoms in ICU survivors; and offer preliminary evidence on the prevalence and predictors of post‐ICU PTSD symptoms in Cyprus. Relevance to clinical practice: DTS‐I‐M is an appropriate screening tool for PTSD symptoms after ICU hospitalization. Patients with longer MVD and LOS are at higher risk for post‐ICU PTSD symptoms and seem to experience more intense relevant symptoms. [ABSTRACT FROM AUTHOR]

Background Child abuse is a health and social problem, and few screening instruments are available for the detection of risk in primary health care. The aim was to develop a screening instrument to be used by professionals in the public health care sector, thus enabling the detection of infants and toddlers at risk of emotional and physical abuse and neglect, and to provide evidence for the feasibility of the instrument in Cyprus, Greece and Spain. Method A total of 50 health professionals from paediatric public health-care centres in the three countries were involved in a three-step process for guiding the development of the screening tool and its application. Results A nine-item screening tool, consisting of items assessing relational emotional abuse, physical abuse and other risk factors, was developed. The screening tool was applied on a total of 219 families with 0 to 3-year-old children attending public health centres in the three countries. Clinicians reported that they agreed on the inclusion of the questions (86.4-100%) and that they found the questions to be useful for the clinical evaluation of the family (63.2-100%). Conclusion The screening tool shows considerable face validity and was reported feasible by an international set of clinicians. [ABSTRACT FROM AUTHOR]

Background and aims Increased nurse-physician collaboration is a factor in improved patient outcomes. Limited autonomy of nurses has been proposed as a barrier to collaboration. This study aims to explore nurse-physician collaboration and potential associations with nurses' autonomy and pertinent nurses' characteristics in adult intensive care units (ICUs) in Cyprus. Design and Methods Descriptive correlational study with sampling of the entire adult ICU nurses' population in Cyprus (five ICUs in four public hospitals, n = 163, response rate 88·58%). Nurse-physician collaboration was assessed by the Collaboration and Satisfaction About Care Decisions Scale (CSACD), and autonomy by the Varjus et al. scale. Results The average CSACD score was 36·36 ± 13·30 (range: 7-70), implying low levels of collaboration and satisfaction with care decisions. Male participants reported significantly lower CSACD scores ( t = 2·056, p = 0·04). CSACD correlated positively with years of ICU nursing experience ( r = 0·332, p < 0·0001) and professional satisfaction ( r = 0·455, p < 0·0001). The mean autonomy score was 76·15 ± 16·84 (range: 18-108). Higher degree of perceived collaboration (CSACD scores) associated with higher autonomy scores ( r = 0·508, p <0·0001). Conclusions Our findings imply low levels of nurse-physician collaboration and satisfaction with care decisions and moderate levels of autonomy in ICU nurses in Cyprus. Relevance to clinical practice The results provide insight into the association between nurse-physician collaboration and nurses' autonomy and the correlating factors. [ABSTRACT FROM AUTHOR]

In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach. [ABSTRACT FROM AUTHOR]

This study is an exploration of nursing students' experiences within the clinical learning environment ( CLE) and supervision provided in hospital settings. A total of 357 second-year nurse students from all universities in Cyprus participated in the study. Data were collected using the Clinical Learning Environment, Supervision and Nurse Teacher instrument. The dimension 'supervisory relationship (mentor)', as well as the frequency of individualized supervision meetings, were found to be important variables in the students' clinical learning. However, no statistically-significant connection was established between successful mentor relationship and team supervision. The majority of students valued their mentor's supervision more highly than a nurse teacher's supervision toward the fulfillment of learning outcomes. The dimensions 'premises of nursing care' and 'premises of learning' were highly correlated, indicating that a key component of a quality clinical learning environment is the quality of care delivered. The results suggest the need to modify educational strategies that foster desirable learning for students in response to workplace demands. [ABSTRACT FROM AUTHOR]

The present descriptive correlational study aims to explore among Greek- Cypriot mental health nurses ( MHNs) the level of professional satisfaction, potential differences with regard to vocational characteristics, and associations with anxiety and depressive symptoms. A random sample of 225 Greek- Cypriot MHNs employed in hospital and community settings completed Hamilton's Anxiety Scale, Beck's Depression Inventory, and Stamps's Index of Work Satisfaction. Moderate levels of overall professional satisfaction of 4.38 ( ±0.58) were detected. Work experience was positively correlated with satisfaction from payment ( τ = 0.230, P < 0.0001). Men seemed to be more satisfied with organizational policies ( P = 0.0043) and performed tasks ( P = 0.027) than women. Nurses working in psychiatric clinics of general hospitals experienced higher levels of professional satisfaction in general, and more satisfaction from organizational policies, autonomy, and task requirements than nurses working in community settings, substance misuse programs, and community mental health centres ( P = 0.001). Nurses working in acute/admission settings were the less satisfied, compared to nurses working in rehabilitation wards ( P = 0.017). Professional satisfaction was associated with anxiety ( τ = 0.280, P < 0.0001) and depressive ( τ = 0.246, P < 0.0001) symptoms. Greek- Cypriot MHNs seem to get moderate satisfaction from their work, whilst professional satisfaction is associated with their psychological well-being. Targeted managerial interventions and longitudinal research are warranted. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore the association between nurses' characteristics (educational level, country, work title, gender, type of work, age, and length of working experience) and their assessments of individualized care. Design: A cross-sectional comparative survey using questionnaires was employed to sample nurses from seven countries. Methods: Data were collected from orthopedic and trauma nurses from Cyprus, Finland, Greece, Portugal, Sweden, Turkey, and the United States ( N= 1,163, response rate 70%) using the Individualized Care Scale-Nurse (ICS-Nurse) and a sociodemographic questionnaire in 2008. Data were analyzed using descriptive statistics and general linear models. Results: When compared with practical nurses, registered nurses, length of working experience, and the country of the nurses were associated with assessments of the support of patient individuality in specific nursing activities (ICS-A-Nurse) and country assessments of individuality in the care provided (ICS-B-Nurse). The background and experience within nursing teams together with the country affect the delivery of individualized care. Conclusions: Overall, our findings suggest that nurses' personal attributes have important effects on their assessments of individualized nursing care that will be useful when making context-dependent recruitment decisions. Clinical Relevance: The characteristics of nurses contribute to the care delivered in healthcare organizations. Recognition of these nurse-related factors may help nurse leaders in the development and management of clinical practice. Journal of Nursing Scholarship, 2012; 44:3 ©2012 Sigma Theta Tau International. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims This study aims to estimate the prevalence of drug use by pregnant women living in Ibiza, using structured interviews and biomarkers in maternal hair. In addition, the potentially detrimental effects of maternal drug abuse on their newborns were investigated. Ibiza has a large international night-life resort associated with clubs, music and use of recreational drugs. Design, setting and participants Hair samples were collected prospectively from January to March 2010 from a cohort of consecutive mothers after giving birth in the Hospital Can Misses in Ibiza. Measurements Opiates, cocaine, cannabis, methadone, amphetamines, 3,4-methylenedioxymethamphetamine (MDMA) and their metabolites were detected in a 3-cm-long proximal segment of maternal hair corresponding to the last trimester of pregnancy by gas chromatography coupled to mass spectrometry ( n = 107). Data on socio-demographic characteristics and on tobacco, alcohol, drugs of prescription and drugs of abuse consumption during pregnancy were collected using a structured questionnaire. Findings Hair analysis showed an overall 16% positivity for drugs of abuse in the third trimester of pregnancy, with a specific prevalence of cannabis, cocaine, MDMA and opiates use of 10.3, 6.4, 0.9 and 0%, respectively. In the questionnaires, only 1.9% of mothers declared using drugs of abuse during pregnancy. Gestational drug of abuse consumption was associated with active tobacco smoking, a higher number of smoked cigarettes and the mother being Spanish. Conclusions Illicit drug use is substantially under-reported among pregnant women living in Ibiza, particularly among Spanish nationals. Voluntary, routine objective biological toxicology screening should be considered as part of routine examinations in antenatal clinics on this Mediterranean island. [ABSTRACT FROM AUTHOR]

Purpose: Theoretically, patient satisfaction is correlated with nursing care, but there is not sufficient evidence to support it. The aim of this study was to address three research questions: (a) What is the correlation between caring as perceived by patients and patient satisfaction? (b) Are there differences across various countries on the correlation on caring as perceived by patients and patient satisfaction? (c) Do caring behaviors affect patient satisfaction? Design: A multicenter correlational design was adopted involving surgical patients from six European countries: Cyprus, Czech Republic, Greece, Finland, Hungary, and Italy. Methods: A convenience sample of 1,565 patients was recruited in autumn 2009. The short version of the Caring Behaviours Inventory (CBI; 24 items) and Patient Satisfaction Scale (PSS; 11 items) were used. Data analysis included descriptive statistics, as well as correlation analysis and stepwise multiple regression, to examine relations between caring behaviors and patient satisfaction. Findings: According to the patients involved, nurses performed caring behaviors between very frequently (score = 5) and always (score = 6). Patient satisfaction with nursing care was also high, between satisfied (score = 3) and very satisfied (score = 4). A positive correlation emerged between CBI and PPS ( r= 0.66, p < .01) ranging between countries from 0.27 to 0.85 (Czech Republic r= 0.27, Cyprus r= 0.76, Finland r= 0.71, Greece r= 0.85, Hungary r= 0.63, and Italy r= 0.45 [ p < .01]). Among the CBI dimensions, 'connectedness' mainly explains patient satisfaction ( R2= 0.404, p < .001), followed by 'assurance' ( R2= 0.032, p < .001) and 'respectful' ( R2= 0.005, p < .001). Conclusions: Caring behaviors enacted by nurses determine a consistent proportion of patient satisfaction. This association between them suggests several implications for nursing education, practice, and management. Clinical Relevance: The results may be utilized by policymakers, nurse ward managers, nurse educators, and clinical nurses as a background for taking appropriate measures to improve nursing care provided, thereby enhancing patient satisfaction. [ABSTRACT FROM AUTHOR]