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Aim: This study aimed to investigate the association between work environment and sense of coherence among staff nurses. Background: In Antonovsky's salutogenetic theory, factors that causes stress are not always harmful when people's sense of coherence is high. Although the effects of sense of coherence have repeatedly been confirmed, few studies have examined factors that increase sense of coherence. Methods: We used cross‐sectional data (N = 6172) surveyed in 2017 from a 2‐year longitudinal study in 2016 and 2017. Multiple group structural equation modelling was conducted for years of nurse experience of different groups. Results: Work environment subscale scores for nurses with less than 5 years of experience ranged from 2.3 to 2.9 and for those with more than 5 years, from 2.1 to 2.7. The averages of sense of coherence for the groups were 36.9 and 39.7, respectively. For both groups, there was a statistically significant association between work environment and sense of coherence. Conclusions: Improvement of nurses' work environment may increase sense of coherence, leading to improvements in health. Implications for Nursing Management: The study suggests that nurse managers should improve the work environment to increase sense of coherence of staff nurses, leading to improved health for any length of a nurse's experience. [ABSTRACT FROM AUTHOR]

Aim: To investigate nurses' perceptions of their work environment and to investigate the relationships between variables measuring the work environment (WE) and nursing outcomes (NOs). Design: A 2‐year prospective longitudinal survey (2013–2015). Method(s): Descriptive statistics of nurse demographics, organizational WE and NOs were calculated by position. The associations between Practice Environment Scale of the Nursing Work Index (PES‐NWI) and NOs were examined for each unit. Results: The participants were 2,992 staff nurses, 137 nurse managers (NMs), and 8 chief nursing officers in Phase 1 and 7,849, 371 and 23 in Phase 2, respectively. The higher the job position, the better the WE was rated. The higher the PES‐NWI scores, the better the outcomes. Descriptive statistics about organizational WEs and NOs and the statistically significant associations between the two were identified. [ABSTRACT FROM AUTHOR]

Aim: To explore how people with heart failure develop and change their views of dying and death. Design: A Straussian grounded theory approach. Methods: Purposive and theoretical sampling were used. Data collection and analysis were repeated until reaching data saturation using the constant comparative method. We conducted semi‐structured interviews between January 2019 and July 2020 with 24 people with heart failure from a university and a community hospital in Japan. Results: Initially, participants' views of dying and death were unrelated to their disease. After the first turning point, namely the confirmation of the deterioration and incurability of the disease, their views became related to their own disease, adding to the suffering caused by the exacerbated symptoms. After the second turning point, namely when participants became tormented by the inevitability of death, they added their struggles with physical, psychological, and spiritual pain owing to medical interventions to their views of dying and death. Only a few participants reached the last stage of this process as it was emotionally distressing; some chose not to proceed to the next stage. Conclusion: Participants develop their views of dying and death gradually and in stages while they experience two turning points. Healthcare providers need to address this process while keeping in mind that proceeding this process requires some turning points, and it can be painful. Impact: This study provides a theoretical framework on the development of the views regarding dying and death of people with heart failure; it showed that these people need some turning points and to pass through stages to develop/individualize their views, and that this process is inherently distressing. This theory provides a cornerstone for healthcare professionals to understand the disease‐specific transition in views of dying and psychological readiness, and it may help establish a therapeutic relationship that includes advance care planning. [ABSTRACT FROM AUTHOR]

Aims: To investigate the end‐of‐life (EOL) nursing care practice process in long‐term care (LTC) settings for older adults in Japan. Design: A qualitative study based on grounded theory developed by Corbin and Strauss. Methods: Sampling, interviewing, and analysis were performed cyclically, with results for each stage used as the basis for data collection and next‐stage analysis decisions. Semi‐structured interviews were conducted from March 2015‐March 2019 with 22 nurses from eight LTC settings. Analysis was performed using coding, constant comparison, and emerging categories. Results: The core category, "guiding the rebuilt care community to assist the dying resident" comprised five categories: "assessing the resident's stage," "harmonizing care with the dying process," "rebuilding a care community," "helping community members care for the resident," and "encouraging community members to give meaning." The participants were described as "traditional village elders" who were the integral members of the care community, as well as guides who helped and encouraged the community. Conclusion: Results revealed the holistic process of EOL nursing‐care practice in Japan. Nurses aimed to allow LTC residents to die as social human beings, surrounded by people, and not just responding physical and psychological distress. Such practice requires nursing expertise, healthcare skills, and leadership qualities to build and serve care communities. Nurses must also consider residents' uncertainties and vulnerabilities as well as their cultural backgrounds. Impact: This study showed that the nurses hold unique roles in providing dying people with care from a community. These findings can potentially be applied for developing a universal model for LTC nurses in many aging populations, to modify their EOL care practice, educate new LTC nurses, and collaborate with other healthcare professionals. [ABSTRACT FROM AUTHOR]