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Background: In Jordan, nurses consider a primary providers of direct patient care, and play a multifaceted role in ensuring healthcare quality. The study aimed to examines the moderating effect of job satisfaction in the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality., Methods: A cross-sectional research approach was adopted among 311 from Registered Nurses (RN) across Jordanian hospitals. Job satisfaction, workload scale and job burnout scale were shared between March and April 2023., Results: The overall findings indicate that workload, job burnout, and turnover intention are negatively and significantly related to healthcare quality, and that job satisfaction moderates the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. These findings have broad implications for healthcare organizations, emphasizing the pivotal role of job satisfaction in mitigating the negative effects of workload, burnout, and turnover intentions among nurses., Consulsion: Strategies to enhance job satisfaction, such as reducing work-related stress and fostering supportive work environments, should be prioritized by healthcare policymakers and institutions to ensure the delivery of high-quality patient care., (© 2024. The Author(s).)

Aims and Background: The COVID-19 pandemic has had adverse effects on nurses, impacting them physically, mentally and psychosocially. These effects stem from heightened workloads, fears of contracting a life-threatening illness due to inadequate protective equipment and concerns about transmitting the disease to their families. This study assessed the impact of COVID-19 on the quality of life of nurses working on the frontlines, aiming to provide insights for future crisis responses., Methods: A descriptive-analytic study included 288 nurses from hospitals affiliated with Çukurova University, Southern Turkey using a stratified sampling method. Data on quality of life and demographics were collected using the WHO Quality of Life-BREF scale and a questionnaire. Data analysis was conducted using SPSS V.25, employing descriptive and analytic measures at a significance level of p<0.05., Results: Overall perceived quality of life was moderate (mean score: 3.31; SD: 0.56), with the highest scores in social relationships, psychological well-being and environmental factors. Positive correlations were found with gender, education, salary, vaccination status and living alone. Negative correlations were observed with alcohol consumption and longer working hours., Conclusions: To strengthen future crisis responses, health authorities should prioritise workload reduction, gender diversity promotion, support for nurses residing with family, better income opportunities, alcohol abstinence encouragement and ensuring vaccination for frontline nurses., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The use of mobile tools in nursing care is indispensable. Given the importance of nurses' acceptance of these tools in delivering effective care, this issue requires greater attention., Objective: This study aims to design the Mobile Health Tool Acceptance Scale for Nurses based on the Expectation-Confirmation Theory and to evaluate it psychometrically., Methods: Using a Waltz-based approach grounded in existing tools and the constructs of the Expectation-Confirmation Theory, the initial version of the scale was designed and evaluated for face and content validity. Construct validity was examined through exploratory factor analysis, concurrent validity, and known-group comparison. Reliability was assessed using measures of internal consistency and stability., Results: The initial version of the scale consisted of 33 items. During the qualitative and quantitative content validity stage, 1 item was added and 1 item was removed. Exploratory factor analysis, retaining 33 items, identified 5 factors that explained 70.53% of the variance. A significant positive correlation was found between the scores of the designed tool and nurses' attitudes toward using mobile-based apps in nursing care (r=0.655, P<.001). The intraclass correlation coefficient, Cronbach α, and ω coefficient were 0.938, 0.953, and 0.907, respectively., Conclusions: The 33-item scale developed is a valid and reliable instrument for measuring nurses' acceptance of mobile health tools., (©Narjes Mirabootalebi, Zahra Meidani, Hossein Akbari, Fatemeh Rangraz Jeddi, Zahra Tagharrobi, Walter Swoboda, Felix Holl. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 17.09.2024.)

Objectives: This paper utilizes an ontological approach to conduct a qualitative literature review in order to investigate the emotional impact of the Covid-19 pandemic on nurses internationally. After identifying common themes in the literature review, primary research is conducted to investigate the emotional impact of the Covid-19 pandemic on nurses working in Bermuda´s only acute healthcare facility., Methods: The literature review used the FRAMEWORK approach (Richie and Spencer, 1994, as cited in Hackett et al. (2018) to select a total of 16 papers for review, each of them qualitative primary research, aside from one paper reviewing international literature. Within the second part of this paper, investigating the experience of nurses in Bermuda, a grounded theory approach was utilised to collect primary data. Convenience sampling was used to recruit subjects to participate in one-on-one semi-structured interviews. Data saturation was achieved after 9 interviews. The FRAMEWORK method was utilised to analyse the interview transcripts, and identify, organise and collate themes., Results: The literature review highlights that nurses have strong emotional responses to caring for patients during the Covid-19 pandemic. Specific responses include: higher stress levels at work due to higher, more challenging workload, and a reliance on clinical leaders to assuage this stress. Stigma experienced outside of work lead to feelings of anxiety and isolation. Despite this, there was a common theme that nurses felt a satisfaction within their role to ´play their part´ in the pandemic. The primary research conducted in Bermuda demonstrates that there was an initial fear of Covid-19, receding as the pandemic developed. Much anxiety was due to a perceived lack of knowledge about the disease, lack of a coherent strategy, and inadequate equipment to protect staff, and properly care for patients. An increased level of cooperation amongst staff, and mutual support amongst nurses was noted, as was social stigma leading to feelings of isolation and anxiety. Social interactions and holistic activities were identified as primary resources to alleviate stress and uncertainty., Conclusions: Nurses in Bermuda elicited many of the same emotional responses as their international colleagues, as a result of caring for patients during the pandemic. These manifested as a result of higher, more challenging workload, and uncertainty about preparedness plan and quickly changing situations within the working environment. The results from this study can help formulate changes in policy to ensure smoother transitions to pandemic preparedness in the future., Competing Interests: The authors have declared that no competing interests exists., (Copyright: © 2024 Moore, Leena. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aim: To explore the views of general practitioners (GPs) and nurses on type 2 diabetes (T2D) management, including the use of recently funded T2D medications in New Zealand (NZ) and their perceived barriers to providing optimal care., Background: T2D is a significant health concern in NZ, particularly among Māori and Pacific adults. Characterised by prolonged hyperglycaemia, T2D is generally a progressive condition requiring long-term care., Methods: Semi-structured interviews were conducted between July and December 2022 with 21 primary care clinicians (10 GPs and 11 nurses/nurse prescribers) from nine different general practice clinics across the Auckland and Waikato regions of NZ. Framework analysis was conducted to identify common themes in clinicians' perceptions and experiences with T2D management., Findings: Three themes were identified: health-system factors, new medications, and solution-based approaches. Lack of clinician time, healthcare funding, staff shortages, and burn-out were identified as barriers to T2D management under health-system factors. The two newly funded medications, empagliflozin and dulaglutide, were deemed to be a positive change for T2D care in that they improved patient satisfaction and clinical outcomes, but several clinicians were hesitant to prescribe these medications. Participants suggested that additional education and specialist diabetes support would be helpful to inform optimal medication prescribing and that better use of a multi-disciplinary team (clinical and support staff) could support T2D care by reducing workload, addressing cultural gaps in healthcare delivery, and reducing burnout. An improved primary care work environment, including appropriate professional development to support prescribing of new medications and the value of collaboration with a non-regulated workforce, may be required to facilitate optimal T2D management in primary care. Future research should focus on interventions to increase support for both clinical teams and patients while adopting a culturally appropriate approach to increase patient satisfaction and improve health outcomes.

Introduction: There is a growing need for alternative forms of care to address citizen demands and ensure a competent healthcare workforce across municipalities and regions. One of these forms of care is the use of mobile care units. The aim of the current study was to describe physicians and nurses experiences of providing care to patients within a mobile care unit in Sweden., Method: Data were collected between March 2022 and January 2023 through qualitative interviews with 14 physicians and nurses employed in various mobile care units in different regions in Sweden. These interviews were transcribed verbatim and subjected to content analysis, with the study adhering to the Standards for Reporting Qualitative Research (SRQR)., Results: The analysis resulted in two main categories: "Unlocking the potential of mobile care", and "The challenges of moving hospitals to patients' homes"; and seven subcategories. The respondents viewed mobile care at home as highly advantageous, positively impacting both patients and caregivers. They believed their contributions enhanced patients' well-being, fostering a welcoming atmosphere. They also noted receiving more quality time for each patient, enabling thorough assessments, and promoting a person-centered approach, which resulted in more gratifying mutual relationships. However, they experienced that mobile care also had challenges such as geographical limitations, limited opening hours and logistical complexity, which can lead to less equitable and efficient care., Conclusions: Physicians and nurses in mobile care units emphasized positive outcomes, contributing to patient well-being through a person-centered approach. They highlighted increased quality time, comprehensive assessments, and overall satisfaction, praising the mobile care unit's unique continuity for enhancing safety and fostering meaningful relationships in the patient's home environment. In order for mobile care to develop and become a natural part of healthcare, challenges such as geographical limitations and logistics need to be addressed., (© 2024. The Author(s).)

Even during the third wave of the COVID-19 pandemic health professionals were facing mental health challenges. The aim of this study was to examine the mental health of doctors, nurses and other professional groups in Europe and to identify differences between the professional groups. We conducted a cross-sectional online survey in 8 European countries. We asked for demographic data, whether the participants were exposed to COVID-19 at work, for main information sources about the pandemic, the Depression Anxiety Stress Scales (DASS-21), and major stressors. A MANCOVA was carried out to find predictors of mental health among health care professionals. The sample (N = 1398) consisted of 237 physicians, 459 nurses, and 351 other healthcare professionals and 351 non-medical professionals with no direct involvement in patient care. The mean mental health of all groups was affected to a mild degree. Major predictors for depression and anxiety were the profession group with higher scores especially in the group of the nurses and working directly with COVID-patients. In the third wave of the COVID-19 pandemic, the psychological burden on health professionals has remained high, with being nurse and working directly with COVID19 patients being particular risk factors for mental distress. We found as a main result that nurses scored significantly higher on depression and anxiety than practitioners., (© 2024. The Author(s).)

Objective: Despite the prevalence of emergency medical service assignments related to chest discomfort, limited research delves into nurses' experiences of caring for such patients. This study aimed to illuminate prehospital emergency nurses' (PENs') experiences of caring for patients with suspected acute myocardial infarction (AMI)., Design: A qualitative interview study., Setting: Two Swedish emergency medical service organisations in two different regions., Participants: Consecutive inclusion of 12 PENs., Data Analysis: An inductive content analysis according to Elo and Kyngäs., Results: The results underline the active role of PENs in providing care for patients with AMI in the emergency medical service. They emphasise the ability to identify classic symptoms and the need for an open-minded approach to diffuse presentations. Ensuring patient security, projecting knowledge and composure are decisive for instilling a sense of safety. Healthcare providers feel profound responsibility and a fear of errors, especially in critical situations with potential patient deterioration. Prioritisation in time-sensitive cases leans towards medical interventions and immediate transportation. Continuing education is essential to enhance patient management and safety. Effective communication and trust are vital for urgent patient care, and prompt activation of the ST-elevation myocardial infarction pathway is recognised as imperative. Malfunctions result in frustration, underlining the importance of pathway functionality., Conclusions: PENs have immense responsibility for the swift and knowledgeable management of patients with suspected AMI. Balancing patient involvement and urgent medical measures is challenging, emphasising the critical role of mental preparedness and comprehensive education. The study underlines the significance of effective communication and trust between healthcare providers, particularly in time-sensitive scenarios. Establishing feedback mechanisms for prehospital staff is important for advancing prehospital emergency care in this patient category., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study assessed the resilience of nurses in Saudi Arabia during the corona virus 2019 (COVID-19) pandemic and examined its influence on their quality of life (QOL). A sample of 356 nurses was surveyed in this quantitative, cross-sectional study using the Resilience Scale for Nurses and the World Health Organization Quality of Life (WHOQOL-BREF) from October 2020 to March 2021. The nurses reported the highest resilience score on "situational pattern", while the lowest score was on "relational pattern." The nurses had good perceptions on their overall QOL and health and rated their "social relationship" as having the highest quality, while their "environmental" domain as having the least quality. Gender, marital status, provision of direct nursing care to COVID-19 patients, "philosophical pattern", "situational pattern" and "dispositional pattern" had multivariate impacts on the QOL dimensions. The study concluded that being resilient can positively impact the nurses' QOL during stressful situations, such as the COVID-19 pandemic., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abdualrahman Saeed Alshehry. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: Both physical and psychosocial risk factors contributing to musculoskeletal disorders occur in the professional nursing group, and previous literature suggested that their interaction may increase the risk of musculoskeletal pain among nurses. The aim of the study was to examine perceived workload and stress as well as physical findings and musculoskeletal complaints in nurses., Material and Methods: The participants consisted of 42 female nurses, age range 23-60 years. They marked on a pain drawing the site/sites that was/were painful at the moment of testing, its duration and intensity. Thereafter they were examined using the movement and respiration domains from the Global Physiotherapy Examination (GPE). Furthermore, a subjective workload measure was made using the paper version of the National Aeronautics and Space Administration Task Load Index and stress was assessed using the Perceived Stress Questionnaire ., Results: Almost the entire study group declared that pain experienced in at least 1 location was chronic, i.e., had lasted ≥1 year (97%). The most frequent locations of pain were low back (22.4%) and cervical/head (21.6%) regions. In the GPE, most scores indicated restricted and reduced movement, with the subdomain flexibility having the highest deviation from the predefined standard. Furthermore, the results indicated hampered respiration, especially visible in standing position. Out of all workload scores, the highest was obtained for temporal demand. Perceived stress level was found to be moderate and significantly associated to chronic chest/ thoracic pain. Interestingly, the compression of thorax test positively correlated with mental (r = 0.42, p < 0.05) and physical demand (r = 0.35, p < 0.05), whereas the elbow drop test and temporal demand correlated negatively (r = -0.37, p < 0.05)., Conclusions: To sum up, the majority of nurses participating in this study had long-lasting pain and limited flexibility of the body and hampered respiration, which both may enhance intensity of experienced musculoskeletal pain. Int J Occup Med Environ Health. 2024;37(3):257-70., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objective: It is of critical importance to determine the factors that contribute to nurses' disaster preparedness. This study aimed to examine nurses' perceptions of disaster preparedness and the factors affecting it., Methods: This descriptive study was conducted with 464 nurses working in the East Marmara region of Türkiye. The data were collected online using the "Personal Information Form," "The Scale of Perception of Disaster Preparedness on Nurses," and the "Adult Motivation Scale." Linear regression analysis was used to analyze the influencing factors., Results: It was found that nurses possessed a high level of perceived disaster preparedness, influenced by individual disaster preparedness, status of receiving disaster-related training, willingness to respond in the case of a disaster, disaster plan awareness, experience with caring for disaster victims, extrinsic motivation, and general motivation., Conclusions: The results of the study offer evidence that can be implemented by managers and educators to better prepare nurses for disasters. Hospital administrators and policy makers should consider the factors affecting nurses' perception of disaster preparedness to develop solutions for such disasters.

Objective: This study aimed to assess nurses' perceptions of patient safety culture (PSC) and its relationship with adverse events in Hail City, Saudi Arabia., Design: A cross-sectional study was conducted between 1 August 2023 and the end of November 2023 at 4 governmental hospitals and 28 primary healthcare centres., Setting: Hail City, Saudi Arabia., Participants: Data were collected from 336 nurses using 3 instruments: demographic and work-related questions, PSC and adverse events., Results: Nurses had positive responses in the dimensions of 'teamwork within units' (76.86%) and 'frequency of events reported' (77.87%) but negative responses in the dimensions of 'handoffs and transitions' (18.75%), 'staffing' (20.90%), 'non-punitive response to errors' (31.83%), 'teamwork across units' (34.15%), 'supervisor/manager expectations' (43.22%) and 'overall perception of patient safety' (43.23%). Significant associations were found between nationality, experience, current position and total safety culture, with p values of 0.015, 0.046 and 0.027, respectively. Nurses with high-ranking perceptions of PSC in 'handoffs and transitions,' 'staffing' and 'teamwork across hospital units' reported a lower incidence of adverse events than those with low-ranking perceptions, particularly in reporting pressure ulcers (OR 0.86, 95% CI 0.78 to 0.94, OR 0.82, 95% CI 0.71 to 0.94 and OR 0.83, 95% CI 0.70 to 0.99, respectively) (p<0.05). Nurses with high-ranking perceptions of PSC in UK 'handoffs and transitions' reported a lower incidence of patient falls. Similarly, those with high-ranking perceptions in both 'handoffs and transitions' and 'overall perception of patient safety reported a lower incidence of adverse events compared with those with low-ranking perceptions, especially in reporting adverse drug events (OR 0.83, 95% CI 0.76 to 0.91 and OR 0.75, 95% CI 0.61 to 0.92, respectively) (p<0.05)., Conclusion: From a nursing perspective, hospital PSCs have both strengths and weaknesses. Examples include low trust in leadership, staffing, error-reporting and handoffs. Therefore, to improve staffing, communication, handoffs, teamwork, and leadership, interventions should focus on weak areas of low confidence and high rates of adverse events., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Imposter phenomenon is described as persistently doubting one's accomplishments, leading to an internalised fear of being exposed as a 'fraud'. This article identifies the nature and prevalence of imposter phenomenon among nursing students, newly registered nurses and senior nurses. It also explores the effects of this phenomenon for nurses and healthcare organisations, including its potential association with burnout, suboptimal performance and a lack of career development. Evidence suggests that addressing imposter phenomenon is not something individuals can accomplish by themselves, but that it requires system-level interventions from healthcare organisations and higher education institutions. This could raise awareness, promote recognition and improve resources and training to mitigate the detrimental effects of this phenomenon on healthcare provision., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Background: Although several digital health interventions (DHIs) have shown promise in the care of skin diseases their uptake in Germany has been limited. To fully understand the reasons for the low uptake, an in-depth analysis of patients' and health care providers' barriers and facilitators in dermatology is needed., Objective: The objective of this study was to explore and compare attitudes, acceptability, barriers, and facilitators of patients, dermatologists, and nurses toward DHIs in dermatology., Methods: We conducted 6 web-based focus groups each with patients (n=34), dermatologists (n=30), and nurses (n=30) using a semistructured interview guide with short descriptions of DHIs described in the literature. A content analysis was performed using deductive constructs, following the unified theory of acceptance and use of technology framework, and inductive categories., Results: Patients identified many positive performance expectancies, such as reduced travel times and improvement in follow-up appointments. Dermatologists also stated positive effects (eg, promotion of standardized care), but also negative implications of health care digitalization (eg, increased workload). All stakeholders reported that a DHI should bring additional value to all stakeholders. A lack of digital competence among patients was identified as the major barrier to adoption by all 3 groups. Nurses and dermatologists want apps that are easy to use and easy to implement into their daily routines. Trust in selected institutions, colleagues, and physicians was identified as a facilitator. Patients reported their dependence on the dermatologists' acceptance. All groups expressed concerns about data privacy risks and dermatologists stated insecurities toward data privacy laws., Conclusions: To ensure successful digitalization in dermatology, apps should be user-friendly, adapted to users' skill levels, and beneficial for all stakeholders. The incorporation of dermatologists' perspectives is especially important as their acceptance may impact use among patients and nurses. DHIs should ensure and be transparent about data privacy. The found barriers and facilitators can be used for implementation strategies., (©Patrick Reinders, Matthias Augustin, Anastasia Fleyder, Marina Otten. Originally published in JMIR Dermatology (http://derma.jmir.org), 03.09.2024.)

Background: Moral injury is prevalent among health care professionals, especially nurses. It can have negative personal consequences for clinicians, and indirectly impact the quality of patient care. Although nurses around the world experienced moral injury during the pandemic, it will continue to be a professional challenge. Thus, this study aimed to determine the psychometric properties of a scale measuring moral injury translated into Spanish., Methods: A methodological study with a cross-sectional approach was conducted. After translating the Moral Injury Symptom Scale for Healthcare Professionals (MISS-HP) into Peruvian Spanish (MISS-HP-S) using International Test Commission methods, data were collected using online survey methods from a sample of 720 Peruvian nurses. Analytical methods included exploratory and confirmatory factor analysis, and invariance by age were examined. The corrected homogeneity index, ordinal alpha, and McDonald's omega allowed the evaluation of internal reliability., Results: Findings from this sample of nurses who were mostly female (92%), from coastal Peru (57%), and averaged 39 (± 11) years of age, provided support for the validity and reliability of the MISS-HP-S. Structural validity was endorsed by findings indicating consistent factorial structure and adequate invariance among different age groups. In this study, three factors were observed: guilt/shame, condemnation, and spiritual strength. Internal consistency values included an ordinal alpha of 0.795 and McDonald's omega of 0.835., Conclusion: These findings differ from those reported from previous studies in other cultural contexts, suggesting the influence of cultural and sample-specific factors in the perception of moral injury among Peruvian nurses. Because this evidence supports the validity of the MISS-HP-S, it can be used in professional practice and in future research to identify and address situations that contribute to nurse moral injury., (© 2024. The Author(s).)

Background: Penicillin allergy delabelling (PAD), the process of evaluating penicillin allergy labels, is a key target in antibiotic stewardship, but uptake of the procedure outside clinical studies is limited. We aimed to explore factors that need to be addressed to sustainably implement a clinical pathway for PAD., Methods: We conducted a qualitative study based on semi-structured interviews with focus groups consisting of a purposive sample of twenty-five nurses and physicians working in four different hospitals in Western Norway. Systematic text condensation was applied for analysis., Results: Psychological safety was reported as crucial for clinicians to perform PAD. A narrative of uncertainty and anticipated negative outcomes were negatively associated with PAD performance. Education, guidelines, and colleague- and leadership support could together create psychological safety and empower health personnel to perform PAD. Key factors for sustainable implementation of PAD were facilitating the informant's profound motivation for providing optimal health care and for reducing antimicrobial resistance. Informants were motivated by the prospect of a simplified PAD procedure. We identified three main needs for implementation of PAD: (1) creating psychological safety; (2) utilising clinicians' inherent motivation and (3) optimal organisational structures., Conclusion: A planned implementation of PAD must acknowledge clinicians' need for psychological safety and aid reassurance through training, leadership, and guidelines. To implement PAD as an everyday practice it must be minimally disruptive and provide a contextually adaptive logistic chain. Also, the clinician's motivation for providing the best possible healthcare should be utilised to aid implementation. The results of this study will aid sustainable implementation of PAD in Norway., Ethics: The study was approved by the Western Norway Regional Committee for Medical Research Ethics (Study No:199210)., (© 2024. The Author(s).)

Introduction: Nurses play a vital role in the provision of health care in rural, remote and isolated locations. Consequently, the current global nursing workforce shortage has significant and far-ranging implications for these communities where there are enduring issues with workforce maldistribution and shortage, instability, high staff turnover and health disparities. This article provides an analysis of existing literature on what rural, remote and isolated practising nurses view as important for the attraction and retention of this workforce in the Australian context., Methods: A structured scoping review informed by Arksey and O'Malley's framework for conducting scoping studies was undertaken. Six electronic databases were searched in August 2022. Cosgrave's person-centred retention improvement framework (which includes attraction) for addressing health workforce challenges in rural contexts was used to guide the synthesis and interpretation of information from the included studies. Key themes were identified inductively, conceptualised within Cosgrave's framework and mapped to the overarching lifecycle stages of attraction, retention and resignation, also referred to as turnover or decision to leave., Results: Twelve articles met the inclusion criteria for this review. Six themes related to attraction, retention and resignation were identified: (1) demanding role and scope of practice; (2) values divergence and professional opportunities; (3) continuing professional development and mentoring; (4) social, lifestyle and personal or family; (5) management and organisation; and (6) pay and incentives. The issues articulated within each of these themes overlapped, highlighting the complexities involved., Conclusion: Limited empirical research that combines a person-centred and whole-of-lifecycle approach to understanding the rural and remote nursing workforce was found. However, our analysis of existing evidence suggests that such approaches are required to appropriately plan for and target solutions that centre nurses' specific needs and experiences for the future nursing workforce. Relatedly, limited translational research on the nursing workforce that explicitly includes and engages with nurses was found. Such research is fundamentally needed to improve retention outcomes.

Aim: To explore the effects of demographic characteristics, mental workload, and Adversity quotient (AQ) on the job engagement of nurses in East China., Design: A quantitative and cross-sectional study., Method: The survey collected questionnaire data on mental workload, adversity quotient, and job engagement from 473 nurses selected working in 12 Grade-A tertiary hospitals based on informed consent in East China between July 2020 and March 2021., Results: The total score of mental workload was 78.24 ± 11.65, the adversity quotient score was 128.26 ± 15.84, job engagement score was 42.32 ± 7.79. Job engagement has a remarkable positive correlation with adversity quotient (r = 0.613, p<0.001), and a negative correlation with mental workload (r = -0.499, p<0.001). Mental workload has an apparent negative correlation with adversity quotient (r = -0.291, p<0.001). Labor-management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self-assessment, control, and endurance could predict 70.9% of job engagement of nurses., Conclusions: The mental workload of nurses was higher, the AQ was at a medium level, and the job engagement of nurses was also slightly higher. Labor-management relationship with current organization, department, study to get a degree or diploma in spare time, attitude towards a career in Nursing, attitude towards the current career position, satisfaction with marriage, social support, load feelings, self-assessment, control, and endurance had predictive effects on nurses' job engagement. It is necessary to take a variety of measures according to the social-demographic characteristics, improve the adversity quotient, and evaluate the mental workload correctly, to improve the job engagement of nurses., Impact: The epidemic situation and other emergencies make the work pressure of nurses in Grade-A tertiary hospitals increase suddenly. It should pay attention to the influence of different demographic factors, and pay attention to the correct guidance of work demand-mental workload, as well as the cultivation, and improvement of job resource-AQ, which can improve the job engagement of nurses to some extent., Patient or Public Contribution: No patient or public contribution., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Background: Human activities have significantly contributed to a persistent climate change trend, posing substantial threats to human health. Nurses regularly interact with patients experiencing the consequences of climate change, making their engagement in addressing this issue crucial. Nonetheless, our understanding of nurses' viewpoints regarding climate change remains limited., Aim: This scoping review aims to identify practicing nurses' and nursing students' perceptions of climate change., Design: To fulfil this objective, a documentary search strategy was developed using an iterative process., Methods: The search strategy was tested in four bibliographic databases, as well as in the grey literature. A 2-stage selection process was conducted, and relevant data were extracted from selected articles for analysis., Results: Twenty-two scientific articles and 11 documents from nursing associations were selected. The findings suggest that while many nurses and nursing students are concerned about climate change and its effects on their patients' health, their role in addressing the climate crisis is not well understood. Many barriers such as having a heavy workload and the lack of support hindered their ability to adjust their practice in response to the changing climate. Furthermore, many expressed a need for trainings on climate change issues., Conclusions: These results raise a great and urgent demand for these professionals to receive appropriate training to cope with climatic threats to health. Future research should focus on the development of nursing climate leadership, and healthcare organizations should support nursing initiatives and help raise nurses' awareness regarding climate change., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Aim: To develop a conceptual framework for nurses' protocol-based care decision-making., Design: Miles & Huberman's bottom-up approach to developing conceptual frameworks was followed, using data collected from a multiple embedded case study examining protocol-based decision-making by nurses in three hospital wards within a university hospital in northern Spain., Methods: The qualitative data from the case study, obtained through documentary analysis, observations, and interviews, underwent a secondary analysis consisting of four steps: data reduction, data display, comparison, and drawing conclusions., Results: The framework for protocol-based care decision-making comprises four components: (1) protocol-based care, as a balance between standardisation and individualised care, (2) the process, (3) the context, and (4) the elements of protocol-based care decision-making. These components and their relationship as a context-dependent, linear, variable and multifactorial process, directly influenced by the perception of risk, are described and illustrated., Conclusions: This study provides a rigorous bottom-up framework for nurses' protocol-based care decision-making. The framework could be a valuable resource for managers, clinical nurses, educators, and researchers to guide and evaluate nurses' decision-making, leading to improved care quality and reduced variability in clinical practice. Furthermore, the framework lays a foundation for further research and practical applications., Impact: This study addressed the problem of understanding nurses' protocol-based care decision-making and the need for a specific conceptual framework. The main findings of the study contribute to the development of a rigorous bottom-up framework comprising four components of protocol-based care decision-making. The framework has the potential to improve care quality, reduce variability, enhance patient safety, and increase healthcare efficiency by guiding nurses' decision-making in various healthcare settings., No Patient or Public Contribution: Patient or public contribution was not applicable since the study focused on nurses' decision making., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

The aims of the research were to investigate the mediating effect of emotional intelligence and the moderating effect of disgust sensitivity on the relationship between proactive personality and caring behavior among clinical nurses. A cross-sectional design while adhering to STROBE guidelines was used for this study. Three hundred ninety-three purposely selected nurses from three tertiary general hospitals completed an online survey. Measures included proactive personality, emotional intelligence, disgust sensitivity, and caring behavior. The findings showed that proactive personality positively predicted nurses' caring behavior, and that emotional intelligence played a mediating role in the relationship between proactive personality and caring behavior. Disgust sensitivity indirectly and negatively moderated the impact of proactive personality on nurses' caring behavior mainly in the second half of this moderated relationship. The findings underscore that the nursing managers may consider incorporating emotional intelligence topic in practical nursing skills training and improving nurses' ability to control their disgust sensitivity can improve their professional behavior, thus to provide patients with high-quality nursing services., (© 2024 John Wiley & Sons Australia, Ltd.)

Objectives: The purpose of this analysis is to develop the concept of sense of belonging in nursing. The secondary purpose is to identify the antithesis or direct opposite beyond the negative consequences related to a lack of belonging in nursing., Design: Rodgers' evolutionary method guided the analysis and advancement of sense of belonging in nursing., Data Sources: Following PRISMA guidelines, peer-reviewed English articles and dissertations were reviewed from PubMed, ERIC, CINAHL, and PsychINFO. Forty-seven articles describing sense of belonging in the nursing profession, both academic and workforce, were included., Review Methods: Inductive thematic analysis was used to determine recurring themes of the antecedents, attributes, consequences, and antithesis of belonging in nursing., Results: A welcoming, positive atmosphere encouraging a culture of mentorship is key to developing an environment of belonging. The attributes of belonging include being trusted, valued, and an accepted part of the team, and encouraging a connection to the community. Nurses and nursing students have improved confidence, self-esteem, and motivation to learn when a sense of belonging is present. They feel supported and respected in the environment. However, historically minoritized students and nurses report discrimination, bias, and condescension resulting in feeling invisible, isolated, excluded, and neglected. Nurses and nursing students feel invisible, isolated, excluded, and neglected without a sense of belonging., Conclusion: Developing a sense of belonging in nurses and nursing students is critical to our profession. Further research is essential to develop interventions and strategies for cultivating a sense of belonging in nursing., (Copyright © 2024 Elsevier Inc. All rights reserved.)

A cross-sectional descriptive study was conducted to assess the level of caring behaviour among clinical nurses in Southern China and explore its influencing factors. The study was carried out in the Sixth Affiliated Hospital, South China University of Technology, Guangdong, China, from December 2022 to February 2023. A total of 537 nurses participated, and the mean scores for caring behaviour, responsibility perception, and inclusive leadership were examined. The mean score for caring behaviour among clinical nurses was 125.25 ± 18.31. The mean responsibility perception score was 21.38 ± 3.36, while the mean inclusive leadership score was 38.04 ± 6.56. Notably, the inclusive leadership questionnaire and responsibility perception showed significant positive correlations with caring behaviour (p <0.01). Furthermore, regression analysis indicated that inclusive leadership and responsibility perception exerted significant influences on nurses' caring behaviour (p <0.01). These findings underscore the importance of creating an inclusive leadership environment that enhances nurses' sense of responsibility perception in order to promote and improve nursing caring behaviour. Key Words: Caring behaviour, Inclusive leadership, Responsibility perception, Influence factor, Clinic nurses.

Aim: Despite the serious consequences of exposure to high job demands for nursing staff, few studies have identified pathways that could reduce the influence of high job demands on burnout. The current study aimed to exaime whether a stress mindset mitigates the positive relationship between job demands and burnout., Design: A cross-sectional survey was adopted and data were collected employing self-report questionnaires., Methods: A convenience sample of 676 nurses recruited from six regional hospitals in China were invited to complete a demographic questionnaire, the Psychological Job Demand Scale, the Stress Mindset Scale and the Burnout Scale. Hierarchical multiple regression analysis and simple slope analysis were used to examine the moderating role of stress mindset., Results: Higher job demands were positively linked to burnout, and stress mindset was negatively linked to burnout. Stress mindset moderated the positive relationship between job demands and burnout. Specifically, compared to nurses with a stress-is-debilitating mindset, the relationship will be smaller for nurses holding a stress-is-enhancing mindset., Patient or Public Contributions: Based on these findings, nursing leaders should foster nurses' stress-is-enhancing mindset, which can ameliorate the adverse effect of job demands., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Aim: To explore internationally qualified nurses' perceptions regarding the facilitators and barriers to specialty skill transfer in Australia., Design: The study utilised a descriptive research design with a cross-sectional survey. Data were collected from July to September 2022., Methods: A self-designed survey was distributed through social media, snowballing and nursing professional organisations. The survey included six open-ended questions which were analysed using thematic content analysis., Results: Sixty-three participants completed the open-ended questions in the survey. The findings identified a range of facilitators (support, previous experience, self-agency) and barriers (systems barriers, bias/discrimination, being undervalued, lack of trust) to skill transition., Conclusion: Recognising and addressing facilitators and barriers, coupled with creating customised pathways for specialty skill integration, are essential for optimising the utilisation of specialised skills in internationally qualified nurses., Impact: This study aims to explore the barriers and facilitators involved in maximising skill utilisation among internationally qualified nurses in Australia. Identifying these barriers and facilitators is essential for improving patient care, as it will guide the development of strategies for safe nursing service delivery and the optimisation of skill usage. These findings hold significant implications for policymakers, healthcare organisations and nurses, providing valuable insights into how to address these obstacles and capitalise on the factors that make skill transfer smoother and more effective., Patient or Public Contribution: Sixty-three internationally qualified nurses shared their experiences and opinions., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Aim: This study analysed and summarized the correlation between various indicators of ICU nurses' personal lives, hospital work situation, social opinion, psychological assessment, and their intention to resign., Design: A descriptive quantitative study., Methods: This study was a multicentre questionnaire on factors influencing intensive care unit (ICU) nurses' intention to resign. This study was completed through the Critical Care E Institute (CCEI) and China Calm Therapy Research Group Academic Organization (CNCSG) by contacting ICU nurses in three hospitals in 34 provinces in China. The questionnaire was in the form of a cell phone WeChat scan code. The survey included 22 indicators, including basic information about nurses (marital and child status, personal income, etc.), hospital work (weekly working hours, night shift, hospital environment, etc.), and psychological symptoms., Results: A total of 1904 nurses were included in this study. Among them, 1060 (55.67%) had the intention to resign. In this study, among the 22 indicators involved, 16 factors, including hospital work hours, job title, satisfaction with current income, having children, and evaluation of the hospital, significantly impact nurses' intentions to resign (all p < 0.05). Logistic regression analysis showed that six indicators influenced nurses' choice of resignation intention (all p < 0.05), including hospital work time, professional title, income satisfaction, hospital work pride, satisfaction of nurses with the compassion and care given to them by their hospitals, and career vision score. The ROC curve showed that all six indicators were <0.70, but the model receiver operating characteristic (ROC) curve constructed for the indicators was 0.756. In China, increasing the income of ICU nurses, fostering pride in hospital work, reducing working hours, ensuring smooth promotion processes, and enhancing career prospects can all decrease their likelihood of choosing to resign. Absorbing practical nursing management and work experience from other countries will help decrease the intention to resign within this group., Patient or Public Contribution: No patient or public contribution., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Implementing evidence-based practice (EBP) in clinical practice is an ongoing challenge for nurses. EQUIP-Evidence-based QUality Improvement Project- is a multiphase project aimed at equipping nurses with the essential skills to implement EBP and advanced nursing practice. EQUIP embraces the assumption that implementation science models and partnership models can facilitate the implementation process of EBP, leading to successful and sustainable change. The current study is one of the EQUIP feasibility investigations in which the perspective of 12 implementation lead nurses (IL nurses) who attended a 1-day PEACE-based workshop was explored. Thematic analysis identified 2 overarching themes, 6 themes, and 18 subthemes. The first overarching theme showed that the PEACE-based workshop has successfully achieved its intended training implications, and the second overarching theme gave insight into factors that may influence the role of IL nurses. IL nurses reported general satisfaction and willingness to use the PEACE model at work; however, some IL nurses found Step 3 difficult to apply. The study's findings provide evidence of the perceived usefulness of adopting the PEACE model as an augmented approach in the EQUIP and the interest and enthusiasm of IL nurses in receiving more training on the implementation process of EBP., (© 2024 John Wiley & Sons Australia, Ltd.)

The aim of the study was to describe nurses' experiences of touch and especially touch when assisting older adult patients in hospital context. The interviewed nurses described 2 ways of assisting by touch: striving to be present and not being there. This study shows that touching and assisting by touch can constitute the core of the act of holistic caring in nursing, in which the most important content is a real encounter with the patient., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Retaining mid-career nurses is a priority to address the nursing shortage exacerbated by COVID-19. Nurses are more likely to stay if they feel valued. This scoping review revealed a variety of intrapersonal, interpersonal, and external factors that influence how mid-career nurses feel valued. Nursing professional development practitioners can influence satisfaction and retention by implementing mentoring and professional development programs for nurses and managers. More research is needed to understand the impact of the mid-career nurse-nurse manager relationship., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Aim and Objectives: The aim of this study was to evaluate the psychosocial difficulties and life experiences of nurses working in the disaster area following the earthquake on February 6, Kahramanmaraş centered earthquake with a phenomenological approach., Background: After natural disasters such as earthquakes, nurses play a significant role in providing both physical and psychosocial support. Therefore, the experiences of nurses in this field are necessary both to support them and to assist disaster survivors., Materials and Methods: In this study, in which the phenomenological research method was used, semi-structured in-depth interviews with 18 nurses who provided health care services during the February 6 Kahramanmaraş earthquake were conducted between January and February 2024 via Whatsapp mobile application. Snowball sampling method was used to reach the sample group. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed. The data were analyzed using thematic analysis. The study was conducted and reported according to the COREQ checklist., Results: Data analysis revealed two themes (psychological and social difficulties caused by the earthquake, traumatic stress and coping experiences as a nurse) and five sub-themes (social difficulties, psychological difficulties, traumatic events, reactions and coping)., Conclusion: As a result of the study, it was determined that nurses providing health care services were negatively affected psychosocially by the traumatic stress situations they experienced in the earthquake centered in Kahramanmaraş on February 6. It was determined that nurses had great difficulty in coping with the traumatic stress situations they experienced. It was concluded that the February 6 earthquake caused secondary traumatization in nurses., (© 2024 The Author(s). Public Health Nursing published by Wiley Periodicals LLC.)

Background: The main purposes of the nursing profession are to protect and improve health and to prevent and heal diseases. It is crucial to investigate the factors that can influence nurses' ability to enhance their performance in their professional lives and conduct the nursing care process more qualitatively and effectively., Objective: This study aimed to examine the association between emotional intelligence and compassionate communication in nurses., Methods: This cross-sectional and descriptive study was conducted with 140 nurses working in various units of the public hospital in Kilis, Turkey. Data were collected through a demographic information form, Emotional Intelligence Scale, and Compassionate Communication Scale., Results: It was determined that nurses' emotional intelligence and compassionate communication were above average. A significant association was found between nurses' emotional intelligence and compassionate communication ( F  = 16.08, P  < .001) and emotional intelligence explains 10% of the variance in compassionate communication ( R  = 0.323, R 2  = 0.104)., Conclusions: Emotional intelligence and compassionate communication should be taken into consideration so that nurses can recognize and understand patients' emotions, alleviate their hurt, and deliver delicate, kind, and compassionate care., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Emergency triage, which involves complex decision-making under stress and time constraints, may suffer from inaccuracies due to workplace distractions. A serious game was developed to simulate the triage process and environment. A pilot study was undertaken to collect preliminary data on the effects of distractors on emergency nurse triage accuracy., Method: A 2 × 2 factorial randomized controlled trial (RCT) was designed for the study. A sample of 70 emergency room nurses was randomly assigned to three experimental groups exposed to different distractors (noise, task interruptions, and both) and one control group. Nurses had two hours to complete a series of 20 clinical vignettes, in which they had to establish a chief complaint and assign an emergency level., Results: Fifty-five nurses completed approximately 15 vignettes each during the allotted time. No intergroup differences emerged in terms of triage performance. Nurses had a very favorable appreciation of the serious game focusing on triage., Conclusion: The results show that both the structure of our study and the serious game can be used to carry out a future RCT on a larger scale. The lack of a distractor effect raises questions about the frequency and intensity required to find a significant impact on triage performance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Problem: There is little documented evidence regarding the practice of midwives providing care for women with acute concerns in early pregnancy (< 20 weeks) in Australia., Background: Women can experience unexpected complications at any gestation of pregnancy and may seek acute care in an emergency or gynaecology service, usually staffed by registered nurses (RNs). They may not receive care from specialised pregnancy clinicians, including midwives. The role and scope of practice of midwives working in acute early pregnancy settings in Australia has not been previously reported. This study provides an opportunity to document practice in an area of pregnancy care not often visible within maternity services in Australia., Research Aim: To describe midwives' and RNs perceptions, perspectives and experiences of role and scope of practice in acute early pregnancy care provision in Australia., Methods: A qualitative descriptive approach was adopted. Midwives and RNs with acute early pregnancy knowledge and experience were recruited. Semi-structured interviews were conducted, and data analysed using inductive thematic analysis., Findings: Fifteen participants were interviewed. Three themes were constructed from interview data: Personal and Professional Influences; Being There for Women; The Impact of Setting., Discussion: Findings reinforce the lack of clarity around how midwives' scope is enabled in traditional acute early pregnancy care. Setting of care has influenced practice and seen a barrier for midwives who don't hold nursing registration from fulfilling professional scope. Results provide novel benchmarking evidence regarding a largely hidden area of midwifery, signposting areas for reform within education, policy and health service sectors., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest in this project., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

Objectives . This study aims to compare the work stress and obsessive-compulsive symptoms of nurses and office workers and to determine the relationship between work stress and obsessive-compulsive symptoms. Methods . A total of 127 nurses and 127 office workers participated in the cross-sectional study and comparative study. Data were collected using the perceived work stress scale and the Maudsley obsessive-compulsive inventory. Results . Nurses had higher work stress scores ( p  = 0.003) in general than office workers. In particular, nurses with a low ( p  < 0.039) and average ( p  < 0.007) economic status, nurses who had been employed for 1-10 years ( p  < 0.001) and nurses working 40 h per week ( p  < 0.042) had higher work stress scores than office workers. There was no difference ( p > 0.05) between obsessive-compulsive symptom scores. There was a positive significant relationship ( p  < 0.001) between work stress and obsessive-compulsive symptom scores of nurses and office workers. Work stress explains 6.1% of the obsessive-compulsive symptoms in nurses and 12.4% in office workers. Conclusion . The results of this study concluded that work stress of nurses is higher than that of office workers and work stress affects the obsessive-compulsive symptoms in both groups.

This study aimed to compare the number of assigned and appropriate patients per nurse in integrated nursing care service wards and analyze factors associated with the gap. For this cross-sectional secondary analysis, data were collected from surveys of 2312 nurses and institutional data from their affiliated 106 hospitals in Korea. We used the Wilcoxon signed-rank test and t-test to compare the number of patients assigned to nurses with the number they considered appropriate. We used ratio analysis for measuring the gap between these numbers, and robust regression to evaluate the factors affecting this gap. The results found an average gap of 1.45, indicating that the reported number of assigned patients per nurse was 1.45 times higher than the appropriate number. Gender, employment type, wage satisfaction, workload, overtime work, and hospital level of care were identified as factors associated with the gap. Findings suggest that the current nurse staffing standard should be revised to consider nurses' professional judgments of appropriate staffing levels and adopt policies that reduce nurses' workload., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

The traditional method of monitoring hand hygiene (HH) based on specific indications does not ensure that HH is performed for all required indications during patient care. This study aimed to compare HH performance rates (HHPRs) based on specific indications versus overall patient care among nurses at a university hospital. The study retrospectively analyzed HH monitoring data for 1398 indications from 543 patients and 190 nurses. Observations were conducted continuously, tracking a single healthcare worker from before patient contact until the end of the contact within a 30-min period. The indication-based HHPR was found to be 89.1%, while the patient-based HHPR was 78.1%. In the context of patient-based HHPR, the lowest rates were observed among nurses in the emergency room (48.3%) and those with less than 1 year of work experience (66.7%). Moreover, the largest discrepancy between indication-based and patient-based HHPR was noted among emergency room nurses with less than 1 year of experience. This significant difference underscores the need for patient-based HH monitoring, particularly for nurses in emergency settings and those with limited experience., (© 2024 John Wiley & Sons Australia, Ltd.)

Rationale: Workplace attitudes among nurses with back pain disability are usually unsupportive as nurses tend to rely on passive approaches like pain medications and taking sick leave to manage the impact of their back pain experiences., Aims and Objectives: To lessen the burden of back pain disability, this paper aimed to collate information from publicly accessible health resources such as posters, pamphlets, and electronic resources and cross-culturally validate this information for nurses in Zambia., Methods: Focus group discussions were used to produce the validation data for this study's qualitative research design. For cross-cultural validation, deductive analysis was carried out using Herdman's framework for Conceptual Equivalence, Item Equivalence, and Semantic Equivalence., Results and Conclusion: The 14 messages on back pain given to the participants were reviewed to enhance clarity, applicability, and acceptability. Messages with similar meanings were merged, reducing the total number to 7. The revisions made to the 14 back pain messages aimed to improve understanding, acceptability, and relevance within the contexts and circumstances in which nurses' practice. This is important because the messages adapted for use in low- and middle-income countries like Zambia are equivalent and applicable to those originally developed in high-income countries., (© 2024 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Background: Nurse-sensitive indicators (NSI) assess the quality of nursing care provided to patients. These indicators assess the structures (supportive measures), processes (nursing actions) and outcomes of care. The McIntyre Audit Tool (MAT) was developed to measure haemodialysis NSIs., Objectives: The objective of this study is to evaluate the feasibility and utility of the MAT in measuring haemodialysis NSIs in clinical practice., Design: Multisite nonrandomized feasibility study., Participants: A convenience sample of nurses (n = 30) were recruited from two haemodialysis units in Australia., Measurements: Participants completed the MAT once daily for 1 week, to measure the extent the clinical indicators were being met. Feasibility data including utility and acceptability of the tool was collected once from each participant. Data were analysed descriptively., Results: Participants completed a total of 97 audits. Results revealed the majority of structural (75%) and process indicators (73%) were being achieved although some variation between sites was observed. Results for the outcome indicators showed more variation (5.9%-94.1). Feasibility results found most nurses (79%) took <5 min to complete the MAT and found the tool easy to use (91.7%). Most participants (83.3%) reported audits could be completed during a shift and auditing was easily implemented (79.2%)., Conclusion: Use of the MAT in clinical practice is a feasible and acceptable way of auditing the quality of haemodialysis nursing practice. The tool could be used to establish minimum standards and improve the quality of nursing care in haemodialysis units, also enabling benchmarking between services., (© 2023 The Authors. Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association.)

We examine new doctors' and nurses' experiences of transitioning from training to practising as health professionals, drawing on the concept of liminality. Liminality is a stage of 'in-betweenness', involving uncertainty and ambiguity as people leave one social context and reintegrate into a new one. Surprisingly little research has explored new health professionals' experiences of liminality during role and career transitions, particularly in precarious and resource-constrained settings. Drawing on 146 qualitative interviews and seven focus groups, involving 121 new graduate medical doctors and nurses transitioning through internship training in Kenya, we describe three aspects of liminality. First, liminal professional practice, where interns realise that best practices learned during medical and nursing schools are often impossible to implement in resource constrained health care settings; instead they learn workarounds and practical norms. Second, liminal relational identities, where interns leave behind being students and adopt the identities and responsibilities of qualified professionals within pre-existing professional hierarchies of status and expertise. We explain how these new doctors and graduate nurses negotiate their liminal status, including in relation to more experienced but less qualified professional colleagues. We also discuss how interns cope with liminality due to disappointing and inadequate supervision and role modelling from senior colleagues but then find peer support and their place within their own professions. Finally, we discuss how new doctors and nurses come to terms with the precarity of working in resource constrained health systems, abandon expectations of secure, permanent employment and careers, and accept the realities of liminal professional careers. We explain how all three forms of liminality influence professionals' developing practices, identities, and careers. We call for further studies with a specific liminality lens to explore this critical period in health workers' careers, to inform policy and practice responding to global transformations in healthcare professions and practice., Competing Interests: Declaration of competing interest Mike English reports financial support, administrative support, article publishing charges, and travel were provided by Wellcome Trust. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This systematic review aimed to identify and compare instruments measuring nurses' organizational well-being, summarise the dimensions measured by these instruments, the statistical analysis performed for validity evidence and identify an instrument that comprehensively investigates nurses' organizational well-being. The JBI Manual for Evidence Synthesis and the PRISMA checklist were used as guidelines. The search was conducted on Medline, CINAHL, Cochrane Library and Scopus. Critical appraisal and data extraction were drawn on the COSMIN checklist. Dimensions were conceptually synthesized by the measurement concepts' similarity. Twenty-two articles were retrieved and they included 21 instruments that measured nurses' organizational well-being. The instruments vary by dimension number (range 2-19), items (range 12-118) and concept elicitation. A plurality of methodologies has been used in instrument development and assessments of evidence for validity. Only four instruments reported a concurrent criterion validity or a measurement comparison with an already tested-for-validity instrument. Similar dimensions were leadership and support, relationships and communication, work-family balance, work demands, violence, control and autonomy, satisfaction and motivation, work environment and resources, careers, and organizational policy. This review underlines the core areas of the instruments that measure nursing organizational well-being. It allows administrators and researchers to choose the appropriate instruments for monitoring this multidimensional concept.

Objectives: This study aimed to evaluate the independent and interactive effects of changes in overtime and night shifts on burnout among nurses during the COVID-19 pandemic., Methods: Nurses working in an Italian university hospital (N=317) completed the Maslach Burnout Inventory in September 2019 and again in December 2020. Based on hospital administrative data, changes in overtime and night shifts in the same years were categorized into three groups each. Linear regressions were used to estimate 2020 burnout differences between exposure groups, controlling for 2019 burnout levels, demographic and work-related characteristics, and to test the interaction between the two exposures., Results: Nurses in the onset of high overtime group had higher emotional exhaustion [4.33, 95% confidence interval (CI) 1.74-6.92], depersonalization (2.10, 95% CI 0.49-3.71), and poor personal accomplishment (2.64, 95% CI 0.55-4.74) compared to stable low overtime nurses. Nurses in the increase in night shifts group had lower emotional exhaustion (-4.49, 95% CI -7.46- -1.52) compared to no night shift nurses. Interaction analyses revealed that this apparently paradoxical effect was limited to stable low overtime nurses only. Moreover, increases in night shifts were associated with higher depersonalization and poor personal accomplishment in nurses in the stable high overtime group., Conclusions: Increase in overtime is an independent risk factor for burnout among nurses, highlighting the need for specific regulations and actions to address it. Long-standing guidelines for the assignment of night shifts might have contributed to attenuate the impact of their increase on nurses' mental health.

Death anxiety may reduce the interaction between nurses and patients, causing nurses to focus more on the physical care needs of patients and ignore their psychosocial and spiritual needs. This study was conducted to examine nurses' death anxiety and attitudes toward caring for dying patients. The data were collected using an information form, the Thorson-Powell Death Anxiety Scale (TPDAS), and the Frommelt Attitudes Toward the Care of the Dying Scale (FATCOD). The mean TPDAS and FATCOD scores were 46.71 (14.48) and 104.97 (13.55), respectively, and it was determined that they had moderate death anxiety and positive attitudes towards the care of dying patients. Those working in intensive care and internal medicine clinics had more positive attitudes toward caring for dying patients compared with those working in surgical clinics. Those who reported having a strong faith had lower death anxiety.

Background: Previous research found that healthcare professionals had low preparedness for palliative care. Thus, it is necessary to explore healthcare professionals' self-efficacy. The Swedish Self-Efficacy in Palliative Care Scale (SEPC-SE) evaluates readiness in communication, patient management and multidisciplinary teamwork; however, it should be tested on a larger population. Furthermore, the constructs of the SEPC-SE should be compared to that of the original SEPC., Aim: This study aimed to evaluate the consensus between the construct validity and reliability of the SEPC and the translated and adapted SEPC-SE. Furthermore, it aimed to describe and compare the self-efficacy of nurses and physicians in hospitals and explore the associated factors., Methods: The nurses (n = 288) and physicians (n = 104) completed the SEPC-SE. Factor analysis with Cronbach's alpha evaluated validity and reliability, and an analysis using the Mann-Whitney U test compared self-efficacy and multiple linear regression-associated factors., Results: The SEPC-SE revealed three factors with high reliability. Education or experience in specialised palliative care was minor, especially for nurses. Self-efficacy was highest in patient management (nurses, median [md] = 74.57, physicians md = 81.71, p = 0.010) and communication (nurses md = 69.88, physicians md = 77.00, p = 0.141) and lowest in multidisciplinary teamwork (nurses md = 52.44, physicians md = 62.88, p = 0.001). The strongest associations with self-efficacy were education at work and advanced homecare experiences. In addition, there were significant associations between years in the profession, male sex, physicians and university education., Conclusion: The SEPC-SE is valid and reliable for measuring self-efficacy. Nurses had lower self-efficacy than physicians. Physicians were associated with higher self-efficacy and had more education and experience in palliative care settings, which may explain their levels of self-efficacy., (© 2024 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.)

Background: The experience of loss and grief in patients' lives with life-long treatment in haemodialysis, and in their families' lives is a major cause of mental health problems. In practice, nurses often describe a lack of time and limited knowledge of how to provide nursing care in situations of loss and grief, thus finding out from nurses' perspectives of what competencies they need to provide care would be useful for the development of nursing practice., Objectives: To develop knowledge in a nursing perspective of competencies to provide care for patients and their families, who experience grief linked to loss due to kidney failure, haemodialysis and/or death., Design: The study took a phenomenological-hermeneutical approach. Semi-structured interviews were conducted 12 nurses caring for patients receiving haemodialysis with no kidney transplantation option and family members. Ricoeur's interpretation theory involving naïve reading, structural analysis and critical interpretation and discussion was used for analysis., Results: Four themes emerged of nurse's experiences: (1) patient's loss and grief in everyday life, (2) dealing with supportive conversations when caring for patients, (3) families' losses are resulting in grief reactions and (4) importance of close relationships when caring for families., Conclusions: To nurses, patients on haemodialysis and their families have multiple loss and grief experiences. Nurses' working in kidney care need to develop competencies to support patients and families to cope with grief and loss. Further research is needed to develop these competencies and then to implement in education and practice., (© 2023 The Authors. Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association.)

The aim of this mixed-methods study was to examine the experiences of nursing students (NSs), nurses, and patients regarding the clinical practices of NSs and to determine NSs' stress levels regarding clinical practices. The quantitative part of the study was completed with 240 NSs, and the "Perceived Stress Scale for Nursing Students" was used. In the qualitative part, the focus group interviews were held with 24 NSs, and the individual interviews were conducted with 15 patients and 20 nurses. Descriptive and stepwise regression analyses were used to analyze quantitative data, and narrative analysis was used to analyze qualitative data. Regression analysis determined that the age, grade point average, and attitude of mentors were associated with the perceived stress levels of NSs. In the narrative analysis of the data obtained from the interviews with NSs and nurses, four categories were identified: Emotions, Facilitators, Barriers, Roles, and Competencies. Three categories (Emotions, Problems, Roles, and Competencies) were identified from patient interviews. This study showed that NSs' clinical practice experiences were affected by many factors and experienced high stress during clinical practice., (© 2024 The Author(s). Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

Job-related burnout is one health outcome in nurses working in neonatal intensive care units (NICUs) due to the heavy workload, which results in negative physical and psychological consequences. One newly introduced approach to improve coping is loving-kindness meditation (LKM). Some studies have shown the effectiveness of the LKM on the mental health of nurses, though more evidence is required to support them. This study aimed to investigate the effectiveness of the LKM on job-related burnout of nurses working in NICU. This clustered controlled randomized clinical trial assessed job-related burnout before and after a month of practicing LKM guided through a virtual method. A total of 66 eligible NICU nurses from 2 referral children hospitals in Tehran were randomly assigned to 2 control (n = 33) and intervention (n = 33) groups. The intervention was performed 3 times a week for 1 month in the form of 20-minute audio files of LKM for the intervention group, and educational files on mental health during the COVID-19 pandemic were sent to the control group. The instruments used in this study were the demographic information questionnaire and the Maslach Burnout Inventory, which participants completed before and after the intervention. The mean difference in the overall scores of burnout before and after the intervention in the intervention group was significantly reduced (P = .003), but no significant difference was observed in the control group (P = .018). These findings support the benefit of LKM in NICU nurses in reducing burnout., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: A key skill of nephrology nursing is cannulation of patients receiving haemodialysis. Traumatic and unsuccessful cannulation experiences, particularly in the initial weeks of haemodialysis, may contribute to the onset of needle distress for patients., Objectives: To identify the key knowledge, skills and attitudes of nephrology nurses working with haemodialysis patients and the competencies relevant to nephrology nursing working with patients with needle-related distress., Design: A qualitative study involving semistructured interviews. Interviews were audio-recorded, transcribed and deductive, and inductive thematic analysis applied., Participants: Nephrology nurses (n = 17) were interviewed from a tertiary kidney service in South Australia. Nurses had varying roles and years of experience (range 1-30 years) working with dialysis patients within the service., Results: Two overarching themes, (1) Flexibility in Practice and Care and (2) Responsibility of Nephrology Nursing, were identified as relevant across all knowledge, skills and attitudes of nephrology nurses working with patients with needle-related distress. Thirty-six knowledge, skills and attitudes were identified; 12 related to knowledge, 14 related to skills and 10 were identified as attitudes and were summarised under seven broad competencies., Conclusion: This study identifies potential knowledge, skills and attitudes and competencies required for nephrology nurses working with patients with needle-related distress. It highlights strategies that may prevent the onset and worsening of needle-related distress, as well as reduce it. It also brings to light that nurses desire additional education regarding strategies to improve the patient experience of cannulation and nurse confidence and skill in this area., (© 2023 The Authors. Journal of Renal Care published by John Wiley & Sons Ltd on behalf of European Dialysis & Transplant Nurses Association/European Renal Care Association.)

Nurses are at increased risk for developing depressive symptoms. While previous research has suggested that strength use may be inversely related to these symptoms, the longitudinal impact of strength use on nurses' depressive symptoms remains under-explored. This study sought to examine the longitudinal relationship between strength use and depressive symptoms among Chinese nurses. Using a two-wave cross-lagged design from 2020 to 2023, 321 nurses participated in an online questionnaire survey. Using structural equation modeling, our results supported the hypothesized reciprocal model, indicating that strength use can significantly predict a reduction in depressive symptoms and vice versa. Given these findings, there's an urgent need for nurse leaders to emphasize the importance of using nurses' strengths as a strategy to alleviate depressive symptoms., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Nurses experience elevated rates of operational stress injuries (OSIs). This can necessitate taking leave from work and subsequently engaging in a workplace reintegration process. An unsuccessful process can have long term impacts on a nurse's career, affecting the individual, their family, and broader community, while contributing to nursing shortages. A knowledge gap regarding the workplace reintegration of nurses experiencing mental health challenges, impedes the development and implementation of initiatives that might increase the success of nurses reintegrating into the workplace. This scoping review explored the existing literature concerning workplace reintegration for nurses experiencing OSIs., Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) reporting guidelines were utilized. Three key search terms across six databases were employed followed by a qualitative content analysis of the resulting literature., Results: Eight documents were included. The literature exhibited high heterogeneity in objectives, content, and article types. The content analysis revealed five themes: (1) recognizing stigma, (2) elements of successful workplace reintegration, (3) considerations for military nurses, (4) considerations for nurses with substance use disorders, and (5) gaps in the existing literature., Conclusion: A paucity of programs, policies, procedures, and research exists regarding workplace reintegration for nurses facing mental health challenges. It is imperative to recognize that nurses may experience OSIs, necessitating mental health support, time off work, and operationally/culturally-specific assistance in returning to work. Innovative and evidence-based approaches to workplace reintegration are needed to enhance the retention of a skilled, experienced, compassionate, and healthy nursing workforce., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.