J Nurs Scholarsh [JOURNAL]
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200 papers
Modifiable work stress factors and psychological health risk among nurses working within 13 countries.
Norful AA, Albloushi M, Zhao J … +7 more , Gao Y, Castro J, Palaganas E, Magsingit NS, Molo J, Alenazy BA, Rivera R
J Nurs Scholarsh · 2024 Sep · PMID 38816945 · Full text
INTRODUCTION: Nurses are identified as having higher work stress and poor mental health risk among health care workforce globally. It remains unclear which modifiable stress factors pose the greatest risk for poor psycho...
INTRODUCTION: Nurses are identified as having higher work stress and poor mental health risk among health care workforce globally. It remains unclear which modifiable stress factors pose the greatest risk for poor psychological health among nursing workforce and needed to inform targeted practice and policy change. To determine which occupation-related or personal stress factors precipitate higher risk for burnout, depression, anxiety, job satisfaction or intention to leave one's position among nurses globally. DESIGN: A cross-sectional anonymous survey was administered via email using a snowball recruitment strategy. METHODS: Academic researchers and clinical industry leaders across 3 global regions collaborated to generate an email listserv of professional nursing contacts for survey distribution. The survey included valid and reliable measures to scale stress factors (Work Stress Questionnaire), and screen for burnout (single item), depression (Patient Health Questionnaire-2), anxiety (Generalized Anxiety Disorder-2), resilience (Brief Resilience Scale) and intention to leave one's job (single item). We used logistic regression, first unadjusted and then adjusted for personal and professional characteristics, to determine associations between stress factors and psychological health risk. RESULTS: The final sample consisted of responses from 2864 nurses working across 13 countries. Most respondents reported working as a clinical nurse in the Philippines (n = 2275), United States (n = 424) and Saudi Arabia (n = 104). One third of nursing respondents endorsed high burnout and intention to leave their job. Those reporting work conflict had significantly higher odds of burnout (odds ratio 3.18; 95% CI 2.22-4.54) and three times more likely to screen positive for depression (odds ratio 3.02; 95% CI 1.36-6.72) and anxiety (odds ratio 2.92; 95% CI 1.57-5.43). Those endorsing difficulty sleeping were 15 times more likely to screen positive for depression (odds ratio 15.63; 95% CI 2.09-117.06). Lack of social support was significantly associated to higher risk for burnout, job dissatisfaction, depression, anxiety, and intention to leave one's position. CONCLUSIONS: Nurses remain at risk for burnout and poor psychological health stemming from work stress. Factors such as clear workplace goals and assignments, increased engagement, good sleep health and social support may serve as protective factors against suboptimal psychological health, and in-turn poor workforce retention. CLINICAL RELEVANCE: Nurses reporting conflict in the workplace are three times more likely to screen positive for burnout, depression, and anxiety. Nurses reporting difficulty sleeping are 15 times more likely to screen positive for depression. Several modifiable factors can be targeted to reduce poor psychological health and high workforce turnover among nurses across countries.
Social support from manager and co-workers in relation to registered nurses' work motivation in three healthcare settings: A cross-sectional study of a Swedish national sample.
Ahlstedt C, Moberg L, Brulin E … +1 more , Nyberg A
J Nurs Scholarsh · 2024 Nov · PMID 38812087 · Publisher ↗
BACKGROUND: Having more registered nurses (RNs) leave their workplace, with a shortage of RNs in healthcare as a consequence, might pose a risk to patient safety. According to the Job Demands Resource model, social suppo...
BACKGROUND: Having more registered nurses (RNs) leave their workplace, with a shortage of RNs in healthcare as a consequence, might pose a risk to patient safety. According to the Job Demands Resource model, social support is a resource that can enhance work motivation, and if RNs are motivated at work, their willingness to remain in the workplace may increase. OBJECTIVE: The aims were to explore (1) differences in RNs' experiences of social support from their immediate manager and co-workers between different healthcare settings, (2) associations between RNs' experiences of social support and aspects of work motivation, and (3) if these associations differed in strength between healthcare settings. DESIGN: A cross-sectional study design. METHODS: A stratified population of Swedish RNs, n = 2290, working in either hospitals, primary care, or home healthcare, responded to a survey in 2022. Chi-squared tests and linear and logistic regression analyses were used to analyze the data. Interaction was measured by adding an interaction term to the fully adjusted regression models. The findings' generalizability was strengthened by including calibrating weights in all analyses. RESULTS: RNs in primary care reported higher social support from their immediate manager than RNs in hospitals and home healthcare. RNs in home healthcare reported lower social support from co-workers than RNs in hospitals and primary care. There were statistically significant associations between higher levels of social support from the immediate manager and co-workers, respectively, and higher ratings in all aspects of work motivation: work engagement (manager: beta coefficient [b] = 0.08, confidence interval [CI] 95% = 0.05; 0.10; co-workers: b = 0.12, CI 95% = 0.08; 0.16), job satisfaction (manager: b = 0.24, CI 95% = 0.21; 0.27; co-workers: b = 0.22, CI 95% = 0.16; 0.28), opportunities to provide high-quality care (manager: b = 0.15, CI 95% = 0.11; 0.18; co-workers: b = 0.19, CI 95% = 0.13; 0.24), satisfaction with the employer (manager: b = 0.46, CI 95% = 0.42; 0.50; co-workers: not statistically significant) and intention to remain at the workplace (manager: odds ratio = 1.89, CI 95% = 1.69; 2.13; co-workers: odds ratio = 1.42, CI 95% = 1.17; 1.72). The associations differed in strength between hospitals, primary care, and home healthcare. CONCLUSIONS: Strengthening social support from the immediate manager and co-workers appears to be a way to increase RNs' work motivation, including their intention to remain at the workplace. This may be important, particularly in primary care and home healthcare. CLINICAL RELEVANCE: To strengthen RNs' work motivation and willingness to stay in the workplace, it appears important for healthcare organizations to provide RN social support.
Systematic review of healthcare interventions for reducing gender-based violence impact on the mental health of women with disabilities.
Pastor-Moreno G, Saletti-Cuesta L, Henares-Montiel J … +3 more , Escudero-Carretero MJ, Higueras-Callejón C, Ruiz-Pérez I
J Nurs Scholarsh · 2024 Sep · PMID 38804594 · Publisher ↗
PURPOSE: Women with disabilities are more exposed to violence. The health sector has a key role in all three levels of prevention of violence against women. The objective of this paper was to review the interventions for...
PURPOSE: Women with disabilities are more exposed to violence. The health sector has a key role in all three levels of prevention of violence against women. The objective of this paper was to review the interventions for preventing gender-based violence and reducing its impact on the mental health of women with any form of disability. METHOD: Relevant studies were identified through conducting searches in PubMed, Scopus, CINAHL, PsyInfo, Social Services Abstracts, and PILOTS. Two reviewers analyzed and selected studies. A qualitative synthesis was made. RESULTS: 3149 references were obtained, among which eight articles describing nine interventions from the USA and the UK. Most were intended for women with mental/intellectual disability and assessed intimate partner or sexual violence. Only one study showed high methodological quality. They were found to be particularly effective as regards improvement of the skills acquired by participants, but the results as regards improved mental health are not consistent. CONCLUSION: Our review shows very little evidence of effective interventions. Further studies are required with higher internal validity and female sample groups with diverse disabilities. CLINICAL RELEVANCE: Gender-based violence is a highly prevalent problem for women with disabilities, and in addition to being a public health challenge is a violation of human rights. Health care systems and policymakers should take a key role in all three levels of prevention of violence against women with disabilities. Interventions with longer follow-up times are required. It is also important for interventions to be designed in consultation with people with disabilities.
Nonpharmacological interventions to improve the cognitive function among persons with traumatic brain injury: A systematic review.
Chuaykarn U, Thato R, Crago EA
J Nurs Scholarsh · 2024 Sep · PMID 38798031 · Publisher ↗
PURPOSE: The systematic review aimed to evaluate the effectiveness of nonpharmacological interventions (NPIs) for improving cognitive function among persons with traumatic brain injury. DESIGN: A systematic review. METHO...
PURPOSE: The systematic review aimed to evaluate the effectiveness of nonpharmacological interventions (NPIs) for improving cognitive function among persons with traumatic brain injury. DESIGN: A systematic review. METHODS: This systematic review was registered in PROSPERO and followed the PRISMA guideline. PubMed, ScienceDirect, Scopus, SpringerLink, Wiley Online Library, JSTOR, and Taylor & Francis were systematically searched for relevant articles of peer-reviewed studies published between 2008 and 2022. Two independent researchers conducted study selection, data extraction, and data quality assessment. FINDINGS: Twenty-one studies met inclusion criteria, numbering a total of 757 participants. Six groups of NPIs were effective in improving cognitive functioning among persons with traumatic brain injury, including multimodal cognitive training, technology innovation, memory training, executive function training, physical activity, and sensory stimulation programs. Pooled evidence revealed that NPIs had a large effect on memory (d = 0.80, p < 0.05 to d = 2.03, p < 0.000), processing speed (d = 1.58, p < 0.05), and cognitive behavior (d = 1.63, p < 0.001 to d = 8.91, p 0.003). There was a medium effect on executive function (d = 0.5, p < 0.01 to d = 0.62, p < 0.05), attention (d = 0.5, p < 0.01), and intelligence (d = 0.57 to d = 0.59, p = 0.000). For visuospatial function and language, there was a significant increase post-intervention. CONCLUSION: Evidence from this systematic review indicates that NPIs, specifically the use of multimodal cognitive training and sensory stimulation programs, were effective in improving cognitive function outcomes among persons with traumatic brain injury, with medium to large effect sizes. CLINICAL RELEVANCE: Nonpharmacological interventions (NPIs) can enhance cognitive function in individuals with traumatic brain injury. These findings can guide healthcare professionals in clinical settings and support the development of technology applications for cognitive rehabilitation using NPIs.
Update to the essential genomic nursing competencies and outcome indicators.
Calzone KA, Stokes L, Peterson C … +1 more , Badzek L
J Nurs Scholarsh · 2024 Sep · PMID 38797885 · Full text
INTRODUCTION: Genomic healthcare applications have relevance to all healthcare professionals including nursing, and most evidence-based clinical applications impact the quality and safety of healthcare. To guide nursing...
INTRODUCTION: Genomic healthcare applications have relevance to all healthcare professionals including nursing, and most evidence-based clinical applications impact the quality and safety of healthcare. To guide nursing genomic competency initiatives, the Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics were established through a process of consensus in 2005. A 2009 update incorporated outcome indicators consisting of specific areas of knowledge and clinical performance indicators, to help support academic integration. Almost 20 years have elapsed since these competencies were first established, yet incorporating the competencies into general and specialty scope and standards of nursing practice is inconsistent, competency integration into curricula is highly uneven, continuing education in genomics for nurses is limited, and the genomic capacity of the nursing workforce remains low. These deficits have persisted despite substantial advances in genomic technology which substantially reduced costs and increased evidence-based clinical applications, including direct to consumer genomic tests, the integration of genomics into evidence-based guidelines, and evidence that genomics impacts the quality and safety of healthcare. DESIGN: The aim of this project was to update and achieve consensus on genomic competencies applicable to all registered nurses. This was a mixed methods study. METHODS: The update to the competencies was performed based first on a literature review to update the competencies based on the current state of the evidence. Using the updated content, a modified Delphi study was conducted with registered nurse panelists from clinical, academic, and research settings. Once consensus was achieved, the competencies were made available through the American Nurses Association for public comment. Public comments were then reviewed and integrated as needed. RESULTS: The literature review resulted in a transition from genetics to genomics, given the reduction in costs, which resulted in an expansion of the scope of testing in both the germline and somatic contexts. Two Delphi rounds were required to reach consensus prior to the public comment period. Public comments were solicited through the American Nurses Association, and each comment was reviewed by the authors and addressed as indicated. CONCLUSION: The Essentials of Genomic Nursing: Competencies and Outcome Indicators constitute the minimum competency in genomics required of all registered nurses regardless of the level of academic training, role, or specialty. CLINICAL RELEVANCE: Evidence-based genomic applications span the entire healthcare continuum and, therefore, are relevant for all registered nurses regardless of academic training, role, practice setting, or clinical expertise. These competencies serve as the guide for the minimum requirements for registered nurse practice as well as guide curricula and continuing education for all registered nurses, including but not limited to administrators, educators, nursing leaders, practicing nurses, and researchers.
Machine learning evaluation of inequities and disparities associated with nurse sensitive indicator safety events.
Georgantes ER, Gunturkun F, McGreevy TJ … +1 more , Lough ME
J Nurs Scholarsh · 2025 Jan · PMID 38773783 · Publisher ↗
PURPOSE: To use machine learning to examine health equity and clinical outcomes in patients who experienced a nurse sensitive indicator (NSI) event, defined as a fall, a hospital-acquired pressure injury (HAPI) or a hosp...
PURPOSE: To use machine learning to examine health equity and clinical outcomes in patients who experienced a nurse sensitive indicator (NSI) event, defined as a fall, a hospital-acquired pressure injury (HAPI) or a hospital-acquired infection (HAI). DESIGN: This was a retrospective observational study from a single academic hospital over six calendar years (2016-2021). Machine learning was used to examine patients with an NSI compared to those without. METHODS: Inclusion criteria: all adult inpatient admissions (2016-2021). Three approaches were used to analyze the NSI group compared to the No-NSI group. In the univariate analysis, descriptive statistics, and absolute standardized differences (ASDs) were employed to compare the demographics and clinical variables of patients who experienced a NSI and those who did not experience any NSIs. For the multivariate analysis, a light grading boosting machine (LightGBM) model was utilized to comprehensively examine the relationships associated with the development of an NSI. Lastly, a simulation study was conducted to quantify the strength of associations obtained from the machine learning model. RESULTS: From 163,507 admissions, 4643 (2.8%) were associated with at least one NSI. The mean, standard deviation (SD) age was 59.5 (18.2) years, males comprised 82,397 (50.4%). Non-Hispanic White 84,760 (51.8%), non-Hispanic Black 8703 (5.3%), non-Hispanic Asian 23,368 (14.3%), non-Hispanic Other 14,284 (8.7%), and Hispanic 30,271 (18.5%). Race and ethnicity alone were not associated with occurrence of an NSI. The NSI group had a statistically significant longer length of stay (LOS), longer intensive care unit (ICU) LOS, and was more likely to have an emergency admission compared to the group without an NSI. The simulation study results demonstrated that likelihood of NSI was higher in patients admitted under the major diagnostic categories (MDC) associated with circulatory, digestive, kidney/urinary tract, nervous, and infectious and parasitic disease diagnoses. CONCLUSION: In this study, race/ethnicity was not associated with the risk of an NSI event. The risk of an NSI event was associated with emergency admission, longer LOS, longer ICU-LOS and certain MDCs (circulatory, digestive, kidney/urinary, nervous, infectious, and parasitic diagnoses). CLINICAL RELEVANCE: Machine learning methodologies provide a new mechanism to investigate NSI events through the lens of health equity/disparity. Understanding which patients are at higher risk for adverse outcomes can help hospitals improve nursing care and prevent NSI injury and harm.
Trajectories of nursing hours over the course of hospitalization and estimated additional nurse staffing requirements to reduce the length of stay.
Kim SA, Cho SH
J Nurs Scholarsh · 2024 Sep · PMID 38745356 · Publisher ↗
PURPOSE: The aims of this study are to examine the trajectories of nursing hours per patient day (NHPPD) over the course of hospitalization according to the patient's length of stay (LOS) and to estimate changes in the t...
PURPOSE: The aims of this study are to examine the trajectories of nursing hours per patient day (NHPPD) over the course of hospitalization according to the patient's length of stay (LOS) and to estimate changes in the total nursing hours during hospitalization, average NHPPD, and the number of nurses additionally required when the LOS was reduced by 1 day. DESIGN: This retrospective longitudinal study analyzed patient data collected from a tertiary university hospital located in Seoul, South Korea. The study sample included 11,316 inpatients who were discharged between September 1 and October 31, 2022. METHODS: NHPPD over the course of each patient's hospitalization was estimated using the total score of the Korean Patient Classification System-1 (KPCS-1), which nurses evaluated and recorded every day from admission to discharge. The NHPPD trajectories were examined using linear mixed models to analyze repeated KPCS-1 measurements and control for the effects of patient characteristics. The changes in the average NHPPD when LOS was reduced by 1 day were estimated using maximum and minimum estimations. The impact of a 1-day reduction in LOS on staffing requirements was calculated as the number of nurses additionally required to work each shift and to be hired. FINDINGS: The average LOS was 5.6 days, and the short (1-6 days) and medium (7-14 days) LOS groups accounted for 78.9% and 14.3% of patients, respectively. The NHPPD trajectories showed a "rise-peak-decline" pattern. Patients in the short LOS group received the most NHPPD on day 1 (day of admission) or day 2, whereas the NHPPD for patients in the medium LOS group peaked on days 3-6. After peaking, the NHPPD tended to decrease toward the end of hospitalization, with the least NHPPD on the day of discharge, followed by the day before discharge. When LOS was reduced by 1 day, the average NHPPD was estimated to increase by 7.7-50.0% in the maximum estimation, and 0.9-12.5% in the minimum estimation. In response to a 1-day reduction, 1.10-7.44 nurses were additionally required to care for 100 patients each shift and 5.28-35.70 additional nurses needed to be hired in the maximum estimation. In the minimum estimation, these values were 0.13-1.85 additional nurses per shift and 0.65-8.90 additional nurses to be hired, respectively. CONCLUSIONS: Since NHPPD exhibited a "rise-peak-decline" trajectory, reducing the LOS by 1 day was estimated to increase the average NHPPD and lead to additional staffing requirements. The additional nurse requirement for a 1-day reduction was not constant; instead, it increased with each day subtracted from an already shorter LOS. CLINICAL RELEVANCE: Sufficient nurse staffing is necessary to provide increased NHPPD as a result of shortened LOS. Changes in the LOS should be considered when determining nurse staffing requirements.
Investigation of core symptoms and symptom clusters in maintenance hemodialysis patients: A network analysis.
Zhang Y, Liu L, Chen L … +3 more , He L, Shi M, Chen H
J Nurs Scholarsh · 2024 Sep · PMID 38741291 · Publisher ↗
PURPOSE: To construct a symptom network of maintenance hemodialysis patients and identify the core symptoms and core symptom clusters. Finally, this study provides a reference for accurate symptom management. DESIGN AND...
PURPOSE: To construct a symptom network of maintenance hemodialysis patients and identify the core symptoms and core symptom clusters. Finally, this study provides a reference for accurate symptom management. DESIGN AND METHOD: A correlational cross-sectional design. A total of 368 patients who underwent maintenance hemodialysis were enrolled from two hemodialysis centers in Chengdu, Sichuan Province, China. A symptom network was constructed with the R coding language to analyze the centrality index. Symptom clusters were extracted by exploratory factor analysis, and core symptom clusters were preliminarily determined according to the centrality index of the symptom network. FINDINGS: The most common symptoms in maintenance hemodialysis patients were fatigue, dry skin, and pruritus. In the symptom network, headache had the highest mediation centrality (rB = 2.789) and closeness centrality (rC = 2.218) and the greatest intensity of numbness or tingling in the feet (rS = 1.952). A total of six symptom clusters were extracted, including pain and discomfort symptom clusters, emotional symptom clusters, gastrointestinal symptom clusters, sleep disorder symptom clusters, dry symptom clusters, and sexual dysfunction symptom clusters. The cumulative variance contribution rate was 69.269%. CONCLUSIONS: Fatigue, dry skin, and pruritus are the sentinel symptoms of maintenance hemodialysis patients, headache is the core symptom and bridge symptom, and pain symptom clusters are the core symptom clusters of MHD patients. Nurses can develop interventions based on core symptoms and symptom clusters to improve the effectiveness of symptom management in maintenance hemodialysis patients. CLINICAL RELEVANCE: Understanding the core symptoms and symptom groups that plague maintenance hemodialysis patients is critical to providing accurate symptom management. To ensure that maintenance hemodialysis patients receive effective support during treatment, reduce the adverse effects of symptoms, and improve the quality of life of patients.
Documentation of social determinants of health across individuals from different racial and ethnic groups in home healthcare.
Hobensack M, Scharp D, Song J … +1 more , Topaz M
J Nurs Scholarsh · 2025 Jan · PMID 38739091 · Full text
INTRODUCTION: Home healthcare (HHC) enables patients to receive healthcare services within their homes to manage chronic conditions and recover from illnesses. Recent research has identified disparities in HHC based on r...
INTRODUCTION: Home healthcare (HHC) enables patients to receive healthcare services within their homes to manage chronic conditions and recover from illnesses. Recent research has identified disparities in HHC based on race or ethnicity. Social determinants of health (SDOH) describe the external factors influencing a patient's health, such as access to care and social support. Individuals from racially or ethnically minoritized communities are known to be disproportionately affected by SDOH. Existing evidence suggests that SDOH are documented in clinical notes. However, no prior study has investigated the documentation of SDOH across individuals from different racial or ethnic backgrounds in the HHC setting. This study aimed to (1) describe frequencies of SDOH documented in clinical notes by race or ethnicity and (2) determine associations between race or ethnicity and SDOH documentation. DESIGN: Retrospective data analysis. METHODS: We conducted a cross-sectional secondary data analysis of 86,866 HHC episodes representing 65,693 unique patients from one large HHC agency in New York collected between January 1, 2015, and December 31, 2017. We reported the frequency of six SDOH (physical environment, social environment, housing and economic circumstances, food insecurity, access to care, and education and literacy) documented in clinical notes across individuals reported as Asian/Pacific Islander, Black, Hispanic, multi-racial, Native American, or White. We analyzed differences in SDOH documentation by race or ethnicity using logistic regression models. RESULTS: Compared to patients reported as White, patients across other racial or ethnic groups had higher frequencies of SDOH documented in their clinical notes. Our results suggest that race or ethnicity is associated with SDOH documentation in HHC. CONCLUSION: As the study of SDOH in HHC continues to evolve, our results provide a foundation to evaluate social information in the HHC setting and understand how it influences the quality of care provided. CLINICAL RELEVANCE: The results of this exploratory study can help clinicians understand the differences in SDOH across individuals from different racial and ethnic groups and serve as a foundation for future research aimed at fostering more inclusive HHC documentation practices.
Beyond order-based nursing workload: A retrospective cohort study in intensive care units.
Chen Y, Chan CW, Dong J … +3 more , Jackson EM, Yip NH, Rossetti SC
J Nurs Scholarsh · 2024 Sep · PMID 38736177 · Publisher ↗
INTRODUCTION: In order to be positioned to address the increasing strain of burnout and worsening nurse shortage, a better understanding of factors that contribute to nursing workload is required. This study aims to exam...
INTRODUCTION: In order to be positioned to address the increasing strain of burnout and worsening nurse shortage, a better understanding of factors that contribute to nursing workload is required. This study aims to examine the difference between order-based and clinically perceived nursing workloads and to quantify factors that contribute to a higher clinically perceived workload. DESIGN: A retrospective cohort study was used on an observational dataset. METHODS: We combined patient flow, nurse staffing and assignment, and workload intensity data and used multivariate linear regression to analyze how various shift, patient, and nurse-level factors, beyond order-based workload, affect nurses' clinically perceived workload. RESULTS: Among 53% of our samples, the clinically perceived workload is higher than the order-based workload. Factors associated with a higher clinically perceived workload include weekend or night shifts, shifts with a higher census, patients within the first 24 h of admission, and male patients. CONCLUSIONS: The order-based workload measures tended to underestimate nurses' clinically perceived workload. We identified and quantified factors that contribute to a higher clinically perceived workload, discussed the potential mechanisms as to how these factors affect the clinically perceived workload, and proposed targeted interventions to better manage nursing workload. CLINICAL RELEVANCE: By identifying factors associated with a high clinically perceived workload, the nurse manager can provide appropriate interventions to lighten nursing workload, which may further reduce the risk of nurse burnout and shortage.
Personal and work-related factors associated with post-traumatic growth in nurses: A mixed studies systematic review.
Tang LK, Yobas P, Wong DNX … +4 more , Pikkarainen M, Zhang R, Ho D, He HG
J Nurs Scholarsh · 2024 Jul · PMID 38703352 · Publisher ↗
INTRODUCTION: Nurses, assuming a wide range of clinical and patient care responsibilities in a healthcare team, are highly susceptible to direct and indirect exposure to traumatic experiences. However, literature has sho...
INTRODUCTION: Nurses, assuming a wide range of clinical and patient care responsibilities in a healthcare team, are highly susceptible to direct and indirect exposure to traumatic experiences. However, literature has shown that nurses with certain traits developed a new sense of personal strength in the face of adversity, known as post-traumatic growth (PTG). This review aimed to synthesize the best available evidence to evaluate personal and work-related factors associated with PTG among nurses. DESIGN: Mixed studies systematic review. METHODS: Studies examining factors influencing PTG on certified nurses from all healthcare facilities were included. Published and unpublished studies were identified by searching 12 databases from their inception until 4th February 2023. Two reviewers independently screened, appraised, piloted a data collection form, and extracted relevant data. Meta-summary, meta-synthesis, meta-analysis, as well as subgroup and sensitivity analyses were performed. Integration of results followed result-based convergent design. RESULTS: A total of 98 studies with 29,706 nurses from 18 countries were included. These included 49 quantitative, 42 qualitative, and seven mixed-methods studies. Forty-six influencing factors were meta-analyzed, whereas nine facilitating factors were meta-summarized. A PTG conceptual map was created. Four constructs emerged from the integration synthesis: (a) personal system, (b) work-related system, (c) event-related factors, and (d) cognitive transformation. CONCLUSION: The review findings highlighted areas healthcare organizations could do to facilitate PTG in nurses. Practical implications include developing intervention programs based on PTG facilitators. Further research should examine the trend of PTG and its dynamic response to different nursing factors. CLINICAL RELEVANCE: Research on trauma-focused therapies targeting nurses' mental health is lacking. Therefore, findings from this review could inform healthcare organizations on the PTG phenomenon and developing support measures for nurses through healthcare policies and clinical practice.
Impact of authentic leadership on nurses' well-being and quality of care in the acute care settings.
Alhalal E, Alharbi JF, Alharbi ST … +4 more , Alotaibi SS, Albagami NS, Alruwaili SM, Alshammari SA
J Nurs Scholarsh · 2024 Sep · PMID 38693598 · Publisher ↗
INTRODUCTION: Both nurses' well-being and quality of care are top priorities of the healthcare system. Yet, there is still a gap in understanding the extent and how authentic leadership influences them. This information...
INTRODUCTION: Both nurses' well-being and quality of care are top priorities of the healthcare system. Yet, there is still a gap in understanding the extent and how authentic leadership influences them. This information is needed to inform the development of effective interventions, organizational practices, and policies. Thus, this study aimed to test the mechanism by which nurses' perception of their managers' authentic leadership impacts nurses' well-being and perception of quality of care, given the role of the nursing practice environment and nurses' psychological capital. DESIGN: A cross-sectional design was used. METHODS: This study recruited a random sample of 680 nurses from six hospitals in Saudi Arabia. A final sample of 415 completed the surveys, with a response rate of 61%. Structural equation modeling was performed to test the hypothesized model. RESULTS: The study showed that nurses' perceptions of authentic leadership in their managers positively and directly affect their perceptions of quality of care but do not directly affect nurses' well-being. Both the nursing practice environment and psychological capital fully mediated the relationship between authentic leadership and nurses' well-being. However, the nursing practice environment partially mediated the relationship between authentic leadership and perceptions of quality of care. CONCLUSION: The findings contribute to understanding the crucial role of authentic leaders' style in nurses' well-being and quality of care through its positive impact on the nursing practice environment and psychological capital. CLINICAL RELEVANCE: Designing interventions and policies that specifically target nursing managers' authentic leadership style has implications for enhancing nurses' well-being and the quality of patient care. Institutional measures are needed to help leaders practice an authentic leadership style to create a positive nursing practice environment and cultivate nurses' psychological capital, both of which contribute to nurses' well-being and attaining a better quality of care. Further work is required to highlight the outcomes of implementing an authentic leadership style relevant to other leadership styles.
Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation tool for rigor in mixed methods implementation research.
Younas A, Fàbregues S
J Nurs Scholarsh · 2024 Sep · PMID 38691344 · Publisher ↗
BACKGROUND: Implementation science helps generate approaches to expedite the uptake of evidence in practice. Mixed methods are commonly used in implementation research because they allow researchers to integrate distinct...
BACKGROUND: Implementation science helps generate approaches to expedite the uptake of evidence in practice. Mixed methods are commonly used in implementation research because they allow researchers to integrate distinct qualitative and quantitative methods and data sets to unravel the implementation process and context and design contextual tools for optimizing the implementation. To date, there has been limited discussion on how to ensure rigor in mixed methods implementation research. PURPOSE: To present Particularity, Engagement, Actionable Inferences, Reflexivity, and Legitimation (PEARL) as a practical tool for understanding various components of rigor in mixed methods implementation research. DATA SOURCES: This methodological discussion is based on a nurse-led mixed methods implementation study. The PEARL tool was developed based on an interpretive, critical reflection, and purposive reading of selected literature sources drawn from the researchers' knowledge, experiences of designing and conducting mixed methods implementation research, and published methodological papers about mixed methods, implementation science, and research rigor. CONCLUSION: An exemplar exploratory sequential mixed methods study in nursing is provided to illustrate the application of the PEARL tool. The proposed tool can be a useful and innovative tool for researchers and students intending to use mixed methods in implementation research. The tool offers a straightforward approach to learning the key rigor components of mixed methods implementation research for application in designing and conducting implementation research using mixed methods. CLINICAL RELEVANCE: Rigorous implementation research is critical for effective uptake of innovations and evidence-based knowledge into practice and policymaking. The proposed tool can be used as the means to establish rigor in mixed methods implementation research in nursing and health sciences.
Comparative efficacy of telehealth interventions on promoting cancer screening: A network meta-analysis of randomized controlled trials.
Zhang S, Zhou L, Yi L … +5 more , Chen X, Zhang Y, Li J, Zhang Y, Hu X
J Nurs Scholarsh · 2024 Jul · PMID 38691056 · Publisher ↗
BACKGROUND: Cancer screening is a pivotal method for reducing mortality from disease, but the screening coverage is still lower than expected. Telehealth interventions demonstrated significant benefits in cancer care, ye...
BACKGROUND: Cancer screening is a pivotal method for reducing mortality from disease, but the screening coverage is still lower than expected. Telehealth interventions demonstrated significant benefits in cancer care, yet there is currently no consensus on their impact on facilitating cancer screening or on the most effective remote technology. DESIGN: A network meta-analysis was conducted to detect the impact of telehealth interventions on cancer screening and to identify the most effective teletechnologies. METHODS: Six English databases were searched from inception until July 2023 to yield relevant randomized controlled trials (RCTs). Two individual authors completed the literature selection, data extraction, and methodological evaluations using the Cochrane Risk of Bias tool. Traditional pairwise analysis and network meta-analysis were performed to identify the overall effects and compare different teletechnologies. RESULTS: Thirty-four eligible RCTs involving 131,644 participants were enrolled. Overall, telehealth interventions showed statistically significant effects on the improvement of cancer screening. Subgroup analyses revealed that telehealth interventions were most effective for breast and cervical cancer screening, and rural populations also experienced benefits, but there was no improvement in screening for older adults. The network meta-analysis indicated that mobile applications, video plus telephone, and text message plus telephone were associated with more obvious improvements in screening than other teletechnologies. CONCLUSION: Our study identified that telehealth interventions were effective for the completion of cancer screening and clarified the exact impact of telehealth on different cancer types, ages, and rural populations. Mobile applications, video plus telephone, and text message plus telephone are the three forms of teletechnologies most likely to improve cancer screening. More well-designed RCTs involving direct comparisons of different teletechnologies are needed in the future. CLINICAL RELEVANCE: Telehealth interventions should be encouraged to facilitate cancer screening, and the selection of the optimal teletechnology based on the characteristics of the population is also necessary.
The effect of work readiness on work well-being for newly graduated nurses: The mediating role of emotional labor and psychological capital.
Ding Y, Tang H, Zhang Y … +4 more , Peng Q, Dong W, Lu G, Chen C
J Nurs Scholarsh · 2024 Sep · PMID 38654402 · Publisher ↗
OBJECTIVE: To investigate the relationship between work readiness and work well-being for newly graduated nurses and the mediating role of emotional labor and psychological capital in this relationship. METHODS: A cross-...
OBJECTIVE: To investigate the relationship between work readiness and work well-being for newly graduated nurses and the mediating role of emotional labor and psychological capital in this relationship. METHODS: A cross-sectional survey was conducted in mainland China. A total of 478 newly graduated nurses completed the Work Readiness Scale, Emotional Labour Scale, Psychological Capital Questionnaire, and Work Well-being Scale. Descriptive statistical methods, Pearson correlation analysis, and a structural equation model were used to analyze the available data. RESULTS: Newly graduated nurses' work readiness was significantly positively correlated with work well-being (r = 0.21, p < 0.01), deep acting (r = 0.11, p < 0.05), and psychological capital (r = 0.18, p < 0.01). Emotional labor and psychological capital partially mediated the relationship between work readiness and work well-being. Additionally, emotional labor and psychological capital had a chain-mediating effect on the association. CONCLUSIONS AND CLINICAL RELEVANCE: Work readiness not only affects newly graduated nurses' work well-being directly but also indirectly through emotional labor and psychological capital. These results provide theoretical support and guidance for the study and improvement of newly graduated nurses' work well-being and emphasize the importance of intervention measures to improve work readiness and psychological capital and the adoption of deep-acting emotional-labor strategies.
Ethical, innovative, and globally significant.
Gennaro S
J Nurs Scholarsh · 2024 May · PMID 38644524 · Publisher ↗
Abstract loading — click title to view on PubMed.
Evaluation of nurse-reported missed care in a post-anesthesia care unit: A mixed-methods study.
Heng LMT, Rajasegeran DD, Lim SH
J Nurs Scholarsh · 2024 Jul · PMID 38627908 · Publisher ↗
BACKGROUND: Nurse-reported missed care (NRMC) is considered as any significant delay or omission in provision of nursing care. AIM: (i) Evaluate the frequency, types, and reasons for NRMC in the Post-anesthesia Care Unit...
BACKGROUND: Nurse-reported missed care (NRMC) is considered as any significant delay or omission in provision of nursing care. AIM: (i) Evaluate the frequency, types, and reasons for NRMC in the Post-anesthesia Care Unit (PACU). (ii) Evaluate associations between nurse demographic and workload factors with NRMC. (iii) Explore nurses' perception of NRMC in the PACU. METHODS: A cross-sectional study was conducted in the PACU in a tertiary acute care hospital over 3 months. Full-time PACU nurses were conveniently sampled to complete an anonymous survey after their daily shift over different shifts. It contained three sections: (i) nurse demographics; (ii) elements of NRMC; and (iii) reasons for NRMC. Qualitative interviews employed a semi-structured guide to explore perceptions and experiences of NRMC. Descriptive, inferential statistics, and thematic analyses were applied. RESULTS: Sixty-six survey responses were collected. 48.5% of respondents indicated at least one NRMC activity. Activities more clinically sensitive were less missed. Eight nurses were interviewed. Four main themes were identified: (i) communication with patients; (ii) communication and teamwork with colleagues; (iii) dual role of documentation; and (iv) staffing inadequacy. Language barriers made communication challenging. Staff shortage exacerbates workload but effective teamwork and documentation facilitates nursing care. CONCLUSION: Communication and staffing concerns aggravate NRMC. Teamwork and personal contentment were satisfactory. Nurses' turnover intention may worsen staffing. CLINICAL RELEVANCE: Timeliness and quality of nursing care is impacted by elements such as manpower, allocation of resources, work processes, and workplace environmental or interpersonal factors such as culture and language fit. Re-evaluation of nursing resources and work processes may assist post-anesthesia care unit nurses in fulfilling their role, decreasing the prevalence of nurse-reported missed care.
Characterizing nursing time with patients using computer vision.
Sun C, Fu C, Cato K
J Nurs Scholarsh · 2024 Jul · PMID 38615340 · Full text
BACKGROUND: Compared to other providers, nurses spend more time with patients, but the exact quantity and nature of those interactions remain largely unknown. The purpose of this study was to characterize the interaction...
BACKGROUND: Compared to other providers, nurses spend more time with patients, but the exact quantity and nature of those interactions remain largely unknown. The purpose of this study was to characterize the interactions of nurses at the bedside using continuous surveillance over a year long period. METHODS: Nurses' time and activity at the bedside were characterized using a device that integrates the use of obfuscated computer vision in combination with a Bluetooth beacon on the nurses' identification badge to track nurses' activities at the bedside. The surveillance device (AUGi) was installed over 37 patient beds in two medical/surgical units in a major urban hospital. Forty-nine nurse users were tracked using the beacon. Data were collected 4/15/19-3/15/20. Statistics were performed to describe nurses' time and activity at the bedside. RESULTS: A total of n = 408,588 interactions were analyzed over 670 shifts, with >1.5 times more interactions during day shifts (n = 247,273) compared to night shifts (n = 161,315); the mean interaction time was 3.34 s longer during nights than days (p < 0.0001). Each nurse had an average of 7.86 (standard deviation [SD] = 10.13) interactions per bed each shift and a mean total interaction time per bed of 9.39 min (SD = 14.16). On average, nurses covered 7.43 beds (SD = 4.03) per shift (day: mean = 7.80 beds/nurse/shift, SD = 3.87; night: mean = 7.07/nurse/shift, SD = 4.17). The mean time per hourly rounding (HR) was 69.5 s (SD = 98.07) and 50.1 s (SD = 56.58) for bedside shift report. DISCUSSION: As far as we are aware, this is the first study to provide continuous surveillance of nurse activities at the bedside over a year long period, 24 h/day, 7 days/week. We detected that nurses spend less than 1 min giving report at the bedside, and this is only completed 20.7% of the time. Additionally, hourly rounding was completed only 52.9% of the time and nurses spent only 9 min total with each patient per shift. Further study is needed to detect whether there is an optimal timing or duration of interactions to improve patient outcomes. CLINICAL RELEVANCE: Nursing time with the patient has been shown to improve patient outcomes but precise information about how much time nurses spend with patients has been heretofore unknown. By understanding minute-by-minute activities at the bedside over a full year, we provide a full picture of nursing activity; this can be used in the future to determine how these activities affect patient outcomes.
The role of psychological ownership in linking decent work to nurses' vigor at work: A two-wave study.
El-Gazar HE, Shawer M, Alkubati SA … +1 more , Zoromba MA
J Nurs Scholarsh · 2024 Nov · PMID 38581146 · Publisher ↗
INTRODUCTION: Nurses' vigor at work profoundly impacts the quality of patient care. However, the determinants of nurses' vigor remain underexplored in the current nursing literature, and the mechanism through which these...
INTRODUCTION: Nurses' vigor at work profoundly impacts the quality of patient care. However, the determinants of nurses' vigor remain underexplored in the current nursing literature, and the mechanism through which these determinants exert their effects remains unclear. AIM: This study aimed to elucidate the mediating role of psychological ownership in linking decent work to nurses' vigor at work. METHODS: A two-wave, time-lagged study was conducted to collect data from 289 nurses working across three hospitals in Port Said, Egypt, between March and June 2023. Data were collected using the Decent Work Scale, the Psychological Ownership Scale, the Shirom-Melamed Vigor Measure, on an Introductory Information Form. Mediation testing was performed using structural equation modeling. RESULTS: Decent work was significantly associated with psychological ownership and vigor at work. Psychological ownership partially mediated the relationship between decent work and nurses' vigor at work. CONCLUSION: Decent work practices are critical in fostering nurses' vigor while working, and psychological ownership plays a mediating role in this relationship. CLINICAL RELEVANCE: Hospital administrators should value decent work practices, which could enhance psychological ownership, resulting in a potential improvement in nurses' vigor at work.
Correction to Editorial for the special issue about the health of transgender and gender diverse people.
J Nurs Scholarsh · 2024 Jul · PMID 38556633 · Publisher ↗
Abstract loading — click title to view on PubMed.
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