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Choi MJ, Kim S, Jeong SH. Factors Associated With Health-promoting Behaviors Among Nurses in South Korea: Systematic Review and Meta-analysis Based on Pender's Health Promotion Model. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:188-202. [PMID: 38692407 DOI: 10.1016/j.anr.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 03/04/2024] [Accepted: 04/24/2024] [Indexed: 05/03/2024] Open
Abstract
PURPOSE Although the importance of health promotion for nurses is increasing, there is a lack of meta-analyses targeting nurses in the world. This study aimed to identify the effect sizes between the health-promoting behaviors and related variables of nurses working in Korea. METHODS Systematic review and meta-analysis were conducted according to the PRISMA and MOOSE guidelines. The literature included in this meta-analysis was published between 1994 and 2022 in core databases such as KMbase, KISS, KoreaMed, ScienceON, DBpia, NAL, RISS, CINAHL, CENTRAL, WoS, PubMed, and hand searched. In this study, the PICO-SD framework was applied with Participants being nurses actively working in various healthcare settings across Korea, and for a more comprehensive search, intervention and comparisons were not set. The outcomes measured were nurses' health-promoting behaviors, assessed using structured tools. The study design included observational studies. The Comprehensive Meta-Analysis and the R software program were used for meta-analysis. RESULTS In total, 50 articles were selected for the systematic review and meta-analysis. The total effect size of the 50 articles was moderate (correlation effect size [ESr] = 0.30). The individual variables presented in the 50 articles were classified into nine sub-categories according to Pender's Health Promotion Model (HPM). Among them, situational influences demonstrated the largest effect size (ESr = 0.44, number of studies [k] = 2), followed by perceived self-efficacy (ESr = 0.39, k = 10) and activity-related affect (ESr = 0.32, k = 12). CONCLUSIONS To achieve the optimal health status of nurses through health promotion intervention programs, these effective variables - situational influences, perceived self-efficacy, and activity-related affect - should be considered when developing the intervention program for nurses. REGISTRATION CRD42022299907.
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Affiliation(s)
- Myung Jin Choi
- Department of Nursing, Presbyterian Medical Center, Jeonju, 54987, Jeollabuk-do, Republic of Korea
| | - Sunmi Kim
- College of Nursing, Woosuk University, Wanju, 55338, Jeollabuk-do, Republic of Korea.
| | - Seok Hee Jeong
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, 54896, Jeollabuk-do, Republic of Korea.
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Bae SH. Comprehensive assessment of factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals: a systematic review. BMC Nurs 2023; 22:31. [PMID: 36739408 PMCID: PMC9899133 DOI: 10.1186/s12912-023-01190-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/24/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the demand for nursing care increased, making the retention of nurses even more important. Among staff nurses, it is reported that the turnover rate of newly licensed registered nurses is higher. However, no systematic reviews have focused on the factors that influence newly licensed registered nurses' turnover. Additionally, because newly licensed registered nurses are a major source of the supply of nurses, it is critical to retain them to meet patient needs. Therefore, this study aimed to systematically synthesize the factors contributing to the actual turnover of newly licensed registered nurses working in acute care hospitals. METHODS CINAHL, Cochrane Library, DBpia, EBSCO, PubMed, PsycINFO, RISS, and Web of Science were searched for studies published between January 2000 and June 2021. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Ten articles from 9029 were included in this review. All studies used a longitudinal design. The annual turnover rates of newly licensed registered nurses ranged from 12 to 25%. Health status, including sleep and healthy lifestyles, were significant factors affecting turnover. Most studies focused on work environment factors, and emotional exhaustion, job satisfaction, peer support, and intent to leave, were significantly associated with newly licensed registered nurses' turnover. Small hospitals located in nonmetropolitan areas were at risk of high turnover of newly licensed registered nurses. CONCLUSIONS Turnover is inevitable in the process of employment, but high turnover can be prevented. Through reviewing ten articles, significant contributing factors for newly licensed registered nurses' turnover included personal factors of health status; work environment factors of physical exhaustion, emotional exhaustion, depersonalization, occupational injuries, income, intent to stay, job satisfaction, and peer support; and hospital factors of hospital size, location, and unionization. Most existing studies focus on work environment factors, which reflects the significance of fostering healthy work conditions to prevent high turnover. These findings can be used to develop strategies and policies for work environment to reduce high turnover of newly licensed registered nurses, and support high-risk groups, such as small hospitals located in nonmetropolitan areas with high levels of nurses' turnover.
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Affiliation(s)
- Sung-Heui Bae
- grid.255649.90000 0001 2171 7754College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Helen Hall #204, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760 Republic of Korea
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Bae SH. Association of Work Schedules With Nurse Turnover: A Cross-Sectional National Study. Int J Public Health 2023; 68:1605732. [PMID: 37168137 PMCID: PMC10164927 DOI: 10.3389/ijph.2023.1605732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 03/29/2023] [Indexed: 05/13/2023] Open
Abstract
Objective: To examine the relationship of work schedules with nurse turnover across various work settings. Methods: A cross-sectional study design was used with data collected from 17,046 nurses who participated in the 2018 National Sample Survey of Registered Nurses in the U.S. Multivariate logistic regression was used to examine the effects of work hours and overtime on nurse turnover. Results: Longer weekly work hours increased nurse turnover (OR = 1.104, 95% confidence interval [CI] = 1.006-1.023). A non-linear relationship was observed between overtime and turnover. Compared with nurses with no overtime, the turnover for nurses working 1-11 h overtime per week decreased (OR = 0.893, 95% CI = 0.798-0.999). When nurses worked ≥12 h, turnover increased (OR = 1.260, 95% CI = 1.028-1.545). Earning from the primary nursing position decreased turnover among nurses working in hospitals, other inpatient settings, and clinics. Job satisfaction decreased turnover. Conclusion: To prevent nurse turnover, it is important to monitor and regulate nurses' working hours at institutional and government levels. Government support and policy implementations can help prevent turnover.
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Kang J, Lee Y. Health-Related Factors Influencing Nurse Turnover by Clinical Career: A Secondary Data Analysis of Clinical Nurses in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15222. [PMID: 36429939 PMCID: PMC9690249 DOI: 10.3390/ijerph192215222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
The increase in clinical nurse turnover is an important issue in human resource management worldwide. Factors influencing it include health-related risk factors such as sleep quality and presenteeism, which need further exploration. We examined differences in job survival time of clinical nurses in relation to nurses' sleep quality and presenteeism. Participants were 857 Korean clinical nurses with more than three months' experience providing direct patient care. Data were analyzed using a time-independent Cox proportional hazard regression analysis of factors affecting actual turnover of clinical nurses. Average job survival times of competent, proficient, and expert nurses were 33, 64, and 143 months, respectively. Sleep quality and presentism significantly affected turnover risk. For clinical nurses with less than three years of experience, sleep quality significantly influenced the risk of turnover. For clinical nurses with more than six years of experience, presenteeism significantly affected the risk of turnover. The findings of this study offer a clinical career-based approach to reduce the turnover rate of clinical nurses. A differentiated approach based on work experience is necessary to establish a turnover management strategy for clinical nurses.
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Affiliation(s)
- Jiwon Kang
- Research Institute of Nursing Science, Ajou University, Suwon 16499, Republic of Korea
- School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA
| | - Youngjin Lee
- College of Nursing, Ajou University, Suwon 16499, Republic of Korea
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Adachi M, Nagaura Y, Eto H, Kondo H, Kato C. The impact of sleep–wake problems on health-related quality of life among Japanese nursing college students: a cross sectional survey. Health Qual Life Outcomes 2022; 20:150. [PMID: 36357879 PMCID: PMC9648011 DOI: 10.1186/s12955-022-02063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022] Open
Abstract
Aim This study was conducted to examine the impact of sleep–wake problems on health-related quality of life of Japanese nursing college students. Methods This cross-sectional study was conducted in 2019 on 150 third and fourth-year nursing college students from two locations in Japan. Insomnia severity was assessed using the Insomnia Severity Index (ISI) and health-related quality of life using the SF-8 questionnaire. The total sleep time (TST) was divided into 3 groups: < 6 h, 6–7 h (reference), and ≥ 7 h. The total ISI score was divided into 2 groups: ≥ 8 points and < 8 points (reference). Logistic regression analysis was performed to evaluate sleep–wake problems related to decline in mental health. Results The median mental health indicated in the SF-8 questionnaire was divided into two groups, and the factors causing decline in mental health were investigated. The odds ratios (95% confidence interval) for adjusted ISI ≥ 8 and TST on weekdays < 6 h was 6.51 (2.96–14.30) and 3.38 (1.40–8.17), respectively. Mental health status was significantly lower when ISI ≥ 8 and even lower when TST < 6 h. Conclusion Insomnia and short sleep duration are associated with decreased mental health status in nursing college students. Many tended to lack sleep on weekdays. Sleep–wake problems identified while in university should be comprehensively dealt with.
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Yin Y, Lyu M, Zuo M, Yao S, Li H, Li J, Zhang J, Zhang J. Subtypes of work engagement in frontline supporting nurses during COVID-19 pandemic: A latent profile analysis. J Adv Nurs 2022; 78:4071-4081. [PMID: 35841320 PMCID: PMC9349902 DOI: 10.1111/jan.15361] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/11/2022] [Accepted: 07/05/2022] [Indexed: 02/05/2023]
Abstract
AIM The aim was to examine the subgroups of work engagement in frontline nurses during the COVID-19 pandemic. BACKGROUND The pandemic may affect the work engagement of nurses who have direct contact with infected patients and lead to a poor quality of care. Identifying classification features of work engagement and tailoring interventions to support frontline nurses is imperative. DESIGN This study utilized a cross-sectional study design. METHODS Three hundred fifty-five nurses were enrolled in this cross-sectional study from 14 February to 15 April 2020. A latent profile analysis was performed to identify classification features of work engagement. Multiple logistic regression analyses were used to examine predictors of profile membership. RESULTS A four-profile model provided the best fit. The four profiles were titled 'low work engagement' (n = 99), 'high vigour-low dedication and absorption' (n = 58), 'moderate work engagement' (n = 63) and 'high work engagement' (n = 135). A regression analysis suggested that young nurses and nurses who were the only children of their family were more likely to be in the 'low work engagement' and 'high vigour-low dedication and absorption' groups. CONCLUSION This study highlights the importance of tailoring interventions for frontline supporting nurses by considering their distinct work engagement patterns, especially during the COVID-19 pandemic, to improve the promotion of work satisfaction and quality of care. IMPACT This was the first study to explore the latent profiles of work engagement in frontline nurses during the COVID-19 pandemic. Over 40% of nurses were in the 'low work engagement' and 'high vigour-low dedication and absorption' groups and reported low levels of work engagement. Understanding different patterns of work engagement in frontline nurses can help nursing managers provide emotional, material and organizational support based on the features of each latent profile, which may improve the quality of care and patient safety.
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Affiliation(s)
- Yizhen Yin
- Xiangya Nursing School, Central South University, Changsha, P.R. China
| | - Mengmeng Lyu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Man Zuo
- Department of Respiratory Medicine, Heyuan Branch of Guangdong Provincial People's Hospital, Heyuan, P.R. China
| | - Shuyu Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, P.R. China
| | - Hui Li
- Department of Orthopedics, West China Hospital/Sichuan University West China School of Nursing, Sichuan University, Chengdu, P.R. China
| | - Juan Li
- Xiangya Nursing School, Central South University, Changsha, P.R. China
| | - Jie Zhang
- School of Nursing, Hunan University of Chinese Medicine, Changsha, P.R. China
| | - Jingping Zhang
- Xiangya Nursing School, Central South University, Changsha, P.R. China
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Pham TTL, Huang TL, Chung KP, Shyu YIL, Wong MK, Ho LH, Teng CI. Do temperament and character make sense in reducing nurse turnover? The role of professional capabilities improvement. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2079805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Tzu-Ling Huang
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Piao Chung
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - May-Kuen Wong
- Taoyuan Branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Lun-Hui Ho
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ching-I. Teng
- Graduate Institute of Management, Chang Gung University, Taoyuan, Taiwan
- Department of Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Business and Management, Ming Chi University of Technology, Taipei, Taiwan
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Abstract
BACKGROUND Cultivating healthy lifestyle beliefs (HLBs) can result in positive health outcomes for students during their nursing program. PURPOSE The purpose of the study was to determine the effectiveness of short wellness interventions (microlearning) in nursing courses on reducing stress and anxiety and enhancing HLB. METHODS Microlearning wellness interventions were offered to graduate and undergraduate nursing students in this cluster randomized intervention study. The Perceived Stress Scale 4, Generalized Anxiety Disorder 7, and Healthy Lifestyle Beliefs Scales were administered. Student perceptions were evaluated using a short answer narrative. RESULTS The intervention group reported higher HLB (P = .15), lower anxiety (P = .06), and lower stress (P = .06) compared with the control group after adjusting for baseline differences. Student comments were favorable and included enjoying the activities, weight loss success, and mindfulness strategies. CONCLUSIONS Incorporating wellness interventions into nursing curricula demonstrates a positive trend toward reducing anxiety and stress and improving HLB.
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Chen SF, Fang YW, Wang MH, Wang TF. Effects of an Adaptive Education Program on the Learning, Mental Health and Work Intentions of New Graduate Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115891. [PMID: 34072629 PMCID: PMC8198471 DOI: 10.3390/ijerph18115891] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/03/2022]
Abstract
Health care workers are at a higher risk of psychological distress than ordinary people. Stress affects physical and mental health, and can even produce an intention to leave. The current training for new graduate nurses (NGNs) during this transitional period mostly focuses on the cultivation of professional ability, with less attention to mental health or emotional feelings, and thus there are insufficient structured support strategies. As such, this study explores the effects of intervention through an appropriate education program on the learning, mental health and work intentions of new recruits during the transition period. A pre-test and post-test for a single group was designed for new nursing staff in a large teaching hospital in northern Taiwan. The test period was from May 2017 to December 2018, and a total of 293 cases were accepted. A three-month adaptive education program was provided and evaluated in terms of: care for learning, care for health, improving professional ability, and individualized guidance on satisfaction, mental health disturbance and work intention. The new graduate nurses who received gentle care and counseling showed a downward trend in their BSRS-5 scores and statistical differences over time (p < 0.001). The higher the BSRS-5 score, the easier it is for new graduate nurses in acute and intensive care units. There is a tendency for turnover leave (p = 0.03). After the intervention of the overall plan, the turnover rate of new graduate nurses within three months was 12.6%, and the one-year retention rate was 87.9%. The adaptive education program uses multiple support strategies to improve learning and professional abilities, to reduce psychological emotions, and thereby to increase retention. Today will face new medical challenges; the education programs will become more important across clinical care settings, and it will be important to rigorously validate their performance in helping NGNs.
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Affiliation(s)
- Shu-Fen Chen
- College of Nursing, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; or
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Yu-Wen Fang
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien City 970302, Taiwan;
| | - Mei-Hua Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
| | - Tze-Fang Wang
- College of Nursing, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan; or
- Correspondence: ; Tel.: +886-2-28267907
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Distinct dyadic coping profiles in Chinese couples with breast cancer. Support Care Cancer 2021; 29:6459-6468. [PMID: 33900457 DOI: 10.1007/s00520-021-06237-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Conceptualizing cancer as a dyadic stress provides new insight into how stress impacts couples with breast cancer. The present study aimed to identify subgroups with distinct dyadic coping profiles in a sample of Chinese couples with breast cancer and to determine how these subgroups differed in terms of demographic and clinical characteristics in addition to marital adjustment outcomes. METHODS Using convenience sampling, a cross-sectional survey was conducted. Couples with breast cancer completed the general information questionnaire, the Dyadic Coping Inventory, and the Locke-Wollance Marital Adjustment Test. The modeling was performed using a latent profile analysis to identify the dyadic coping subgroups. Parametric and nonparametric tests were applied to examine between-group differences across the identified classes. RESULTS The analytical results supported a three-class solution of dyadic coping groups: high (27.4%), medium (32.2%), and low (40.4%). Between-group differences were found in educational background, number of children, postoperative time, and type of surgery. CONCLUSION Most couples reported low levels of dyadic coping. The couples with an educational level of primary school or below, with one child or who were childless, and who had undergone breast preservation surgery within the past year were more likely to belong to the low dyadic coping group. When supporting couples with breast cancer, it is essential to assess several demographic and clinical risk factors in addition to the marital adjustment level to identify high-risk subgroups that warrant intervention.
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Li Z, Cao J, Wu X, Li F, Zhu C. Intention to leave among newly graduated nurses: A descriptive, multicenter study. J Adv Nurs 2020; 76:3429-3439. [PMID: 32989820 DOI: 10.1111/jan.14545] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/01/2020] [Accepted: 08/19/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Zhen Li
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Jing Cao
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Xinjuan Wu
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Fangfang Li
- Department of Internal Medicine Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
| | - Chen Zhu
- Department of Nursing Chinese Academy of Medical Sciences ‐ Peking Union Medical College Peking Union Medical College Hospital Beijing China
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Macedo TTS, Mussi FC, Sheets D, Campos ACP, Patrão AL, Freitas CLM, Paim MAS. Lifestyle behaviors among undergraduate nursing students: A latent class analysis. Res Nurs Health 2020; 43:520-528. [PMID: 32797687 DOI: 10.1002/nur.22064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 08/05/2020] [Indexed: 11/06/2022]
Abstract
This is a cross-sectional study whose objective was to identify clustering of lifestyle behaviors among undergraduate nursing students to inform health promotion efforts and improve health outcomes later in life. All 353 undergraduate nursing students from the School of Nursing in a public university, Bahia, Brazil were invited to participate. The inclusion and exclusion criteria were according to the major project. Participants must be enrolled and attending the 1st to 10th semester, with a minimum age of 18 years. Participants were excluded if they had any physical disabilities that limited the collection of anthropometric measures or were completing an internship off-campus. A total of 286 undergraduate nursing students met the criteria and completed the survey. The questionnaires included standardized measures for demographic, academic, and lifestyle behaviors (e.g., tobacco use, alcohol use, physical activity level, sedentary behavior, and fruits and vegetables consumed). Latent class analysis was performed to identify any clustering of lifestyle behaviors. Descriptive analyses indicated that 3.1% of the students were smokers, 23.1% consumed alcohol, 34.3% were inactive, 85.0% were sedentary, and 80.8% did not consume recommended amounts of fruits and vegetables. Latent class analysis produced four distinct subtypes of health risk: (a) low-health risk (33.57%); (b) moderate-health risk (27.97%); (c) high-health risk (19.58%); and (d) very high-health risk (18.88%). Approximately 38.5% of students were in the very high or high-risk classes. The proportion of students with very high and high-health risks emphasizes the importance of health promotion programs for university nursing students.
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Affiliation(s)
- Tassia T S Macedo
- Enfermagem, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Fernanda C Mussi
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Debra Sheets
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | - Ana C P Campos
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Ana L Patrão
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Caren L M Freitas
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Melissa A S Paim
- Escola de Enfermagem, Universidade Federal da Bahia, Salvador, Bahia, Brazil
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Novice nurses' sleep disturbance trajectories within the first 2 years of work and actual turnover: A prospective longitudinal study. Int J Nurs Stud 2020; 112:103575. [PMID: 32404261 DOI: 10.1016/j.ijnurstu.2020.103575] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 01/14/2020] [Accepted: 01/18/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Novice nurses experience radical changes in their sleep-wake cycle and sleep difficulties after exposure to a rotating shift work schedule. The link between workplace hardship and employee turnover may be dependent on factors at the individual level, e.g., individual health. Nurses with sleep disturbance are more vulnerable to stressful stimuli and lack resilience at work compared with those without sleep disturbance. OBJECTIVES To classify novice nurses according to sleep disturbance trajectories during the first 2 years of work, to compare turnover rates according to trajectory classification, and to compare levels of sleep disturbance between stayers and leavers within each trajectory class. DESIGN Prospective longitudinal design. SETTINGS A tertiary hospital in Seoul, South Korea. PARTICIPANTS A total of 465 newly graduated nurses who started work between September 2014 and December 2015. METHODS Data were collected 6 times within the first 2 years of work (on the first day of orientation before ward placement, at 6 weeks after starting work, and at 6, 12, 18, and 24 months of work). Sleep disturbance was assessed using the General Sleep Disturbance Scale. Turnover information was retrieved from the hospital's administrative data system to determine whether anyone had left the hospital at each data collection point. Unconditional latent growth curve analysis was performed to identify latent classes of trajectories of sleep disturbance among novice nurses during the first 2 years of work. RESULTS The 2-year trajectories of sleep disturbance were classified into two distinct groups: the high symptomatic group (Class 1: 57.4%) and the low symptomatic group (Class 2: 42.6%). In comparison with Class 2, Class 1 consistently showed a higher turnover in each period. In Class 1, leavers who left the hospital at the next measurement point tended to report more severe sleep disturbance at prior measurements. This pattern was also observed for the overall sample. However, in Class 2, an inconsistent pattern between stayers and leavers was observed. CONCLUSIONS This study identified two distinct classes of sleep disturbance among novice nurses during the first 2 years of work. Given that many nurses experience sleep problems at pre-employment and during the early career period, a comprehensive approach to address this issue should be implemented in nursing schools and hospitals. The basic nursing curriculum should include self-care management strategies for sleep difficulties to ensure retention at work. At-risk nurses should receive organizational support and early monitoring to prevent the adverse effects of poor sleep.
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