Nurses' Self-Efficacy, Confidence and Interaction With Patients With COVID-19: A Cross-Sectional Study

An evaluation of nursing students' learning self-efficacy: A multi-dimensional instrument development and structural validation

BACKGROUND

Nursing learning self-efficacy (NLSE) is essential in nursing students' learning, and since it is a task-dependent construct, accurate measurements require a multidimensional instrument.

OBJECTIVE

This research aimed to develop and validate a multidimensional NLSE instrument to measure Taiwanese nursing students' views of nursing learning self-efficacy.

DESIGN

The cross-sectional study design was used for this investigation.

PARTICIPANTS

The study included 1143 nursing students from a nursing junior college.

METHODS

To assess the validity and reliability of the instrument's factors, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were utilized. Conceptual understanding, higher-order cognitive skills, practical work, everyday application, and nursing communication were identified as five factors. A comparison of five proposed models was also conducted.

RESULTS

The study found that the correlated and one-factor second-order models were acceptable and provided a simple structure for evaluating nursing students' perceptions of NLSE. Furthermore, a specific model with two second-order scales (Cognition and Application) and one first-order scale (nursing communication) was identified, highlighting the crucial role of nursing communication in nursing students' self-efficacy.

CONCLUSIONS

Evaluating nursing students' learning self-efficacy using a valid and reliable instrument is crucial for understanding their learning confidence. The creation of such a scale constitutes the primary contribution of this study.

Exploring intensive care nurses' perception of simulation-based learning: A systematic review and meta-synthesis

AIM(S)

To explore intensive care nurses' (ICN) perceptions of simulation-based learning (SBL).

DESIGN

A systematic review and meta-synthesis.

METHODS

The review followed the PRISMA guidelines for reporting a systematic review. A systematic search strategy was developed using a modified PICo framework. A comprehensive search was conducted in July 2023 in CINAHL, OVID Embase, Medline complete, Web of Science, ERIC and Scopus databases for articles published in English between 2013 and 2023. Data were extracted using the Joanna Briggs Institute QARI Data Extraction, with data synthesis guided by Braun and Clark's thematic analysis approach. Quality appraisal was assessed using the CASP tool.

RESULTS

Eleven studies providing qualitative data were included for analysis. Analysis and meta-synthesis led to the construction of two themes: The learning experience and professional growth through collaboration.

CONCLUSION

The review highlights the balance needed in finding the appropriate simulation approach, with the right level of fidelity, conducted at appropriately regular intervals, incorporating the correct makeup of professional team members, conducted in the right environment and facilitated by a skilled facilitator, to ensure best outcomes and return on investment for ICN's education.

IMPLICATIONS FOR PRACTICE

These findings are a valuable resource for educators and organisations considering simulation-based learning initiatives in the intensive care setting.

NO PATIENT OR PUBLIC CONTRIBUTION

This review involved analysis of existing literature and as such no unique patient or public involvement occurred.

REPORTING METHOD

The systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines.

From Anxiety to Hardiness: The Role of Self-Efficacy in Spanish CCU Nurses in the COVID-19 Pandemic

Background and Objectives: Evidence shows that throughout the COVID-19 pandemic, nurses suffered from emotional symptoms, yet in spite of this, few studies within "positive psychology" have analyzed the emergence/promotion of positive traits, such as hardiness. In this context, the present study aimed to test a model regarding the mediating role of self-efficacy between anxiety experienced at the beginning of the COVID-19 pandemic and hardiness assessed six months later among nurses in critical care units (CCU) in Spain. Materials and Methods: An observational, descriptive, prospective longitudinal study with two data collection periods: (1) from the 1 to the 21 June 2020 (final phase of the state of alarm declared in Spain on 14 March) in which socio-demographic and occupational variables, anxiety (Depression, Anxiety and Stress Scale, DASS-21), self-efficacy (General Self-Efficacy Scale, GSES) and basal resilience (Resilience Scale-14, RS-14) were assessed, and (2) a follow-up 6 months later (January-March 2021) in which hardiness (Occupational Hardiness Questionnaire, OHQ) was evaluated. To analyze the data, multivariate regressions were performed using the PROCESS macro (simple mediation, model 4). Results: A total of 131 Spanish nurses from CCUs, with a mean age of 40.54 years (88.5% women) participated in the study. Moderate and severe levels of anxiety were observed in 19.1% of the sample. Significant and positive correlations were observed between self-efficacy, hardiness and resilience (all p < 0.001). Significant negative correlations were observed between anxiety and self-efficacy (p < 0.001), hardiness (p = 0.027) and resilience (p = 0.005). The indirect effect of anxiety on hardiness through self-efficacy was significant (Effect (SE) = -0.275 (0.100); LLCI = -0.487, ULCI = -0.097), contributing to 28% of the variance, including resilience (p = 0.015), age (p = 0.784), gender (p = 0.294) and years of experience (p = 0.652) as covariates. A total mediation was observed (non-significant anxiety-hardiness direct effect; Effect (SE) = -0.053 (0.215), t = 0.248, p = 0.804, LLCI = -0.372, ULCI = 0.479). Conclusions: The results suggest that in Spanish CCU nurses, anxiety experienced at the beginning of the COVID-19 pandemic may contribute to the development of hardiness through positive resources such as self-efficacy.

Nurses' coping strategies caring for patients during severe viral pandemics: A mixed-methods systematic review

BACKGROUND

Nurses play an essential role in responding to severe viral disease which bring considerable challenges to their personal and professional well-being. This subsequently can affect the delivery of care and healthcare systems' organisational capacity to respond. Understanding nurses' experiences of these challenges will help inform healthcare policies.

AIM

To explore the experiences and coping strategies of nurses caring for patients during severe viral disease pandemics.

DESIGN

A mixed-methods systematic review informed by the Joanna Briggs Institute (JBI) methodology.

METHODS

A mixed-methods systematic review. Five electronic databases Medline, CINAHL, PsychInfo, ASSIA and Scopus were searched on 4th April 2021. Results were reported in accordance with PRISMA. The findings were analysed and reported in the context of the Self-Regulatory Common-Sense Model.

RESULTS

In total, 71 peer-review primary research articles describing nurses' experiences of caring for patients during SARS, MERS, Swine flu H1N1, Avian influenza or SARS-CoV-2 / COVID-19 published in English from 2003 to 2021 were included. We found links between nurses' perception of the health threats, their emotional reactions, and coping strategies. Perceived health threats were influenced by organisational factors including frequent changes in clinical guidelines and workplace protocols, onerous workloads and working hours, unavailability of PPE, and lack of knowledge and training in pandemic management. These impacted nurses' physical, psychological and social well-being. Nurses also reported helpful and unhelpful coping strategies to manage the health threats.

CONCLUSIONS

It is vital for stakeholders, policymakers, government and healthcare institutions to recognise and monitor the wider impact on healthcare workers from health emergencies. In addition, support to develop and implement effective systems and individual mechanisms to offset the anticipated impact pre and post pandemics/epidemics is needed. Our findings can inform those strategies for similar future health emergencies.

RELEVANCE TO CLINICAL PRACTICE

Nurses are often the first point of contact in providing direct care to patients, hence they are at high risk of being infected. The findings from this review can help managers and policymakers in developing programmes to enhance resilience in the nursing workforce.

NO PATIENT OR PUBLIC CONTRIBUTION

This was a literature review study.

Nurse perceptions of caring for pediatric patients with behavioral health needs on non-psychiatric units during the COVID-19 pandemic

PURPOSE

The study examined nurses' perceptions of barriers and needs when caring for pediatric patients with behavioral health needs in inpatient non-psychiatric units during the pandemic.

DESIGN AND METHODS

A quantitative descriptive comparative design was used. Members of Society of Pediatric Nurses and National Pediatric Nurse Scientist Collaborative were recruited. The survey included questions about perceived barriers and needs in caring for children with behavioral health needs in their units.

RESULTS

A total of 335 nurses across the United States participated. Descriptive statistics, chi-square, and Kruskal-Wallis evaluated responses. Nurses in Southeast/Southwest regions were less fearful when caring for pediatric patients with behavioral health needs (p = .03), more often knew what to do (p = .01), and were supported by a behavioral health team with regular rounding (p = .035). Nurses in adult/pediatric hospitals were less likely to have adequate education to feel competent (p = .012). Nurses in the emergency department were less fearful (p = .02), more confident (p = .025), and more competent (p = .006). Nurses with up to two years of experience were likelier to feel assignments reflected the patient workload (p = .001) and more familiar with trauma-informed care protocols (p = .013).

CONCLUSIONS

This study illustrated significant variations in competence, readiness, and attitudes among nurses across different regions, hospital types, departments, and experience levels when caring for pediatric patients with behavioral health needs.

PRACTICE IMPLICATIONS

Results from this study could lead to the development of clinical practice guidelines, protocols, or policies to guide practice.

Reliability and validity of the Chinese version of the Self-Efficacy Perception Scale for Administrator Nurses

Objectives

This study aimed to translate the Self-Efficacy Perception Scale of Administrator Nurses (SEPSAN) into Chinese and test its reliability and validity among nurse managers.

Methods

A scale translation and cross-sectional validation study was conducted. The English version was translated for Chinese by the Brislin translation model included direct translation, back translation, integration, and cultural adjustment. A total of 382 nurse administrators were recruited from 20 general hospitals in five Chinese cities to assess the reliability and validity of the scale from April to May 2023. Validity assessments included content, structural, and convergent validity. Reliability was evaluated using Cronbach's α coefficient and test-retest reliability.

Results

The item-content validity index (I-CVI) of the scale ranged from 0.86 to 1.00, and the average scale-level content validity index (S-CVI/Ave) for the overall scale was 0.98. The exploratory factor analysis indicated five dimensions (planning, organizing, commanding, coordinating, controlling, and inspecting) with 41 items. The cumulative variance contribution rate was 63.72%. Confirmatory factor analysis showed an acceptable fit. The general Cronbach's α coefficient was 0.95, and the test-retest reliability was 0.87.

Conclusion

The Chinese version of SEPSAN showed satisfactory reliability and validity and thus can be used to assess the self-efficacy of nurse administrators in China.

Nursing Informatics Competency and Self-Efficacy in Clinical Practice among Nurses in Palestinian Hospitals

This study purposed to determine the levels of nursing informatics competency and self-efficacy in clinical practice and influencing factors on self-efficacy among Palestinian nurses in hospitals. A descriptive-correlational design was adopted. The nurses who worked in the North West Bank of Palestine (N = 331) were recruited. The data were collected using the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) which consists of 30 items rated on a 5-point Likert scale, ranging from 1(not competent) to 5 (expert), and scored by calculating the mean as follows: novice/low (1.00-2.59), beginner/moderate (2.60-3.39), and competent/high (3.40-5.00); and the New General Self-Efficacy Scale (NGSE) that consists of eight items rated on a 5-point Likert scale, ranging from 1(strongly disagree) to 5(strongly agree) and scored according to the average of the scale, whereas the average of > 3 indicated high self-efficacy, and ≤ 3 reflected low self-efficacy. The data were collected during the period from September to November 2020. Findings showed that the total mean score for the nursing informatics competency scale was 2.9 (SD = 0.7), which indicated that the nurses had a moderate level of nursing informatics competency. The average score for the self-efficacy scale was 3.5 (SD = 0.8), which reflected that nurses had high self-efficacy. Self-efficacy in clinical practice increased with age and with nursing informatics competency. Thus, it is necessary to enhance nurses' informatics competency by developing continuous educational programs about this technology for nurses and engaging nurses in such programs to enhance their competencies in this system.

Impact of Unexpected In-House Major COVID-19 Outbreaks on Depressive Symptoms among Healthcare Workers: A Retrospective Multi-Institutional Study

The coronavirus disease 2019 (COVID-19) has significantly affected the mental health of healthcare workers (HCWs). The authors have provided psychosocial support to HCWs working in typical hospitals and nursing homes in Fukushima Prefecture, Japan, where major COVID-19 outbreaks have occurred since December 2020. This study retrospectively examines depressive symptoms before psychosocial interventions among HCWs working at typical hospitals and nursing homes experiencing in-house major COVID-19 outbreaks. We have offered psychosocial support in eight hospitals and nursing homes, obtaining data on the mental health status of 558 HCWs using the Patient Health Questionnaire-9. The study's results indicate that 29.4% of HCWs have exhibited moderate or higher depressive symptoms, and 10.2% had suicidal ideation. Multiple logistic regression analysis showed that being a nurse was associated with higher depressive symptoms and suicidal ideation compared to other HCWs. In addition, multiple logistic regression analysis of Polymerase Chain Reaction-positive HCWs showed that being a nurse and the number of COVID-19-related symptoms was associated with high depressive symptoms. These results suggest that HCWs in typical hospitals and nursing homes experiencing major COVID-19 outbreaks are more likely to exhibit severe depressive symptoms, which may worsen if infected with COVID-19. This study's findings expand the current understanding of HCWs' depressive symptoms and the importance of psychosocial support during unexpected major outbreaks in healthcare facilities.

The influence of deliberate rumination on the post-traumatic growth of college students during the COVID-19 pandemic and the moderating role of self-efficacy

Objective

To understand the relationship between deliberate rumination and post-traumatic growth and the mechanisms affecting this relationship, we constructed an adjustment model to test the impact of deliberate rumination on the post-traumatic growth of college students and the moderating role of self-efficacy during the 2019 COVID-19 pandemic.

Study design and setting

A total of 881 college students from a university of science and technology in Guangdong Province, China, completed a questionnaire that measured deliberate rumination, post-traumatic growth, and self-efficacy. SPSS (version 26) and the PROCESS plug-in (version 4.0) were used for correlation and moderation analyses.

Results

The correlation analysis showed that deliberate rumination was positively correlated with post-traumatic growth (r = 0.353, P < 0.01) and self-efficacy (r = 0.261, P < 0.01). Self-efficacy was also positively correlated with post-traumatic growth (r = 0.466, P < 0.01). In addition, we found that self-efficacy had a regulatory effect on the relationship between deliberate rumination and post-traumatic growth (R ² = 0.287, P < 0.001) and that this effect was significant.

Conclusion

The results show that deliberate rumination can be a positive predictor of post-traumatic growth and can play a certain role in fostering such growth. In addition, self-efficacy is a moderator that plays a buffer role between deliberate rumination and post-traumatic growth. These results contribute to a more comprehensive understanding of the mechanisms that affect post-traumatic growth.

Nurse-patient interaction during the Covid-19 pandemic: Creating and maintaining an interactive space for care

AIMS

To explore nurse-patient interactions during the Covid-19 pandemic from both nurses' and patients' perspectives.

DESIGN

Qualitative study using constructive grounded theory.

METHODS

A total of 34 patients and 49 nurses from acute and home care settings participated in individual or focus group interviews between December 2020 and May 2021. Data were analysed by a team of researchers using coding, memo-writing, theoretical sampling and constant comparison and integration.

RESULTS

We identified the creation and maintenance of an interactive space as the main social process. This interactive space was shaped by the care context and the course of the pandemic. For nurses, four factors were key, namely protecting oneself and others, navigating communication barriers, adapting nursing actions to the evolving situation, and providing emotional care work. Patients experienced attentive caring relationships with nurses and felt that, for the most part, their individual needs had been met despite the pandemic challenges.

CONCLUSION

Nurses and patients created an interactive space in which they were able to provide and receive the necessary care. Maintaining the interactive space was often challenging, and required an intentional effort by nurses, particularly in acute care settings. The findings illustrate that nurses ensured the provision of necessary care even during a public health crisis, thereby enabling patient access to good quality care.

IMPACT

Nurse-patient relationships are important for effective, person-centred care delivery. Despite the pandemic challenges, nurses managed to uphold their caring imperative and ensure quality care. Findings provide further insights on the importance of nurse-patient interaction in maintaining quality care. They inform models of nursing care delivery and strategies to support quality care during public health crises.

Psychometric Properties of the Albanian Version of the Nursing Self-Efficacy Scale

There are few tools to ascertain self-efficacy, which is a valuable component of nursing skills. This study has tested the psychometric properties of an Albanian translation of the Nursing Profession Self-Efficacy Scale (NPSES), which is based on Bandura's theory of social cognition. Data were collected using questionnaires which were filled out by 423 nurses from the twelve provinces of the Albanian health system. The scale's content, face, and construct validity were evaluated. Reliability was verified using Cronbach's α and test-retest and by calculating the intraclass correlation coefficients. The original NPSES has two factors; for the A-NPSES analyzed in this study, four factors emerged from the factorial analysis of our reference sample: nursing care procedure situation, nursing research situation, nursing ethics situation, and nursing practice situation. Cronbach's α was 0.91, indicating that the tool is reliable. The results of this study demonstrate the validity and reliability of the Albanian version of the NPSES. This scale is a valuable tool for self-assessing nurses' self-efficacy. An adequate scale for measuring nurses' self-efficacy can be used to improve the quality of clinical nursing care.

Stress coping strategies used by nurses during the COVID-19 pandemic

Introduction

The risk of getting SARS-CoV-2 infection, worries about exposing loved ones, anxiety and frustration, emotional and physical exhaustion, burn out, a feeling of being overwhelmed, and struggles and challenges with parenting are a few among many factors that affect nurses' personal lives and professional functioning. The aim of the research is to assess nurses' level of stress during the COVID-19 pandemic and their sense of self-efficacy, and to learn what coping strategies they use.

Methodology/Methods

The study was carried out online and based on the diagnostic poll method, using an original survey questionnaire, the General Self-Efficacy Scale (GSES 10-40), the Mini-COPE questionnaire (0-3), and the Perceived Stress Scale PSS-10 (0-40). The respondent group was made up of nurses (n = 220) who provide health services in inpatient and outpatient health care institutions in the northeastern region of Poland. The statistical analysis was performed using the STATISTICA 13.0 package (StatSoft). The distribution of variables was checked with Shapiro-Wilk tests. The Mann-Whitney U test was used to compare two independent samples, while the Kruskal-Wallis test was used to compare more samples. The adopted statistical significance level was p < 0.05. Multivariate regression analysis was applied to determine which factors were related to the level of stress.

Results

The mean age of the participants was 43.3 years. The vast majority were women (96.4). The mean work experience of the nurses was over 20 years (58.2%). A total of 62.3% worked directly with patients in hospitals, including 11.8% respondents working at COVID-19 units and 37.7% working at primary care institutions. The analyses show that the respondents represented a high level of stress (PSS-10 - 20.9), related to their work experience as a nurse (β -0.250, p = 0.014), the number of hours worked a month (β 0.156, p = 0.015), and self-assessed health status (β -0.145, p = 0.037). They declared an average sense of self-efficacy (GSES - 29.1), which significantly depended on the nurses' places of employment (p = 0.044). Out of stress coping strategies (Mini-COPE), the younger nurses mentioned venting (p = 0.010), instrumental support (p = 0.011), sense of humour (p = 0.013) and self-blame (0.031). Practice nurses also chose the strategy of behavioral disengagement (p = 0.032), and nurse managers chose the strategy of planning (p = 0.018).

Conclusions

The experience of the COVID-19 pandemic highlights the need to implement some strategies to protect nurses' mental health and to take extensive prevention measures in critical situations. Special attention should be given to nurses who are younger and have shorter work experience. It is also important to monitor nurses' working time and health status, and those who work at outpatient health care institutions should be given more support and information.

Association between work-related psychological empowerment and quality of nursing care among critical care nurses

AIM

This study aimed to examine the association between work-related psychological empowerment and quality of nursing care in Jordanian critical care nurses.

BACKGROUND

Nurses' work-related empowerment is the essential element to enhance nurses' quality of care. There are few studies about this area among critical care nurses.

METHODS

A cross-sectional design was used, and data were collected from critical care registered nurses (N = 480) from different health sectors.

RESULTS

The mean scores of work-related psychological empowerment and quality of nursing care were 5.22 (SD = 0.92) and 3.75 (SD = 0.62), respectively. The nurses had agreement level of psychological empowerment and very good level of quality of nursing care. There was a positive relationship between quality of nursing care and psychological empowerment.

CONCLUSION

The need to enhance work psychological empowerment is necessary to improve quality of nursing care.

IMPLICATION FOR NURSING MANAGEMENT

The results reflect the need for policy-makers and nursing managers to develop and implement strategies to promote psychological empowerment to provide high quality of nursing care among critical care nurses.

Individual and group level risk factors in preventive health and panic buying behaviors during COVID-19 pandemic in India

The present research explored individual and group level risk factors in preventive health and panic buying behaviors during the COVID-19 pandemic in India. Perceived susceptibility, perceived severity, COVID-19 anxiety, and personal identity were considered individual-level risk factors. Group based identities such as family, religious groups, and identification with one's nation were considered as group level risk factors. Standardized scales have been used to measure all the constructs under study. Data were collected electronically from 305 Indian respondents. Hierarchical regression analysis in SPSS Version 22 was used to test the hypotheses. Results showed that personal identity and identification with the nation predicted preventive health behavior. Panic buying behavior was predicted by the location of the respondents (containment versus non-containment zones), perceived severity, and one's personal identity. The interplay of individual and social factors is reflective of both individual and collective agencies in the adoption of preventive health behaviors, while only individual-level factors led to panic buying behavior. The findings of this study have implications for curbing, managing, and reinforcing desirable and non-desirable behavior during the present pandemic as well as in the future as well.