The Role of Professional Competency in Influencing Job Satisfaction and Organizational Citizenship Behavior Among Palliative Care Nurses

Nurses' experiences of the attributes of the organizational citizenship behavior: a qualitative content analysis

BACKGROUND AND AIM

Organizational citizenship behavior (OCB) among nurses, as the key human resources in healthcare systems, is of paramount importance to nursing care quality and patient outcomes. The present study was to reflect on Iranian nurses' experiences of OCB.

METHODS

This qualitative study was completed in Iran from December 2022 to October 2023. In total, 20 nurses involved in hospitals, meeting the inclusion criteria, were recruited by purposive sampling with maximum variation. The data were then collected using 20 semi-structured interviews, each one lasting 30-60 min, and finally analyzed through qualitative content analysis.

RESULTS

The data analysis revealed the nurses' experiences of OCB under nine subcategories and three main categories, including (i) "helping behavior", comprised of four subcategories of helping colleagues at work, helping colleagues outside of work, boosting morale, and creating a culture of support and appreciation, (ii) "extra-role behavior" with two subcategories of cooperation in advancing tasks, and creativity and efforts to promote services, and (iii) "contribution to professional growth and development", consisting of two subcategories of individual professional development and support for colleagues' professional development.

CONCLUSION

Nursing managers and instructors can use the study results to enhance nurses' OCB by evaluating and employing nurses, and incorporating OCB into nursing curricula and continuous training programs.

Efficacy of a virtual nursing simulation-based education to provide psychological support for patients affected by infectious disease disasters: a randomized controlled trial

BACKGROUND

Virtual simulation-based education for healthcare professionals has emerged as a strategy for dealing with infectious disease disasters, particularly when training at clinical sites is restricted due to the risk of infection and a lack of personal protective equipment. This research evaluated a virtual simulation-based education program intended to increase nurses' perceived competence in providing psychological support to patients affected by infectious disease disasters.

METHODS

The efficacy of the program was evaluated via a randomized controlled trial. We recruited 104 nurses for participation in the study and allocated them randomly and evenly to an experimental group and a control group. The experimental group was given a web address through which they could access the program, whereas the control group was provided with a web address that directed them to text-based education materials. Data were then collected through an online survey of competence in addressing disaster mental health, after which the data were analyzed using the Statistical Package for the Social Sciences(version 23.0).

RESULTS

The analysis showed that the experimental group's disaster mental health competence (F = 5.149, p =.026), problem solving process (t = 3.024, p =.003), self-leadership (t = 2.063, p =.042), learning self-efficacy (t = 3.450, p =.001), and transfer motivation (t = 2.095, p =.039) significantly statistically differed from those of the control group.

CONCLUSIONS

A virtual nursing simulation-based education program for psychological support can overcome limitations of time and space. The program would also be an effective learning resource during infectious disease outbreaks.

CLINICAL TRIAL REGISTRATION

This Korean clinical trial was retrospectively registered (21/11/2023) in the Clinical Research Information Service ( https://cris.nih.go.kr ) with trial registration number KCT0008965.

Job Involvement as a Mediating Factor Between Empowerment and Organizational Citizenship Behavior Among Clinical Instructors at Nursing Technical Institutes

Introduction

Empowerment is an important motivator for clinical instructors to develop organizational citizenship behaviors. Job engagement may serve as a moderator, amplifying the impact of empowerment on organizational citizenship behavior.

Objective

This study examines the effect of job participation as a mediator between empowerment and organizational citizenship behavior among clinical teachers at nursing technical institutes.

Methods

This cross-sectional analytical study was performed on a convenience sample of 161 clinical instructors from six technical nursing institutes connected with five Egyptian Universities. For data collection, a self-administered questionnaire, including measures for assessing job engagement, empowerment, and citizenship behavior, was employed. This ran till November 2019, starting in June.

Results

Most clinical instructors had a high level of job involvement (82%), 72.0% had high empowerment score, and 55.3% had high citizenship behavior. Empowerment, job involvement, and citizenship scores were positively correlated. The female gender predicted empowerment positively. The workplace was also a powerful predictor of job engagement and empowerment ratings. Importantly mediated the link between empowerment and citizenship behavior was occupational engagement.

Conclusions

Employment participation was a crucial moderator of the link between autonomy and citizenship behavior. The nursing institutes' administration needs to empower clinical instructors with more autonomy and participation in decision making through psychological support and fair salaries. It is proposed that an additional study be conducted to assess the efficacy of empowerment initiatives as a pathway to job engagement, resulting in higher civic behavior among clinical instructors.

Organizational citizenship behaviour as a protective factor against the occurrence of adverse nursing-sensitive outcomes: A multilevel investigation

AIMS

This study aimed to investigate the association between organizational citizenship behaviour enacted by nurses and the occurrence of adverse nursing-sensitive patient outcomes.

BACKGROUND

Managing psychosocial factors (i.e., aspects concerning the work environment) is key to ensure patient safety, to prevent exacerbation of case complexity and to cope with critical shortages in human and financial resources.

METHODS

Self-report measures of nurses' organizational citizenship behaviour were combined with objective data on the incidence of adverse nursing-sensitive outcomes (i.e., pressure ulcers and restraint use) collected through patients' medical records. Participants were 11,345 patients and 1346 nurses across 52 teams working in 14 Italian hospitals. Data were analysed using multilevel binary logistic regression models.

RESULTS

A negative relationship between nurses' organizational citizenship behaviour and restraint use was identified, with an odds ratio of 0.11. Thus, for a one-unit higher organizational citizenship behaviour score, the odds of using restraints shrink to about one eighth of the previous level.

CONCLUSIONS

Intervention strategies to foster the implementation of organizational citizenship behaviour among nurses may inhibit the occurrence of critical outcomes affecting patients' health and well-being (i.e., using restraint devices).

IMPLICATIONS FOR NURSING MANAGEMENT

In health care organizations, shaping a psychosocial environment encouraging organizational citizenship behaviour can mitigate the occurrence of adverse nursing-sensitive outcomes such as restraint use on patients.

Predicting factors of organizational citizenship behavior in Indonesian nurses

This present study investigates the relationship between transformational leadership, learning culture, job satisfaction, and organizational citizenship behavior. In addition, it also examines the mediating role of learning culture and job satisfaction on transformational leadership and organizational citizenship behavior. This study utilized online questionnaires to collect data from nurses in a public hospital in Indonesia. Partial least square (PLS) was used as an analysis tool for 205 collected data. The findings indicated that transformational leadership did not significantly affect organizational citizenship behavior, but this has substantial implications for learning culture and job satisfaction. Both learning culture and job satisfaction significantly and positively predict organizational citizenship behavior. In addition, learning culture and job satisfaction act as perfect mediators between transformational leadership and organizational citizenship behavior. This study suggests leaders to maximize a systematic learning program and to pay attention to the nurses’ job satisfaction rate to improve organizational citizenship behavior. The findings also provide learning culture and job satisfaction as critical factors, directly and indirectly, in motivating employees to perform organizational citizenship behavior.

Burdens, resources, health and wellbeing of nurses working in general and specialised palliative care in Germany - results of a nationwide cross-sectional survey study

BACKGROUND

Palliative care in Germany is divided into general (GPC) and specialised palliative care (SPC). Although palliative care will become more important in the care sector in future, there is a large knowledge gab, especially with regard to GPC. The aim of this study was to identify and compare the burdens, resources, health and wellbeing of nurses working in GPC and SPC. Such information will be helpful for developing prevention programs in order to reduce burdens and to strengthen resources of nurses.

METHODS

In 2017, a nationwide cross-sectional survey was conducted. In total, 437 nurses in GPC and 1316 nurses in SPC completed a questionnaire containing parts of standardised instruments, which included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ), the Patient Health Questionnaire (PHQ-2), the Resilience Scale (RS-13) Questionnaire, a single question about back pain from the health survey conducted by the Robert Koch Institute as well as self-developed questions. The differences in the variables between GPC and SPC nurses were compared.

RESULTS

SPC nurses reported higher emotional demands as well as higher burdens due to nursing care and the care of relatives while GPC nurses stated higher quantitative demands, i.e. higher workload. SPC nurses more often reported organisational and social resources that were helpful in dealing with the demands of their work. Regarding health, GPC nurses stated a poorer health status and reported chronic back pain as well as a major depressive disorder more frequently than SPC nurses. Furthermore, GPC nurses reported a higher intention to leave the profession compared to SPC nurses.

CONCLUSIONS

The findings of the present study indicate that SPC could be reviewed as the best practice example for nursing care in Germany. The results may be used for developing target group specific prevention programs for improving health and wellbeing of nurses taking the differences between GPC and SPC into account. Finally, interventional and longitudinal studies should be conducted in future to determine causality in the relationship of burdens, resources, health and wellbeing.

Moderating Role of Violence by Patients and Their Relatives on the Behaviors of Healthcare Professionals

OBJECTIVE

Studies examining violent behaviors occurring in health settings emphasize direct effects of the variables, and the findings are collected in a limited area. This study aimed to investigate the role of the moderator in the relationship between organizational citizenship behavior (OCB) and job satisfaction in the setting of violent behavior by the patients and their relatives toward healthcare professionals.

METHODS

Research data were collected by face-to-face questionnaire method by interviewing the participants. The study included 512 healthcare workers, physicians, nurses, midwives, and health technicians, working in different units of 13 public hospitals in Ankara and providing health services directly to the patients.

RESULTS

According to the results of the regression analysis, a significant and direct effect of the general level of OCB that predicts the general level of job satisfaction has emerged (β = 0.284, t = 6.68, P < .001). It has been determined that violent behaviors toward healthcare professionals explain approximately 12.5% of the variance with its differentiating role reducing this effect (R² = 0.125, F = 25.30, P = .001).

CONCLUSION

This study showed that the positive contribution of OCB to job satisfaction is higher in healthcare workers who are not exposed to violent behavior. The results of this study also revealed that the relationship between variables regarding the attitudes and behaviors of healthcare professionals may differ owing to the violence perpetrated by the patients and their relatives.

The relationship between workload and burnout among nurses: The buffering role of personal, social and organisational resources

Workload in the nursing profession is high, which is associated with poor health. Thus, it is important to get a proper understanding of the working situation and to analyse factors which might be able to mitigate the negative effects of such a high workload. In Germany, many people with serious or life-threatening illnesses are treated in non-specialized palliative care settings such as nursing homes, hospitals and outpatient care. The purpose of the present study was to investigate the buffering role of resources on the relationship between workload and burnout among nurses. A nationwide cross-sectional survey was applied. The questionnaire included parts of the Copenhagen Psychosocial Questionnaire (COPSOQ) (scale 'quantitative demands' measuring workload, scale 'burnout', various scales to resources), the resilience questionnaire RS-13 and single self-developed questions. Bivariate and moderator analyses were performed. Palliative care aspects, such as the 'extent of palliative care', were incorporated to the analyses as covariates. 497 nurses participated. Nurses who reported 'workplace commitment', a 'good working team' and 'recognition from supervisor' conveyed a weaker association between 'quantitative demands' and 'burnout' than those who did not. On average, nurses spend 20% of their working time with palliative care. Spending more time than this was associated with 'burnout'. The results of our study imply a buffering role of different resources on burnout. Additionally, the study reveals that the 'extent of palliative care' may have an impact on nurse burnout, and should be considered in future studies.

Analysis of factors and corresponding interactions influencing clinical management assistant ability using competency model in China

The clinical management assistant (CMA) is an innovative and practical way to help manage a hospital, so the selection of CMA is important. This research is to find the influencing factors on the competency of CMA and help to select proper candidate of CMA.Based on the items of competency theory using the structural equation model, the data of 600 hospital managers from Shanghai, Guangzhou and Wuhan were identified by exploratory factor analysis and confirmatory factor analysis. In further analysis, the interactions among the factors were evaluated.A total of 20 items were identified as critical to CMA capability, which were further tested and divided into 3 factors: (1) personal characteristics; (2) competence; (3) thinking. The subsequent analysis showed that all factors had significant impact on CMA's ability, and competence contributed the most to the formation of CMA's ability, while the intermediary role of personal characteristics and thinking could not be ignored in practice. The results showed that the competency model contained these 3 factors and had the same structure as the classic competency model.This study presented a tentative approach for assessing CMA's competency, as well as provided the criteria to find and evaluate a CMA.

Systems of Care in Crisis: The Changing Nature of Palliative Care During COVID-19

Among the far-reaching impacts of COVID-19 is its impact on care systems, the social and other systems that we rely on to maintain and provide care for those with "illness." This paper will examine these impacts through a description of the influence on palliative care systems that have arisen within this pandemic. It will explore the impact on the meaning of care, how care is performed and identified, and the responses of palliative care systems to these challenges. It will also highlight the current and potential future implications of these dynamics within the unfolding crisis of this pandemic.

Nursing competencies across different levels of palliative care provision: A systematic integrative review with thematic synthesis

BACKGROUND

Palliative care exists in diverse healthcare settings. Nurses play a crucial role in its provision. Different levels of palliative care provision and education have been recognized in the literature. Therefore, nurses need a set of various competencies to provide high-quality palliative care.

AIMS

To systematically synthesize the empirical evidence of (1) nursing competencies needed in palliative care and (2) whether these competencies differ across the level of palliative care.

DESIGN

Systematic integrative review with thematic synthesis. Prospero: CRD42018114869.

DATA SOURCES

CINAHL, PubMed, Academic Search Premier, Scopus and Medic databases. Studies on nursing competencies linked to palliative care reported in English, Swedish, Finnish, Spanish, Portuguese or German were considered. Search terms: 'palliative care or hospice care or end-of-life care', 'competency or professional competence or skills' and 'nursing'. Articles were independently screened and reviewed by two researchers. Quality appraisal was conducted following Hawker's criteria.

RESULTS

A total of 7454 articles were retrieved, 21 articles were included in the analysis. Six diverse nursing competencies dimensions, namely leadership, communication, collaboration, clinical, ethico-legal and psycho-social and spiritual were identified. The reports rarely defined the level of palliative care and covered a wide array of healthcare settings.

CONCLUSION

Nurses need a wide range of competencies to provide quality palliative care. Few studies focused on which competencies are relevant to a specific level of palliative care. Further research is needed to systematize the nursing competencies and define which nursing competencies are central for different levels of palliative care to enhance palliative care development, education and practice.

Health and intention to leave the profession of nursing - which individual, social and organisational resources buffer the impact of quantitative demands? A cross-sectional study

Background

The aim of this study was to analyse the buffering effect of individual, social and organisational resources on health and intention to leave the profession in the context of burden due to quantitative job demands.

Methods

In 2017, a cross-sectional survey was carried out anonymously among nurses in palliative care in Germany. One thousand three hundred sixteen nurses responded to the questionnaire (response rate 38.7%), which contained, amongst others, questions from the German version of the Copenhagen Psychosocial Questionnaire (COPSOQ). Moderator analyses were conducted to investigate the buffering effect of different resources on health (‘self-rated health’ and ‘burnout’) and ‘intention to leave’ in the context of quantitative demands.

Results

‘Self-rated health’ was significantly buffered by the resources ‘recognition through salary’ (p = 0.001) and ‘good working team’ (p = 0.004). Additionally, buffering effects of the resources ‘workplace commitment’ and ‘good working team’ on ‘burnout’ (p = 0.001 and p = 0.006, respectively) as well as of the resources ‘degree of freedom’, ‘meeting relatives after death of patients’, ‘recognition from supervisor’ and ‘possibilities for development’ on ‘intention to leave’ (p = 0.014, p = 0.012, p = 0.007 and p = 0.036, respectively) were observed.

Conclusions

The results of our study can be used to develop and implement job (re) design interventions with the goal of reducing the risk of burnout and enhancing job satisfaction among nurses in palliative care. This includes for example adequate payment, communication training and team activities or team events to strengthen the team as well as the implementation of some rituals (such as meeting relatives after the death of patients). As our study was exploratory, the results should be confirmed in further studies.

Stimulated by insight: Exploration of critical care nurses' experience of research participation in a recovery programme for intensive care survivors

AIMS AND OBJECTIVES

To explore critical care nurses' experiences of research participation during a one-year recovery programme for intensive care survivors.

BACKGROUND

Nurse-led postintensive care follow-up consultations have emerged to help patients to recover and overcome problems related to critical illness and admission at the intensive care unit (ICU). Previous research exploring post-ICU follow-up programmes have shown inconclusive evidence of their effectiveness on patient-reported outcome measurements, and provider evaluation is scarce. The context of this study is the Recovery and Aftercare in Postintensive care Therapy (RAPIT) trial.

DESIGN

A qualitative descriptive telephone interview study.

METHODS

Data were collected after completion of the RAPIT trial. Participants (n = 14) were trained intensive care nurses, who delivered the post-ICU recovery programme, representing nine out of ten sites from the RAPIT trial. Two focus group discussions were used to construct a semistructured interview guide. A thematic data analysis was performed using Braun and Clark's six-step method. This study conforms to the COREQ Research Reporting Guidelines for qualitative studies.

RESULTS

Our study indicated that nurses considered participation in research as a positive experience. The main finding "Stimulated by insight" described how nurses' engagement and professional growth was gained by reflection, patient feedback and research competencies acquired in the clinical setting. The research programmes stimulated to new knowledge, broaden their perspectives and enhanced critical reflection of ICU nursing practice.

CONCLUSIONS

The study indicates that nurses developed research competencies and enhanced their job satisfaction by using critical reflection and patient feedback. However, there is still a substantial need for support to strengthen nurses' competencies in collaboration with colleagues, managers and researchers.

RELEVANCE TO CLINICAL PRACTICE

This study can contribute to the development of recommendations supporting nurses doing research and to optimise implementation of clinical research.