Research lessons from implementing a national nursing workforce study

Translations of the Practice Environment Scale of the Nursing Work Index: A systematic review

Since 2002, the Practice Environment Scale of the Nursing Work Index has been used worldwide to evaluate nurse work environments. High quality translations in different languages can help advance science and inform practice globally. The study purposes were to conduct a systematic review of published translations of the instrument and to assess their linguistic equivalence and psychometric performance. We conducted a comprehensive search, a quality assessment and synthesis of linguistic equivalence, reliability, and validity data. Studies published through July 2021 were identified in the CINAHL, LILACS, EMCare, and Scopus databases. Thirty-eight publications were selected, comprising 46 translations into 24 languages and 15 language variants, and 35 countries. Translations are in predominantly European, Southeast Asian, and Middle Eastern languages. Two-thirds of the translations reflected medium to high fulfillment of translation quality criteria. The GRADE ratings, reflecting satisfactory fulfillment of cross-cultural equivalence and psychometric properties, were predominantly high (n = 23), then low (n = 15), then moderate (n = 8). The identified translations will support the advancement of global science and the improvement of nurses' work environments.

The Effect of Subjective Perception of Work in Relation to Occupational and Demographic Factors on the Mental Health of Polish Nurses

Introduction: Nursing is considered one of the most stressful professions in the world. The high emotional burden associated with excessive workload in qualitative and quantitative terms, exposure to existing and emerging infectious diseases, daily confrontation with the suffering of individuals and their families and low social support leads to the development of numerous stress reactions among nurses, resulting in the development of anxiety, insomnia, social dysfunction and depression. Indeed, somatic and mental stress-related disease rates are higher among nurses than in the general population. Aim: To determine the impact of subjective work characteristics on the mental health of nurses in relation to demographic and occupational factors. Material and method: The research was carried out among 558 nurses working in hospitals in Podlaskie Voivodeship, and used the Subjective Work Evaluation Questionnaire (SWEQ) and Goldberg's GHQ-28 Questionnaire. Results: As measured by SWEQ, and as self-assessed by means of the GHQ-28 questionnaire, overall stress negatively affects the nurses' health (R ² = 18.7%). Among the partial measures of the SWEQ questionnaire, work overload had strong and the lack of rewards, social relations and lack of support had weak negative effect on the overall mental health assessment of nurses (R ² = 19.2%). The responsibility measure was an exception that had a positive impact on the nurses' well-being. Among occupational and demographic factors, only higher education in relation to secondary education in interactions with the overall stress measure and unpleasant work conditions had a positive effect on the overall mental health self-assessment of nurses (R ² = 20.7%). Conclusions: The results of our study provide a clear message to the hospital management that improving the work organization and atmosphere of nurses by reducing perceived work overload and increasing the responsibility of nurses can have a positive impact on their mental health. Encouraging nurses to improve their education can result not only in an obvious improvement in staff qualifications, but also in better resistance to stressors in the workplace and, consequently, in better staff well-being. Both measures can have a positive impact on the quality of care provided by nurses and on reducing staff turnover.

Content Validation of the Arabic Translation of the Practice Environment Scale of the Nursing Work Index-Revised

BACKGROUND AND PURPOSE

There is no reliable and valid version of the Practice Environment Scale of the Nursing Work Index-Revised (PES-NWI-R) in Arabic. The purpose of this study was to describe the systematic instrument translation and validation of the PES-NWI-R.

METHODS

Using the Content Validity Indexing-based approach, 32 expert nurses from four countries in the Eastern Mediterranean Region (Jordan, Oman, Saudi Arabia, and United Arab Emirates) participated in the validation of this translation.

RESULTS

The content validity index score of the overall scale was excellent (0.87 for the relevancy, and 0.95 for the quality of Arabic translation).

CONCLUSION

Our study supported the content validity of the Arabic version of the instrument which provided the first valid Arabic translation of the instrument.

US nursing and midwifery research capacity building opportunities to achieve the United Nations sustainable development goals

To meet the United Nations Sustainable Development Goals (SDGs) in the United States, research by nurses and midwives has a real opportunity to make a significant impact. This paper identifies opportunities to strengthen research capacity in the United States amongst nurses and midwives in ways that will help meet the SDGs and ensure its sustainability. Research capacity means that in a country, there are individuals and teams capable of defining problems, setting priorities, establishing objectives for the goals of the research study, and following rigorous scientific procedures. By strengthening U.S. research capacity by addressing critical weaknesses in content expertise, nursing and midwifery's voices in policy dialogues, and global research initiatives will be have greater assurance of being included.

Strategies for overcoming language barriers in research

AIM

This paper seeks to describe best practices for conducting cross-language research with individuals who have a language barrier.

DESIGN

Discussion paper.

DATA SOURCES

Research methods papers addressing cross-language research issues published between 2000-2017.

IMPLICATIONS FOR NURSING

Rigorous cross-language research involves the appropriate use of interpreters during the research process, systematic planning for how to address the language barrier between participant and researcher and the use of reliably and validly translated survey instruments (when applicable). Biases rooted in those who enter data into "big data" systems may influence data quality and analytic approaches in large observational studies focused on linking patient language preference to health outcomes.

CONCLUSION

Cross-language research methods can help ensure that those individuals with language barriers have their voices contributing to the evidence informing healthcare practice and policies that shape health services implementation and financing. Understanding the inherent conscious and unconscious biases of those conducting research with this population and how this may emerge in research studies is also an important part of producing rigorous, reliable, and valid cross-language research.

IMPACT

This study synthesized methodological recommendations for cross-language research studies with the goal to improve the quality of future research and expand the evidence-base for clinical practice. Clear methodological recommendations were generated that can improve research rigor and quality of cross-language qualitative and quantitative studies. The recommendations generated here have the potential to have an impact on the health and well-being of migrants around the world.

The Relationship between Mental Health and the Quality of Life of Polish Nurses with Many Years of Experience in the Profession: A Cross-Sectional Study

BACKGROUND

In their professional work, nurses struggle repeatedly with difficult situations that are causes of stress. Another issue is the low prestige of the nursing profession compared with other professions, which results in dissatisfaction, increased frustration, and lack of precision when performing professional tasks. The aim of this study was to assess the relationship between mental health and quality of life and satisfaction with life in nurses with many years of experience in the profession.

METHODS

The study was conducted in a group of 523 randomly selected professionally active nurses aged over 40 years old from the Podlaskie Voivodeship. Standardized questionnaires were used, including WHOQOL-BREF, a short version of a questionnaire assessing quality of life, the general health questionnaire (GHQ-28), and the satisfaction with life scale (SWLS).

RESULTS

The mental health component was found to be significantly affected by financial situation (p = 0.005). Among respondents describing their financial status as bad, the assessment of negative mental health symptoms was higher. The remaining studied variables-work experience, nature of work, place of residence, age, material status, having a partner, and having children-did not affect the respondents' mental health status. The co-occurrence of chronic diseases affected (p = 0.008) the intensification of negative mental health symptoms such as somatic symptoms, anxiety, insomnia, and social dysfunction. The intensification of negative mental health symptoms was not connected with absence from work.

CONCLUSIONS

The financial situation of the respondents significantly determined their quality of life as well as influencing mental health components. Nurses' satisfaction with life was correlated with all studied domains of quality of life.

How Factor Analysis Results May Change Due to Country Context

PURPOSE

To present how factor analysis results of a Practice Environment Scale of the Nursing Work Index (PES-NWI) translation changed due to country context.

DESIGN

Validity and reliability analysis of a cross-culturally adapted, Polish translation of the PES-NWI came from a cross-sectional, national survey that included 2,605 registered nurses working in surgical (50.4%) and medical (49.6%) units of 30 Polish hospitals.

METHODS

Exploratory factor analysis (EFA) using the principal component analysis (PCA) method with varimax rotation and confirmatory factor analysis (CFA) was used to examine factor structure of the instrument in the Polish context. Zero-order and partial Pearson correlation coefficients were used to establish the range of variance shared by the dimensions of the Polish version. The Cronbach's alpha coefficient determined internal consistency reliability. The internal consistency of the scale was also tested based on Kline's criterion.

FINDINGS

The PCA conducted in the sample of Polish nurses extracted six factors, explaining together 56% of the total variance. The varimax rotation, however, restricted results to five factors, explaining 52.7% of the total variance and generating a factor structure closer to that based on previous studies. The CFA model, based on a PCA solution with five nonorthogonal factors, fitted data better than the theoretically driven model.

CONCLUSIONS

Dimensions of the PES-NWI nurses' work environments remain conceptually consistent in Poland, but load differently. Health system or nursing profession factors related to the country context are potential explanations for these differences.

CLINICAL RELEVANCE

When using a translation of the Practice Environment Scale of the Nursing Work Index-Revised to examine the influences of work environment quality on nursing and patient outcomes, it is important to consider contextual differences when using results to inform policy.