Development and validation of the Nursing Profession Self-Efficacy Scale

Development of the clinical trial site performance metrics instrument: A study protocol

Clinical trials (CTs) are essential for medical advancements, yet their increasing complexity and cost demand improved efficiency in trial management. One major challenge in multicenter studies is the inconsistency in evaluating site performance. This study aims to develop and validate a Clinical Trial Site Performance Measure (CT-SPM) to assess "good performance" across trials. The tool will be tested and refined through psychometric analysis, resulting in both a comprehensive scale and a short form for universal application. The study is conducted in three phases: Phase 1 involves metric selection through expert consensus; Phase 2 focuses on psychometric testing to evaluate the reliability and validity of the instrument; and Phase 3 defines a cut-off for "good performance" using statistical models. This protocol aims to standardize site performance evaluation, potentially reducing research costs and enhancing trial quality.•The study develops and validates a Clinical Trial Site Performance Measure (CT-SPM) using expert consensus and psychometric testing.•A comprehensive and short-form tool will be created to evaluate site performance in multicenter clinical trials.•A cut-off for "good performance" will be established using statistical models, facilitating consistent and efficient site evaluations.

Investigation of the relationship between nurses’ levels of mental health literacy, holistic nursing competencies, and professional self-efficacy

BACKGROUND

Given their responsibility for the well-being of individuals, nurses with advanced mental health literacy, along with strong holistic nursing competencies and professional self-efficacy, are better equipped to assess both the mental and physical health of their patients, leading to the provision of holistic nursing care.

AIM

To investigate the relationship between nurses’ mental health literacy levels and their holistic nursing competencies, as well as their nursing professional self-efficacy.

METHODS

This study is cross-sectional, correlational research. The study sample consisted of a total of 261 volunteer nurses working in a training and research hospital and a state hospital between March 11, 2024 and April 8, 2024. Data were collected face to face with the “Descriptive Data Form”, “Mental Health Literacy Scale (MHLS)”, “Holistic Nursing Competence Scale (HNCS)”, and the “Nursing Profession Self-Efficacy Scale (NPSES)”.

RESULTS

The mean scale scores for the nurses were as follows: MHLS: 95.88 ± 11.67; HNCS: 179.46 ± 33.82; NPSES: 64.79 ± 11.24. A low-level positive correlation was found between the total scores of the MHLS, HNCS, and NPSES, and a moderate-level positive correlation was observed between the total scores of the HNCS and NPSES. These correlations were statistically significant (P < 0.05).

CONCLUSION

It is recommended that initiatives be undertaken to enhance the mental health literacy and holistic nursing competencies of nurses and that similar studies be conducted with nurses in different institutions and with a larger number of nurses.

Effect of Self-efficacy, Disease Perception, Social Support, Anxiety, and Depression on Self-management in Young Patients With Stroke

ABSTRACT

BACKGROUND: Better self-management of chronic diseases may benefit patient functional status, medication effectiveness, lifestyle, and psychosocial health. Self-efficacy, disease perception, social support, anxiety, and depression are determinants of self-management behaviors in individuals with chronic illnesses. There remains a gap in the empirical exploration of the influence of these factors on self-management behaviors in young Chinese stroke survivors. This study examined how these factors affect specific self-management behaviors. METHODS: Validated instruments were used to evaluate patient self-efficacy, disease perception, social support, anxiety, and depression in a cross-sectional study. Structural equation modeling was used to examine the hypothesis. RESULTS: Self-efficacy and social support showed a positive correlation with self-management (0.421 and 0.446, respectively; P < .001). Disease perception, anxiety, and depression were negatively correlated with self-management (-0.158 and -0.336, respectively; P < .05). The structural equation model fit the data very well; social support had a direct positive effect on self-management ( t = 3.002, P < .05) and self-efficacy ( t = 5.773, P < .001). However, the presence of social support had a positive impact on reducing anxiety and depression ( t = -5.046, P < .001). Furthermore, self-efficacy positively affected self-management ( t = 1.226, P < .05), whereas anxiety and depression ( t = -1.190, P < .05) and disease perception ( t = -1.068, P < .05) had adverse effects on self-management. CONCLUSION: Medical staff and caregivers can improve patient self-management by helping them recognize the disease, reducing negative perceptions, communicating more for better understanding and care, intervening in anxiety and depression, and promoting mental health. This is especially important for young stroke patients.

Development and content validity of the cognition in daily life scale (CDL)

Cognitive impairment can negatively influence daily functioning. Current cognitive measures are essential for diagnosing cognitive impairment, but findings on these tests do not always represent the level of cognitive functioning in daily life. Therefore, this study aimed to design a structured measurement instrument to observe and rate the impact of cognitive impairment in daily life, named the cognition in daily life scale for persons with cognitive problems (CDL). In this paper we describe the development, expected usability, and psychometric properties (content and face validity) of the instrument. The CDL was established through three consecutive development phases: (1) item selection, (2) item categorization and comparison, and (3) item revision and manual construction. Subsequently, a panel of eleven international experts rated the relevance of the selected items and provided comments on the expected usability and face validity. Content validity was estimated with the content validity index, based on which four items were removed. The experts' comments led to minor adjustments of the manual, domains, and formulation of the maintained items. The final instrument consists of 65 items describing behaviour that relies on cognitive functions within six domains. Future research should focus on evaluating the construct validity and reliability of the CDL.

The efficacy of computerized cognitive training in patients with coronary heart disease and cognitive impairment, no dementia: study protocol for a randomized controlled trial

BACKGROUND

Cognitive training has been confirmed to significantly improve the overall cognitive function in patients. For patients with coronary heart disease, in addition to controlling common risk factors, there is a lack of effective evidence for the treatment of cognitive function in patients with coronary heart disease and its effectiveness. This randomized controlled study was designed to evaluate the effectiveness of computer-based cognitive training for improving cognitive function in such patients.

METHODS

COG-T CHD is a multicenter, double-blind, parallel-designed, randomized controlled trial. The patients will be divided 1:1 into two groups by a central randomized system, a cognitive digital therapy group or a positive control group. Patients assigned to the cognitive digital therapy group will undergo computer-based cognitive training for 30 min at least five times a week for 12 weeks. At the end of the 12 weeks, the subjects were randomly divided into two groups. One group continued the 12 weeks of cognitive digital therapy training and the other group stopped the training. Patients assigned to the positive control group will undergo computer-based cognitive training with little or no difficulty changes for 30 min at least five times a week for 12 weeks. The study will last approximately 2 years, with enrollment completed in approximately 18 months, with the last enrolled patient followed for at least 24 weeks. The primary outcome is the proportion of improvement in overall cognitive function at 12 weeks, using the Basic Cognitive Ability Test (BCAT). Secondary outcomes are the proportion of improvement in the overall cognitive function from baseline at 24 weeks, the change in overall cognitive function scores at 12 and 24 weeks, and the proportion of improvement in each cognitive domain, General Self-Efficacy Scale score, EuroQol five-dimension three-level questionnaire score, and Generalized Anxiety Disorder-7 score at 12 and 24 weeks from baseline. The investigational outcome is the change in head MRI structure and function from baseline at weeks 12/24.

DISCUSSION

COG-T CHD is the first clinical trial to evaluate the efficacy of computer-based cognitive training in patients with coronary heart disease, filling an important gap in the treatment evidence for cognitive digital therapy.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05735041. Registered on Jan. 18, 2023.

The relationship between reflective ability and professional identity: the mediating effect of self-directed learning and self-efficacy for junior clinical nurses

BACKGROUND

Nursing is crucial for delivering healthcare services; however, nursing shortages pose a significant global challenge, which the high turnover rate of junior nurses is expected to exacerbate. Enhancing nurses' professional identities is likely to be an effective strategy for reducing turnover rates.

METHODS

We recruited 865 junior clinical nurses from three tertiary hospitals in Henan Province, China. The participants completed a demographic questionnaire along with the Reflective Ability Scale for Clinical Nurses, the Nursing Profession Self-efficacy Scale, the Nursing Staff Self-learning Ability Evaluation Scale, and the Professional Identity Scale for Nurses. The relationships between reflective ability, self-directed learning, self-efficacy, and professional identity were evaluated using SPSS26.0, with PROCESS version 3.5 used to construct a chain-mediation model.

RESULTS

Positive correlations were found between reflective ability, self-directed learning, self-efficacy, and professional identity. Chain mediation model analysis showed that reflective ability, self-directed learning, and self-efficacy directly and positively affected professional identity (β = 0.22, β = 0.30, β = 0.66, all p < 0.001). Self-directed learning and self-efficacy exerted a significant chain mediating effect between reflective ability and professional identity (95% confidence interval [CI]: 0.06-0.13). The total effect of reflective ability on the professional identity of clinical nurses was 0.51 (p < 0.001, 95%CI: 0.42-0.59), the direct effect was 0.22 (p < 0 0.001, 95%CI: 0.14-0.29), and the indirect effect was 0.29 (p < 0.001, 95%CI: 0.22-0.37).

CONCLUSION

Self-directed learning and self-efficacy partially mediated the relationship between reflective ability and professional identity. Multifaceted strategies targeted at enhancing reflective ability, self-directed learning, and self-efficacy are recommended to improve junior clinical nurses' professional identities.

[Validity and Reliability of the Korean Version of the Occupational Coping Self-Efficacy Scale for Nurses]

PURPOSE

This study aimed to evaluate the validity and reliability of the Korean version of the occupational coping self-efficacy for nurses (K-OCSE-N) scale.

METHODS

The English version of the OCSE-N scale was translated into Korean using a translation and back-translation process. Data were gathered from 213 nurses employed in a general hospital in South Korea. The content validity was assessed using the content validity index. The construct validity was verified through exploratory and confirmatory factor analyses. Criterion validity was assessed using Pearson's correlation coefficients with the job stress coping and general self-efficacy scales. Reliability was examined using item-total score correlation and Cronbach's α coefficient for internal consistency.

RESULTS

The exploratory factor analysis identified two factors that explained 61.8% of the cumulative variance: occupational burden and relational difficulty. In confirmatory factor analysis, the model exhibited adequate fit (χ²/df = 2.07, GFI = .95, SRMR = .04, RMSEA = .07, CFI = .97, and TLI = .95), with both convergent and discriminant validity deemed acceptable. The criterion validity presented a positive correlation of the K-OCSE-N with both job stress coping (r = .72, p < .001) and general self-efficacy (r = .72, p < .001). The internal consistency of the scale using Cronbach's α for the total items was .89.

CONCLUSION

The K-OCSE-N scale is a valid and reliable tool for measuring nurses' occupational coping self-efficacy. This study suggests that various intervention studies can use the scale to assess and strengthen nurses' occupational coping self-efficacy in nursing practice.

Exploring the relationship between pressure ulcer knowledge and self-efficiency among nursing students: A multicenter study

AIM

To determine the relationship between the knowledge and self-efficiency regarding pressure ulcers of nursing students.

METHODS

This descriptive and correlational study was conducted with 775 nursing students from three different universities in various regions of Turkey. The "Pressure Ulcer Knowledge Assessment Tool-Updated Version" and "Pressure Ulcer Management Self-Efficiency Scale for Nurses" tool were used to collect data between May and September 2023. The Strengthening the Reporting of Observational Studies checklist was followed to report this study.

RESULTS

The mean knowledge score was 7.27 ± 3.09, and the mean self-efficiency on pressure ulcer management score was 35.5 ± 18.3. A statistically significant positive correlation was found between nursing students' knowledge and self-efficiency mean scores regarding pressure ulcers (p < 0.05). A significant difference was also found between the students' academic levels and gender and their knowledge and self-efficiency scores regarding pressure ulcers.

CONCLUSION

In this study, where the data covers these three institutions, students' pressure ulcer knowledge and self-efficiency scores were lower compared to all academic years. Accordingly, it was also determined that students with more nursing practice experience showed higher knowledge and self-efficacy scores than students with less nursing practice experience. Additionally, the students' self-efficacy increased along with their knowledge level. Training courses may be suggested to improve students' knowledge and self-efficiency regarding pressure ulcers.

Intensive and critical care nurses patient safety, care quality, professional self-efficacy, and missed nursing care: Structural equation model analysis

BACKGROUND

Globally, nurses' patient safety, care quality, and missed nursing care are well documented. However, there is a paucity of studies on the mediating roles of care quality and professional self-efficacy, particularly among intensive and critical care unit (ICCU) nurses in developing countries like the Philippines.

AIM

To test a model of the interrelationships of patient safety, care quality, professional self-efficacy, and missed nursing care among ICCU nurses.

METHODS

A cross-sectional, correlational design study was used. ICCU nurses (n = 335) were recruited via consecutive sampling from August to December 2023 and completed four validated self-report scales. Spearman Rho, structural equation modeling, mediation, and path analyses were utilized for data analysis.

RESULTS

The emerging model demonstrated acceptable fit parameters. Patient safety positively influenced care quality (β = .34, p = .002) and professional self-efficacy (β = .18, p = .011), while negatively affecting missed nursing care (β = -.34, p = .003). Care quality positively and negatively influenced professional self-efficacy (β = .40, p = .003) and missed nursing care (β = -.13, p = .003), respectively. Professional self-efficacy indirectly impacted missed nursing care (β = -.32, p = .003). Care quality (β = -.10, p = .003) and professional self-efficacy (β = .13, p = .003) showed mediating effects between patient safety and missed nursing care.

LINKING EVIDENCE TO ACTION

ICCU nurses' care quality and professional self-efficacy are essential mediating factors that can bolster patient safety practices, hence reducing missed nursing care. Therefore, healthcare organizations, nurse managers, and policymakers should cultivate care quality and self-efficacy by creating support programs and providing a positive practice environment. Nurses and nurse supervisors could directly observe missed nursing care in the ICCU to understand its underreported causes.

Development of Safe Blood Transfusion Self-Efficacy Scale for nurses: Validity and reliability study

AIM

The aim of the study is to develop a scale to measure nurses' self-efficacy levels regarding safe blood transfusion practice.

METHODS

This study, applied in methodological design, was conducted in a public university hospital in Istanbul between March-April 2021. The sample included 372 nurses. A draft form consisting of 75 items was prepared. Content validity, construct validity, distinctiveness, internal consistency reliability, two-half test reliability, test-retest, and item analysis methods were used to determine the psychometric properties of the scale.

RESULTS

The exploratory factor analysis showed that the scale had a four-factor structure that explained 71.36 % of the total variance. The factor loads of 49 items were found to vary between 0.50 and 0.92. The item-total correlations were found to be between 0.55 and 0.92. The Cronbach's alpha value for the whole scale was 0.96.

CONCLUSION

The results of the analysis show the items constituting Safe Blood and Blood Products Transfusion Self-Efficacy Scale have validity and reliability criteria that can measure the nurses' self-efficacy levels regarding safe blood transfusion practice.

The Relationship Between Work Environment and Missed Nursing Care in Nurses: The Moderator Role of Profession Self-Efficacy

AIMS

This study aimed to examine the relationship between work environment and missed nursing care (MNC) in nurses and determine whether profession self-efficacy has a moderator role in this relationship.

DESIGN

A quantitative, cross-sectional, correlational study design was used to test the study model.

METHODS

The study was conducted with 433 nurses in 2 city hospitals in Istanbul, Turkey. Data were collected between November 2022 and February 2023 using the "MISSCARE Survey-Turkish," the "Work Environment Scale," and the "Nursing Profession Self-Efficacy Scale."

RESULTS

The participants had a mean Nursing Profession Self-Efficacy Scale score of 66.67 ± 14.37, a mean Work Environment Scale score of 84.96 ± 13.62, a mean elements of MNC score of 1.30 ± 0.73, and a mean reason for MNC score of 3.18 ± 0.78. Nursing profession self-efficacy was determined to be positively related to the work environment of the participants and their reasons for MNC (respectively, r = 0.276 and r = 0.114) and negatively related to elements of MNC ( r = -0.216) ( P < 0.05). There was also a negative relationship between the work environment and elements of MNC ( r = -0.249; P < 0.05). Profession self-efficacy had a significant moderator role in the relationship between the work environment and elements of MNC. Having low or moderate levels of profession self-efficacy moderated the negative effects of the work environment on elements of MNC.

CONCLUSIONS

There is a need for interventions to reduce elements of missed nursing care in nurses. Especially nurses and/or nurse managers may have difficulties in improving their work environment, considering its multifaceted structure. In such cases, administrators can reduce missed nursing care by increasing the profession self-efficacy of nurses. Therefore, profession self-efficacy should be considered in addition to interventions for the work environment to improve care.

Enhancing nurse competence in early recognition of cardiotoxicity

BACKGROUND

Preliminary research reveals that many nurses feel inadequate and possess limited knowledge when it comes to managing cardiotoxicity, underscoring the necessity for educational programs to enhance nursing skills in this area.

METHODS

The aim of the study was to assess the impact of an educational intervention on nurses perceived self-efficacy in recognizing patients exhibiting symptoms of cancer treatment-related cardiotoxicity. The study was set in a 16-bed cardiac critical care unit (CCU) within a 462-bed hospital. The sample group was comprised of registered nurses (RNs) working on or floating to the CCU. The study used a within-subjects design. Participants completed a pre-education survey, attended one of six 30-minute education interventions, and completed a post-education survey. The outcome variables were 7 self-confidence questions from the Nursing Self-Efficacy Scale for Managing Cancer Treatment-Related Cardiotoxicity (NSS-CTC) on a 5-point Likert scale and one yes or no self-efficacy question. Descriptive statistics and paired T-tests were applied to analyze pre- and post-education surveys.

RESULTS

The pre-and post-education comparative analysis for each of the 7 NSS-CTC self-confidence questions was statistically significant with test statistics ranging from t = 3.43 to t = 8.69 and p-values ranging from 0.0021 to less than 0.0001. All 26 RNs answered "yes" in their ability to detect symptoms of cancer therapy-related cardiotoxicity after the education.

CONCLUSIONS

The lack of education for cardiac nurses against the backdrop of increasing cardiotoxicity in cancer patients showcases the essential need for cardiac nurse early symptom recognition education.

The mediating effect of self-efficacy on the relationship between self-care ability and disability level in older adult patients with chronic diseases

Objective

This study investigates the mediating effect of self-efficacy on the relationship between self-care ability and disability level in older adult patients with chronic diseases.

Methods

A convenience sampling method was used to select 372 older adult patients with chronic diseases from five tertiary hospitals in Chengdu, Sichuan Province. General demographic information was collected using a questionnaire, and self-efficacy, self-care ability, and disability were assessed using standardized scales. Data were analyzed using SPSS 26.0, and the PROCESS macro was employed to test the mediating effect of self-efficacy.

Results

The mean score for self-efficacy was 26.09 ± 7.20, for self-care ability was 113.19 ± 23.31, and for disability was 154.19 ± 29.32. Self-efficacy was positively correlated with self-care ability (r = 0.73, p < 0.001. and negatively correlated with disability (r = -0.84, p < 0.001. and self-care ability and disability (r = -0.91, p < 0.001.. The indirect effect of self-efficacy on the relationship between self-care ability and level of disability was -0.03 (95% CI -0.08 to -0.04), accounting for 16.67% of the total effect.

Conclusion

Self-efficacy partially mediates the relationship between self-care ability and disability in older adult patients with chronic conditions. Healthcare providers can improve self-care behaviours and self-efficacy in older adult patients through effective interventions to reduce the incidence of disability.

Development and Validation of Knowledge Assessment Scales for Dementia and Urinary Incontinence in Community Older People

To develop and validate scales for reliably assessing dementia and urinary incontinence knowledge of older adults in the community. Items were generated through a literature review, refined through a Delphi study (n = 19), and then revised through a pilot study (n = 29). Item analysis and exploratory factor analysis were applied to finalize the scales (n = 244). Construct validity, reliability, and acceptability were evaluated (n = 243). The two knowledge assessment scales for dementia and urinary incontinence, respectively, comprised 12 items and 8 items. Model fit indicators of both met the criteria of confirmatory factor analysis. Cronbach's α were .82 and .70, respectively. Completion ratio and completion time of the two scales was 83.51% and 4.22 ± 1.90 minutes. The knowledge assessment scales for dementia and urinary incontinence with satisfactory validity, reliability, and acceptability, could be served as valid tools for disease prevention and management among older adults in the community.

Reliability and Validity of a Theory-Based Determinants of Eating and Physical Activity Behaviors Questionnaire for Chinese Elementary School Children

OBJECTIVE

The primary objective of this study was to develop and validate a Social Cognitive Theory-based instrument to identify psychosocial factors that influence diet and physical activity among Chinese children aged 10-12 years.

DESIGN

This is a cross-sectional study, with data collected from questionnaires.

SETTING

Two elementary schools in Beijing, China.

PARTICIPANTS

Fourth to sixth-grade students (N = 1,486) aged 10-12 years were recruited.

VARIABLES MEASURED

Gender, height, weight, nation, and grade were collected. Energy-balanced eating behaviors and their related sociopsychological factors were surveyed.

ANALYSIS

Confirmatory factor analysis, Pearson correlations, Cronbach α index, and mediation analysis were used.

RESULTS

(1) Confirmatory factor analysis revealed a 6-factor solution (51 items) and all factor loadings > 0.32, indicating that the model fitness was acceptable. (2) All correlation coefficients are statistically significant. All of the Cronbach α indexes were > 0.65, indicating acceptable reliability. (3) The mediating effect of goal intention and outcome expectations between self-efficacy and habit strength was statistically significant (P < 0.01), verifying the theory structure.

CONCLUSIONS AND IMPLICATIONS

This questionnaire exhibits good internal consistency, reliability, and structural validity. It can be effectively employed to investigate energy-balanced eating behaviors related to the Social Cognitive Theory in Chinese children.

Mindfulness-based intervention for hypertension patients with depression and/or anxiety in the community: a randomized controlled trial

OBJECTIVE

To evaluate mindfulness-based intervention for hypertension with depression and/or anxiety.

METHODS

10-week mindfulness-based intervention, including health education for hypertension, exclusively for the control group, was administered to the intervention group to assist sixty hypertension patients with depression/anxiety. Among them, the intervention group comprised 8 men and 22 women, with a mean age of 60.02 years and a mean duration of hypertension of 6.29 years. The control group consisted of 14 men and 16 women with a mean age of 57.68 years and a mean duration of hypertension of 6.32 years. The severity of depressive and/or anxiety symptoms was assessed using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder scale (GAD-7), along with blood pressure (BP) measurements taken twice daily. The study utilized a self-made self-efficacy scale and awareness of physical and mental health to evaluate mental health and state.

RESULTS

The depression PHQ-9 or GAD-7 scores reduced by 21.1% or 17.8% in the mindfulness-based intervention group, compared to the control (Z = -2.040, P = 0.041) post 10-week period, suggesting significant reduction in anxiety/stress. These results were consistent with a reduction in systolic BP of 12.24 mm Hg (t = 6.041, P = 0.000). The self-efficacy score of the mindfulness intervention group significantly improved compared to the control (t = 7.818, P < 0.001), while the awareness of physical and mental health in the mindfulness intervention group significantly improved compared to the control (χ2 = 5.781, P = 0.016).

CONCLUSION

Mindfulness-based, short-term focused interventions provide modest relief for depression and/or anxiety and are effective in lowering blood pressure and improving self-efficacy scores.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR1900028258. Registered 16 December 2019, https://www.chictr.org.cn/showproj.html?proj=43627 .

The process of nurses' role negotiation in general practice: A grounded theory study

AIM

To explain the process by which nurses' roles are negotiated in general practice.

BACKGROUND

Primary care nurses do important work within a social model of health to meet the needs of the populations they serve. Latterly, in the face of increased demand and workforce shortages, they are also taking on more medical responsibilities through task-shifting. Despite the increased complexity of their professional role, little is known about the processes by which it is negotiated.

DESIGN

Constructivist grounded theory.

METHODS

Semi-structured interviews were conducted with 22 participants from 17 New Zealand general practices between December 2020 and January 2022. Due to COVID-19, 11 interviews were via Zoom™. Concurrent data generation and analysis, using the constant comparative method and common grounded theory methods, identified the participants' main concern and led to the construction of a substantive explanatory theory around a core category.

RESULTS

The substantive explanatory theory of creating place proposes that the negotiation of nurse roles within New Zealand general practice is a three-stage process involving occupying space, positioning to do differently and leveraging opportunity. Nurses and others act and interact in these stages, in accordance with their conceptualizations of need-responsive nursing practice, towards the outcome defining place. Defining place conceptualizes an accommodation between the values beliefs and expectations of individuals and pre-existing organizational norms, in which individual and group-normative concepts of need-responsive nursing practice are themselves developed.

CONCLUSION

The theory of creating place provides new insights into the process of nurses' role negotiation in general practice. Findings support strategies to enable nurses, employers and health system managers to better negotiate professional roles to meet the needs of the populations they serve, while making optimum use of nursing skills and competencies.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Findings can inform nurses to better negotiate the complexities of the primary care environment, balancing systemic exigencies with the health needs of populations.

IMPACT

What Problem Did the Study Address? In the face of health inequity, general practice nurses in New Zealand, as elsewhere, are key to meeting complex primary health needs. There is an evidence gap regarding the processes by which nurses' roles are negotiated within provider organizations. A deeper understanding of such processes may enable better use of nursing skills to address unmet health need. What Were the Main Findings? Nurses' roles in New Zealand general practice are determined through goal-driven negotiation in accordance with individual concepts of need-responsive nursing practice. Individuals progress from occupying workspaces defined by the care-philosophies of others to defining workplaces that incorporate their own professional beliefs, values and expectations. Negotiation is conditional upon access to role models, scheduled dialogue with mentors and decision-makers, and support for safe practice. Strong clinical and organizational governance and individuals' own positive personal self-efficacy are enablers of effective negotiation. Where and on Whom Will the Research Have Impact? The theory of Creating Space can inform organizational and individual efforts to advance the roles of general practice nurses to meet the health needs of their communities. General practice organizations can provide safe, supported environments for effective negotiation; primary care leaders can promote strong governance and develop individuals' sense of self-efficacy by involving them in key decisions. Nurses themselves can use the theory as a framework to support critical reflection on how to engage in active negotiation of their professional roles.

REPORTING METHOD

The authors adhered to relevant EQUATOR guidelines using the COREQ reporting method.

PATIENT OR PUBLIC CONTRIBUTION

Researchers and participants currently working in general practice were involved in the development of this study. By the process of theoretical sampling and constant comparison, participants' comments helped to shape the study design. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: An understanding of the processes by which health professionals negotiate their roles is important to support them to meet the challenges of increased complexity across all health sectors globally.

Interprofessional Differences in Multidimensional Self-Efficacy Associated With Professional Performance in Nephrology During Case-Based Learning

Introduction

Postgraduate medical education assumes rising importance in the rapidly advancing field of medicine. Case-based learning (CBL), a learner-centered pedagogy employing clinical cases to improve decision-making, is widely embraced in postgraduate medical education, including nephrology. Studies suggest that learning self-efficacy (SE) was closely associated with learning motivation and academic performance; however, very few studies examined this association in postgraduate nephrology education. None evaluated whether there were interprofessional differences concerning such association.

Methods

In 2022, we prospectively enrolled physicians and nurses participating in chronic kidney disease (CKD) care from institutions around Taiwan. They completed the Professional Medical Learning Self-efficacy (PMLS) questionnaire after attending >1 CBL session involving CKD care. We undertook confirmatory factor analysis (CFA), followed by structural equation modeling (SEM) to evaluate associations between 5 dimensions of learning SE (conceptual understanding [CU], higher-order cognitive skills [HC], practical work [PW], everyday application [EA], and medical science communication [MSC]) and their professional SE in nephrology according to participants' medical professions.

Results

A total of 513 healthcare providers were surveyed. The convergent and construct validity of our questionnaire were satisfied after analyses. We found that better perceived professional performance in the form of higher professional SE in nephrology was significantly associated with all 5 dimensions of learning SE among physicians and nurses. Only CU and PW were significantly associated with physicians' professional performance; whereas among nurses, only HC and MSC were significantly associated.

Conclusion

We showed that learning SE was an important determinant of nephrology professional performance. Different medical professions posed influences on major SE dimensions.

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.

Psychometric properties of the pediatric ward nurses' caring self-efficacy scale: A Turkish validity and reliability study

PURPOSE

To translate the 51-item Pediatric Ward Nurses' Caring Self-Efficacy Scale into Turkish and to test the validity and reliability of the Turkish version of the scale in the Turkish population.

DESIGN AND METHODS

The study was conducted with 308 nurses working in the pediatric/pediatric wards of two hospitals in Turkey between September 2021 and January 2022. A Personal Information Form, the Pediatric Ward Nurses' Caring Self-Efficacy Scale, and the Nursing Profession Self-Efficacy Scale (NPSES) were used to determine the care self-efficacy levels of the research sample.

RESULTS

The Cronbach alpha value of the scale, which was adapted to Turkish culture, was 0.982, and the test-retest reliability coefficient was 0.994. Factor loads varied between 0.40 and 0.89. The Kaiser-Meyer-Olkin sample fit coefficient of the scale was 0.963 and the Barlett sphericity test χ2 value was 15,259.02 (p < 0.001). It was determined to have a six-factor structure in Turkish culture and showed good fit indices for the Turkish scale (GFI = 0.93, CFI = 0.97, TLI = 0.96 and RMSEA = 0.09).

CONCLUSIONS

The Pediatric Ward Nurses' Caring Self-Efficacy Scale was found to be valid and reliable for sensitively detecting changes in the care self-efficacy levels of nurses working in pediatric wards.

PRACTICE IMPLICATIONS

The scale can be used by professionals interested in scientific knowledge about pediatric population.

A stepwise methodological approach to develop and validate the digital and technological self-efficacy scale for healthcare workers among nurses and nursing students

AIMS

To develop and validate the Digital and Technological Self-Efficacy Scale (Digitech-S) for healthcare workers among nurses and nursing students.

BACKGROUND

Digital and technological solutions (DTS) significantly impact working life in healthcare and educational settings. DTS-related self-efficacy might be defined the individual's confidence in proficiently performing digital and technological tasks, even when faced with challenges. Its assessment might guide educators in orienting focused interventions to enhance the self-efficacy of nurses and nursing students. Thus far, the assessment of DTS-related self-efficacy is currently undermined by the lack of valid and reliable measurements.

DESIGN

A stepwise methodological approach was employed in two main phases. Phase one focused on tasks guided by literature for generating items reflecting DTS. Phase two encompassed three steps: A content validity step, a first cross-sectional data collection for Mokken scaling analysis (MSA) performed to reduce the number of items toward a unidimensional structure and with a hierarchical approach, and a confirmatory factor analysis including the group (nurses vs. nursing students) as a covariate (MIMIC) to cross-validate the unidimensional structure and assess the measurement invariance using a second cross-sectional data collection round. A Multi-Group Confirmatory Factor Analysis (MG-CFA) was also conducted to test for configural, metric, scalar, and strict invariance across the two groups.

RESULTS

Phase one resulted in 36 items derived from a literature review, which was reduced to 33 after the content validity process. 660 responders (nurses = 388; nursing students = 272) were included in the sample analyzed with MSA, and 13 items were hierarchically selected for the subsequent data collection (Rho reliability = 0.95; Hs = 0.67; Hi ranging from 0.55 to 0.72). MIMIC models were performed on 421 responders (nurses = 268; nursing students = 153), and three items that caused non-invariance between nurses and nursing students were identified and removed from the final version (Cronbach's alpha = 0.928). The MG-CFA demonstrated configural and metric invariance, suggesting a consistent factor structure and factor loadings across both groups, but scalar and strict invariance were not fully achieved.

CONCLUSIONS

The Digitech-S is a 10-item scale showing a unidimensional and stable structure, which could be used for educational and research purposes.

Determining Self-Efficacy of Nurses Who Graduated From Distance Education Because of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study

BACKGROUND

The current literature states that distance education has caused a lack of professional skills, regression of existing professional skills (Kaya & Akin Isik, 2021; Kürtüncü & Kurt, 2020), a lack of self-confidence, and feelings of inadequacy among nursing students (George et al., 2020). The current study examined the professional self-efficacy of nurses who graduated from distance education because of the coronavirus disease 2019 pandemic.

METHOD

This multicenter cross-sectional study was conducted between November 2020 and June 2022 with 164 nurses who graduated from distance education in 2020-2021 from three faculties of health sciences.

RESULTS

Professional self-efficacy of the nurses was found to be above average. Male nurses and nurses who believed distance education had a negative impact on their professional skills had significantly higher professional self-efficacy. Some nurses reported that their professional theoretical knowledge was insufficient and defined the effect of distance education on their professional skills as relatively negative.

CONCLUSION

Most of the nurses expressed that distance education had a negative effect on their professional self-efficacy and working life. [J Contin Educ Nurs. 2023;54(10):480-488.].

An Observational Cross-Sectional Study on the Correlation between Professional Competencies and Self-Efficacy in Albanian Registered Nurses

(1) Background: The assessment and application of registered nurses' professional skills are essential to providing quality and safe care. Self-efficacy can positively affect the professional competence of registered nurses. This study analysed professional competence and its association with self-efficacy among registered nurses. (2) Methods: A cross-sectional observational study was conducted. The sampling was conventional. The data collection took place through the Albanian version of the Nurse Professional Competence Scale Short Form (A-NPCS-SF), which was used to assess their professional skills, and the Albanian version of the Nursing Profession Self-Efficacy Scale (A-NPSES), which was used to assess their self-efficacy. The study was based on a convenience sample of 985 registered nurses from the 12 Albanian provinces. (3) Results: The Cronbach alpha value for the A-NPCS-SF scale was 0.947, while for the A-NPSES scale, it was 0.875, proving both scales to be reliable. Self-efficacy does not play an essential role in the development of the professional competence of registered nurses since our survey found only one dimension correlates with these two elements. (4) Conclusions: The results of our analysis have instead highlighted the importance of a close relationship between job satisfaction and the development of professional skills.

The validity and reliability of Turkish version of the self-efficacy scale in nursing care of children with epilepsy

PURPOSE

This study was conducted to the Turkish validity and reliability study of the 'Scale of Self-efficacy in Nursing Care of Children with Epilepsy' (SSENCCE).

DESIGN AND METHODS

The construct validity of the scale was evaluated with explanatory factor analysis (EFA) and confirmatory factor analysis. The reliability of the scales used in the research was examined with composite reliability and Cronbach's alpha coefficients.

RESULTS

A total of 144 nurses participated in the study. The variance explained in the 12-item scale was 53.6%, and the eigenvalue was found as 6.442. The commonality values of the scale items ranged from 0.304 to 0.712, and the factor loads ranged from 0.552 to 0.844. Cronbach's α of the SSENCCE was calculated as 0.907.

CONCLUSION

The Turkish version of the ESSENCE is a valid, reliable, and appropriate tool for assessing the self-efficacy of nurses providing care for children with epilepsy.

PRACTICE IMPLICATIONS

Considering that there is no scale that is used to evaluate the self-efficacy of nurses who provide care for children with epilepsy in Turkey, it is thought that this study will guide future research on the subject and the improvement of the clinical experience of nurses.

Individual-Level Variables Associated with Self-Efficacy in Nutritional Care for Older People among Italian Nurses: A Multicenter Cross-Sectional Study

Malnutrition in older people is still an unsolved issue. Clinical nurses have a key role in malnutrition prevention. This study aims to describe the individual-level variables associated with self-efficacy in nutrition care for older adults among nurses. A cross-sectional descriptive observational study was performed involving nurses from four northern Italy hospitals. The self-efficacy scale for nursing nutrition care (SE-NNC) and Multiple linear regression (MLR) models were used, enrolling 305 nurses. The mean SE-NNC total score was 53.3 ± 19.7. Considering the three dimensions of the SE-NNC, mean scores were 45.9 ± 21.7 for boosting knowledge, 55.4 ± SD = 20.3 for assessment and evidence utilization, and 57.7 ± 21.1 for care delivery. To be a younger nurse, working in a chronic care setting, and being male were associated with a higher level of self-efficacy, both considering the SE-NNC total score and its dimensions. Working in acute care settings and being an older nurse was associated with lower nursing self-efficacy in nutrition care for older adults.

Nursing Profession Self-Efficacy Scale-Version 2: A Stepwise Validation with Three Cross-Sectional Data Collections

BACKGROUND

The nursing professional self-efficacy scale (NPSES) is one of the most used self-reporting tools for assessing nursing self-efficacy. Its psychometric structure was described differently in several national contexts. This study aimed to develop and validate version 2 of the NPSES (NPSES2), which is a brief version of the original scale selecting items that contribute to stably detecting attributes of care delivery and professionalism as descriptors of salient aspects of the nursing profession.

METHODS

Three different and subsequent cross-sectional data collections were employed to reduce the number of items to generate the NPSES2 and validate its new emerging dimensionality. The first (June 2019-January 2020) involved 550 nurses and was used to reduce the number of the original scale items by using a Mokken scale analysis (MSA) to ensure the selection of items consistently with the invariant item ordering properties. The subsequent data collection was performed to conduct an exploratory factor analysis (EFA) involving 309 nurses (September 2020-January 2021), and the last data collection (n = 249) was performed to cross-validate with a confirmatory factor analysis (CFA), the most plausible dimensionality derived from the EFA (June 2021-February 2022).

RESULTS

The MSA led to the removal of twelve items and retention of seven items (Hs = 0.407, standard error = 0.023), which showed adequate reliability (rho reliability = 0.817). The EFA showed a two-factor solution as the most plausible structure (factors loading ranged from 0.673 to 0.903; explained variance = 38.2%), which was cross-validated by the CFA that showed adequate fit indices: χ² (13, N = 249) = 44.521, p < 0.001; CFI = 0.946; TLI = 0.912; RMSEA = 0.069 (90% CI = 0.048-0.084); SRMR = 0.041. The factors were labeled as care delivery (four items) and professionalism (three items).

CONCLUSIONS

NPSES2 is recommended to allow researchers and educators to assess nursing self-efficacy and inform interventions and policies.

Vascular access and clinical competency: Which elements matter? The development of three bottom-up and evidence-grounded self-assessment tools

BACKGROUND

Assessing competency in the speciality of vascular access is still limited, and few valid and reliable tools are available. Therefore, this study aimed to develop and validate three different tools for assessing competency in managing the care of short peripheral cannulas (SPCs), midlines, peripherally inserted central catheters (PICCs), centrally inserted central catheters (CICCs), and arterial catheters (ACs) (tool one), placing SPCs (tool two), placing PICCs and midlines (tool three).

METHODS

A two-phase and multi-method design was adopted. Phase one was implemented to develop the initial pool of items for each tool, starting from a literature overview. Panel discussions were adopted for developing the items. In phase two, the developed items were tested for content and face validity, involving a panel of 10 experts. Once obtained adequate content validity, a cross-sectional data collection was implemented to enroll three samples of healthcare workers who had to assess their competency through the developed tools. Dimensionality was assessed by performing a principal component analysis (PCA) and assessing internal consistency (Cronbach's α).

RESULTS

Tool one had 26 items, and the dimensionality was given by placement, risk assessment, procedure conformity and traceability, and patient education to self-care. Tool two had 35 items; its principal components were: risk evaluation, identification, clinical assessment and orientation to self-care, placement, and procedure registration shaped the competency of placing SPCs. Tool three had 31 items; its principal components were: risk assessment, placement, conformity to standards and procedure traceability, education, and orientation to self-care were the essential elements for adequately placing midlines and PICCs. Cronbach's α values ranged between 0.806 and 0.959.

CONCLUSIONS

The three developed tools reflected the core elements of competency in each application area, representing an initial framework that could be useful in future research and educational projects. Cross-national investigations are required to corroborate the described results.

Student nurses' end-of-life and post mortem care self-efficacy: A descriptive study

BACKGROUND

Student nurses providing end-of-life care reported that caring for a person dying created anxiety, fear, and increased stress and reflected low self-efficacy. New nurses felt unprepared academically and emotionally. High self-efficacy is necessary to handle adverse emotional reactions. However, the literature lacks an instrument to evaluate nursing students' self-efficacy in caring for someone who is dying.

OBJECTIVE

The study aims to investigate the reliability and validity of the "End-of-Life and Postmortem Self-Efficacy Scale" and explore nursing students' self-efficacy associated with the nursing duties and responsibilities of caring for individuals during the active phase of dying and immediately after death.

DESIGN

The study was a quantitative descriptive, cross-sectional design.

PARTICIPANTS

National Student Nurses' Association members enrolled in undergraduate registered nurse associate's, bachelor's degree programs, or a nursing diploma program.

METHOD

National Student Nurses' Association members responded to an electronic survey containing 18 items related to end-of-life and post mortem nursing responsibilities.

RESULTS

A total of 498 responses were analyzed. Cronbach's alpha (α = 0.938) showed high reliability of the 18 items on the instrument. The Kaiser-Meyer-Olkin was 0.925 and indicated sampling adequacy. Bartlett's test of sphericity was highly significant (p = .001). The nursing students' mean end-of-life and post mortem self-efficacy score was 62 (scale of 0-100).

CONCLUSION

The "End-of-Life and Postmortem Self-Efficacy Scale" showed high reliability in evaluating the latent concept of end-of-life and post mortem self-efficacy. The low mean self-efficacy score indicated that nursing students might be underprepared to provide EOL and post mortem care as new graduates. Faculty can use the "End-of-Life and Postmortem Self-Efficacy Scale" to assess student readiness and identify gaps in knowledge in the care of someone who is dying. Future research is needed to determine how increasing nursing students' end-of-life and post mortem self-efficacy influences the perception of end-of-life preparedness.

Translation and psychometric evaluation of the persian version of the "Nursing Profession Self-Efficacy Scale"

BACKGROUND

Self-efficacy demonstrates the general competence of nurses in providing nursing care. Evaluation of nurses' self-efficacy is of particular importance to improve nursing care. The existing self-efficacy scales in Iran are insufficient due to lack of focus on the specific issues of the nursing profession. This study was conducted with the aim of translating and psychometrically evaluating the Persian version of "Nursing Profession Self-Efficacy Scale" (NPSES).

MATERIALS AND METHOD

This cross-sectional study was conducted in two parts: translation and psychometric evaluation. After getting permission from the original developer of the scale, the process of translating the questionnaire into Persian was done based on the Polit and Yang model. Then, the face validity was explored using a qualitative method with the participation of 10 nurses. The content validity was investigated using a qualitative and quantitative method (content validity index) with the participation of 15 experts. Construct validity was surveyed with exploratory and confirmatory factor analysis via completing the questionnaire by 550 nurses worked in different wards of hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd/Iran, who were selected using convenience sampling. The reliability of the tool was also established with internal consistency and stability methods, with the participation of 30 nurses. SPSS20 and AMOS were used for data analysis.

RESULTS

"Nursing Profession Self-Efficacy Scale" includes 19 items for which the translation and cultural compatibility of the Persian version were confirmed. Face validity and content validity (SCVI/Ave = 0.9) were acceptable. By conducting exploratory factor analysis, three factors (professional situation, care situation, and support situation) were identified, which accounted for 62.38% of the variance of the scores. In the confirmatory factor analysis, the values of the fit indices confirmed the appropriate fit of the model. The reliability was established using Cronbach's α method (α = 0.86) and an ICC of 0.83, indicating that the scale was reliable.

CONCLUSION

The translation, validity, and reliability of the Persian version of "Nursing Profession Self-Efficacy Scale" suggested that this tool has a clear and legitimate translation. Also, this tool has good validity and reliability and can be used as one of the tools to measure the self-efficacy of Iranian nurses.

Development and psychometric testing of Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS)

BACKGROUND

For nurses to carry out their responsibilities related to preoperative care in the best possible way, it is very important for them to receive competency-based training and for their competences to be measured with reliable and valid tools in the training process.

OBJECTIVE

To develop a measurement tool that evaluates nursing students' perceived competence for preoperative nursing care.

DESIGN

A cross-sectional, methodological study.

SETTING

Two universities in the Eastern Black Sea Region of Turkey.

PARTICIPANTS

A total of 661 second, third and fourth grade nursing students participated in the study.

METHODS

Items were created in line with the nursing competencies published by the International Council of Nurses, the competencies in the perioperative period nursing practices published by the European Operating Room Nurses Association, and a review of the literature. Then, to test the content validity, the items were submitted for expert opinion and a pilot implementation was made with 50 nursing students. Furthermore, the construct validity of the scale was tested with exploratory factor analysis (n = 253) and confirmatory factor analysis (n = 350). Test-retest stability was also investigated for the PPreCC-NS (n = 58), in the study.

RESULTS

According to the results of the exploratory factor analysis, the Kaiser-Meyer-Olkin value was 0.948, and the Bartlett test χ2 was 7765.23; p < 0.001. Three items with a factor loading value below 0.50 were removed from the scale, and the obtained factor structure explained 62.25 % of the variance. The fit indices of the scale model tested in the confirmatory factor analysis were determined as χ²/df = 2.74, RMSEA = 0.07, CFI = 0.92, GFI = 0.88, AGFI = 0.85, IFI = 0.92. The structure of the draft scale was confirmed with 5 factors and 22 items. The Cronbach alpha values were found to be 0.79-0.96 for the sub-dimensions of the scale and 0.94 for the total scale. Data also showed a good test-retest stability (ICC = 0.72).

CONCLUSIONS

This scale is a reliable and valid measurement tool for nursing students to determine their level of perceived competence for preoperative nursing care. It is recommended that the psychometric structure of the scale be evaluated with further studies on larger and more diverse samples.

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.

Exploring links between Chinese military recruits' psychological stress and coping style from the person-environment fit perspective: The chain mediating effect of self-efficacy and social support

The choice of coping style of recruits under psychological stress in the process of military task execution has been an important topic in the promotion of military operations and cohesion of military forces. Taking a positive coping style under psychological stress can help recruits overcome the negative effects of stress and improve military morale and group combat effectiveness. Although soldiers' psychological stress in the process of military mission execution having an impact on coping style has been studied by a large body of literature, very little literature has focused on the mechanism of self-efficacy and social support between recruits' psychological stress and coping style from the person-environment fit perspective. Therefore, this study was conducted to analyze the impact of recruits' psychological stress on coping style through a chain mediation model and to discuss the role of self-efficacy and social support in this relationship. Two waves of survey data were utilized to test the research hypotheses on a sample of 1028 Chinese recruits performing military tasks. The results indicated that recruits' psychological stress negatively impacted positive coping styles and positively correlated with negative ones. In addition, self-efficacy and social support mediated the relationship between psychological stress and positive coping style, and self-efficacy mediated the relationship between psychological stress and negative coping style. More importantly, self-efficacy and social support play the chain mediating effect between psychological stress and positive coping style.

Psychometric Properties of the Taiwanese Pressure Ulcer Management Self-Efficacy Scale in Nursing Practice

Self-efficacy strongly predicts clinical performance and competence. In Taiwan, there is no reliable method for assessing self-efficacy in the management of pressure injury. This study aims to establish psychometric properties of the Pressure Ulcer Management Self-Efficacy Scale (PUM-SES) translated for Taiwan and determine the validity and reliability of the Taiwanese version of the PUM-SES. Materials and methods: The PUM-SES was translated for use in Taiwan using Brislin’s method. The translation’s content validity, concurrent validity, predictive validity, internal consistency, and test−retest reliability were evaluated. The Pressure Ulcer Management Self-Efficacy Scale, Taiwanese version (PUM-SES-T), the Attitude toward Pressure Injury Prevention Scale (APIPS) and the Practice toward Pressure Injury Prevention Scale (PPIPS) of preventing pressure injury, and the General Self-Efficacy Scale (GSES) were tested using Pearson’s correlation. A cross-sectional survey with 330 RNs in Taiwan was conducted. The PUM-SES-T was used to predict the PPIPS, and a predictive regression model was constructed considering nursing demographic variables. Results: Seven experts evaluated the PUM-SES-T with a CVI value of 0.995. An internal consistency, using Cronbach’s α, of 0.762 and a test−retest reliability of 0.997 were obtained. The PUM-SES-T was positively correlated with the GSES (p < 0.001). Multiple regression revealed that the PUM-SES-T predicted practice with a strong predictive validity (F = 8.077, p < 0.001), had an adjusted R2 of 0.455, but collinearity was insignificant. In this study, PUM-SES-T is a valid instrument for intervention-related educational programs to measure self-efficacy with good reliability and validity. It can be employed when intervening in related education strategies or promoting policies.

Self-efficacy of caring for patients in the intensive care unit with delirium: Development and validation of a scale for intensive care unit nurses

BACKGROUND

Improving the self-efficacy of intensive care unit nurses for delirium care could help them adapt to the changing situation of delirium patients. Validated measures of nurses' self-efficacy of delirium care are lacking OBJECTIVES: The objective of this study was to develop a Delirium Care Self-Efficacy Scale for assessing nurses' confidence about caring for patients in the intensive care unit and to examine the scale's psychometric properties.

METHODS

Draft scale items were generated from a review of relevant literature and face-to-face interviews with intensive care unit nurses; content validity was conducted with a panel of five experts in delirium. A group of nurses were recruited by convenience sampling from intensive care units (N = 299) for item analysis of the questionnaire, assessment of validity, and reliability of the scale. Nurse participants were recruited from nine adult critical care units affiliated with a hospital in Taiwan. Data were collected from August 2020 to July 2021.

RESULTS

Content validity index was 0.98 for the initial 26 items, indicating good validity. The critical ratio for item discrimination was 14.47-19.29, and item-to-total correlations ranged from 0.67 to 0.81. Principal component analysis reduced items to 13 and extracted two factors, confidence in delirium assessment and confidence in delirium management, which explained 66.82% of the total variance. Cronbach's alpha for internal consistency was 0.94 with good test-retest reliability (r = 0.92). High scale scores among participants were significantly associated with age (≥40 years), work experience in an intensive care unit (≥10 years), delirium education, and willingness to use delirium assessment tools.

CONCLUSIONS

The newly developed Delirium Care Self-Efficacy Scale demonstrated acceptable reliability and validity as a measure of confidence for intensive care nurses caring for and managing patients with delirium in the intensive care unit.

Quality of Life of Pediatric Nurses During the COVID-19 Pandemic: A Cross-sectional Study

BACKGROUND

In a public health emergency, the psychological stress of nursing staff should be assessed, and nurses who cared for coronavirus disease 2019 (COVID-19) patients were constantly under pressure. Currently, frontline health care workers are experiencing mental health issues. The personal quality of life is directly related to the working environment, especially at this moment, when nursing could be a highly stressful and emotionally draining job.

OBJECTIVES

During the COVID-19 pandemic, the primary objectives of the study were to describe the quality of life, posttraumatic stress disorder, and self-efficacy and to identify any associated factors of pediatric critical care nurses. This study is a multicenter cross-sectional study.

METHODS

Data were collected between February and May 2021 from pediatric critical care nurses. The following instruments were used: the Nursing Quality of Life Scale, the Nursing Profession Self-Efficacy Scale, and the Impact of Event Scale.

RESULTS

One hundred twelve nurses participated in this study with a 40% of response rate. Data suggest a better global perception of quality of life by male subjects (F = 6.65, P = .011). The nurses who cared for COVID-19 patients reported a lower quality of social life (F = 4.09, P = .045); furthermore, the nurses who had clinically vulnerable people in their families reported a worse quality of physical life (F = 4.37, P = .045). Approximately 50% of nurses reported sleep disturbances, and 37% reported symptoms of posttraumatic stress disorder, especially female nurses (F = 8.55, P = .04).

CONCLUSION

According to this study, female nurses were more likely to experience posttraumatic stress disorder symptoms during the COVID-19 pandemic. Furthermore, findings also highlighted a lower quality of social life for those with clinically vulnerable relatives may be due to a self-limitation of interactions with other people. Finally, sleep disturbances were prevalent, potentially affecting nurses' mental health and performance.

Clinical Application Value of Group-Sharing Nursing Management Based on Case Analysis

The purpose of this study was to explore the clinical application value of group sharing nursing management based on a case analysis. The archive data of 90 nurses in 15 nursing units of our hospital were analyzed retrospectively. A total of 90 nurses from 15 nursing units in our hospital were retrospectively analyzed: the nurses before the implementation of the “case study-based group shared care management” program from January 2019 to January 2020 were set up as the control group, and the same nurses after the implementation of the program from January 2020 to January 2021 were set up as the study group. The nurses in the study group and the control group corresponded to 9759 and 8973 clinical inpatients, respectively. The overall incidence of medication-related, falling, tube-related, exam-related, and other types of adverse events was lower in the study group (0.52% vs. 1.29%) than those in the control group (P < 0.05); the overall nursing adverse event rating was lower in the study group than that in the control group (P < 0.05). Nurses in the study group scored higher than the control group on the following scales: Perceived Occupational Benefit Scale, General Self-Efficacy Scale, and Karlausk/Miller Satisfaction Scale (P < 0.05). The case study-based group-shared care management model can reduce the risk and harm of adverse events in hospitals and improve nurses' sense of professional benefit and self-efficacy.

Influence of continuing nursing care team mode on the rehabilitation of patients with pancreatic cancer after postoperative daily chemotherapy

OBJECTIVE

This study aimed to investigate the effect of continuing nursing care team mode on postoperative outpatient chemotherapy patients with pancreatic cancer.

METHODS

One-hundred patients receiving postoperative outpatient chemotherapy for pancreatic cancer between September 2019 and December 2020 were enrolled in this study and divided into two groups, an intervention group and a control group (n = 50 each), by random number table method or coin tossing method. The patients in the intervention group were followed up using continuing nursing care team mode, while those in the control group were followed up using the traditional telephone follow-up mode. The effects of the two modes on patients' self-care ability, quality of life, anxiety, hospital waiting time, and the nurses' communication ability and self-efficacy were compared and analyzed.

RESULTS

The self-care ability and quality of life of the patients in the intervention group were better than those of the control group (p < 0.05), the anxiety score and hospital waiting times were lower than those in the control group (p < 0.05), and the communication ability and general self-efficacy of the nurses were also significantly stronger than those in the control group (p < 0.05).

CONCLUSION

The application of the continuing nursing care team mode for follow-up can improve the self-care ability and quality of life of patients, effectively reduce the anxiety and hospital waiting time of outpatient chemotherapy patients, and improve the nurses' communication ability and general self-efficacy. Therefore, this practice is worthy of clinical popularization.

Factors Associated with Nurses' Perceived Competence in Pressure Injury Care in a Tertiary Hospital in Yunnan, China

OBJECTIVE

To assess nurses' perceived competence in pressure injury (PI) care and explore the association between perceived competence and nurses' backgrounds, knowledge, attitudes, and self-efficacy in PI care.

METHODS

This study used a descriptive correlational design. During January and February 2021, the authors sent an online questionnaire to 117 nurses caring for patients with or at risk of PI at a tertiary level hospital in Kunming, Yunnan Province, China, to collect information regarding demographics, knowledge, attitude, self-efficacy, and perceived competence in PI care. Univariate and multiple regressions were performed to assess the associations.

RESULTS

A total of 111 completed questionnaires were obtained, a response rate of 94.9%. Nurses reported inadequate knowledge and relatively low self-efficacy in PI care. However, they had positive attitudes and acceptable levels of perceived competence in PI care. According to a univariate analysis, being a wound specialist, having read PI-related articles or practice guideline within the past year, and having knowledge and self-efficacy in PI care were associated with nurses' perceived competence.

CONCLUSIONS

Pressure injury-related knowledge, attitude, and self-efficacy are independently associated with nurses' perception of their competency in PI care.

The role of anesthesiologists' perceived self-efficacy in anesthesia-related adverse events

BACKGROUND

Self-efficacy, as the vital determinant of behavior, influencing clinicians' situation awareness, work performance, and medical decision-making, might affect the incidence of anesthesia-related adverse events (ARAEs). This study was employed to evaluate the association between perceived self-efficacy level and ARAEs.

METHODS

A cross-sectional study was performed in the form of an online self-completion questionnaire-based survey. Self-efficacy was evaluated via validated 4-point Likert scales. Internal reliability and validity of both scales were also estimated via Cronbach's alpha and validity analysis. According to the total self-efficacy score, respondents were divided into two groups: normal level group and high level group. Propensity score matching and multivariable logistic regression were employed to identify the relationship between self-efficacy level and ARAEs.

RESULTS

The response rate of this study was 34%. Of the 1011 qualified respondents, 38% were women. The mean (SD) age was 35.30 (8.19) years. The Cronbach's alpha of self-efficacy was 0.92. The KMO (KMO and Bartlett's test) value of the scale was 0.92. ARAEs occurred in 178 (33.0%) of normal level self-efficacy group and 118 (25.0%) of high level self-efficacy group. Before adjustment, high level self-efficacy was associated with a decreased incidence of ARAEs (RR [relative risk], 0.76; 95% CI [confidence interval], 0.62-0.92). After adjustment, high level self-efficacy was also associated with a decreased incidence of ARAEs (aRR [adjusted relative risk], 0.63, 95% CI, 0.51-0.77). In multivariable logistic regression, when other covariates including years of experience, drinking, and the hospital ranking were controlled, self-efficacy level (OR [odds ratio], 0.62; 95% CI, 0.46-0.82; P = 0.001) was significantly correlated with ARAEs.

CONCLUSIONS

Our results found a clinically meaningful and statistically significant correlation between self-efficacy and ARAEs. These findings partly support medical educators and governors in enhancing self-efficacy construction in clinical practice and training.

Does the Synergy Model Implementation Improve the Transition from In-Hospital to Primary Care? The Experience from an Italian Cardiac Surgery Unit, Perspectives, and Future Implications

The demand for care services in the healthcare system has changed and is triggering a smooth transition from in-hospital to primary care. In this regard, patient-centered-care models of care delivery might provide a framework to follow patients' journeys throughout their transition between different levels of care. Accordingly, an Italian research group at a cardiac hospital in Northern Italy implemented the Synergy Model in a Cardiac Surgery Unit, a patient-centered-care model, and is using the framework of the model to guide a smooth transition of patients towards rehabilitation and primary care after their hospitalization. This discursive paper is focused on the experience, perspectives, and future implications of adopting the Synergy Model to facilitate the transition from in-hospital to primary care. The presented experience and discussion might be helpful to the international debate regarding the strategies to boost a smooth transition from in-hospital to primary care.

Psychometric Properties of the Korean Version of the Nursing Profession Self-Efficacy Scale

BACKGROUND

Self-efficacy in the nursing profession has been reported to have a positive effect on personal performance in terms of clinical performance and decision-making abilities, nursing performance, professional intuition, organizational commitment, and turnover intention.

PURPOSE

The purpose of this study was to verify the validity and reliability of the Korean version of the Nursing Profession Self-Efficacy Scale (K-NPSES).

METHODS

This methodological study used questionnaires collected from 307 nurses at medical institutions in South Korea. The content validity of the questionnaire was verified using the averaging method, whereas the criterion-related validity was evaluated by calculating the correlation with the Sherer General Self-Efficacy Scale. The construct validity was determined by analyzing the explanatory and confirmatory factors. Reliability was verified using Cronbach's α and test-retest by calculating intraclass correlation coefficients.

RESULTS

The content validity index of the K-NPSES was found to be greater than .95, and the criterion-related validity was satisfactory (coefficient = .57, p < .001). The original Nursing Profession Self-Efficacy Scale has two subfactors, and the K-NPSES analyzed in this study has four subfactors. The data were appropriate for factor analysis using Kaiser-Meyer-Olkin (.87) and Bartlett's sphericity test (χ2 = 1236.01, df = 137, p < .001). The model fit was acceptable (normed chi-square [χ2/df] = 2.22, root mean square residual = .05, root mean square error of approximation = .09, comparative fit index = .88, Tucker-Lewis index = .86, goodness-of-fit index = .83). Regarding reliability, Cronbach's α was .91 and the intraclass correlation coefficient was .78 (p < .001).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The findings of this study confirmed the K-NPSES as having acceptable validity. In addition to predicting nursing clinical performance, a well-established nursing profession self-efficacy scale may be used to improve the quality of clinical nursing.

SonoGames: sounds of the right kind introducing gamification into radiology training

BACKGROUND

Radiology as compared to other fields of medicine has lagged, in incorporating modern training modalities such as gamification and simulation into its teaching curriculum.

OBJECTIVE

This study aims to evaluate effectiveness of simulation-based teaching in collaboration with gamification. Bandura's conception of self-efficacy was used to provide qualitative assessment of participants' learning process through training event. Modified competitive game-based teaching methodology was utilized in an experimental study conducted for radiology residents. Workshop was divided into two sessions, first being three interactive didactic lectures followed by three competitive rounds. All participants were required to fill pre and post-self-efficacy questionnaire along with an activity evaluation form.

RESULTS

Significant self-efficacy scores were calculated for simulation-based stations of knowledge assessment and hands-on stations. Whereas significant association was also found between gender and knowledge assessment in communication skill (0.054), Professionalism (0.004), and general knowledge (0.018). Similarly, noteworthy correlation was found between gender and all hands-on skills. In conclusion, study reported an overall increase in knowledge of post-test scores compared to pre-test scores due to use of gamification in combination with simulation-based teaching which shows a positive role in clinical training. However, further consideration is needed to improve process of integrating simulation in clinical training of participants.

Development and Validation of the Safe Parenteral Medication Administration Self-Efficacy Scale

BACKGROUND

This study aimed to develop a valid and reliable measurement instrument for determining the self-efficacy perceptions of nurses concerning safe medication practices.

METHOD

The study was conducted at the hospital of a state university in Istanbul, Turkey, between August and December 2016. The sample consisted of 278 nurses.

RESULTS

The exploratory factor analysis indicated the scale had a single-factor structure that explained 47.92% of the total variance. The remaining 76 items had factor loads ranging from .50 to .87. The item-total correlations varied between .49 and .86, and Cronbach's alpha coefficient for the scale was .98.

CONCLUSION

The results of the analysis show the items constituting the scale have validity and reliability criteria that can measure the self-efficacy of nurses related to parenteral medication administration. [J Contin Educ Nurs. 2021;52(6):267-273.].

Pediatric Ward Nurses' Caring Self-Efficacy Scale: Development and Validation

BACKGROUND

No instrument specifically designed to investigate the caring self-efficacy of nurses in pediatric wards was found. The aim of the present study was therefore to develop a scale to evaluate pediatric wards nurse's caring self-efficacy.

MATERIALS AND METHODS

In this study, an exploratory, sequential, mixed method was used in 2015 in Iran. Data collected from 27 semi-structured interviews with nurses in pediatric wards were analyzed using conventional content analysis. The initial version of the scale was obtained with 65 items. Face validity was determined using impact score and content validity using the Content Validity Index (CVI) and Content Validity Ratio (CVR). The construct validity of the scale was investigated using exploratory factor analysis with 305 nurses in pediatric wards. The concurrent validity of the scale was acquired using the General Self-Efficacy Scale. Internal consistency and test-retest reliability were also examined.

RESULTS

The scale-CVI (S-CVI) (average) was 0.85. The 14 items with a CVR and CVI of less than 0.51 and 0.70, respectively, were deleted and the final 51-item scale was approved. All 51 items had good impact score (>1.50). In the final scale, four subscales were extracted using construct validity. The concurrent validity of the scale was also obtained (r = 0.77, p < 0.001). The total Cronbach's α correlation coefficient of the scale was 0.96 and test-retest reliability was 0.98.

CONCLUSIONS

The Pediatric Ward Nurses' Caring Self-Efficacy (PWNCSE) scale developed in this study is a practical, reliable, and valid scale to evaluate pediatric ward nurses' caring self-efficacy.

Nursing self-efficacy for oral anticoagulant therapy management: Development and initial validation of a theory-grounded scale

AIM

This study aimed to develop and validate a nursing self-efficacy scale for OAC management (SE-OAM).

BACKGROUND

Oral anticoagulant therapy (OAC) requires specific nursing competencies. Given that self-efficacy acts as a proxy assessment of nursing competence, its measurement is pivotal for addressing educational programs to enhance nursing competence in managing OAC. Thus far, the measurement of self-efficacy in OAC is undermined by the unavailability of valid and reliable tools.

METHODS

A multi-method and multi-phase design was adopted: Phase one was a methodological study encompassing developmental tasks for generating items. Phase two comprised the validation process for determining the content validity, construct and concurrent validity, and internal consistency through two cross-sectional data collections.

RESULTS

In total, 190 nurses were enrolled for determining the psychometric structure of the SE-OAM through an exploratory approach, and 345 nurses were subsequently enrolled to corroborate its most plausible factor structure derived from the exploratory analysis. The SE-OAM showed evidence of face and content validity, adequate construct, concurrent validity, good internal consistency, and stability. The final version of the scale encompassed 21 items kept by five domains: clinical management, care management, education, clinical monitoring, and care monitoring.

CONCLUSIONS

The SE-OAM showed evidence of initial validity and reliability, fulfilling a current gap in the availability of tools for measuring nursing self-efficacy in managing OAC. SE-OAM could be strategic for performing research to improve the quality of OAC management by enhancing nursing self-efficacy.

Professional values and nursing self-efficacy in the Italian context. Correlational descriptive study

INTRODUCTION

Nurses' professional values (NPVs) and self-efficacy (SE) are two fundamental elements in nursing care that influence its professional identity, competences, resulting in changing the behaviour of professionals and their response to the patient's health needs. The various studies produced so far have not investigated a possible relationship between these two areas. Therefore, the objective of the following study is to identify and deepen the relationship between NPV and SE, in order to improve the knowledge of these issues.

MATERIALS AND METHODS

An observational, correlational and multicentric study has been carried out through a questionnaire based survey. The sampling was conventional. The data collection took place through Nursing Professional Values Scale, version 3 (NPVS-3), which investigates professional values; and Nursing Professional Self-Efficacy Scale (NPSES), which investigates self-efficacy and a socio-demographic questionnaire.

RESULTS

The total sample was 532 nurses and 65.6% was female, with a median age of 42 years and a median of 15 working years. Positive statistically significant correlations between the various domains of the NPVS-3 and NPSES scales were found. These relationships also emerged in the analyses between geographical areas. Overall, the relationships between self-efficacy and values were similar in all the analyses.

DISCUSSION

As the professional values of nurses increase in their response to the patient's health needs, self-efficacy perceived by them increases and vice versa, significantly effecting the clinic and care outcomes of the patients and improving nursing outcomes. The stratification of the sample by geographical area regarding the relationship between age, years of work and professional values indicated that these variables strongly influence the NPV and SE of nurses. Therefore, in some contexts, more support in maintaining a stable value structure may be needed; moreover, it is necessary to incentivise nurses with more effective interventions, as an example and a basis of motivation for future generations.

Validation of the Korean Version of the Nursing Profession Self-Efficacy Scale: A Methodological Study

Background: The Nursing Profession Self-Efficacy (NPSE) scale was developed to reflect the characteristics of nursing tasks. This study was conducted to validate the Korean version of the NPSE (K-NPSE) scale. Methods: The NPSE scale with nineteen items was translated into Korean after forward and backward translation according to Devellis’ guideline. For the exploratory factor analysis (EFA), 298 nurses participated and criterion-related validity and reliability were verified. For the confirmatory factor analysis (CFA), 218 other nurses participated. Content validity, criterion-related validity, and internal consistency reliability were examined. Additionally, construct validity was examined. SPSS and AMOS were used for the data analyses. Results: Nineteen items were selected after evaluating the content and cognitive validity and comprised three factors: “Professional (10 items)”, “Advocating (4)”, and “Caring (5)”. Construct validity was supported by the CFA. Criterion-related validity was supported by comparison with the General Self-Efficacy Test (r = 0.43, p < 0.001). Cronbach’s alpha of the K-NPSE was 0.93. Conclusions: Study findings indicate that the K-NPSE could be useful for assessing nurses’ self-efficacy. The K-NPSE may be used as a valuable reference for developing programs or policies that promote nursing professionals. It is expected that continued use of this scale in various clinical settings to further generalize and validate the scale.