Nurses’ perceptions of individualized care: an international comparison

Does individualized care make a difference in postpartum discharge?: A block randomized controlled trial

With this study, we aimed to determine the severity of physical symptoms displayed by mothers who received individualized care during the early postpartum period and their level of perceived readiness for discharge after birth. We conducted the study as a single-blind randomized controlled trial, assigning the mothers to the experimental (EG = 60) and control (CG = 60) groups using the permuted block randomization method. We administered the EG individualized care and the CG a routine care. Both groups received Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form. The mean posttest scores the groups obtained from Postpartum Physical Symptom Severity Scale and Readiness for Hospital Discharge Scale-New Mother Form were significant in favor of the EG (p < 0.05). It is fair to state that individualized care is effective in reducing the physical complaints increasing the maternal health and improving the general health.

Effects of health literacy competencies on patient-centered care among nurses

Background

This study aims to identify the relationship between health literacy competencies and patient-centered care by clinical nurses.

Methods

The participants were 180 nurses working at three university hospitals located in G City and J Province, South Korea. Self-evaluation questionnaires were used to collect data that were collected from June 1 to 30, 2021. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression with SPSS 26.0.

Results

The mean of health literacy competencies was 3.19 (4 point scale) and the mean of patient-centered care was 3.48 (5 point scale). There were significant positive relationships between health literacy competencies and patient-centered care by clinical nurses (r = .50, p < .001). Factors influencing the health literacy competencies of clinical nurses were identified as education level (university) (β = .82), education level (masters) (β = .74), prior health literacy knowledge (β = .52), and health literacy competencies (β = .44). The explanatory power of this regression model was 36%, which was statistically significant (F = 17.65, p < .001).

Conclusion

Clinical nurses’ health literacy competencies should be developed to improve patient-centered care. Nursing education programs should emphasize the integration of health literacy into the nursing school curriculum.

Factors influencing mental health nurses in providing person-centered care

BACKGROUND

Mental health nurses advocate for patients through a person-centered approach because they care for people experiencing mental distress who tend to be limited to exercising their human rights and autonomy through interpersonal relationships. Therefore, it is necessary to provide high-quality person-centered care for these patients by identifying the influencing factors.

AIM

This study aims to identify the factors affecting mental health nurses in performing person-centered care for patients.

RESEARCH DESIGN

This study had a cross-sectional, descriptive-correlational survey design.

PARTICIPANTS AND METHOD

Nurses (N = 166) working at psychiatric wards in Korea completed an online questionnaire on moral sensitivity, attitudes toward people with mental illness, and person-centered care. The t-test and stepwise multiple regression analysis were used.

ETHICAL CONSIDERATIONS

Ethical approval for the study was obtained from the relevant ethics committee.

FINDINGS

Moral sensitivity was a significant factor correlating with the provision and perception of person-centered care. Attitudes toward patients had no effect on person-centered care. The predictor variables for the provision of person-centered care (R² = 0.247) were moral sensitivity (β = 0.33), having a professional qualification (β = 0.19), marital status (β = 0.18), and closed ward (β = -0.15). The predictor variables for the perception of person-centered (R² = 0.150) care were closed ward (β = -0.25), moral sensitivity (β = 0.23), and marital status (β = 0.18).

DISCUSSION AND CONCLUSION

Mental health nurses can strengthen person-centered care by improving moral sensitivity related to the ethical aspect of nursing and professional competence to address the complex needs of patients. Person-centered care needs to be applied more carefully in closed wards where human rights issues may arise. Through these efforts, the dignity of patients can be protected.

Occupational fatigue, individualized nursing care, and quality of nursing care among hospital nurses

PURPOSE

This study aimed to evaluate the relationships among nurse fatigue, individualized nursing care, and nurse-reported quality of care.

DESIGN

The study used a cross-sectional design. Data from 858 registered nurses providing bedside care in hospitals were collected between March and April 2021 in the United States.

METHODS

Participants completed a self-administered online survey, including the Occupational Fatigue Exhaustion Recovery scale, the Individualized Care Scale-Nurse version, and a single item assessing nursing care quality. Relationships among the study variables were examined using multiple linear and logistic regression models.

FINDINGS

Nurses' higher levels of acute fatigue were significantly associated with decreased perceptions of individualized nursing activities provided to patients on their last shifts, specifically related to personal life condition and decision-making control. Nurses' higher levels of chronic fatigue were significantly associated with decreased perception of individualized nursing activities provided to patients on their last shifts related to clinical condition, personal life condition, and decision-making control. Nurses with higher levels of acute or chronic fatigue, and who perceived their nursing care activities as less individualized were less likely to assess their quality of care as excellent.

CONCLUSION

These findings suggest that addressing hospital nurses' acute and chronic fatigue may contribute to promoting the delivery of individualized nursing care and in improving patients' quality of care.

CLINICAL RELEVANCE

Healthcare institutions are encouraged to regularly monitor and manage nurse fatigue to improve the delivery of individualized and quality nursing care to their patients.

The Relationship Between Nurses' Professional Values and Their Attitudes Towards Care Giving Roles: A Structural Equation Model

Objective: The study was carried out to examine the relationship between nurses' professional values and caregiver roles. Methods: This study is based on a descriptive correlational research design using a structural equation model. 366 nurses participated in the study. It was gathered using Nurse Promotion Form the Professional Values Scale of Nurses and the Attitude Scale for Their Caregiver Roles. Results: The total mean score of the Nurses' Professional Values Scale was determined as 94.73±17.87. Nurses' Perceptions of Caregiving Roles Attitude Scale total score mean was determined as 62.41±9.22. According to the Structural Equation model, professional values of nurses explain 39% of the change in the value of the attitude towards caregiver roles (R2 =0.39). Conclusion: Nurses' professional values and attitudes towards caregiver roles are at a good level and professional values of nurses partially affect the attitude towards caregiver roles.

"Walking in the patient's shoes": An innovative training method using storytelling to promote knowledge transfer of patient-centered care in hospital: A quasi-experimental study

OBJECTIVE

To evaluate an onsite patient-centered care (PCC) training program for nurses using a digital patient-storytelling approach.

BACKGROUND

PCC is a dominant model for improving the quality of care. Effective strategies for providing PCC training to nurses can yield numerous benefits.

DESIGN

A pretest-posttest design was used with a nonrandomized control group METHODS: PCC training program involved participants playing a patient role to experience their hospital journey. Nurses' perception of PCC, compassion and knowledge transfer were measured before (pretest) and after (posttest) PCC training (experimental group). Controls received PCC training only after pretest and posttest evaluations.

RESULTS

Changes in PCC perception and compassion were significantly greater in the experimental group (n = 39) than in controls (n = 49; p = .001 and .006, respectively). PCC knowledge transfer was significantly correlated with PCC perception (r = 0.55) and compassion (r = 0.63).

CONCLUSIONS

Through the PCC training program, the perceived improvements of the nurses' views on supporting patient individuality and compassion while providing care were revealed. This program is also potential for promoting PCC knowledge transfer into the daily activities of nurses. Therefore, such PCC training programs could be a good beginning in developing a patient-centered culture in healthcare systems.

Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers

Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient’s clinical situation, personal life situation, and decisional control. Methods: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. Results: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals’ perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients’ ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals’ and patients’ samples, related to the personal life situation sub-scale. Conclusions: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients’ understanding and experience of individuality in care.

An evaluation of instruments measuring behavioural aspects of the nurse-patient relationship

The Fundamentals of Care Framework is an evidence-based, theory-informed framework that conceptualises high-quality fundamental care. The Framework places the nurse-patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse-patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse-patient relationship instruments by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty-seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring 'focus', 'anticipate' and 'evaluate'. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse-patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework.

Relationship between individualized care perception and innovativeness among final-year nursing students

PURPOSE

The aim of this study was to evaluate the relationship between individualized care (IC) perceptions and innovativeness among final-year nursing students.

DESIGN AND METHODS

The population of this analytical study consisted of 230 students. Data were collected using a student information form (individualized care scale [ICS]-nurse version, individual innovativeness). Data analysis was carried out using descriptive, comparative, correlational, and stepwise regression analysis statistics.

FINDINGS

Nursing students had a high perception of IC and an early majority level of innovativeness. As their innovativeness levels increased, their perceptions of IC also increased. There was a positive correlation between the total ICS-A-nurse score and the individual innovativeness scale/openness to experience subscale. In regression analysis, the individual innovativeness total increased IC.

PRACTICE IMPLICATIONS

Courses and practical work should be organized for students to raise their awareness of IC and to increase their innovativeness.

Association between Turkish clinical nurses' perceptions of individualized care and empathic tendencies

PURPOSE

This study aimed to determine the association between nurses' perceptions of individualized care and empathic tendencies.

DESIGN AND METHODS

This cross-sectional study was conducted with 269 nurses working in Yozgat City Hospital between June 2018 and December 2018. Data were collected with the Personal Information Form, Individualized Care Scale-A-Nurse Version, Empathic Tendencies Scale. For the analysis, descriptive statistics, t test, analysis of variance, Pearson's correlation, multivariate linear regression analysis were used.

FINDINGS

Marital status, education level, length of service, clinic worked in, number of patients, and empathic tendency level was determined to be statistically significant predictive factors for nurses' perceptions of individualized care (P < .05).

PRACTICE IMPLICATIONS

Nurse managers can organize in-service training programs to improve clinical nurses' perceptions of individualized care, empathic tendencies, and skills.

Factors associated with the provision of individualized care during hospitalization: A systematic review

AIM

To analyse and integrate the existing literature on nurses' perceptions regarding factors associated with the provision of individualized care in hospital contexts.

BACKGROUND

Individualized care considers the personal characteristics of patients and promotes their participation in decision-making. The application of individualized care is not standardized among professionals.

METHODS

A systematic literature search was performed in Scopus, Web of Science, MEDLINE, Índice Médico Español, CUIDEN, ProQuest, PsycoINFO, CINAHL and the Cochrane Library, for studies published in English or Spanish analysing nurses' perceptions on factors associated with the provision of individualized care.

RESULTS

A total of 6,330 articles were retrieved, of which 13 fulfilled the inclusion criteria. The provision of individualized care was influenced by the nurses' personal characteristics (academic training, being a specialist, age, professional experience, personal motivation, empathy and culture) and by organisational factors (staff ratio, routinization and standardization of care, autonomous professional practice, leadership and positive work environment).

CONCLUSIONS

Nurses' perceptions on the provision of individualized care are influenced by their personal characteristics and organisational factors.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers may optimize personalization of care by encouraging positive work environments; ensuring adequate staffing; avoiding routinization or standardization of care; and promoting training, leadership and autonomy of nursing professionals.

The Dutch Individualised Care Scale for patients and nurses - a psychometric validation study

Aims and objectives

Translating and psychometrically assessing the Individualised Care Scale (ICS) for patients and nurses for the Flemish and Dutch healthcare context.

Background

Individualised care interventions have positive effects on health outcomes. However, there are no valid and reliable instruments for evaluating individualised care for the Flemish and Dutch healthcare context.

Design

Psychometric validation study.

Setting and participants

In Flemish hospitals, data were collected between February and June 2016, and in Dutch hospitals, data were collected between December 2014 and May 2015. Nurses with direct patient contact and a working experience of minimum 6 months on the wards could participate. Patient inclusion criteria were being an adult, being mentally competent, having an expected hospital stay of minimum 1 day, and being able to speak and read the Dutch language. In total, 845 patients and 569 nurses were included.

Methods

The ICS was translated into Dutch using a forward–backward translation process. Minimal linguistic adaptations to the Dutch ICS were made to use the scale as a Flemish equivalent. Omega, Cronbach’s Alpha, mean inter‐item correlations and standardised subscale correlations established the reliability and confirmatory factor analysis the construct validity of the ICS.

Results

Internal consistency using Omega (Cronbach’s Alpha) ranged from 0.83 to 0.96 (0.82–0.95) for the ICS‐Nurse and from 0.88 to 0.96 (0.87–0.96) for the ICS‐Patient. Fit indices of the confirmatory factor analysis indicated a good model fit, except for the root mean square error of approximation, which indicated only moderate model fit.

Conclusion

The Dutch version of the ICS showed acceptable psychometric performance, supporting its use for the Dutch and Flemish healthcare context.

Relevance to clinical practice

Knowledge of nurses’ and patients’ perceptions on individualised care will aid to target areas in the Dutch and Flemish healthcare context in which work needs to be undertaken to provide individualised nursing care.

The association of job satisfaction and burnout with individualized care perceptions in nurses

Background:

Individualized care is closely related to the fulfillment of nurses’ ethical responsibilities regarding the provision of healthcare as well as having a strong foundation in the philosophy of nursing.

Objective:

This study aimed to determine the association of job satisfaction and burnout with individualized care perceptions in nurses working at a university hospital located in the Central Black Sea region of northern Turkey.

Research design:

A cross-sectional correlational survey design.

Participants and research context:

The study was conducted between 15 February 2017 and 15 August 2017 with 419 nurses working at a public university hospital located in Samsun. Data were collected using an information form, the Individualized Care Scale-Nurse Version, the Minnesota Job Satisfaction Scale, and the Maslach Burnout Inventory. The Mann–Whitney U test, Kruskal–Wallis test and Spearman Correlation were used.

Ethical considerations:

Ethical approval for the study was obtained from the Ondokuz Mayıs University Clinical Studies Board of Ethics. Oral informed consent was taken from the participants.

Findings:

There was a significant positive relationship between the total Individualized Care Scale-A Nurse Version score and the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale (r = 0.121, p < 0.05). The total Individualized Care Scale-A Nurse Version score increased as the General Satisfaction subscale score of the Minnesota Job Satisfaction Scale increased. There was a significant negative relationship between the total Individualized Care Scale-B Nurse Version score and the Desensitization (r = –0.143, p < 0.01) and Personal Achievement subscale scores of the Maslach Burnout Inventory (r = –0.182, p < 0.01). The Desensitization and Personal Achievement subscale scores of the Maslach Burnout Inventory increased as the total Individualized Care Scale-B Nurse Version score decreased.

Discussion:

Factors associated with the individualized care perceptions of nurses, such as job satisfaction and burnout levels and factors related to personal life and worklife should be taken into consideration. Also in order to increase job satisfaction and motivation in nurses, personal preferences regarding the service they want to work at should be taken into account.

Conclusion:

Nurses with lower burnout and higher job satisfaction were found to have higher individualized care perceptions and to support the individuality of patients in care applications. It is important to consider work-related factors associated with individualized care perceptions, job satisfaction, and burnout in nurses.

The relationship amongst student nurses’ values, emotional intelligence and individualised care perceptions

Background:

Students’ gaining and adopting basic professional values, improving their emotional intelligence skills during the process of nursing education plays a significant role on meeting the needs of healthy/patient individual and his or her family, and individualized care practices.

Objectives:

This (descriptive, correlational) research was carried out to evaluate the nursing values, emotional intelligence levels, and individualized care perceptions of senior nursing students and to determine the relationship between them.

Research question:

(1) What is the status of students to adopt nursing values? (2) What is the level of students’ emotional intelligence? (3) What is the students’ individualized care perception? (4) Is there a relationship between students’ nursing values, levels of emotional intelligence, and individualized perceptions of care?

Participants and research context:

The research was carried out with 218 senior nursing students at the Faculty of Nursing, affiliated to a state university in Istanbul, who agreed to participate in the study, completing basic nursing education in May 2017.

Ethical considerations:

Ethical approval for this study was obtained from the Ethics Committee of Clinical Investigations of the Istanbul University Dentistry Faculty. Written permission was also obtained from the institution that research would be conducted. Before the data were collected, verbal permission was obtained by the investigator.

Findings:

It was observed that nursing values perceptions of students, emotional intelligence levels and individualized care perceptions were at a good level and there was a supportive relationship between them in the positive direction. It was determined that emotional intelligence skills of students, adoption of nursing values and individualized care perceptions increased in parallel with each other.

Conclusion:

In nursing education, nursing values peculiar to affective field, caring behaviors, and emotional intelligence skills that are guiding to maintain and direct these behaviors should be gained to students by supporting with correct learning methods and role models.

Individualized Care Scale-patient: A Spanish validation study

Background:

I suggest this individualized care is a fundamental principle closely linked to nursing ethics and has important benefits for the patients, however, nurses do not always take into consideration the principles of individualized care. Moreover, there is no validated instrument to assess patients’ views of individualized care in Spanish-speaking countries.

Objectives:

To assess the validity and reliability of the Spanish version of the Individualized Care Scale-patient.

Design:

A cross-sectional study design was conducted. A questionnaire survey, including the Individualized Care Scale-patient, was used for data collection. Psychometric properties of reliability and validity were assessed. Fit indices of the overall model were computed.

Participants and research context:

Survey data were collected from a sample of 118 inpatients at a public hospital in Spain.

Ethical considerations:

Informed consent from participants and ethical approval was obtained from a regional Clinical Research Ethics Committee.

Findings:

Ordinal Cronbach’s alphas were 0.966 for Individualized Care Scale-patient subscale A and 0.969 for Individualized Care Scale-patient subscale B. The polychoric correlation between each item and the subscale ranged between 0.653–0.874 and 0.604–0.916, respectively. The exploratory factor analysis revealed a three-factor solution. Personal life situation explained relatively large amounts of the variance. Goodness of fit index showed a good fit for the model.

Discussion:

This study confirms three factors underlining the individualized care concept, but some differences were found in the load of the factors, such as the relevance of “personal life situation” subscale, that need further research.

Conclusion:

The Spanish version of the Individualized Care Scale-patient is reliable, valid, user-friendly, and suitable to be used in Spanish-speaking countries showing satisfactory properties. This instrument may help managers better understand and develop areas in which patients perceive lower individualized care received and the factors influencing it. Such key information will help ensure the right of the patient to be respected as an individual.

Variability in Acuity in Acute Care

OBJECTIVE

This study was designed to describe variable acuity among 1 population of acute care patients.

BACKGROUND

Acuity, defined as the individual patient need for nursing care, can inform level of care, nurse staffing, and the nurse-to-patient assignment. Nurse-generated data in the electronic health record can be mined and analyzed for decision support.

METHODS

This study used a descriptive, retrospective analysis of repeated measures of acuity generated from 28 739 nursing assessments of 405 consecutive subjects treated for heart failure (HF) in a 455-bed southern hospital.

RESULTS

Patients treated for HF have variable care needs throughout the course of treatment. Univariate analysis of variance and post hoc analysis found that gender, age, type of unit, and length of stay (LOS) had a significant impact on acuity, P < .01, with a very small effect of less than 1%, indicating that acuity should be measured instead of assumed. Patients in medical-surgical and step-down units had highly variable acuity, ranging from ready to discharge to acuity levels consistent with critical care. Across the LOS, the mean acuity stabilized at 12 hours after admission, decreased until 88 hours, then increased steadily through discharge.

CONCLUSIONS

Understanding the variability in acuity within an individual patient, or a specific patient population, will contribute to decision support levels of patient care, staffing, nurse-patient assignments, and the cost of care. Frequent, sequential, and real-time measures of acuity may be valuable for tracking patient progress or measuring response to nursing interventions.

Level of Perception of Individualized Care and Satisfaction With Nursing in Orthopaedic Surgery Patients

Lately, individualized nursing care and patient satisfaction are important and current issues being discussed. But there is not enough information for patients undergoing orthopaedic surgery. The aim of this study was to determine the individualized care perception and satisfaction in nursing care levels in orthopaedic surgery patients. This descriptive cross-sectional study was conducted with 156 patients who underwent orthopaedic surgery. Data were collected using the personal information form, the Individualized Care Scale, and the Newcastle Satisfaction With Nursing Scale. The Spearman correlation analysis and descriptive statistics were performed. The mean individualized care and satisfaction with nursing care scores were found to be close to the preset maximum value, and it was determined that an increase in the level of awareness about nursing interventions and the level of perceived individualized care caused an increase in satisfaction levels regarding nursing care. Nurses should recognize the importance of performing individualized care in order to increase the level of satisfaction with nursing care in orthopaedic surgery patients.

The relationship between individualized care and the practice environment: an international study

BACKGROUND

Previous research studies have found that the better the quality of practice environments in hospitals, the better the outcomes for nurses and patients. Practice environment may influence nurses' ability to individualize care but the detailed relationship between individualized care and the professional practice environment has not been investigated widely. Some evidence exists about the association of practice environments with the level of individualization of nursing care, but this evidence is based on single national studies.

OBJECTIVES

The aim of this study was to determine whether nurses' views of their professional practice environment associate with their views of the level of care individualization in seven countries.

DESIGN

This study had an international, multisite, prospective, cross-sectional, exploratory survey design.

SETTINGS

The study involved acute orthopedic and trauma surgical inpatient wards (n=91) in acute care hospitals (n=34) in seven countries, Cyprus, Finland, Greece, the State of Kansas, USA, Portugal, Sweden, and Turkey.

PARTICIPANTS

Nurses (n=1163), registered or licensed practical, working in direct patient care, in orthopedic and trauma inpatient units in acute care hospitals in seven countries participated in the study.

METHODS

Self-administered questionnaires, including two instruments, the Revised Professional Practice Environment and the Individualized Care Scale-Nurse (Individualized Care Scale-Nurse A and B) were used for data collection. Data were analyzed statistically using descriptive statistics, simultaneous multiple regression analysis, and generalized linear model.

RESULTS

Two regression models were applied to assess the predictive validity of the Revised Professional Practice Environment on the Individualized Care Scale-Nurse-A and B. The results showed that elements of the professional practice environment were associated with care individualization. Internal work motivation, cultural sensitivity, control over practice, teamwork, and staff relationship with physicians were predictors of support (Individualized Care Scale-A) for and the delivery (Individualized Care Scale-B) of individualized care.

CONCLUSIONS

The results of this study provide evidence that environment aspect could explain variations in care individualization. These findings support the assertion that individualized care needs to be understood in a broader context than the immediate nurse-patient relationship and that careful development of the care environment may be an effective way to improve care quality and outcomes.

Cypriot and Greek nurses' perceptions of the professional practice environment

BACKGROUND

Research evidence supports that the role of the professional practice environment is crucial for the delivery of quality care as it is significantly correlated with patient and nurse outcomes. However, in countries sharing similar cultural and ethnic backgrounds, like Cyprus and Greece, as well as the increased mobility of patients and healthcare workers, there is a lack of information regarding this issue. The aim of this study is to explore and compare Cypriot and Greek nurses' perceptions of their professional practice environment.

METHODS

A descriptive comparative survey was employed using a sample of nurses in Cyprus (N = 150) and Greece (N = 147). Information was collected with the Revised Professional Practice Environment Scale (RPPE).

RESULTS

The results revealed significant differences between the two countries in three out of eight factors of the RPPE, with Greece's mean value being higher than Cyprus's: Handling Disagreements and Conflicts, Leadership and Autonomy in Clinical Practice, and Teamwork.

CONCLUSIONS

The findings generate additional knowledge about the organizational context of care delivery that might help nursing leaders to understand how nurses perceive their work environment and how this influences their work, and consequently the care provided. The results can be utilized by nurse ward managers to improve the quality of nursing care provided. Further research is needed using different approaches to explore nurses' experience in more depth.

IMPLICATIONS FOR NURSING OR HEALTH POLICY

Measuring nurses' perceptions of their professional practice environment may assist managers and policymakers in introducing interventions that contribute to a better practice environment and consequently to improved nursing, as well as patient, outcomes.

Nursing organizational climates in public and private hospitals

Background:

Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction.

Objectives:

The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals.

Materials and methods:

A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals.

Results:

A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale.

Discussion and conclusions:

In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate.

Patients’ and nurses’ perceptions of respect and human presence through caring behaviours: A comparative study

Although respect and human presence are frequently reported in nursing literature, these are poorly defined within a nursing context. The aim of this study was to examine the differences, if any, in the perceived frequency of respect and human presence in the clinical care, between nurses and patients. A convenience sample of 1537 patients and 1148 nurses from six European countries (Cyprus, Czech Republic, Finland, Greece, Hungary and Italy) participated in this study during autumn 2009. The six-point Likert-type Caring Behaviours Inventory-24 questionnaire was used for gathering appropriate data. The findings showed statistically significant differences of nurses’ and patients’ perception of frequency on respect and human presence. These findings provide a better understanding of caring behaviours that convey respect and assurance of human presence to persons behind the patients and may contribute to close gaps in knowledge regarding patients’ expectations.

Caregivers' work satisfaction and individualised care in care settings for older people

AIM AND OBJECTIVES

To examine the association between caregivers' work satisfaction and individualised care in different care settings for older people.

BACKGROUND

Work satisfaction in older people care settings has been associated with absenteeism, staff turnover and the quality of care delivered. The management of individuality is an important quality of care issue. Although these two issues are important there is little evidence about the possible association between them.

DESIGN

An exploratory and correlational survey design.

METHODS

Data were collected using three questionnaires, the Individualised Care Instrument the Individualised Care Scale-Nurse and the Index of Work Satisfaction from a sample of professional nursing caregivers (n=263, response rate 71%) in care settings for older people in one health care area in Finland in 2010. Statistical analysis included descriptive statistics, correlations, analysis of variance and multiple regression analysis.

RESULTS

Caregivers support the patient's individuality through specific activities, perceiving that they maintain individuality in care provision whilst reporting moderate work satisfaction. The ratings of individuality assessments were the lowest in nursing homes followed by long-term care in in-patient wards. There were statistically significant correlations between work satisfaction and specific perceptions in the support of individuality. The sub-scales of the instruments used were: the Support of Individuality in general, Individuality in the Care Provided, Knowing the Person, Staff-to-Resident Communication and Staff-to-Staff Communication. Significant statistical differences in the results were found between staff working in home care, primary health care, in-patient wards and nursing homes.

CONCLUSIONS

Low job satisfaction can affect the provision of individualised care emphasising the need to promote individualised care at an organisational level as a means of improving work satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Instruments to measure work satisfaction and individualised care can be used to improve care quality.