Development and psychometric testing of the Nursing Workplace Relational Environment Scale (NWRES)

Measuring Nurses' Organizational Well-Being: A Systematic Review of Available Instruments

This systematic review aimed to identify and compare instruments measuring nurses' organizational well-being, summarise the dimensions measured by these instruments, the statistical analysis performed for validity evidence and identify an instrument that comprehensively investigates nurses' organizational well-being. The JBI Manual for Evidence Synthesis and the PRISMA checklist were used as guidelines. The search was conducted on Medline, CINAHL, Cochrane Library and Scopus. Critical appraisal and data extraction were drawn on the COSMIN checklist. Dimensions were conceptually synthesized by the measurement concepts' similarity. Twenty-two articles were retrieved and they included 21 instruments that measured nurses' organizational well-being. The instruments vary by dimension number (range 2-19), items (range 12-118) and concept elicitation. A plurality of methodologies has been used in instrument development and assessments of evidence for validity. Only four instruments reported a concurrent criterion validity or a measurement comparison with an already tested-for-validity instrument. Similar dimensions were leadership and support, relationships and communication, work-family balance, work demands, violence, control and autonomy, satisfaction and motivation, work environment and resources, careers, and organizational policy. This review underlines the core areas of the instruments that measure nursing organizational well-being. It allows administrators and researchers to choose the appropriate instruments for monitoring this multidimensional concept.

Safeguarding the retention of nurses: A systematic review on determinants of nurse's intentions to stay

AIM

To explore factors that influence registered nurses' intention to stay working in the healthcare sector.

DESIGN

A systematic review and narrative synthesis.

METHODS

CINAHL, Medline and Cochrane library databases were searched from Jan 2010 to Jan 2022 inclusive and research selected using a structured criterion, quality appraisal and data extraction and synthesis were guided by Campbell's Synthesis Without Meta-analysis.

RESULTS

Thirty-four studies identified that nurses stay if they have job satisfaction and/or if they are committed to their organizations. The factors permeating these constructs weigh differently through generations and while not an infallible explanation, demonstrate stark differences in workplace needs by age, which influence the intention to stay, job satisfaction, organizational commitment and ultimately nurse turnover.

PUBLIC CONTRIBUTION

Environmental, relational and individual factors have bearing on improving nurse satisfaction and commitment. Understanding why nurses stay through a generational behavioural and career stage lens can bolster safeguarding nurse retention.

Appraisal and evaluation of the instruments measuring the nursing work environment: A systematic review

AIMS

To appraise the current instruments available for measurement the nursing work environment and re-examine the definition and construct of the nursing work environment.

BACKGROUND

A psychometrically sound instrument is fundamental to understanding and improving the nursing work environment. The nursing work environment is a complex construct, and its definition remains inconclusive. None of the instruments available is considered as the gold standard.

EVALUATION

A comprehensive searching was undertaken in August 2021 in six databases according to PRISMA. The COSMIN and modified GRADE were applied to assess the methodological quality and measurement properties of the instruments. Instruments were categorized into three levels. The definition and construct of nursing work environment were revisited.

KEY ISSUES

41 studies (19 instruments) were included. One, fourteen, and four instruments are respectively appraised as A-, B-, and C-level recommendation. Definition and eight labels of nursing work environment are identified.

CONCLUSION

This paper provides recommendations for selecting a proper instrument for the nursing work environment.

IMPLICATIONS FOR NURSING MANAGEMENT

This study helps nurse managers to select instruments and understand the construct of the nursing work environment. The eight labels can be used as a reference for tailoring policy aimed at creating a favorable nursing work environment.

Factors Influencing Retention Intention of Nurses at Long-Term Care Hospitals in Korea

The current study aimed to assess relationships among role conflict, nursing professionalism, nursing work environment, and retention intention of nurses at long-term care (LTC) hospitals. Participants comprised 183 nurses at nine LTC hospitals located in Busan, Korea. Data were collected using a structured self-report questionnaire and analyzed using descriptive statistics, t test, one-way analysis of variance, Pearson's correlation coefficient, and multiple linear regression. Retention intention had a signifi-cant positive correlation with nursing professionalism (r = 0.39, p < 0.001) and nursing work environment (r = 0.51, p < 0.001). Nursing work environment had a significant negative correlation with role conflict (r = -0.30, p < 0.001) and a significant positive correlation with nursing professionalism (r = 0.48, p < 0.001). In the final multiple regression analysis, factors influencing retention intention of participants included number of beds (β = -0.15 p < 0.026), nursing professionalism (β = 0.19, p = 0.007), and nursing work environment (β = 0.36, p < 0.001). The explanatory power of number of beds, nursing professionalism, and nursing work environment on retention intention was 34% (F = 16.66, p < 0.001). Improving nursing professionalism and nursing work environment of nurses at LTC hospitals will ultimately enhance their retention intention and positively impact the quality of gerontological nursing care. [Journal of Gerontological Nursing, 47(10), 44-53.].

Psychometric evaluation of instruments measuring the work environment of healthcare professionals in hospitals: a systematic literature review

Purpose

Research shows that the professional healthcare working environment influences the quality of care, safety climate, productivity, and motivation, happiness, and health of staff. The purpose of this systematic literature review was to assess instruments that provide valid, reliable and succinct measures of health care professionals’ work environment (WE) in hospitals.

Data sources

Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, CINAHL EBSCOhost and Google Scholar were systematically searched from inception through December 2018.

Study selection

Pre-defined eligibility criteria (written in English, original work-environment instrument for healthcare professionals and not a translation, describing psychometric properties as construct validity and reliability) were used to detect studies describing instruments developed to measure the working environment.

Data extraction

After screening 6397 titles and abstracts, we included 37 papers. Two reviewers independently assessed the 37 instruments on content and psychometric quality following the COSMIN guideline.

Results of data synthesis

Our paper analysis revealed a diversity of items measured. The items were mapped into 48 elements on aspects of the healthcare professional’s WE. Quality assessment also revealed a wide range of methodological flaws in all studies.

Conclusions

We found a large variety of instruments that measure the professional healthcare environment. Analysis uncovered content diversity and diverse methodological flaws in available instruments. Two succinct, interprofessional instruments scored best on psychometrical quality and are promising for the measurement of the working environment in hospitals. However, further psychometric validation and an evaluation of their content is recommended.

Work Climate Scale in Emergency Services: Abridged Version

This study is based on a 40-item work climate scale in hospital emergency services (WCSHES). Teams working in these emergency services experience a heavy workload and have a limited amount of time with each patient. COVID-19 has further complicated these existing issues. Therefore, we believed it would be helpful to draft an abridged version of the 40-item WCSHES, considering both validity and reliability criteria, but giving greater weight to validity. One hundred and twenty-six workers between the ages of 20 to 64 (M = 32.45; standard deviation (SD = 9.73)) years old participated voluntarily in the study. The validity, reliability, and fit model were evaluated in an iterative process. The confirmatory factor analysis yielded appropriate global fit indices in the abridged 24-item version (Χ²(248) = 367.84; p < 0.01, RMSEA = 0.06 with an interval of 90% from 0.05 to 0.07, SRMR = 0.08, GFI = 0.9, AGFI = 0.96, CFI = 0.98, NFI = 0.95, and NNFI = 0.98), along with test criteria validity (ρ_XY = 0.68, p < 0.001) and excellent reliability (α = 0.94 and ω = 0.94), maintaining the same conceptualization and usefulness of the original scale. The abridged 24-item version was used to measure four work climate factors (work satisfaction, productivity/achievement of aims, interpersonal relations, and performance at work). Evidence of the usefulness of the new abridged scale is provided along with a description of our study limitations and future areas for development.

Coping with Maternal Deaths: The Experiences of Midwives

Background

Life is said to be meaningful only when the individual is able to cope with challenges associated with it. Challenges at the workplace, whether physical, psychological or social, all contribute to occupational trauma. Coping with the challenges of work is an important part of achieving occupational wellbeing, irrespective of how difficult the job may be. Midwives are trained to be responsible for safe motherhood. However, when faced with maternal deaths, work becomes difficult as they have to cope with trauma resulting from their encounters with these deaths. Thus, the aim of this study was to explore and describe the coping challenges of maternal deaths among midwives in the Ashanti Region of Ghana.

Method

An exploratory descriptive qualitative design was used in the study. Data were collected by means of semi-structured interviews (18) and focus group discussions (8) with inclusion criteria of being a midwife with at least one year working experience and having witnessed maternal death while on duty. Data were audio recorded, transcribed and analysed using thematic content analysis.

Results

Four themes emerged from the study: difficulty accepting maternal death, exhibition of grief reactions, difficulty forgetting the deceased and lack of concentration.

Conclusion

The study concluded that since the midwife's ability to cope with maternal deaths is challenged, occupational workplace programmes, for example, Employee Assistance Programme (EAP) should be employed in Ghanaian hospitals to help midwives get debrief after maternal death occurs.

Job satisfaction of nurses and identifying factors of job satisfaction in Slovenian Hospitals

Aim

To determine the level of job satisfaction of nursing professionals in Slovenian hospitals and factors influencing job satisfaction in nursing.

Methods

The study included 4 hospitals selected from the hospital list comprising 26 hospitals in Slovenia. The employees of these hospitals represent 29.8% and 509 employees included in the study represent 6% of all employees in nursing in Slovenian hospitals. One structured survey questionnaire was administered to the leaders and the other to employees, both consisting 154 items evaluated on a 5 point Likert-type scale. We examined the correlation between independent variables (age, number of years of employment, behavior of leaders, personal characteristics of leaders, and managerial competencies of leaders) and the dependent variable (job satisfaction – satisfaction with the work, coworkers, management, pay, etc) by applying correlation analysis and multivariate regression analysis. In addition, factor analysis was used to establish characteristic components of the variables measured.

Results

We found a medium level of job satisfaction in both leaders (3.49 ± 0.5) and employees (3.19 ± 0.6), however, there was a significant difference between their estimates (t = 3.237; P = <0.001). Job satisfaction was explained by age (P < 0.05; β = 0.091), years of employment (P < 0.05; β = 0.193), personal characteristics of leaders (P < 0.001; β = 0.158), and managerial competencies of leaders (P < 0.000; β = 0.634) in 46% of cases. The factor analysis yielded four factors explaining 64% of the total job satisfaction variance.

Conclusion

Satisfied employees play a crucial role in an organization’s success, so health care organizations must be aware of the importance of employees’ job satisfaction. It is recommended to monitor employees’ job satisfaction levels on an annual basis.