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Bulut A, Sengül H, Mumcu Çİ, Mumcu B. Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors. Nurs Ethics 2024:9697330241252971. [PMID: 38768998 DOI: 10.1177/09697330241252971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. OBJECTIVES In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy. DESIGN The present study utilized a cross-sectional survey design following quantitative methods. METHODS This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59 years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in. ETHICAL CONSIDERATION Research ethics approval was obtained from the researcher's university. RESULTS Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]). DISCUSSION Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. CONCLUSION Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.
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Vitale E, Mea R, Chang YC. The effect of sex, age, work experience, education, shift, and ward on nursing autonomy perceptions. Work 2024:WOR230740. [PMID: 38669509 DOI: 10.3233/wor-230740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In Italy, cultural and professional nursing improvements are reached thanks to the university-based education which marks the clinical competency and the professional autonomy in nursing decision-making. OBJECTIVE To highlight how Italian nurses perceived their nursing autonomy level in the main action-points highlighted in the Italian regulation law according to sex, age, work experience, education, shift and ward. METHODS A cohort explorative study was carried out from September 2022 to January 2023 to highlight how Italian nurses perceived their nursing autonomy levels in the main action-points highlighted in the Italian regulation law for the nursing profession according to demographic characteristics, like: gender, age, work of experience, education, shift, ward employment. RESULTS A total of 403 nurses were enrolled. Significant differences were recorded in: decision-making authority in patient care and shift (p≤0.001) and ward employment (p = 0.045); ability to initiate nursing interventions and education (p < 0.001) and ward employment (p = 0.011); collaboration and communication with healthcare team members and education (p < 0.001) and ward employment (p = 0.010); independence in clinical judgment and critical thinking and shift (p < 0.001); responsibility for the planning and evaluation of nursing care and education (p = 0.005) and shift (p = 0.002) and ward employment (p = 0.013); autonomy in professional development and continuing education and shift (p < 0.001) and ward employment (p < 0.001). CONCLUSIONS The results highlighted the intricate world both of the healthcare surrounding and the abilities to act autonomously within the multiprofessional staff. Future studies will develop qualitative and phenomenological designs in order to better define in which fields nurses will act their professional autonomy.
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Affiliation(s)
- Elsa Vitale
- Centre of Mental Health Modugno, Local Healthcare Company Bari, Italy
| | | | - Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung, Taiwan
- Nursing Department, China Medical University Hospital, Taichung, Taiwan
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Ito Y, Oe R, Sakai S, Fujiwara Y, Kishimoto H. Intensive Care Unit Nurses' Professional Autonomy: A Scoping Review. Cureus 2024; 16:e57350. [PMID: 38694419 PMCID: PMC11062492 DOI: 10.7759/cureus.57350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 05/04/2024] Open
Abstract
Intensive care unit (ICU) nurses' professional autonomy is a critical factor affecting their ability to sustainably provide high-quality care to patients who are critically ill and to their families. However, in the absence of a systematic or scoping review of ICU nurses' professional autonomy, limited information and evidence are available on this topic. The aim of this scoping review was to clarify the extent and type of evidence on ICU nurses' professional autonomy. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. The following research questions were addressed: (1) Which areas of interest and trends regarding ICU nurses' professional autonomy have been explored in studies published in scientific journals? And (2) What is known about ICU nurses' professional autonomy? The data sources included MEDLINE, CINAHL Ultimate, PsycINFO, Cochrane Library, and Ichushi-Web of the Japan Medical Abstracts Society databases. Identified studies were mapped based on their aim, design, methodology, and key findings and categorized according to their focus areas. Of the 734 identified studies, 16 were analyzed. The identified categories were as follows: "relationship between professional autonomy and mental issues," "experiences and processes of exercising professional autonomy," "relationship between professional autonomy and nurse-physician collaboration," "relationship between professional autonomy and demographic characteristics," "concept of professional autonomy," "barriers to professional autonomy," and "team approach to improve professional autonomy." Most studies have focused on the relationship between professional autonomy and mental health issues and nurse-physician collaboration and few included interventions to enable or promote the exercise of professional autonomy, highlighting a research gap. Future research should identify factors that inhibit the professional autonomy of ICU nurses and that can be changed through interventions and should develop educational and organizational change-based interventions to modify the factors.
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Affiliation(s)
- Yoshiyasu Ito
- College of Nursing Art and Science, University of Hyogo, Akashi, JPN
| | - Rie Oe
- College of Nursing Art and Science, University of Hyogo, Akashi, JPN
| | - Shota Sakai
- Department of Nursing, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, JPN
| | - Yayoi Fujiwara
- Department of Nursing, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, JPN
| | - Hiroshi Kishimoto
- Department of Nursing, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, JPN
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Boxall C, Fenlon D, May C, Nuttall J, Hunter MS. Implementing a nurse-delivered cognitive behavioural therapy intervention to reduce the impact of hot flushes/night sweats in women with breast cancer: a qualitative process evaluation of the MENOS4 trial. BMC Nurs 2023; 22:317. [PMID: 37715249 PMCID: PMC10503156 DOI: 10.1186/s12912-023-01441-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 08/09/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Hot flushes and night sweats are life-altering symptoms experienced by many women after breast cancer treatment. A randomised controlled trial (RCT) was conducted to explore the effectiveness of breast care nurse (BCN)-led group cognitive behavioural therapy (CBT). This paper reported findings from a qualitative process evaluation to optimise the CBT intervention and explore the determinants of implementation into routine practice. METHODS Qualitative process evaluation occurred in parallel with the RCT to explore patient and healthcare staff experiences and perspectives using semi-structured interviews pre-and post-intervention. Normalisation Process Theory (NPT) informed data collection, analysis, and reporting of findings. The analysis involved inductive thematic analysis, NPT coding manual and subsequent mapping onto NPT constructs. RESULTS BCNs (n = 10), managers (n = 2), surgeons (n = 3) and trial participants (n = 8) across six recruiting sites took part. All stakeholders believed group CBT met a need for non-medical hot flushes/night sweats treatment, however, had little exposure or understanding of CBT before MENOS4. BCNs believed the work fitted with their identity and felt confident in delivering the sessions. Despite little understanding, patients enrolled onto group CBT because the BCNs were trusted to have the knowledge and understanding to support their needs and despite initial scepticism, reported great benefit from group-based participation. Both managers and surgeons were keen for BCNs to take responsibility for all aspects of CBT delivery, but there were some tensions with existing clinical commitments and organisational priorities. CONCLUSIONS Both healthcare staff and patient participants believe BCN-led group CBT is a beneficial service but barriers to long-term implementation into routine care suggest there needs to be multi-level organisational support. TRIAL REGISTRATION NCT02623374 - Last updated 07/12/2015 on ClinicalTrials.gov PRS.
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Affiliation(s)
- Cherish Boxall
- Southampton Clinical Trials Unit, University of Southampton, Southampton, SO16 6YD, UK.
| | - Deborah Fenlon
- Department of Nursing, School of Health and Social Care, Faculty of Medicine, Health and Life Science, University of Swansea, Swansea, UK
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Jacqui Nuttall
- Southampton Clinical Trials Unit, University of Southampton, Southampton, SO16 6YD, UK
| | - Myra S Hunter
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Lommi M, Caruso R, Conte G, Magon A, Porcelli B, Stievano A, Rocco G, Notarnicola I, Sabatino L, Latina R, De Maria M, Di Simone E, De Benedictis A, Gualandi R, Tartaglini D, Ivziku D. Assessment of the Psychometric Characteristics of the Italian Version of the Nurse Manager Actions Scale. NURSING REPORTS 2023; 13:1185-1202. [PMID: 37755345 PMCID: PMC10534939 DOI: 10.3390/nursrep13030102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/09/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses' autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items' scalability as well as the scale's validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT= 0.630, Molenaar-Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT= 0.620, Molenaar-Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage.
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Affiliation(s)
- Marzia Lommi
- Unit Care to the Person, Local Healthcare Authority Rome 2, 00159 Rome, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS San Donato Hospital, San Donato Milanese, 20097 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS San Donato Hospital, San Donato Milanese, 20097 Milano, Italy
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS San Donato Hospital, San Donato Milanese, 20097 Milano, Italy
| | - Barbara Porcelli
- Unit Care to the Person, Local Healthcare Authority Rome 2, 00159 Rome, Italy
| | - Alessandro Stievano
- Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy
| | - Gennaro Rocco
- Department of Biomedical Sciences, Catholic University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Ippolito Notarnicola
- Department of Biomedical Sciences, Catholic University "Our Lady of Good Counsel", 1000 Tirana, Albania
| | - Laura Sabatino
- INAIL Istituto Nazionale per L'assicurazione Contro Gli Infortuni sul Lavoro, 00192 Rome, Italy
| | - Roberto Latina
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90128 Palermo, Italy
| | - Maddalena De Maria
- Department of Biomedical Sciences, Catholic University "Our Lady of Good Counsel", 1000 Tirana, Albania
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Emanuele Di Simone
- Department of Clinical and Molecular Medicine, Sapienza University, 00185 Rome, Italy
| | - Anna De Benedictis
- Clinical Directory, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Raffaella Gualandi
- Department of Healthcare Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Daniela Tartaglini
- Department of Healthcare Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Società Italiana per la Direzione e il Management delle Professioni Infermieristiche (SIDMI), 00198 Rome, Italy
| | - Dhurata Ivziku
- Department of Healthcare Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
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Alruwaili MM, Abuadas FH. Professional autonomy among nurses in Saudi Arabian critical care units. BMC Nurs 2023; 22:224. [PMID: 37386470 DOI: 10.1186/s12912-023-01390-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/20/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Professional autonomy is essential in expanding the scope of nursing practice and has been recognized as a top nursing priority. OBJECTIVE This study aims to assess Saudi nurses' autonomy level in critical care settings and examine the influence of sociodemographic and clinical characteristics on their autonomy level. METHODS A correlational design and a convenience sampling approach were used to recruit 212 staff nurses from five Saudi governmental hospitals in Jouf region of Saudi Arabia. The data were collected through a self-administered questionnaire composed of two sections, including sociodemographic characteristics and the Belgen autonomy scale. The Belgen autonomy scale used in this study measures nurses' autonomy levels and consists of 42 items rated on an ordinal scale. The scale's minimum score of 1 indicates nurses with no authority, while the maximum score of 5 indicates nurses with full authority. RESULTS Descriptive statistics revealed that nurses in the sample had a moderate overall work autonomy (M = 3.08), with higher autonomy in patient care decisions (M = 3.25) compared to unit operations decisions (M = 2.91). Nurses had the highest level of autonomy in tasks related to preventing patient falls (M = 3.84), preventing skin breakdown (M = 3.69), and promoting health activities (M = 3.62), while they had the lowest level of autonomy in ordering diagnostic tests (M = 2.27), determining the day of discharge (M = 2.61), and planning the unit's annual budget (M = 2.22). The multiple linear regression model (R2 = 0.32, F (16, 195) = 5.87, p < .001) showed that education level and years of experience in critical care settings were significantly related to nurses' work autonomy. CONCLUSION Saudi nurses in acute care settings have moderate professional autonomy, with higher autonomy in making patient care decisions than unit operations decisions. Investing in nurses' education and training could increase their professional autonomy, leading to improved patient care. Policymakers and nursing administrators can use the study's results to develop strategies that promote nurses' professional development and autonomy.
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Affiliation(s)
- Majed M Alruwaili
- Nursing Administration & Education Department, College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia
| | - Fuad H Abuadas
- Community Health Nursing Department, College of Nursing, Jouf University, Sakaka, 72388, Saudi Arabia.
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López‐Deflory C, Perron A, Miró‐Bonet M. An integrative literature review and critical reflection on nurses' agency. Nurs Inq 2023; 30:e12515. [PMID: 35971209 PMCID: PMC10078309 DOI: 10.1111/nin.12515] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/25/2023]
Abstract
The idea of agency has long been used in the nursing literature in the study of nurses' roles regarding the patients they take care of, but it has not often been used to study its relationship with nurses themselves and their status in the healthcare system. The purpose of this article is to analyze how the idea of agency is used in nursing research to better understand how we might advance our thinking around nurses' agency to shape nursing and healthcare with an emancipatory intent. Based on the results of a literature review focused on the study of conceptions, treatments, and applications of the concept of agency in nursing, we present a critical discussion to reflect on the need to consistently define the idea of nurses' agency, to guide research concerned with this topic in theoretical frameworks with emancipatory and social change tenets, and to make a call to develop the idea of agency as a central one to rework nurses' relationship with themselves. The idea of agency provides a valuable analytical framework for the study of a wide range of issues around nurses' status in healthcare organizations and in the healthcare system while offering a means for nurses' emancipation.
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Affiliation(s)
- Camelia López‐Deflory
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsPalmaBalearic IslandsSpain
- Care, Chronicity and Health Evidences Research GroupHealth Research Institute of the Balearic Islands (IdISBa)PalmaBalearic IslandsSpain
| | - Amélie Perron
- School of Nursing, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
| | - Margalida Miró‐Bonet
- Department of Nursing and PhysiotherapyUniversity of the Balearic IslandsPalmaBalearic IslandsSpain
- Care, Chronicity and Health Evidences Research GroupHealth Research Institute of the Balearic Islands (IdISBa)PalmaBalearic IslandsSpain
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The Daily Basic Psychological Need Satisfaction and Work Engagement of Nurses: A ‘Shortitudinal’ Diary Study. Healthcare (Basel) 2022; 10:healthcare10050863. [PMID: 35627999 PMCID: PMC9141162 DOI: 10.3390/healthcare10050863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/26/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022] Open
Abstract
Nurses’ satisfaction and work engagement have been linked to patient outcomes. Nightshift nurses provide healthcare to the population and experience unique challenges in performing their healthcare tasks. Therefore, the current study aimed to investigate the daily basic needs satisfaction and work engagement of nightshift nurses in accordance with the satisfaction of three basic psychological needs as indicated by the Self-Determination Theory. A quantitative, ‘shortitudinal’ design (diary study; over a few days) with a multi-level research approach using a daily diary survey method was completed by a convenience sample of nurses working the nightshift in a public hospital (n = 33). The results revealed that the daily need for autonomy and need for relatedness did not significantly predict variance in daily work engagement. However, need for competence did significantly predict variance in daily work engagement, and general emotional load explained significant variability in daily need satisfaction of competence. Lastly, general role clarity had a negative impact on the daily variability in work engagement. This study provides healthcare organisations with explanations for variance in nursing performance and suggests possible interventions to address nursing outcomes in accordance with the three basic needs of nightshift nurses in daily activity.
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Impact of Nurse-Physician Collaboration, Moral Distress, and Professional Autonomy on Job Satisfaction among Nurses Acting as Physician Assistants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020661. [PMID: 35055482 PMCID: PMC8776133 DOI: 10.3390/ijerph19020661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 02/01/2023]
Abstract
Although there is considerable literature on job satisfaction among nurses in various settings, there is little research about contributing factors, including moral distress to job satisfaction among a certain group of nurses, such as nurses acting as physician assistants. The purpose of this study was to verify the impact of nurse-physician collaboration, moral distress, and professional autonomy on job satisfaction among nurses acting as physician assistants. Descriptive and correlational research was conducted on a convenience sample of 130 nurses from five general hospitals in South Korea. In the final regression model, the adjusted R square was significant, explaining 38.2% of the variance of job satisfaction (F = 8.303, p < 0.001), where 'cooperativeness' (β = 0.469, p = 0.001) from nurse-physician collaboration, 'institutional and contextual factor' from moral distress (β = -0.292, p = 0.014), and professional autonomy (β = 0.247, p = 0.015) were included. In hospital environments, a more cooperative inter-professional relationship between nurses and physicians led to less moral distress caused by organisational constraints. A higher level of professional autonomy among nurses acting as physician assistants is required to increase their job satisfaction.
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Bloemhof J, Knol J, Van Rijn M, Buurman BM. The implementation of a professional practice model to improve the nurse work environment in a Dutch hospital: A quasi-experimental study. J Adv Nurs 2021; 77:4919-4934. [PMID: 34605566 PMCID: PMC9293086 DOI: 10.1111/jan.15052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/12/2021] [Accepted: 09/16/2021] [Indexed: 12/01/2022]
Abstract
Aims To evaluate the effects of the implementation of a professional practice model based on Magnet principles on the nurse work environment in a Dutch teaching hospital. Design A quasi‐experimental study. Methods Data were collected from registered nurses working on the clinical wards and outpatient clinics of the hospital in June/July 2016 (baseline) and in June/September 2019 (measurement of effects). Participants completed the Dutch Essentials of Magnetism II survey, which was used to measure their perception of their work environment. After baseline measurements were collected, interventions based on a professional practice model incorporating Magnet principles were implemented to improve the nurse work environment. Descriptive statistics and independent t‐tests were conducted to examine differences between survey outcomes in 2016 and 2019. Results Survey outcomes revealed significant changes in the nurse work environment between 2016 and 2019. Seven of the eight subscales (essentials of magnetism) improved significantly. Score for overall job satisfaction increased from 7.3 to 8.0 and score for quality of care increased from 7.0 to 7.6. On unit level, 17 of the 19 units showed improvement in the nurse work environment. Conclusion The implementation of a professional practice model positively affects the nurse work environment, job satisfaction and quality of care. Impact Nowadays, the quality of care is threatened by workload pressure and the low autonomy experienced by nurses. Considering the global shortage of nurses and growing complexity of healthcare, it is important to invest in improving the nurse work environment. The Magnet concept created a work environment in which nurses can deliver optimal quality of care. Knowledge of how Magnet principles affect the nurse work environment in the Netherlands is missing. These study results, including the description of how the interventions were implemented, will assist other hospitals to develop improvement strategies by focusing on the nurse work environment.
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Affiliation(s)
- Janet Bloemhof
- Department of Nursing Staff, Tergooi Hospital, Hilversum, The Netherlands.,Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Jeannette Knol
- Department of Nursing Staff, Tergooi Hospital, Hilversum, The Netherlands
| | - Marjon Van Rijn
- Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Bianca M Buurman
- Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Medicine for Older People, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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Demýrsoy N, Ture A. Development and Validation of the Turkish Version of the Attitude Toward Professional Autonomy Scale for Nurses. J Nurs Meas 2021; 30:JNM-D-20-00115. [PMID: 34518429 DOI: 10.1891/jnm-d-20-00115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Autonomy in nursing practice is one of the recurring fields in literature of research. For nurses to be autonomous is considered to have a great importance on the quality of healthcare services. This study aimed to examine the validity and reliability of the Turkish version of the Attitude Toward Professional Autonomy Scale for Nurses. This methodological study adopted a descriptive cross-sectional design. The study was done in a secondary care hospital. Sample group includes 199 nurses that work at a secondary care hospitals. It was carried out while culturally adjusted and it also included two-way translations of English version of the Attitude Toward Professional Autonomy Scale for Nurses. To evaluate its validity, LISREL statistics software was used to make confirmatory factor analysis. Internal consistency was evaluated by using Cronbach's α and total-item correlations. Average age of the sample group was found 28.35 ± 6.16. Confirmatory factor analysis yielded t-scores, which were significant for all the 18 items (p < .05). Fit indices of the model, resemblance rate chi-square statistics were identified as 𝜒 2/df = 198.01/132 = 1.50. The Cronbach's alpha of the scale (.918) was indicative of strong internal consistency. The scale demonstrated strong validity and internal consistency. This scale can be used to assess perceptions of nursing practices that enhance the quality of nursing care.
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Affiliation(s)
| | - Aysun Ture
- Eskisehir Osmangazi University Faculty of Health Science, Turkey
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12
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Hara Y, Asakura K, Sugiyama S, Takada N, Ito Y, Nihei Y. Nurses Working in Nursing Homes: A Mediation Model for Work Engagement Based on Job Demands-Resources Theory. Healthcare (Basel) 2021; 9:316. [PMID: 33809246 PMCID: PMC7999486 DOI: 10.3390/healthcare9030316] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022] Open
Abstract
This study examined the impact that the attractiveness of working in nursing homes and autonomous clinical judgment have on affective occupational commitment, and whether work engagement mediates these relationships. This analysis was based on the job demands-resources theory. The study setting was 1200 nursing homes (including long-term care welfare facilities and long-term care health facilities) in eastern Japan. An anonymous, self-report questionnaire survey was administered to two nurses from each facility, resulting in a prospective sample of 2400 participants. Overall, 552 questionnaires were analyzed, in which structural equation modeling and mediation analysis using the bootstrap method were performed. The results showed that the attractiveness of working in nursing homes does not directly affect affective occupational commitment; work engagement fully mediates the impact of attractiveness of working in nursing homes on affective occupational commitment. Additionally, autonomous clinical judgment showed a direct impact on both work engagement and affective occupational commitment, indicating that work engagement partially mediates the impact on affective occupational commitment. To increase the affective occupational commitment of nurses working in nursing homes, managers should help nurses recognize the attractiveness of working in nursing homes, and then provide appropriate support to help such nurses work in a motivated manner.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Shoko Sugiyama
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Nozomu Takada
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
| | - Yoshimi Ito
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
- School of Nursing, Miyagi University, 1-1 Gakuen, Taiwa-cho, Kurokawa-gun, Miyagi 981-3298, Japan
| | - Yoko Nihei
- Graduate School of Medicine, Tohoku University, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan; (K.A.); (S.S.); (N.T.); (Y.I.); (Y.N.)
- Department of Nursing, Faculty of Health Sciences, Tohoku Fukushi University, 1-8-1 Kunimi, Aoba-ku, Sendai, Miyagi 981-8522, Japan
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Pursio K, Kankkunen P, Sanner-Stiehr E, Kvist T. Professional autonomy in nursing: An integrative review. J Nurs Manag 2021; 29:1565-1577. [PMID: 33548098 DOI: 10.1111/jonm.13282] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/15/2021] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
AIM To summarize knowledge of professional autonomy in nursing. BACKGROUND Professional autonomy is associated with experienced meaningfulness of the work. This refers to participation in decision-making and the ability to influence working practices. EVALUATION In an integrative review, relevant studies were retrieved from four databases. Quality was systematically evaluated using critical appraisal tools. PRISMA guidelines were followed. Inductive content analysis was used to analyse current knowledge of the focal subject. KEY ISSUES The search identified 27 relevant studies published between 2000 and 2019. Elements describing nurses' professional autonomy were independence in decision-making and ability to utilize one's own competence. Themes relating to nurses' professional autonomy were shared leadership, professional skills, inter- and intra-professional collaboration and healthy work environment. CONCLUSION Understanding the multidimensional nature of professional autonomy is essential to create attractive work environments. It is important to enable nurses to participate in decision-making and develop nursing through shared leadership to enhance the recruitment and retention of a skilled workforce. IMPLICATIONS FOR NURSING MANAGEMENT The findings have anticipated utility for supporting nursing practice and nurse leaders' understanding of approaches to foster nurses' professional autonomy.
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Affiliation(s)
- Katja Pursio
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | | | - Tarja Kvist
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Paquette L, Kilpatrick K. L’autonomie décisionnelle d’infirmières de soins intensifs lors du sevrage de la ventilation mécanique : une analyse de concept. Rech Soins Infirm 2021:76-91. [PMID: 33485287 DOI: 10.3917/rsi.143.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Nurses have a leading role in weaning patients from mechanical ventilation (WMV) given their constant presence and their continuous monitoring. To promote proper WMV, nurses must exercise autonomy and be involved in decision-making. However, in certain care contexts, there is little involvement of nurses. The purpose of this text is to establish the characteristics of the concept of autonomous decision-making applied to nursing during WMV. An analysis of this concept was carried out according to the evolutionary method of Rodgers. The identification of the attributes, antecedents, and consequences made it possible to note ambiguity in the definition of this concept. Nurses use autonomous decision-making for the execution of assigned tasks and when they make decisions according to a pre-prescribed decision-making algorithm. Significant foundations for the decision-making autonomy of critical care nurses during WMV emerged from this analysis : scope of practice, in-depth knowledge of the patient, and commitment to the success of WMV. Participation in interdependent decision-making allows nurses to bring the patient’s perspective into decisions. Avenues of reflection have also emerged, including decisions based on evidence to provide new avenues for autonomous decision-making.
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Türk G, Karagözoğlu Ş, Adana F, Ülkü HH, Ulku HH. Autonomy Levels and Professional Attitudes of Nurse Educators. Florence Nightingale Hemsire Derg 2021; 29:22-29. [PMID: 35929911 PMCID: PMC8137737 DOI: 10.5152/fnjn.2021.19198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AIM This study aimed to determine the autonomy levels and the professional attitudes of nurse educators. METHODS This study was a descriptive, cross-sectional design. Total of 486 people, including 172 faculty members, 103 lecturers, and 211 research assistants were included in this study. The individual information form, Sociotropy-Autonomy Scale autonomy subscale, and the inventory of professional attitude at occupation were used to collect the research data. RESULTS The mean age of academics participating in the study was 35.14±8.39. In total, 94.2% of them were women. Of the academics, 35.5% were faculty members, 21.2% were lecturers, and 43.4% were research assistants. The mean autonomy score was 80.04±15.69 and the mean score of the professional attitude inventory was 146±10.59. The mean autonomy score was found to be the highest among professors, the mean score of professional attitudes inventory was highest among associate professors, while the mean value of both scale scores was the lowest in research assistants. CONCLUSION According to the research findings, it was concluded that the autonomy levels of the nurse educators were above average, their professionalism was at a high level, and they developed more professional attitude as the professional experience increased.
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Affiliation(s)
- Gülengün Türk
- Department of Fundamentals of Nursing, Aydın Adnan Menderes University, Faculty of Nursing, Aydın, Turkey
| | - Şerife Karagözoğlu
- Department of Fundamentals of Nursing, Cumhuriyet University Faculty of Health Sciences, Sivas, Turkey
| | - Filiz Adana
- Department of Public Health Nursing, Aydın Adnan Menderes University Faculty of Nursing, Aydın, Turkey
| | - Hilal Hatice Ülkü
- Aydın Adnan Menderes University, Buharkent Vocational School, Aydın, Turkey
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Hara Y, Asakura K, Asakura T. The Impact of Changes in Professional Autonomy and Occupational Commitment on Nurses' Intention to Leave: A Two-Wave Longitudinal Study in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176120. [PMID: 32842676 PMCID: PMC7504321 DOI: 10.3390/ijerph17176120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/18/2020] [Accepted: 08/20/2020] [Indexed: 02/07/2023]
Abstract
This study aimed to investigate changes in nurses’ attitudes toward professional autonomy and occupational commitment over time, and their effect on nurses’ intentions to leave, using a two-wave longitudinal design. Anonymous, self-report questionnaires were distributed to all nurses working at 28 hospitals in western Japan on two separate occasions (n = 1778). Multivariate analysis using a generalized estimation equation was conducted, with the intention to leave at Time 2 as the dependent variable, and the changing secular trends in all subscales of attitudes toward professional autonomy and occupational commitment as the independent variables. Age, sex, education, and intention to leave at Time 1 were control variables. Results showed that increasing changing secular trends in control over work conditions, which is a subscale of attitudes toward professional autonomy, increased intention to leave at Time 2, while increasing changing secular trends in all subscales of occupational commitment decreased intention to leave at Time 2. Nurses with a progressive attitude toward discretion of control over work conditions may have higher intentions to leave. Therefore, increasing control over their work conditions may reduce this intention. Additionally, it is necessary to continually enhance nurses’ occupational commitment by offering professional development programs.
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Affiliation(s)
- Yukari Hara
- Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan;
- Correspondence: ; Tel.: +81-22-717-7932
| | - Kyoko Asakura
- Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan;
| | - Takashi Asakura
- Faculty of Education, Tokyo Gakugei University, 4-1-1, Nukuikita, Koganei, Tokyo 184-8501, Japan;
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Nikitara M, Constantinou CS, Andreou E, Latzourakis E, Diomidous M. Views of People with Diabetes Regarding Their Experiences of the Facilitators and Barriers in Type 1 Diabetes Inpatient Care: An Interpretative Phenomenological Analysis. Behav Sci (Basel) 2020; 10:E120. [PMID: 32707985 PMCID: PMC7463672 DOI: 10.3390/bs10080120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The aim of this study was to comprehend how people with diabetes view their experiences of the possible barriers and facilitators in inpatient care for type 1 diabetes from non-specialized nurses. DESIGN An interpretative phenomenology analysis (IPA) was conducted. METHODS The sample consisted of people with type 1 diabetes 1 (n = 24) who use the services of the state hospitals in Cyprus. The data were collected in two phases: firstly, focus groups with people with diabetes (n = 2) were conducted and analysed, and then individual semi-structured interviews with people with diabetes (n = 12) were conducted. RESULTS It is evident from the findings that people with diabetes experienced several barriers in diabetes inpatient care, which is concerning since this can have adverse effects on patients' outcomes. No facilitators were reported. CONCLUSION Significant results were found in relation to the barriers to diabetes inpatient care. Crucially, the findings demonstrate that all these factors can negatively affect the quality of care of patients with diabetes, and most of these factors are related not only to diabetes care but also generally to all patients who receive inpatient care. Interestingly, no participant reported any facilitators to their care, which further affected the negative perceptions of the care received.
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Affiliation(s)
- Monica Nikitara
- Department of Life and Health Sciences/ School of Science and Engineering, University of Nicosia, Cyprus 46 Makedonitissas Avenue, P.O. Box 24005, CY-1700, Nicosia CY-2417, Cyprus; (E.A.); (E.L.)
| | - Costas S. Constantinou
- Medical School, University of Nicosia, Cyprus 46 Makedonitissas Avenue, P.O. Box 24005, CY-1700, Nicosia CY-2417, Cyprus;
| | - Eleni Andreou
- Department of Life and Health Sciences/ School of Science and Engineering, University of Nicosia, Cyprus 46 Makedonitissas Avenue, P.O. Box 24005, CY-1700, Nicosia CY-2417, Cyprus; (E.A.); (E.L.)
| | - Evangelos Latzourakis
- Department of Life and Health Sciences/ School of Science and Engineering, University of Nicosia, Cyprus 46 Makedonitissas Avenue, P.O. Box 24005, CY-1700, Nicosia CY-2417, Cyprus; (E.A.); (E.L.)
| | - Marianna Diomidous
- Nursing Department, School of Sciences, National and Kapodistrian University of Athens, Athens 10679, Greece;
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Furuno T, Fujino N, Fujimoto Y, Shirai H, Iwamoto Y, Kamada Y, Yamaguchi F. Development of a Visiting Nursing Practice Self-Evaluation Scale: Assessment of Skill for Caring for Individuals With Behavioral and Psychological Symptoms of Dementia. Res Gerontol Nurs 2020; 13:49-60. [PMID: 31584690 DOI: 10.3928/19404921-20190930-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/29/2019] [Indexed: 11/20/2022]
Abstract
Behavioral and psychological symptoms of dementia (BPSD) continue to be a concern for our rapidly progressing aging society. Visiting nurses play an important role in community service for individuals with BPSD. The aim of the current study was to develop a visiting nursing practice self-evaluation scale for nurses who care for individuals with BPSD. The study was conducted in two phases. Semi-structured interviews were arranged to generate a draft scale that was further examined by an expert panel. A national survey was performed using the draft scale and two existing scales. Four factors and 22 items were obtained from exploratory factor analysis: (a) assessment and response factors related to BPSD, (b) interventions for reducing family care burdens, (c) nonpharmacological approaches, and (d) attitudes in trying to understand a patient's intentions. Reliability and validity were verified. The scale is useful for improving visiting nursing services for individuals with dementia. [Research in Gerontological Nursing, 13(1), 49-60.].
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Setoodegan E, Gholamzadeh S, Rakhshan M, Peiravi H. Nurses' lived experiences of professional autonomy in Iran. Int J Nurs Sci 2019; 6:315-321. [PMID: 31508453 PMCID: PMC6722471 DOI: 10.1016/j.ijnss.2019.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/11/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives Nurses' autonomy is a complex and multi-dimensional concept that has often been overlooked. Although many studies have addressed patients' autonomy, there has been no assessment of nurses' experience of professional autonomy. The present study aimed to assess nurses’ lived experiences of professional autonomy in Shiraz, Iran. Methods The present qualitative study was conducted in Shiraz (Iran) from January 2016 to February 2018. The target population was selected among nursing professionals employed by various hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The experiences of the participants were assessed through 14 in-depth semi-structured interviews. The response of the participants was analyzed using Van Manen's 6-step approach for interpretive phenomenology. Results Based on the analysis of the interviews, 4 themes, 11 categories, and 13 sub-categories were extracted. The themes were: Advocacy for patients and nurses, independence in the workplace, Involvement in professional decision-making, and Professional accountability. Conclusion Due to the intense interaction between nurses and patients, a better quality of care will be achieved if the professional autonomy of nurses is ensured. Healthcare authorities and hospital managers should provide the framework and permit the nurses to practically exercise full independence in the workplace.
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Affiliation(s)
- Elahe Setoodegan
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.,Beheshti Hospital, Iranian Social Security Organization, Shiraz, Iran
| | - Sakineh Gholamzadeh
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahnaz Rakhshan
- Nursing Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Peiravi
- Nursing Care Research Center, Department of Critical Care and Emergency Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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20
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Confusion About Professional Autonomy Among Final-year Nursing Students in Spain. J Prof Nurs 2019; 35:147-152. [DOI: 10.1016/j.profnurs.2018.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/20/2018] [Accepted: 07/25/2018] [Indexed: 11/19/2022]
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Labrague LJ, McEnroe-Petitte DM, Tsaras K. Predictors and outcomes of nurse professional autonomy: A cross-sectional study. Int J Nurs Pract 2018; 25:e12711. [PMID: 30426592 DOI: 10.1111/ijn.12711] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 10/08/2018] [Accepted: 10/20/2018] [Indexed: 11/30/2022]
Abstract
AIMS This paper is a report examining the level of professional autonomy as well as its predictors and outcomes among practicing nurses in the Philippines. METHODS This study adopted a descriptive, cross-sectional research design. One hundred sixty-six (n = 166) nurses participated in the study or a response rate of 83% during the months of January 2017 to May 2017. Seven self-reported scales were used for this study: the Nurse Autonomy Scale, Job Stress Scale, Burnout Measure Scale, Job Satisfaction Index, Organizational Commitment Questionnaire, Turnover Intention Inventory Scale, and the Six Dimension Scale of Nursing Performance. Inferential and descriptive statistics were used to analyse the collected data. RESULTS Nurses demonstrated moderate levels of professional autonomy with education and hospital bed capacity as strong predictors. Regression analysis showed positive effects of professional autonomy on nurses' job outcomes such as organizational commitment, job satisfaction, and work performance. CONCLUSION Consistent to international studies, nurses in the Philippines demonstrated moderate levels of professional autonomy. Nurses who had higher levels of autonomy tended to be high performing, satisfied, and committed in their jobs. Organizational efforts are critically important to foster autonomy in practicing nurses through adequate support, education, training, and developed policies.
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Affiliation(s)
| | | | - Konstantinos Tsaras
- Nursing Department, Technological Educational Institute of Thessaly, Lárisa, Greece
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22
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Maurits EEM, de Veer AJE, Groenewegen PP, Francke AL. Attractiveness of people-centred and integrated Dutch Home Care: A nationwide survey among nurses. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e523-e531. [PMID: 29508473 DOI: 10.1111/hsc.12564] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 06/08/2023]
Abstract
The World Health Organization is calling for a fundamental change in healthcare services delivery, towards people-centred and integrated health services. This includes providing integrated care around people's needs that is effectively co-ordinated across providers and co-produced by professionals, the patient, the family and the community. At the same time, healthcare policies aim to scale back hospital and residential care in favour of home care. This is one reason for the home-care nursing staff shortages in Europe. Therefore, this study aimed to examine whether people-centred, integrated home care appeals to nurses with different levels of education in home care and hospitals. A questionnaire survey was held among registered nurses in Dutch home-care organisations and hospitals in 2015. The questionnaire addressed the perceived attractiveness of different aspects of people-centred, integrated home care. In total 328 nurses filled in the questionnaire (54% response rate). The findings showed that most home-care nurses (70% to 97%) and 36% to 76% of the hospital nurses regard the different aspects of people-centred, integrated home care as attractive. Specific aspects that home-care nurses find attractive are promoting the patient's self-reliance and having a network in the community. Hospital nurses are mainly attracted to health-related prevention and taking control in complex situations. No clear differences between the educational levels were found. It is concluded that most home-care nurses and a minority of hospital nurses feel attracted to people-centred, integrated home care, irrespective of their educational level. The findings are relevant to policy makers and home-care organisations who aim to expand the home-care nursing workforce.
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Affiliation(s)
- Erica E M Maurits
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Anke J E de Veer
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Peter P Groenewegen
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Department of Sociology and Department of Human Geography, Utrecht University, Utrecht, The Netherlands
| | - Anneke L Francke
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Centre, Utrecht, The Netherlands
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The influence of effective communication, perceived respect and willingness to collaborate on nurses' perceptions of nurse-physician collaboration in China. Appl Nurs Res 2018; 41:73-79. [PMID: 29853219 DOI: 10.1016/j.apnr.2018.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 04/13/2018] [Accepted: 04/18/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Nurse-physician collaboration is a critical prerequisite for high-quality care. Previous researchers have addressed multiple factors that influence collaboration. However, little of this research has explored the influence of interactional factors on nurses' perception of nurse-physician collaboration in China. AIMS To examine the influence of interactional factors (effective communication, perceived respect and willingness to collaborate) on nurses' perception of nurse-physician collaboration. METHODS A cross-sectional survey of 971 registered nurses in nine hospitals was conducted. An author-designed interactional factor questionnaire and the Nurse-Physician Collaboration Scale were used to collect data. Multiple regression analysis was used. RESULTS Nurse-physician collaboration was identified as at a moderate level (mean = 3.93 ± 0.68). Interactional factors (effective communication, perceived respect and willingness to collaborate) were identified as relatively moderate to high (mean = 4.03 ± 0.68, mean = 3.87 ± 0.75, mean = 4.50 ± 0.59, respectively). The results showed that effective communication, perceived respect and willingness to collaborate explained 57.3% of the variance in nurses' perception of nurse-physician collaboration (Adjusted R2 = 0.573, F = 435.563, P < 0.001). Perceived respect (β = 0.378) was the strongest factor relevant to nurses' perception of nurse-physician collaboration, second was effective communication (β = 0.315), and the weakest factor among these three factors was willingness to collaborate (β = 0.160). CONCLUSION Nurses' perceptions of collaboration were relatively positive, mainly in Sharing of patient information; however, improvements need to be made regarding Joint participation in the cure/care decision-making process. Effective communication, perceived respect and willingness to collaborate significantly affect nurses' perception of nurse-physician collaboration, with perceived respect having greater explanatory power among the three interactional factors. It is necessary for hospital managers to develop strategies to build professional respect for nurses, facilitate effective nurse-physician communication and improve nurses' willingness to collaborate.
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Basaran Acil S, Dinç L. Turkish adaptation and psychometric characteristics of the Nursing Authority and Autonomy Scale. J Nurs Manag 2018; 26:735-743. [PMID: 29656579 DOI: 10.1111/jonm.12611] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 11/29/2022]
Abstract
AIM To adapt the Nursing Authority and Autonomy Scale (NAAS) into Turkish the Nursing Authority and Autonomy Scale (NAAS) to Turkish and assess its psychometric properties for Turkish nurses and nurse managers. BACKGROUND The NAAS is a tool that specifically measures nursing authority and autonomy from the perspectives of nurses and nurse managers. METHODS The study sample consisted of 160 nurse managers and 266 staff nurses. Content validity was assessed using expert approval. Construct validity was assessed using confirmatory factor analysis. Internal consistency was assessed using Cronbach's α, and the test-retest reliability was assessed using Pearson's correlation coefficients. RESULTS The model achieved a good fit. The internal reliability of the NAAS' authority and autonomy in nursing practice and importance of nursing practice subscales were .84. The Cronbach's α of the instrument was .88. The test-retest scores within an interval of 3 weeks were statistically not significant. CONCLUSIONS The Turkish version of the NAAS has good psychometric properties and this scale can be employed to measure nurses' authority and autonomy. IMPLICATION FOR NURSING MANAGEMENT Nurse managers and educators should use an appropriate scale such as NAAS in order to assess nurses' clinical authority and autonomy to improve patient outcomes and develop nurses.
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Affiliation(s)
| | - Leyla Dinç
- Hacettepe University Faculty of Nursing, Ankara, Turkey
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Santos ÉID, Gomes AMT, Marques SC, Ramos RDS, Silva ACSSD, Oliveira FTD. Comparative study of representations of professional autonomy produced by first and last-period undergraduate nursing students. Rev Lat Am Enfermagem 2017. [PMCID: PMC5614237 DOI: 10.1590/1518-8345.1919.2927] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: to compare the social representations of professional nurse autonomy produced by
first and last-period undergraduate nursing students. Method: qualitative, descriptive and exploratory study, based on the structural approach
of social representations, the Central Core Theory, carried out with 171 students
from three federal public universities, using the free association technique on
the object “professional nurse autonomy”. The data were submitted to EVOC 2005
software and to similarity analysis. Results: care was the central core of the representational structure identified among the
students of the first period. Among last-period students, knowledge stood out as a
core element. The term responsibility was identified as common to both central
cores. Conclusion: regarding professional autonomy, the results point to an overlapping process of
the reified and consensual universes during the undergraduate course. However,
responsibility, inherent in the profession, remains cross-sectional. For the first
period students, autonomy is resignified in a practical and attitudinal way,
whereas for the last period students, the knowledge acquired stimulates them to
assign meaning to professional autonomy with a cognitive and attitudinal
representation. The data can support the use of innovative teaching practices in
nursing undergraduate courses.
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AllahBakhshian M, Alimohammadi N, Taleghani F, Nik AY, Abbasi S, Gholizadeh L. Barriers to intensive care unit nurses' autonomy in Iran: A qualitative study. Nurs Outlook 2017; 65:392-399. [PMID: 28069249 DOI: 10.1016/j.outlook.2016.12.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 11/18/2016] [Accepted: 12/05/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND The acute nature of the intensive care unit (ICU) environment necessitates that urgent clinical decisions are frequently made by the health care team. Therefore, it is important that critical care nurses have the authority to make decisions about their patient care. PURPOSE The purpose of this study was to explore perceived barriers to the practice of professional autonomy from the perspectives of ICU nurses in Iran. METHODS In this qualitative study, 28 critical care nurses were interviewed using a semistructured in-depth interview method. The interviews were recorded, transcribed verbatim, and analyzed using content analysis. DISCUSSION Data analysis led to identification of two main themes and five subthemes: (a) the profession-related barriers with two associated subthemes of "lack of capacity to exercise autonomy" and "lack of strong professional bodies"; (b) organizational barriers with the associated subthemes of "role ambiguity," "a directive rather than supportive workplace," and "lack of motivation." CONCLUSION ICU nurses in Iran may face many challenges in gaining professional autonomy. The identified inter- and intraprofessional barriers to the exercise of autonomy need to be addressed to promote critical thinking, job satisfaction, and motivation of ICU nurses, which can in turn lead to improved patient outcomes.
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Affiliation(s)
- Maryam AllahBakhshian
- Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrollah Alimohammadi
- Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Fariba Taleghani
- Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Yazdan Nik
- Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Abbasi
- Department of Anesthesiology and Critical Care Medicine, Critical care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney, Sydney, Australia
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Lee YW, Dai YT, Chang MY, Chang YC, Yao KG, Liu MC. Quality of Work Life, Nurses' Intention to Leave the Profession, and Nurses Leaving the Profession: A One-Year Prospective Survey. J Nurs Scholarsh 2017; 49:438-444. [PMID: 28605164 DOI: 10.1111/jnu.12301] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine the associations among quality of work life, nurses' intention to leave the profession, and nurses leaving the profession. DESIGN A prospective study design was used. METHODS Participants were 1,283 hospital nurses with a purposive sampling in Taiwan. The self-reported questionnaire consisted of three questionnaires: the Chinese version of the Quality of Nursing Work Life scale, an intention-to-leave profession questionnaire, and a demographic questionnaire. Records of nurses leaving the profession were surveyed 1 year later. Data were analyzed by descriptive statistics and inferential statistics. FINDINGS As many as 720 nurses (56.1%) had tendencies to leave their profession. However, only 31 nurses (2.5%) left their profession 1 year later. Nurses' intention to leave the profession mediated the relationship between the milieu of respect and autonomy, quality of work life, and nurses leaving the profession. CONCLUSIONS The milieu of respect and autonomy describing the quality of work life predicts the nurses' intention to leave the profession, and together these predict nurses leaving the profession. CLINICAL RELEVANCE This study illustrates that nurse managers could provide effective interventions to ameliorate the milieu of respect and autonomy aspect of quality of work life to prevent nurses from leaving their profession.
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Affiliation(s)
- Ya-Wen Lee
- Supervisor, Department of Nursing, Changhua Christian Hospital, Taiwan. Assistant Professor, Department of Nursing, Central Taiwan University of Science and Technology, Taiwan
| | - Yu-Tzu Dai
- Professor, Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Mei Yeh Chang
- Associate Professor, Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yue-Cune Chang
- Professor, Department of Mathematics, Tamkang University, Taipei, Taiwan
| | - Kaiping Grace Yao
- Professor, Department of Psychology, National Taiwan University, Taipei, Taiwan
| | - Mei-Chun Liu
- Professor, Institute for Labour Research, National Chengchi University, Taipei, Taiwan
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Sarkoohijabalbarezi Z, Ghodousi A, Davaridolatabadi E. The relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards. Int J Nurs Sci 2017; 4:117-121. [PMID: 31406730 PMCID: PMC6626124 DOI: 10.1016/j.ijnss.2017.01.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 11/30/2022] Open
Abstract
Background Nurses serve as the primary source of care for minor patients in intensive care units. Even though they support both patients and their relatives, these nurses may experience moral distress from their profession. While managing their daily relationships with their patients, nurses must also be able to control their actions to feel that they are from a social unit and feel their competence in association with others. Objective This study aimed to investigate the relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards. Methods This descriptive/comparative cross-sectional study was conducted in 2015 using 120 nurses as subjects. Subjects were selected using the census method. The research tools used to gain measurable data were the Pankratznursing questionnaire(PNQ) and Corley'sMoral distress scale (MDS). In order to analyze the collected data, descriptive statistic tests such as the relative frequency distribution, mean, standard deviation and the Pearson correlation test, T-test, ANOVA, and regression were used. The SPSSv.20 software was also used to analyze the data obtained. Results The relationship between professional autonomy and moral distress revealed that there was a significant positive relationship between professional autonomy and moral distress in the intensity (r = 0.39; P < 0.001) and the iteration (r = 0.41; P < 0.001). In addition, professional autonomy predicted 18% of changes in intensity of moral distress in total(MR = 0.42, R2 = 0.18) and also professional autonomy predicted 25% of iteration in moral distress in total(MR = 0.507, R2 = 0.25). Conclusions The results of this study revealed that there was a direct positive relationship between professional autonomy and moral distress.
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Affiliation(s)
- Zahra Sarkoohijabalbarezi
- Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Arash Ghodousi
- Forensic Medicine Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Elham Davaridolatabadi
- Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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Rao AD, Kumar A, McHugh M. Better Nurse Autonomy Decreases the Odds of 30-Day Mortality and Failure to Rescue. J Nurs Scholarsh 2016; 49:73-79. [PMID: 28094907 DOI: 10.1111/jnu.12267] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2016] [Indexed: 12/23/2022]
Abstract
RESEARCH PURPOSE Autonomy is essential to professional nursing practice and is a core component of good nurse work environments. The primary objective of this study was to examine the relationship between nurse autonomy and 30-day mortality and failure to rescue (FTR) in a hospitalized surgical population. STUDY DESIGN This study was a secondary analysis of cross-sectional data. It included data from three sources: patient discharge data from state administrative databases, a survey of nurses from four states, and the American Hospital Association annual survey from 2006-2007. METHODS Survey responses from 20,684 staff nurses across 570 hospitals were aggregated to the hospital level to assess autonomy measured by a standardized scale. Logistic regression models were used to estimate the relationship between nurse autonomy and 30-day mortality and FTR. Patient comorbidities, surgery type, and other hospital characteristics were included as controls. FINDINGS Greater nurse autonomy at the hospital level was significantly associated with lower odds of 30-day mortality and FTR for surgical patients even after accounting for patient risk and structural hospital characteristics. Each additional point on the nurse autonomy scale was associated with approximately 19% lower odds of 30-day mortality (p < .001) and 17% lower odds of failure to rescue (p < .01). CONCLUSIONS Hospitals with lower levels of nurse autonomy place their surgical patients at an increased risk for mortality and FTR. CLINICAL RELEVANCE Patients receiving care within institutions that promote high levels of nurse autonomy have a lower risk for death within 30 days and complications leading to death within 30 days. Hospitals can actively take steps to encourage nurse autonomy to positively influence patient outcomes.
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Affiliation(s)
- Aditi D Rao
- Director of Nursing Practice, Hospital of the University of Pennsylvania; Adjunct Assistant Professor, University of Pennsylvania School of Nursing, Center for Health Outcomes & Policy Research, Philadelphia, PA, USA
| | - Aparna Kumar
- Nurse Practitioner, Department of Child & Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia; University of Pennsylvania School of Nursing, Center for Health Outcomes & Policy Research, Philadelphia, PA, USA
| | - Matthew McHugh
- Associate Professor of Nursing, University of Pennsylvania School of Nursing, Center for Health Outcomes & Policy Research, Philadelphia, PA, USA
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Asakura K, Satoh M, Watanabe I. The Development of the Attitude Toward Professional Autonomy Scale for Nurses in Japan. Psychol Rep 2016; 119:761-782. [PMID: 27572336 DOI: 10.1177/0033294116665178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study's aim was to develop and test the psychometric properties of the Attitude toward Professional Autonomy Scale for Nurses in Japan. In Study 1, the initial (26-item) version of the scale was pilot tested on 454 Japanese nurses; item analysis and exploratory factor analysis were performed. In Study 2, the revised version of the scale (19 items) was administered to 802 Japanese nurses. The scale had good internal consistency (α = .85). Correlations with the scale of the desire of self-determination supported its concurrent validity. The scale could facilitate the assessment of cognitive aspects of professional autonomy among nurses and contribute to assessment of the propensity to behave autonomously among nurses in various clinical settings.
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Affiliation(s)
- Kyoko Asakura
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Miho Satoh
- School of Nursing, Tokyo Healthcare University, Tokyo, Japan
| | - Ikue Watanabe
- School of Health Science, Tohoku Fukushi University, Sendai, Japan
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Lakanmaa RL, Suominen T, Ritmala-Castrén M, Vahlberg T, Leino-Kilpi H. Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:536724. [PMID: 26557676 PMCID: PMC4628747 DOI: 10.1155/2015/536724] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Accepted: 04/23/2015] [Indexed: 11/25/2022]
Abstract
Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1-5, 1 = poor and 5 = excellent) was employed among Finnish intensive care unit nurses (n = 431). Intensive care unit nurses' self-assessed basic competence was good (mean 4.19, SD 0.40). The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses' basic competence was their experience of autonomy in nursing care (F value 60.85, β 0.11, SE 0.01, and P ≤ 0.0001). Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses' experienced autonomy in nursing.
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Affiliation(s)
| | - Tarja Suominen
- School of Health Sciences, University of Tampere and University of Turku, 33014 Tampere, Finland
| | - Marita Ritmala-Castrén
- Department of Anesthesiology and Intensive Care, Helsinki University Hospital, HUS, 00029 Helsinki, Finland
| | - Tero Vahlberg
- Biostatistics, University of Turku, 20014 Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, 20014 Turku, Finland
- Turku University Hospital, 20521 Turku, Finland
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Maurits EEM, de Veer AJE, van der Hoek LS, Francke AL. Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: a questionnaire survey. Int J Nurs Stud 2015; 52:1816-23. [PMID: 26250835 DOI: 10.1016/j.ijnurstu.2015.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/26/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The need for home care is rising in many Western European countries, due to the ageing population and governmental policies to substitute institutional care with home care. At the same time, a general shortage of qualified home-care staff exists or is expected in many countries. It is important to retain existing nursing staff in the healthcare sector to ensure a stable home-care workforce for the future. However, to date there has been little research about the job factors in home care that affect whether staff are considering leaving the healthcare sector. OBJECTIVE The main purpose of the study was to examine how home-care nursing staff's self-perceived autonomy relates to whether they have considered leaving the healthcare sector and to assess the possible mediating effect of work engagement. DESIGN, SETTING AND PARTICIPANTS The questionnaire-based, cross-sectional study involved 262 registered nurses and certified nursing assistants employed in Dutch home-care organisations (mean age of 51; 97% female). The respondents were members of the Dutch Nursing Staff Panel, a nationwide group of nursing staff members in various healthcare settings (67% response rate). METHODS The questionnaire included validated scales concerning self-perceived autonomy and work engagement and a measure for considering pursuing an occupation outside the healthcare sector. Logistic regression and mediation analyses were conducted to test associations between self-perceived autonomy, work engagement and considering leaving the healthcare sector. RESULTS Nursing staff members in home care who perceive more autonomy are more engaged in their work and less likely to have considered leaving the healthcare sector. The positive association between self-perceived autonomy and considering leaving, found among nursing staff members regardless of their level of education, is mediated by work engagement. CONCLUSION In developing strategies for retaining nursing staff in home care, employers and policy makers should target their efforts at enhancing nursing staff's autonomy, thereby improving their work engagement.
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Affiliation(s)
- Erica E M Maurits
- Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands.
| | - Anke J E de Veer
- Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands
| | - Lucas S van der Hoek
- Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands
| | - Anneke L Francke
- Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands; Department of Public and Occupational Health, EMGO Institute for Health and Care Research (EMGO+), VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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Lee YW, Dai YT, McCreary LL, Yao G, Brooks BA. Psychometric properties of the Chinese-version Quality of Nursing Work Life Scale. Nurs Health Sci 2014; 16:298-306. [PMID: 24635946 DOI: 10.1111/nhs.12099] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 09/12/2013] [Accepted: 09/13/2013] [Indexed: 11/28/2022]
Abstract
In this study, we developed and tested the psychometric properties of the Chinese-version Quality of Nursing Work Life Scale along seven subscales: supportive milieu with security and professional recognition, work arrangement and workload, work/home life balance, head nurse's/supervisor's management style, teamwork and communication, nursing staffing and patient care, and milieu of respect and autonomy. An instrument-development procedure with three phases was conducted in seven hospitals in 2010-2011. Phase I comprised translation and the cultural-adaptation process, phase II comprised a pilot study, and phase III comprised a field-testing process. Purposive sampling was used in the pilot study (n = 150) and the large field study (n = 1254). Five new items were added, and 85.7% of the original items were retained in the 41 item Chinese version. Principal component analysis revealed that a model accounted for 56.6% of the variance with acceptable internal consistency, concurrent validity, and discriminant validity. This study gave evidence of reliability and validity of the 41 item Chinese-version Quality of Nursing Work Life Scale.
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Affiliation(s)
- Ya-Wen Lee
- Department of Nursing, National Taiwan University, Taipei, Taiwan; Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan
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Sabatino L, Stievano A, Rocco G, Kallio H, Pietila AM, Kangasniemi MK. The dignity of the nursing profession. Nurs Ethics 2014; 21:659-72. [DOI: 10.1177/0969733013513215] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Nursing continues to gain legitimation epistemologically and ontologically as a scientific discipline throughout the world. If a profession gains respect as a true autonomous scientific profession, then this recognition has to be put in practice in all environments and geographical areas. Nursing professional dignity, as a self-regarding concept, does not have a clear definition in the literature, and it has only begun to be analyzed in the last 10 years. Objectives: The purpose of this meta-synthesis was to determine the various factors that constitute the notion of nursing professional dignity. The target was to create a tentative model of the concept. Research design: The research design was a meta-synthesis (N = 15 original articles) of nursing professional dignity described in the literature, based on the guidelines by Noblit and Hare. Method and findings: Original studies were sought out from electronic databases and manual searches. The selection of literature was conducted on stages based on titles (n = 2595), abstracts (n = 70), and full-texts (n = 15) according to the inclusion and exclusion criteria. From this analysis, a clear definition of nursing professional dignity emerged that underscored two main macro-dimensions constituting this intertwined, multidimensional, and complex notion: characteristics of the human beings and workplace elements. Conclusion: The recognition of nursing professional dignity could have a positive impact on patients because the results clearly showed that nurses are more prone to foster patients’ dignity, patients’ safety, and a better quality of care if their own dignity is respected. If nurses are uncomfortable, humiliated, or not seen in their professional role, it is difficult to give to others good care, good support, or good relationships.
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Amini K, Negarandeh R, Ramezani-Badr F, Moosaeifard M, Fallah R. Nurses' autonomy level in teaching hospitals and its relationship with the underlying factors. Int J Nurs Pract 2013; 21:52-9. [PMID: 24256084 DOI: 10.1111/ijn.12210] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study aimed to determine the autonomy level of nurses in hospitals affiliated to Zanjan University of Medical Sciences, Iran. In this descriptive cross-sectional study, 252 subjects were recruited using systematic random sampling method. The data were collected using questionnaire including Dempster Practice Behavior Scale. For data analysis, descriptive statistics and to compare the overall score and its subscales according to the demographic variables, t-test and analysis of variance test were used. The nurses in this study had medium professional autonomy. Statistical tests showed significant differences in the research sample according to age, gender, work experience, working position and place of work. The results of this study revealed that most of the nurses who participated in the study compared with western societies have lower professional autonomy. More studies are needed to determine the factors related to this difference and how we can promote Iranian nurses' autonomy.
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Affiliation(s)
- Kourosh Amini
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
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Abstract
Background: The development of a profession’s autonomy closely relates to that profession’s level of autonomy in performing its specific role. For the nursing profession, this key role is nursing care. Objectives: This study was undertaken to evaluate the professional autonomy of nurses in care provision, from an ethical perspective. Research design: A mixed methods approach is employed in this research, which makes use of both quantitative and qualitative methods. The quantitative dimension of this research covers sociodemographic aspects and makes use of the Sociotropy–Autonomy Scale. The qualitative dimension of the research relates to the factors that affect professional autonomy in nursing care. Participants and research context: The sample consisted of 30 nurses working in the orthopedics, neurology, or intensive care units of three hospitals. Ethical considerations: Before conducting this research, we received permission from the ethical committee, as well as written permits from all the institutions in which the research was carried out. Informed consent was obtained from all participants. Findings: According to the findings of this study, only 6.7% of the nurses surveyed stated that nurses had professional autonomy; they also stated that professional autonomy in nursing was mostly restricted by the need to be “dependent upon the physician in nursing implementations” and that autonomy in nursing care was mostly limited by a “high number of patients per nurse.” Discussion: This study determined that delays in resolving problems with regard to professional autonomy in nursing care in Turkey could be creating many of the professional and ethical problems that nurses face there. Conclusion: It is recommended that: individuals choose the nursing profession conscientiously; nurses need to be given professional awareness; their professional organizations need to be strengthened; and plans need to be made to increase research and to accumulate both knowledge and expertise.
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Harrison R, Birks Y, Hall J, Bosanquet K, Harden M, Iedema R. The contribution of nurses to incident disclosure: a narrative review. Int J Nurs Stud 2013; 51:334-45. [PMID: 23910400 DOI: 10.1016/j.ijnurstu.2013.07.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 07/02/2013] [Accepted: 07/03/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To explore (a) how nurses feel about disclosing patient safety incidents to patients, (b) the current contribution that nurses make to the process of disclosing patient safety incidents to patients and (c) the barriers that nurses report as inhibiting their involvement in disclosure. DESIGN A systematic search process was used to identify and select all relevant material. Heterogeneity in study design of the included articles prohibited a meta-analysis and findings were therefore synthesised in a narrative review. DATA SOURCES A range of text words, synonyms and subject headings were developed in conjunction with the York Centre for Reviews and Dissemination and used to undertake a systematic search of electronic databases (MEDLINE; EMBASE; CENTRAL; PsycINFO; Health Management and Information Consortium; CINAHL; ASSIA; Science Citation Index; Social Science Citation Index; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effects; Health Technology Assessment Database; Health Systems Evidence; PASCAL; LILACS). Retrieval of studies was restricted to those published after 1980. Further data sources were: websites, grey literature, research in progress databases, hand-searching of relevant journals and author contact. REVIEW METHODS The title and abstract of each citation was independently screened by two reviewers and disagreements resolved by consensus or consultation with a third person. Full text articles retrieved were further screened against the inclusion and exclusion criteria then checked by a second reviewer (YB). Relevant data were extracted and findings were synthesised in a narrative empirical synthesis. RESULTS The systematic search and selection process identified 15 publications which included 11 unique studies that emerged from a range of locations. Findings suggest that nurses currently support both physicians and patients through incident disclosure, but may be ill-prepared to disclose incidents independently. Barriers to nurse involvement included a lack of opportunities for education and training, and the multiple and sometimes conflicting roles within nursing. CONCLUSIONS Numerous potential benefits were identified that may result from nurses having a greater contribution to the disclosure process, but the provision of support and training is essential to overcome the reported barriers faced by nurses internationally.
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Affiliation(s)
- Reema Harrison
- Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT, England, United Kingdom.
| | - Yvonne Birks
- University of York, York, England, United Kingdom
| | - Jill Hall
- University of York, York, England, United Kingdom
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Snelling PC. Ethical and professional concerns in research utilisation: intentional rounding in the United Kingdom. Nurs Ethics 2013; 20:784-97. [PMID: 23533211 DOI: 10.1177/0969733013478306] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intentional rounding, a process involving the performance of regular checks on all patients following a standardised protocol, is being introduced widely in the United Kingdom. The process has been promoted by the Prime Minister and publicised by the Chief Nursing Officer at the Department of Health as well as by influential think tanks and individual National Health Service organisations. An evidence base is offered in justification. This article subjects the evidence base to critical scrutiny concluding that it consists of poor quality studies and serial misreporting of findings and a failure to consider wider concerns, including transference of evidence to differing health-care systems, and the conflation of perception and quality of care. Political promotion and wide implementation of intentional rounding despite the flimsy and questionable evidence base raise questions about the use of evidence in ethical nursing practice and the status of nursing as an autonomous profession.
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Struwe JH, Baernholdt M, Noerholm V, Lind J. How is nursing care for stroke patients organised? Nurses' views on best practices. J Nurs Manag 2013; 21:141-51. [DOI: 10.1111/jonm.12016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - Marianne Baernholdt
- School of Nursing and Department of Public Health Sciences; University of Virginia; Charlottesville VA USA
| | - Vibeke Noerholm
- School of Nursing UC Diakonissestiftelsen; Copenhagen Denmark
| | - Jette Lind
- School of Nursing UC Diakonissestiftelsen; Copenhagen Denmark
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Abstract
The purpose of this qualitative study was to analyse nurses’ professional dignity in their everyday working lives. We explored the factors that affect nursing professional dignity in practice that emerge in relationships with health professionals, among clinical nurses working in hospitals and in community settings in central Italy. The main themes identified were: (i) nursing professional dignity perceived as an achievement; (ii) recognition of dignity beyond professional roles. These two concepts are interconnected. This study provides insights into professional dignity in nursing being perceived as an achievement linked to the intrinsic dignity of every human being. The ‘nursing professional dignity perceived as an achievement’ was perceived as having declined in different social factors. Some factors of nursing professional dignity perceived as an achievement were attained more easily in community settings. ‘Recognition of dignity beyond professional roles’ underpins the intrinsic dignity as an expression of humanity, embedded in persons regardless of any profession, and values, such as: respect, moral integrity, humility, working conscientiously and kindness.
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