Care of the menopausal patient: A nurse practitioner?s view

Individualized care scale - nurse version: a Finnish validation study

RATIONALE

Nurses' work is inextricably linked to the evaluation of the quality of care provision in health care. Within this evaluation, individualized care is a topical theme in western countries. Currently, there is no suitable instrument to measure the level of individualized care from the nurses' point of view.

AIM

To report the development process of the individualized care scale - nurse (ICS-Nurse) and to ensure its validity and reliability.

METHODS

A methodological design was used. Data were obtained from 544 nurses (N = 923, response rate 59%) from inpatient wards in one university, two regional and two psychiatric hospitals as well as four health centres. Three expert analyses were used to ensure content validity. Cronbach's alpha coefficients and item analysis were used to examine internal consistency reliability. A principal components analysis, Spearman's correlation coefficients, multiple regression analysis and structural equation modelled by LISREL were conducted to evaluate construct validity.

RESULTS

The expert analyses provided good content validity evidence. The ICS-Nurse was easy to administer and able to be completed quickly. There were few missing data. Cronbach's alpha coefficients ranged 0.72-0.84. All item-to-total correlations were acceptable (>0.30), but some of the inter-item correlations were high. The principal components analysis supported the three-component structure explaining 52% of the variance in ICS-A-Nurse and 56% in ICS-B-Nurse. LISREL supported the theoretical model.

CONCLUSIONS

The ICS-Nurse is a valid and reliable instrument that can be used to measure nurses' perceptions of individualized nursing care in inpatient wards. There is a need to test instrument further, both nationally and internationally.

The driving and restraining forces that promote and impede the implementation of individualised nursing care: a literature review

BACKGROUND

Despite substantial attention devoted to the development of individualised care in recent years, there is a lack of coherent information and empirical research assessing the driving and restraining forces that promote and impede its implementation.

OBJECTIVES

The aim of this integrative literature review is to describe the driving and restraining forces for the implementation of individualised nursing care from the nurse's point of view. This information is useful for the development of clinical nursing care and in identifying areas for future research.

DESIGN

An integrative literature review.

DATA SOURCES

An integrative analysis of empirical studies and reviews derived from the MEDLINE, CINAHL databases and EMB Reviews - The Cochrane Database of Systematic Reviews (individual* care & nurse, from earliest through April 2008) was conducted focusing on studies which used nurses as informants. The final sample of 43 articles published in English focusing on the individualised care of adult patients from the nurse's point of view was retrieved after a two-stage process.

REVIEW METHODS

The integrative analysis of the studies included three steps. Firstly, the full texts of the final eligible studies were read. Secondly, the driving and restraining forces, that respectively promote or impede the delivery of individualised care were identified and listed in a working sheet. A total of nine categories were identified. Thirdly, a working sheet was completed summarising the information found in the studies reviewed and listing the authors.

RESULTS

Nine categories describing both driving and restraining forces for individualised nursing care were identified: (1) nurse's personal characteristics, (2) skills enhancement, (3) ethical issues, (4) nursing care delivery and interventions, (5) patient characteristics, (6) organisation of work, (7) staffing, (8) team work and group dynamics, and (9) leadership and management.

CONCLUSIONS

A body of knowledge was identified for future research. The results inform both clinical practice and education and promote better use of the nursing work force in order to provide individualised care for patients and maximise good patient outcomes.