Nurses' view of their work environment, health and safety: A qualitative study

The effect of practice environments and psychological empowerment perceptions of nurses on their care behaviours: A cross-sectional study

AIM

The aim of this study was to examine the effect of professional and individual characteristics, practice environments and psychological empowerment perceptions of nurses on their care behaviours.

DESIGN

The study used a cross-sectional research design following the STROBE guidelines.

METHODS

The sample of this descriptive and correlational study consisted of 584 nurses working in a university hospital in Turkey. The data were collected between January and June 2023 using the Nursing Information Form, the Practice Environment Scale of the Nursing Work Index (PES-NWI), the Psychological Empowerment Scale (PES), and the Caring Behaviours Scale-30, and analysed using descriptive statistics, Spearman's correlation and multiple linear regression.

RESULTS

It was determined that PES-NWI, PES and Caring Behaviours Scale (CBI-30) scores of nurses were higher than the average. The study revealed that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on their care behaviours.

CONCLUSION

The results of the study showed that nurses' PES-NWI, PES and CBI-30 scores were higher than the average, and that certain professional and individual characteristics of nurses, practice environments and psychological empowerment perceptions had an effect on care behaviours. Nursing service managers, in particular, are required to understand the importance of this relationship and create appropriate working conditions which are integrated with psychological empowerment to improve caring behaviours of nurses.

Development and psychometric evaluation of a tool to assess oncology nurses' occupational health needs

BACKGROUND

Oncology nurses are confronted with various occupational hazards; consequently, it is of great importance to identify and measure their occupational health needs. Due to the fact that standard tools are not available to assess these needs, this study was conducted to develop a tool for assessing oncology nurses' occupational health needs.

MATERIALS AND METHODS

This study consisted of two phases from 2020 to 2021. The first phase was item generation and tool design. The initial development of the item pool was based on the result of the qualitative study and literature search. The second phase was item reduction and psychometric evaluation of the formulated tool including, face, content, and construct validity and reliability. Construct validity was assessed using exploratory factor analysis and convergent validity with the participation of 300 oncology nurses. The reliability of the tool was assessed using internal consistency (Cronbach's alpha) and test-retest (intra-cluster correlation coefficient).

RESULTS

The mean content validity index (CVI) of the tool was 0.95. The results of exploratory factor analysis showed that this tool consisted of 69 items and four factors, explaining 65.88% of the variance. The results of the convergent validity assessment showed a significant positive correlation between the mean scores of occupational health needs and occupational stress (P < 0.0001 and r = 0.40). Cronbach's alpha coefficient (0.98) and tool stability (0.98) confirmed the appropriate reliability of the tool.

CONCLUSION

The developed tool is recommended as a valid and reliable tool for assessing oncology nurses' occupational health needs that can be used both in practice and in future studies.

Prevalence of dyslipidaemia within Polish nurses. Cross-sectional study - single and multiple linear regression models and ROC analysis

BACKGROUND

Maintaining good health is vital not only for own well-being, but also to ensure high-quality patient care. The aim of this study was to evaluate the prevalence of dyslipidaemia and to determine the factors responsible for the development of this disorder among Polish nurses. Lipid profile disorders are the most prevalent and challenging risk factors for the development of cardiovascular disease. Nurses have significant potential and play a crucial role in providing care and treatment services.

METHODS

This cross-sectional study involved nurses and included measurements of body weight composition (Tanita MC-980), body mass index, waist circumference, blood pressure (Welch Allyn 4200B), lipid profile, and fasting blood glucose (CardioChek PA).

RESULTS

The results revealed that more than half of the nurses (60.09%) were overweight or obese, with 57.28% exhibiting elevated blood pressure, 32.25% having fasting glucose levels, and 69.14% experiencing dyslipidaemia. Multiple model evaluation using ROC curves demonstrated that multiple models accurately predicted hypercholesterolemia (AUC = 0.715), elevated LDL (AUC = 0.727), and elevated TC (AUC = 0.723) among Polish nurses.

CONCLUSION

Comprehensive education programmes should be implemented that include the latest advances in cardiovascular disease prevention. Regular check-ups, as well as the promotion and availability of healthy food in hospital canteens, are essential.

Association between occupational stress, occupational burnout, and depressive symptoms among medical staff during COVID-19: A cross-sectional study in Chongqing, China

BACKGROUND

Studies have extensively examined the factors contributing to the onset of occupational stress, burnout, and depression. However, the relationship between these variables is limited.

OBJECTIVE

This study aimed to explore the association between occupational stress, burnout, and depressive symptoms and to investigate the mediating effect of burnout between occupational stress and depressive symptoms in medical staff.

METHODS

A cross-sectional survey was conducted among medical staff in Chongqing, China. The Core Occupational Stress Scale (COSS), Maslach Burnout Inventory: General Survey (MBI-GS), and Patient Health Questionnaire-9 (PHQ-9) were used to assess the status of occupational stress, burnout, and depressive symptoms, respectively. The bootstrapping analyses using SPSS PROCESS macros version 3 were conducted to examine mediating effects.

RESULTS

The study conducted on medical staff in Chongqing revealed that the detection rates of occupational stress, occupational burnout, and depressive symptoms were 31.8%, 23.3%, and 30.3%, respectively. Hierarchical regression analysis revealed that occupational stress and burnout accounted for 19.3% (p < 0.001) and 18.8% (p < 0.001) of the variance in depressive symptoms, respectively. Mediation analysis showed that occupational stress indirectly affected depressive symptoms through the mediating effect of occupational burnout, with a mediation effect value of 0.13 (bootstrap 95% CI: 0.116-0.144) and the mediation effect accounting for 44.8% of the total effect.

CONCLUSION

Our results indicated that occupational stress and burnout were predictors of depressive symptoms. Occupational stress had a significant indirect effect on depressive symptoms via burnout. These results suggest that reducing occupational stress and burnout could be effective strategies for preventing depression among medical staff.

Opinions of emergency nurses in Turkey on their work environment during the COVID-19 pandemic and its relationship with their health: A qualitative study

Introduction

COVID-19 patients being admitted to emergency service pose a high risk of exposure and infection to emergency nurses. Therefore, one of the primary responsibilities of hospital management is to provide an appropriate work environment for nurses.

Aim

To analyze the opinions of emergency nurses about their work environment, and to understand how the working environment is related to their health during the COVID-19 pandemic.

Methods

The study employed a qualitative descriptive research design and purposive sampling method. It was conducted in the emergency service of a state hospital in the central Anatolia region of Turkey, which was providing COVID-19 care at the time. The data were collected through semi-structured individual interviews held between January and February 2021. Each interview was conducted only once via WhatsApp video calls. Data collection was continued to reach data saturation (n:14). The data were analyzed using Colaizzi's seven-step content analysis. The Consolidated Criteria for Reporting Qualitative (COREQ) Studies checklist was followed in the study.

Results

Three themes emerged in the analysis of the data obtained from a total of 14 emergency nurses: (a) "Insufficient Physical Environment"; (b) "Inadequacies in Managerial Roles and Skills"; and (c) "The Effect of the Work Environment on Nurses' Health". It was determined that the work environment of emergency nurses was inadequate in terms of resting areas, ventilation and separation of clean and infected areas, and they stated that they had not received adequate support from their managers and encountered difficulties due to equipment shortage, particularly in the early stages of COVID-19. It was also determined that the work environment caused psychological and ergonomic health issues.

Conclusions

It is important to provide adequate managerial support and to make arrangements that resolve the physical and mental obstacles in improving the work environment of emergency nurses.

Work climate from the perspective of nurses: qualitative research

Introduction

This study aims to determine the nurses' view of the work climate. A positive work climate is one of the keys determining factors in improving nurse outcomes and affects patient satisfaction with care.

Methods

In this qualitative research, a semi-structured interview was used to understand nurses' perceptions of their work environment. The participants' responses were recorded and transcribed. Between November and December 2021, 22 nurses participated in the study. Purposive sampling was used to choose nurses for the research, and interviews were performed with these nurses utilizing a semi-structured interview form. The interviews were analyzed using a theme analysis.

Results

The themes identified in the data centered on four dominant elements that together shaped the prevailing work climate: participation in making decisions, companionship, job satisfaction, and changes they expect.

Conclusion

It is necessary to implement meetings at the level of departments and hospitals, where employees will receive support from the authorities and learn how they can improve the working climate.

Implications for nursing management

Research findings on the working climate can help hospital managers makers design interventions to create a good working environment for nurses.

Nurses' perceptions of quality of work life in private hospitals in Enugu, Nigeria: A qualitative study

Despite being essential for retaining nurses, not much is known about nurses' quality of work life (QWL) in private hospitals in sub-Saharan Africa, including Nigeria. We explored nurses' perceptions of QWL, factors influencing it, how it affects motivation, and strategies for its improvement. The study was conducted in seven private hospitals in Enugu, Nigeria. The design was qualitative, using focus group discussion (n = 7) with registered nurses (n = 66) purposively selected using maximum variation sampling and the inclusion criteria. Data were analyzed using verbatim transcription and thematic analysis. The nurses understood QWL from work-family life, work design, work context and work world perspectives. Opportunities for skill acquisition, resource availability, helpfulness from colleagues, and a hygienic work environment improved the QWL and motivation of nurses. Work-family life factors including caring obligations, night shifts, long hours, burnout, and inappropriate leave policies; work design factors including declining autonomy, inadequate staffing, and a high workload; work context factors consisting of a lack of participatory decision-making, blaming nurses for gaps, restrictive training policy, limited training opportunity, and insecurity; and work world factors related to poor remuneration, poor community view of nursing and ease of job termination undermined QWL and demotivated nurses. Strategies identified by the nurses to improve QWL included improving staffing, vacation, care coordination, supportive supervision, teamwork, promotion, participatory decision-making, training opportunities, timely hand-over of shifts, job recognition, and compensation. The quality of nursing work life in private hospitals in Enugu needs improvement. Quality improvement programs addressing the barriers to nurses' QWL are warranted.

The effects of the COVID-19 pandemic on healthcare workers' psychological and mental health: The moderating role of felt obligation

BACKGROUND

The ravages of COVID-19 have created a worldwide emergency in healthcare units. Under these circumstances, the perception of an infection threat is primarily affecting the employees' performance in reducing contagion effects.

OBJECTIVE

The purpose of this study is to develop substantial measures of support for healthcare employees to maintain adequacy in job performance.

METHODS

Data were collected from state-owned hospitals in Pakistan to test the current study's proposed model. We applied structural equation modeling through a partial least square regression in addition to the blindfolding approach in Smart-PLS. Confirmatory factor analysis was also employed to measure the study's validity.

RESULTS

The current study's findings show that the perception of a threat from COVID-19 and the inadequate protective measures have influenced frontline healthcare workers' performance levels. The mediating path of depression symptoms indicated the threat of COVID-19 and the absence of protective measures as potential determinants of poor performance. However, an employee's ability to feel obligated toward their job duties reduces the effect of depression on employee performance.

CONCLUSION

The current model highlights an individual's feelings of obligation to maintain their performance level by minimizing the effect of depression and professional anxiety. The present study extensively described the psychological constraints healthcare workers are facing during the current pandemic. Current research addressing healthcare employees' mental health is vital for better prevention and control during pandemic circumstances. The current study's findings extend the emerging understanding of employee psychology in such circumstances.

Focus on Polish nurses' health condition: a cross-sectional study

Background

The nursing profession carries with it many negative factors and a high risk of developing chronic diseases, including overweight and obesity. According to statistics, the health condition of this professional group is much worse than that of the average population of the same age. As the largest and most trusted professional group in the world, nurses are critical to the health of any nation. The aim of the study was to assess the Polish nurse's health condition based on real measurements of parameters important for the occurrence of metabolic diseases.

Methods

This is the cross-sectional, conducted among two age groups of Polish nurses (<50 years and ≥50 years). Study included the measurements with DXA, the assessment of glucose concentration and lipid profile, the measurement of blood pressure and socio-demographic data of the surveyed nurses.

Results

The majority of respondents above 50 years old were nurses with elevated total cholesterol (79.3%), elevated LDL cholesterol (72.8%), 42.4% of studied nurses had hypertension.

Conclusion

Individual, local and national measures to prevent and support the health of this professional group are needed.

Factors affecting nurses' retention in Iranian hospitals

AIM

This research was conducted to study the factors affecting nurses' retention in Iranian hospitals.

BACKGROUND

Health care systems should pay attention to their human resources' retention to deliver health care services and maintain their organizational values. This issue becomes more significant when we consider the human and financial limitations in place.

METHOD

Data were analyzed using conventional qualitative content analysis based on the model developed by Elo & Kyngäs. Forty-two managers and nurses were selected by purposive sampling. Data were obtained through 45 semi-structured interviews until data saturation was reached.

RESULTS

The data analysis resulted in four main categories and seventeen subcategories. The main categories included dignity and respect, ethics and spirituality, empathy, and flourishing. The main theme extracted was "maternal management".

CONCLUSION

The present study proposes "maternal management" as a strategy to increase the retention of nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Maternal management is a combination of management knowledge and empathy when dealing with the staff's problems. By creating an amiable and empathetic environment, maternal management motivates and encourages the staff. In the face of financial and human resources shortage, what helps retain the staff is a friendly atmosphere and mutual understanding between them and the nursing manager.

Nurses' Working Experiences of Their Provision of Cross-Cultural Services to Tibetan Patients With Kashin-Beck Disease: A Qualitative Study

INTRODUCTION

Limited qualitative studies exist on nurses' experience in terms of communicating with and caring for patients with endemic diseases. The purpose of this study was to describe the working experiences of nurses caring for Tibetan patients with Kashin-Beck disease in China.

METHOD

A qualitative design was used in this study. Sixteen nurses who worked in the orthopedics department of a large tertiary general hospital in Wuhan, China, constituting a purposive sample, were interviewed face-to-face using semi-structured guided questions.

RESULTS

Three major themes and nine subthemes were identified. Major themes included the challenge in cross-cultural nursing, stress adjustment in cross-cultural nursing, and reshaping competencies in cross-cultural nursing.

DISCUSSION

This study revealed that nurses encountered multifaceted challenges when caring for Tibetan patients with Kashin-Beck disease. In a multiethnic society, communication and language skills, cultural competency and cultural sensitivity, and diverse training methods to improve cross-cultural knowledge could increase ethnic minority patient satisfaction with cross-cultural care.

The relationship between occupational stress, job burnout and quality of life among surgical nurses in Xinjiang, China

BACKGROUND

Nursing is a high-risk occupation that involves exposure to stress. The physical and mental health of nurses is directly related to the quality of medical services, so the quality of life of nurses cannot be ignored. This study is a Chinese nursing study that investigated occupational stress, job burnout, and quality of life of surgical nurses in Xinjiang, China.

METHODS

This study employed the cluster random sampling method and carried out a questionnaire survey among 488 surgical nurses from five hospitals from May 2019 to September 2019. The study analyzed the relationship between occupational stress, job burnout and quality of life. The Effort-Reward Imbalance questionnaire (ERI), Maslach Burnout Inventory General Survey (MBI-GS) and the 36-item Short Form Health Survey (SF-36) were used to evaluate occupational stress, job burnout and quality of life among surgical nurses.

RESULTS

A total of 550 questionnaires were distributed in this study, and 488 were retrieved, with an effective recovery rate of 88.73 %. The results revealed that the quality of life score among surgical nurses was not high, and differences were observed in the quality of life score of patients according to gender, age, title, and frequency of night shifts (P < 0.05). There was a positive correlation between occupational stress and job burnout. Higher levels of occupational stress and job burnout were associated with a poorer quality of life score. Occupational stress and job burnout were identified as risk factors for quality of life, and the interaction between high levels of stress and burnout seriously reduced quality of life. The structural equation model revealed that occupational stress and job burnout had a direct impact on quality of life, occupational stress had a direct impact on job burnout, and job burnout was identified as a mediating factor in the relationship between occupational stress and quality of life.

CONCLUSIONS

Surgical nurses have a high level of occupational stress and burnout, and low quality of life score. Quality of life is correlated with occupational stress and job burnout. According to the individual characteristics and psychological state of nurses, managers can implement personalized intervention measures promptly and effectively to relieve their tension and burnout, and improve the quality of life of surgical nurses.

Lessons from Italian front-line nurses' experiences during the COVID-19 pandemic: A qualitative descriptive study

AIM

To explore nursing management issues within COVID-19 narratives of Italian front-line nurses.

BACKGROUND

The COVID-19 pandemic has dramatically affected health systems and professionals worldwide. Italian nurses have key messages for nursing leaders following their acute experiences in the pandemic.

METHOD

A descriptive qualitative study with thematic analysis.

RESULTS

Twenty-three testimonies from clinical nurses were analysed. Six macrothemes were identified as follows: organisational and logistic change; leadership models adopted to manage the emergency; changes in nursing approaches; personal protective equipment issues; physical and psychological impact on nurses; and team value/spirit.

CONCLUSIONS

Our testimonies highlighted the huge impact of COVID-19 on the Italian nursing workforce, especially in terms of the high risks associated with caring for COVID-19 patients, exacerbated by the shortage of appropriate personal protective equipment. Nurses had to care for their colleagues and live separately from their families to avoid infecting them, revealing nurses' resilience and the important role of effective and sensitive management.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers must be prepared for the impact of pandemics on staff and need to ensure availability and replacement of quality personal protective equipment, rehearse strategies for communicating with patients while wearing personal protective equipment and establish protocols for communicating with relatives.

Experiences of clinical first-line nurses treating patients with COVID-19: A qualitative study

AIM

To explore the work experience of clinical first-line nurses treating patients with coronavirus disease 2019 (COVID-19).

BACKGROUND

COVID-19 has been listed as an international public health emergency. Clinical first-line nurses are at a high risk of infection, and they face a lack of experience and inadequate preparation for COVID-19, leading to physical and psychological disorders.

METHODS

A qualitative study was conducted from January to February 2020 at a COVID-19-designated hospital in Wuhan, China. Thirty nurses were selected for the study using a purposive sampling method. Data were collected by semi-structured interviews and analysed using content analysis.

RESULTS

Two main categories were defined in the study from the perspective of nurses: negative experiences during clinical first-line work and positive impacts of clinical first-line work. Under the first category, two subcategories were included: psychological experiences of clinical first-line work and difficulties faced during clinical first-line work. The analysis further yielded two subcategories for the second category: the needs of clinical first-line work and the impact of clinical first-line work on professional attitudes.

CONCLUSIONS

The results demonstrate that success depends upon strengthening emergency training and knowledge of infectious diseases for nurses, providing adequate protective equipment and improving the emergency response plans of hospitals for public health emergencies.

IMPLICATIONS FOR NURSING MANAGEMENT

It is believed that our findings will guide hospital managers to make improvements in personal, administrative and institutional areas and that they will provide a reference and inspiration for nurses with regard to public health emergencies in the future.

Senior nurses' perceptions of junior nurses' incident reporting: A qualitative study

AIM

To develop an understanding of senior nurses' ranking and perceptions of incident reporting by junior nurses.

BACKGROUND

Nurses must be encouraged to report incidents to nursing management. It is important to ascertain how senior nurses perceive their concerns, as it is crucial to ensuring that patient safety is managed.

METHOD

Qualitative study. Four focus groups explored senior nurses' perceptions of risks identified by nurses from a live incident reporting database. Data were analysed using framework analysis.

RESULTS

Five themes emerged demonstrating the differences in opinions in relation to the classification of events by senior and non-senior nurses. Senior nurses held the view that some junior nurses use incident reporting to 'vent frustration.'

CONCLUSION

There is a mismatch between senior nurses' and junior nurses' perceptions of safety incidents. Nurses need to develop the writing style and use language that red flags incidents when reporting incidents. Senior nurses need to create a positive culture where risk from incident reporting is used to improve patient safety and subsequently a positive work environment. Implications for Nursing Management Our research identified the need for joint training to promote a shared understanding among nurses as to how incident report should be completed to promote patient safety.

Prevention of occupational injuries and accidents: A social capital perspective

Prior research has consistently established the pragmatic nature of literature regarding occupational injuries and accidental happenings faced by nursing professionals. However, current realities require a subjective approach to identify preventative measures that could influence occupational health and safety in healthcare sectors. A qualitative design followed a descriptive approach to assess unbiased opinions towards occupational obstructions that lead to accidental happenings. This study used the social capital framework in particular as a support resource to eliminate its detrimental effects on nurse's capacity to serve their patients. The findings extended the fundamental understanding of social capital from social ties to workplace and personal ties as potential mechanisms of support. Healthcare organizations need to redefine their control policies to provide the ultimate support to their care agents. A social capital model offers nursing practitioners and nursing managers an approach for building evidence-based policies with implications for nurse's safety, education and training.

Adaptation and validation of the Compliance with Standard Precautions Scale amongst nurses in Turkey

AIMS

To adapt and psychometrically test the Compliance with Standard Precautions Scale for use by Turkish nurses.

BACKGROUND

Measurement of standard precautions compliance is important to manage the safety of both patients and health care teams.

METHODS

This two-phase methodological study employed a correlational design with repeated measures. In phase one, the scale's adaptation, including translation, semantic equivalence, content and face validity, was implemented. In phase two, internal consistency and stability were used to examine the reliability of the scale. Construct validity was tested using the Rasch rating scale model. This study was conducted by recruiting 411 nurses from three different hospitals between September 2015 and September 2016.

RESULTS

Adaptation results showed that the Turkish version of the Compliance with Standard Precautions Scale (CSPS-T) is adequate for linguistic and content validation. The content validity index and comprehensibility of the scale were similarly satisfactory. The reliability of the CSPS-T was examined by Cronbach's alpha, corrected item-total correlations and intraclass correlation coefficient, and good results were obtained. The Rasch model showed that all items were compatible with the model. Whereas Item 4 was the most difficult, Item 10 was the easiest.

CONCLUSION

The CSPS-T is a reliable and valid tool for assessing compliance with standard precautions amongst Turkish nurses.