A cross sectional study on factors influencing professionalism in nursing among nurses in Mekelle Public Hospitals, North Ethiopia, 2012

Factors Associated with Nursing Professionalism: Insights from Tertiary Care Center in India

BACKGROUND

Professionalism among nurses plays a critical role in ensuring patient safety and quality care and involves delivering competent, safe, and ethical care while also working with clients, families, communities, and healthcare teams.

AIMS AND OBJECTIVES

To assess the level of nursing professionalism and the factors affecting professionalism among nurses working at a tertiary care center in India.

METHODS

A descriptive cross-sectional study was conducted from October 2022 to March 2023 using a total enumeration sampling technique. Following institutional ethics committee approval, standardized tools were administered consisting of Nursing Professionalism Scale and socio-demographic, personal, and organizational characteristics.

RESULTS

A total of 270 nurses participated, with a response rate of 93.7%. The mean age of the participants was 27.33 ± 2.75 years, with the majority being female (82.6%) and belonged to the age group of 23-27 years (59.6%). More than half of the nurses exhibited high professionalism (53%), with the highest and lowest median scores for professional responsibility (29.0) and valuing human beings (13.0) respectively. Multivariate regression analysis demonstrated that, compared with their counterparts, nurses with a graduate nursing qualification (AOR = 4.77, 95% CI = 1.16-19.68), up-to-date training (AOR = 4.13, 95% CI = 1.88-9.06), and adequate career opportunity (AOR = 33.91, 95% CI = 14.48-79.39) had significant associations with high nursing professionalism.

CONCLUSION/IMPLICATIONS FOR PRACTICE

The majority of the nurses had high professionalism, particularly in the domains of professional responsibility and management. Hospitals and healthcare institutions can use these findings to develop policies and prioritize opportunities for nurses to attend conferences and workshops to enhance their professional values, ultimately leading to improved patient care outcomes.

PATIENT AND PUBLIC CONTRIBUTION

No patient or public contribution.

Nurse educators' professional practice attributes and its determinants

BACKGROUND

Professional practice attributes of nurses help to promote nursing as a profession and advance nursing education. Nursing professionals need to demonstrate a high level of professional commitment to their practices and must be professionally competent to perform their roles.

MATERIAL AND METHODS

Descriptive survey was conducted at the nursing educational institutes affiliated with the Indian Nursing Council and situated in the selected Northern Indian states. The sample included 343 nurse educators who were selected using simple random sampling. The self-reported method was adopted to collect data where three questionnaires including socio-demographic information, organizational characteristics of current place of work, and professional practice attributes assessment criteria were used. Descriptive and inferential statistics were used for data analysis.

RESULTS

Overall, the study's participants scored poorly on professional practice attributes (Mean, SD: 1.98, 2.03), which were linked to their personal (age and gender), professional (educational background, professional qualification, current designation), and organizational (duration of organization's establishment, courses provided, college management) characteristics.

CONCLUSION

The findings highlighted the need for nurse educators to be more competent and dedicated in their respective fields. The study also suggests that in order to raise the standard of nursing education, nursing regulatory bodies like nursing councils, universities, and governments must take the necessary steps to foster the professional development of nurse educators.

Level of Professionalism and Associated Factors Among Nurses Working in South Wollo Zone Public Hospitals, Northeastern Ethiopia, 2022

Introduction

Nurses are the frontline force for patient care, and nursing professionalism is a key tool for quality of care. Nursing professionalism and its characteristics should be defined in accordance with the current system.

Objective

To determine the level of professionalism in nursing and its associated factors in the South Wollo Public Hospital, Northeast Ethiopia.

Methods

A multicenter hospital-based cross-sectional study design was used in South Wollo Zone Public Hospitals from March to April 2022, with 357 nurses selected using a simple random sampling method. Data were collected using a pretested questionnaire, then entered and analyzed using EpiData 4.7 and SPSS 26. Finally, predictors of nursing professionalism were identified using a multivariate logistic regression.

Result

Of the 350 respondents, 179 (51.1%) were women and 171 (48.9%) were men, with 68.6% displaying high levels of professionalism. Being women (adjusted odds ratio [AOR] = 2.93, 95% CI [1.718, 5.000]), having a positive self-image (AOR = 2.96, 95% CI [1.421, 6.205]), having a good organizational culture (AOR = 3.16, 95% CI [1.587, 6.302]), being a member of the nursing association (AOR = 1.95, 95% CI [1.137, 3.367]), and nurses who were satisfied with their job were significantly associated with nursing professionalism.

Conclusion

In this study, the level of nursing professionalism was encouraging but needed more effort. Furthermore, sex, self-image, organizational culture, nursing association membership, and job satisfaction were positive predictors of nursing professionalism. As a result, hospital administrations consider factors that maintain a pleasant institutional working environment to foster a positive self-image and increase job satisfaction.

Exploring Ghanaian nurses knowledge and application of bio-ethical principles in postoperative pain management

Managing postoperative pain require good understanding of the bio-ethical principles in order to preserve patients’ rights. Bio-ethical principles in health care include autonomy, beneficence, justice and nonmaleficence. It is important that health care professionals understand that patients in pain have the right to satisfactory management. Good insight on ethical principles and how they relate to pain management places the nurse on a better pedestal to manage postoperative pain effectively. However, there is scanty literature on the level of Ghanaian nurses’ knowledge and application of bio-ethical principles in postoperative pain management. Therefore, the study objectives were to: explore nurses’ understanding of the bio-ethical principles in postoperative pain management; explore how nurses apply bioethical principles in postoperative pain management. The study employed qualitative exploratory descriptive design. Purposive sampling technique was used to recruit participants from the surgical wards. Semi-structured interview guide was designed for data collection. Data saturation was reached at the fourteenth participant. Thematic analysis method was used and themes emerged inductively. Three main themes identified through inductive content analysis of data were: beneficence, autonomy and justice. Findings showed that nurses had some appreciable level of knowledge of the fundamental principles related to ethics and applied them in postoperative pain management. Nurses knew their duties in advocating for patients. Patients rights to refuse treatment was also appreciated by some nurses. Nurses also demonstrated humanity by helping patients financially to settle hospital debts which explicitly shows the empathetic characteristics of nurses. The study concluded that nurses are knowledgeable in bioethical principles underpinning post operative pain management and also applied these principles when caring for surgical patients.

Factors influencing professionalism among nurse educators: A qualitative study

BACKGROUND

Nurse educators require to exhibit specialized behaviors that demonstrate the beliefs of the nursing profession. The aim of the study is to explore the factors influencing professionalism among nurse educators in the selected nursing educational institutes of Indian States.

MATERIALS AND METHODS

Qualitative approach was adopted where multiple focus group discussions were planned and conducted. The study was carried out among nurse educators from the Northern Indian states. Thematic analysis, using the argumentative interactions approach was used. The consolidated criteria for reporting qualitative research (COREQ) guide were followed.

RESULTS

Three types of factors, that is, individual (micro-level), organizational (meso-level), and external professional occupational (macro-level) were explored, where individual factors emerged as having a strong positive impact on nurse educators' professionalism as compared to other factors. Poor organizational infrastructure, privatization of educational institutions, and other related factors were reported as having a negative influence on nurse educators' professionalism.

CONCLUSION

Most of the educational institutions included in the present study, lacked basic infrastructure/facilities for the professional development of nurse educators and professionalism.

Practice of code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021: a mixed-method study design

BACKGROUND

Ethics is the science of moral and ethical rules recognised in human life and attempts to verify what is morally right and wrong. Healthcare ethics is seen as an integrated part of the daily activities of health facilities. Healthcare professionals' standardisation and uniformity in healthcare ethics are urgent and basic requirements. Therefore, this study aimed to assess the practice of the code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021.

METHODS

A facility-based cross-sectional study design with a mixed method was conducted on 631 health professionals from Central Gondar Zone public hospitals. For the quantitative part, pre-tested self-administered questionnaires were used, and for the qualitative part, key informant interviews with a semi-structured questionnaire were used. Variables with a p value of < 0.2 in binary logistic regression entered into a multivariable logistic regression, then p value < 0.05 and AOR were used to declare statistically significant variables in quantitative data. A thematic content analysis was used for qualitative data analysis.

RESULTS

This study revealed that only 286 (46.7%) health professionals had good practice of the code of ethics. Good ethical knowledge (AOR = 1.95, 95% CI 1.37, 2.77), favourable attitude (AOR = 1.55, 95% CI 1.11, 2.16), and satisfaction of health professionals with their jobs (AOR = 1.45, 95% CI (1.04, 2.04) were significantly associated with the practice of health care ethics.

CONCLUSIONS

Health professionals' overall level of practice of health care ethics in the Central Gondar Zone public hospitals was poor. This necessitates practical training, ongoing follow-up, availing of necessary medical equipment, a smooth working environment, and modification of the recognition system for health professionals.

Study of Nightingale's nursing professionalism: a survey of nurses and nursing students in China

Background

Nursing professionalism is highly significant to the development of nursing. Florence Nightingale was the founder and leader of modern nursing, and Nightingale’s nursing professionalism has a significant impact on nursing in China and all over the world. In the new era, a new understanding of Nightingale’s nursing professionalism should be developed, and its positive role in nursing reshaped.

Methods

A total of 1,557 nurses and nursing students from 27 provincial administrative regions of China were surveyed using a customized questionnaire. Their recognitions of Nightingale’s nursing professionalism were evaluated based on scores, and statistical differences between and within the groups were analyzed using an Analysis of Variance (ANOVA). The elements of Nightingale’s nursing professionalism were extracted by the exploratory factor method and a principal component analysis.

Results

The Cronbach’s α of the questionnaire was 0.965, and the two groups did not differ significantly (p > 0.05). Based on the standard that the cumulative contribution rate of common factor should be > 85%, three common factors of Nightingale’s nursing professionalism, including professional emotion, professional ability and professional ethics, were extracted based on the Scree plot.

Conclusions

This study aimed to explore the connotation of Nightingale’s nursing professionalism. Our survey indicates that Nightingale’s nursing professionalism is highly recognized by nurses and nursing students in China. Its connotation includes professional emotion, ability and ethics. Nursing education and nursing management should fully utilize the leading role of Nightingale and guide the professional behaviors of nurses to be consistent with Nightingale’s nursing professionalism, thus, improving the degree of nurse professionalism.

Redefining the concept of professionalism in nursing: an integrative review

Objective

In today's world with sweeping changes, nurses are responsible for providing high-quality and cost-benefit care, which would almost be impossible unless they achieve their high professional status. To date, no precise and comprehensive definition of professionalism in nursing has been evidently proposed. In fact, many of the previously proposed definitions are either complicated or ambiguous. Moreover, there is no consensus in the literature on an exhaustive definition for “a professional nurse.” The present study aimed to illustrate the concept of professionalism in nursing and identify its defining characteristics.

Methods

In this study, concept analysis was conducted using Whittemore et al.'s method for the integrated review. A comprehensive search of electronic, scientific databases including Eric, PubMed, Scopus, Web of Science, EBSCO, PsychoINFO, Embass, MagIran, IranDoc, SID, and IRANMEDEX was carried out using the keywords such as professionalism, professional behavior, nursing professionalism (NP), professional attribute, and nursing.

Results

In the present study, a comprehensive search of 11 electronic databases retrieved 5738 articles. Then, 2837 duplicate articles were removed by endnote (version 8). Based on a preliminary examination of the titles and abstracts as well as the inclusion and exclusion criteria, 1517 articles were excluded. In addition, 137 articles were removed for scientific reasons. Finally, 52 articles in English and Persian were selected. Content analysis of the articles revealed four major themes, namely, individual prerequisite, professional prerequisite, appropriate structure, and socio-individual factors.

Conclusions

Professionalism in nursing is a major, multidimensional concept according to the literature that included individual prerequisites, professional prerequisites, appropriate structures, and socio-individual factors. In fact, professionalism in nursing comprises a wide range of personal characteristics, self-regulation, professional values, striving to acquire and enhance professional expertise, professional interactions, social, professional, and legal responsibility, and creation of a sense of belonging, and professional development.

The Emory-Addis Ababa PhD in Nursing Program: A sustainable model for strengthening nursing research capacity in Ethiopia

In 2015, Ethiopia's first PhD in nursing program was established in collaboration between the Addis Ababa University (AAU) and Emory University Schools of Nursing. Eleven students have entered the program since its inception, six have successfully defended their proposals, one has graduated, and two have received Fogarty Global Health Fellowships. This paper describes the evolution of this international partnership and the innovative processes and mechanisms involved in program implementation; the authors address the description of the program, central implementation challenges, notable outcomes, and student achievements. One key implementation challenge has been that, although nursing is one of the largest healthcare workforces in Ethiopia, nurses remain underutilized and undervalued in the workplace. This treatment is due, in part, to limited professional regulations, leading some of the PhD students to apply their leadership skills to advocate for national practice reform. According to students, the PhD program has been a means not only to improve nursing research capacity and education in Ethiopia, but also to generate the regulations necessary for graduates to practice according to their degree. While the opportunity to generate knowledge is vitally important, students also value the chance to transform the profession of nursing.

Assessment of professionalism: From where have we come - to where are we going? An update from the Ottawa Consensus Group on the assessment of professionalism

BACKGROUND

In 2009, an International Working Group (IWG) on the Assessment of Professionalism began collaborating and published recommendations in 2011. Nearly a decade later the IWG reconvened to take stock of the state of practice and research in professionalism and the impact of the 2011 report.

METHOD

A bibliometric study identified all publications on assessment of professionalism since 2011, noting those that cited the original report. Articles were coded to identify the reason for citation and new trends in assessment. Bibliometric data were supplemented by discussion groups held at key international education meetings.

RESULTS

Six-hundred publications on the assessment of professionalism were found in Google Scholar and 164 in Web of Science since 2011, of which 177 (30%) and 84 (50%) respectively cited the original IWG publication. English language publications were most common (83%), but there were articles in 13 other languages by authors from 40 countries. The report was cited commonly to justify attention to professionalism in general (41%), assessment of professionalism (38%) and to explore professionalism in different countries and professions (25%). A thematic analysis showed that of 9 research areas recommended in 2011, 7 of 9 categories were represented with a large increase in research across languages and cultures.

CONCLUSIONS

Though the assessment of professionalism remains a challenge the research base continues to grow, especially related to professionalism across cultures and languages, and a large percentage of publications cite the IWG recommendations. There remains a gap in research and writing about patients' perspectives.

Learning professionalism through hidden curriculum: Iranian medical students' perspective

Learning professionalism is a central topic in medical education. While many factors could affect the educational process of professionalism, hidden curriculum is considered one of the most important ones. As the working components of a hidden curriculum might be specific to the settings, this study explored its components in terms of professionalism and ethical conduct from the viewpoint of Iranian undergraduate medical trainees. Semi-structured and in-depth interviews were used to collect medical students' experiences and viewpoints, which were then analyzed through simple content analysis and the codes and categories were extracted. Finally, themes were derived as the central organizing concepts. Saturation occurred after 17 interviews. Seven main themes were extracted as the working components of hidden curriculum regarding professionalism in the setting: 'convenient patients', 'evaluate me', 'trust as the base of team interactions', 'perceiving encouragement', 'relationship satisfaction and authenticity', 'workload and students' well-being' and 'role modeling at the heart of professionalism'. Students' perception and experiences are a rich source of gaining a deeper understanding of the working hidden curriculum. In this study, two groups of human-related and environment-related elements were extracted. They were effective in the formation of the current 'ethical climate', which shaped the professional and ethical identity of medical trainees. Moreover, specific plans regarding the condition of the settings may provide opportunities for medical educators to enhance professionalism in their institutions.

Development of nursing professionalization elements in Slovenia: the group interview technique

Introduction: An occupation becomes a profession once it uses a systematic approach to generate new knowledge and transfer it directly into professional work. The aim of this paper is to show the attitudes of nursing care professionals towards the professionalization of nursing care and make a contribution by means of identifying the factors that are important for the development of the professionalization of nursing in Slovenia. Methods: The group interview technique was used with two rounds. Participants responded to 15 open premises/questions. Purposive sampling was used and groups were comprised of professionals from all levels of clinical environments, secondary and higher education teachers and master's and doctoral degree students (n = 48). Results: The results of the first round produced 3 themes, while the second round generated findings related to 4 themes. The synthesis of the findings from both rounds resulted in two overarching themes. The first is "National responsibility" which includes the responsibility of the nursing care management and the management of higher education institutions as well as the responsibility of the Nurses and Midwives Association of Slovenia for developing nursing care as a scientific discipline. The second theme is "National indicators for the realization of national responsibility" which includes (1) Classification of jobs in nursing care to reflect the 4 levels of nursing care competencies, (2) research and development as work tools in nursing care, and (3) the national institute for nursing care research. Discussion and conclusion: The responsibility for the development of professionalization lies with several sectors. A clear and ambitious vision, and a strategy for the development of nursing care that should include responsibility for setting a new paradigm for the development of nursing care as a response to the needs of the society, occupation and science, are needed. The strategy should be supported by means of a planned distribution of means to facilitate its realisation.

Determinants of Quality of Work Life among Nurses Working in Hawassa Town Public Health Facilities, South Ethiopia: A Cross-Sectional Study

Background

A high quality of work life (QWL) is a crucial issue for health care facilities to have qualified, dedicated, and inspired employees. Among different specialties in health care settings, nurses have a major share among other health care providers. So, they should experience a better QWL to deliver high-quality holistic care to those who need help.

Objective

To assess the level of quality of work life and its predictors among nurses working in Hawassa town public health facilities, South Ethiopia.

Methods

A facility based cross-sectional study was conducted on 253 nurses of two hospitals and nine health centers. The total sample size was allocated to each facility based on the number of nurses in each facility. Data were collected using a structured questionnaire. The interitem consistency of the scale used to measure QWL had Cronbach's alpha value of 0.86. A multinomial logistic regression model was fitted to identify significant predictors of quality of work life using SPSS version 20.

Results

The study showed that 67.2% of the nurses were dissatisfied with the quality of their work life. We found that educational status, monthly income, working unit, and work environment were strong predictors of quality of work life among nurses (p < 0.05).

Conclusion

Significant proportions of the nurses were dissatisfied with the quality of their work life. The findings in this study and studies reported from elsewhere pinpoint that perception of nurses about the quality of their work life can be modified if health care managers are considerate of the key issues surrounding QWL.

Job satisfaction and attitudes towards nursing care among nurses working at Mzuzu Central Hospital in Mzuzu, Malawi

BACKGROUND

Job satisfaction is a major determinant of performance at the workplace. Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and attitude towards nursing care at Mzuzu Central Hospital in Mzuzu, Malawi.

METHODS

This was a descriptive correlational study. Eighty-nine nurses were selected using simple random sampling. A self-administered questionnaire was used to collect data. Data were analysed using Stata (version 12). Frequencies, means, and standard deviations were used to summarise sociodemographic data and also to determine job satisfaction and attitudes towards nursing care among the participants. Independent t-tests were used to determine if differences in professional qualifications, job title, work experience, or the clinical setting in which the nurses worked were associated with differences in job satisfaction and attitude. Pearson's product-moment correlation was used to determine the relationship between job satisfaction and attitude in the study sample.

RESULTS

The nurses who participated in this study generally had positive attitudes towards nursing care and were moderately satisfied with their jobs. There was a significant variation in attitude depending on the amount of time a nurse worked at a particular post (P = 0.0308), as well as the amount of time a nurse had worked at the hospital (P = 0.0012). There was a significant positive relationship between job satisfaction and attitude (r = 0.226, P = 0.033).

CONCLUSIONS

The nurses in the study sample were moderately satisified with their work and generally had positive attitudes towards nursing care. There was a positive correlation between attitude towards nursing care and job satisfaction. Addressing factors which dissatisfy nurses can promote nurses' attitudes and likely improve performance and patient care.

The Effect of Job Demand-Control-Social Support Model on Nurses' Job Satisfaction in Specialized Teaching Hospitals, Ethiopia

Background

The job demand-control-social support model has been widely studied in western countries but has not been theoretically addressed on health workers of sub-Saharan African countries. Therefore, this study investigates the relationship between Job Demand-Control-Support Model and job satisfaction in specialized teaching hospitals in Ethiopia.

Method

A cross-sectional survey was conducted from September 2014 to May 2015 in three public specialized teaching hospitals in Ethiopia. Among 1371 nurses, 360 were selected as sample. Data was collected using Job Content Questionnaire and Job Satisfaction Survey Questionnaire. After the data was collected, it was analyzed using SPSS version16.0 statistical software. The results were analyzed using of descriptive statistics followed by inferential statistics on the variables.

Results

The result revealed that control variables (gender, age, educational qualification, and work experience) accounted for a significant increment explaining 2.1 percent of the variance in job satisfaction. Job demand and social support together explained 24.5 percent of job satisfaction. Job demand(β=−0.152; p<0.01) had significant but negative relationship with job satisfaction and social support (β=0.458; p<0.01) had significant and positive relationship with job satisfaction. On the other hand, job control (β=0.042; p>0.05) did not have a significant relationship with job satisfaction. Furthermore, there was no straight three-way interaction effect among job demand, job control and social support (β=0.05, p>0.05).

Conclusion

Job demand and social support are related to nurses' job satisfaction, but job control neither related to nor moderated the relationship between job demands and job satisfaction. Furthermore, there was no joint three-way interaction effect among job demand, job control and social support.