Cross-cultural adaptation and psychometric evaluation of the Slovenian version of the nurse professional competence scale

BACKGROUND

The competency-based approach to the assessment of nursing practice has been adopted as a key policy in the developed world. The continual self-assessment of competence gives nurses the opportunity to reflect on their competencies and has a significant impact on the quality of nursing practice and patient safety. The study was designed to describe the process of cross-cultural adaptation and to assess the psychometric properties of the Slovenian version of a short form of the Nurse Professional Competence scale (NPC-SF) and to evaluate the efficacy of this instrument in a sample of registered nurses.

METHODS

A cross-sectional and validation study was conducted in 425 registered nurses to test the psychometric properties of the Slovenian version of a short form of the scale and to evaluate nurses' professional competence. A multilevel approach was used: Translation, back-translation, language validity, face and content validity, construct validity, and reliability of the Slovenian version of the scale were analysed respectively. Participants completed an online survey, with the data being collected between April and July 2020.

RESULTS

Factor analysis showed that the Slovenian version of the scale could be used in four dimensions explained with 65 % of the variance. Cronbach's α was 0.972. The four-factor model fit the data (RMSEA = 0.083, CFI = 0.731). Self-reported competence was high and rated higher by nurses employed at the tertiary level of healthcare, followed by nurses employed at the secondary and primary, and from social care institutions. Nurses with more years of experience assessed their competence higher.

CONCLUSIONS

The NPC-SF helps understand and identify nurses' self-reported core competencies in clinical settings, thereby providing an important predictor of the professional development of nursing. The Slovenian version of the scale demonstrated acceptable psychometric properties and may be used in research and clinical practice to evaluate nurses' professional competence.

Zdravstveni coaching kot pristop zdravstvene vzgoje k zdravemu življenjskemu slogu mladih

Uvod: Sočasna podvrženost več dejavnikom tveganja v povezavi z nezdravim življenjskim slogom vodi v nastanek kroničnih nenalezljivih bolezni in je v Sloveniji najbolj razširjena med mladimi odraslimi (25–34 let). Zdravstveni coaching je pristop zdravstvene vzgoje, ki bi bil lahko uporaben za zmanjševanje pojavnosti multiplih dejavnikov tveganja v povezavi z nezdravim življenjskim slogom med mladimi. Namen raziskave je bil pregledati in analizirati literaturo o uporabi zdravstvenega coachinga za zdrav življenjski slog mladih.Metode: Izveden je bil pregled znanstvene literature v podatkovnih bazah PubMed in PubMed Central. Upoštevana so bila priporočila PRISMA. Identificirane zadetke smo uvrstili v nivo hierarhije dokazov in ocenili kakovost s pomočjo orodja za ocenjevanje kakovosti raziskav z mešano metodološko zasnovo.Rezultati: Izmed 777 identificiranih zadetkov je bilo v končno analizo vključenih sedem izvirnih znanstvenih člankov. Zdravstveni coaching je pri obravnavi multiplih dejavnikov tveganja v povezavi z nezdravim življenjskim slogom najpogosteje uporabljen za hkratno promocijo zdrave prehrane in telesne dejavnosti. Uporaba pristopa pri mlajših od 35 let pogosto vključuje rabo sodobne informacijsko-komunikacijske tehnologije.Diskusija in zaključek: Zdravstveni coaching lahko pomembno vpliva na odpravo in preprečevanje multiplih dejavnikov tveganja v povezavi z nezdravim življenjskim slogom med mladimi. Implementacija pristopa mora temeljiti na premišljeni zasnovi in neprekinjeni evalvaciji uspešnosti in učinkovitosti.

Opisna raziskava mnenj in stališč študentov zdravstvene nege ter kliničnih mentorjev glede ocenjevanja kliničnega usposabljanja

Uvod: Z nenačrtovanim ocenjevanjem na podlagi pomanjkljivo opredeljenih kriterijev lahko spregledamo neuspešnega študenta in tako prispevamo k njegovemu nevarnemu delovanju v kliničnem okolju. Namen raziskave je bil ugotoviti, kakšna so stališča in mnenja kliničnih mentorjev ter študentov zdravstvene nege glede ocenjevanja kliničnega usposabljanja. Metode: Uporabljena je bila kvantitativna deskriptivna metoda dela. Spletno anketo je izpolnilo 84 dodiplomskih študentov zdravstvene nege, njeno tiskano različico pa 37 kliničnih mentorjev. Zbiranje podatkov je potekalo od oktobra do novembra 2015. V analizi je bila uporabljena osnovna opisna statistika, hi-kvadrat test, Mann-Whitneyev U-test in Pearsonov koeficient korelacije. Rezultati: Klinični mentorji so v večji meri kot študenti mnenja, da bi se morali na klinično usposabljanje načrtno pripraviti (U = 790, p < 0,001). S Pearsonovim koeficientom korelacije (r = −0,215, p = 0,024) smo ugotovili, da je zadovoljstvo z ocenjevanjem vseh anketiranih večje, če je ocenjevanje sprotno in ne le končno. Hi-kvadrat test je pokazal, da anketiranci ocenjevalni list ocenjujejo kot samo zadovoljiv (n = 47, 43,5 %; χ2 = 4,3, p = 0,229). Diskusija in zaključek: Večina anketirancev ni zadovoljnih z načinom ocenjevanja kliničnega usposabljanja. Zavedajo se pomanjkljivosti ocenjevalnega lista, opozarjajo tudi na pomanjkanje časa pri mentoriranju študentov. Raziskava prispeva k boljšemu razumevanju razmer v procesu ocenjevanja kliničnega usposabljanja.

Knowledge of health principles among professionals in Slovenian kindergartens

Objectives

Preschool children have significant health issues. From the relevant legislation and regulations, it can be seen that kindergarten teachers (KTs) and kindergarten teacher assistants (KTAs) are expected to be familiarwith the basic hygienic measures and steps for preventing injuries and illnesses, to recognize infectious diseases, and to know how to give the first aid. To gain these skills, a continuous life-long learning is necessary, because the characteristics of diseases are changing. Study design: original research.

Methods

45 kindergartens in Slovenia were randomly selected and a questionnaire with 17 questions on health themes was sent. An analysis was performed via SPSS 17.0, using descriptive methods and nonparametric χ² tests.

Results

There were 774 participants, of whom 56% were KTs and 44% KTAs. The share of KTs and KTAs who consider their knowledge of health principles to be very good or excellent is 67%. Their estimation of first aid knowledge is lower. They are also well aware of the importance of health knowledge in their work; a total of 87% strongly agree with this. The results also show that they are familiar with hygiene principles. The χ² test showed there are certain statistically characteristic connections between the age of teachers and their assistants, occupation and work experiences.

Conclusions

Because children are a particularly vulnerable group, teachers can encounter injuries and sudden illnesses at their work. Supplementary education is necessary among skilled workers in educational institutions, including kindergartens.

Sources of workplace violence against nurses

BACKGROUND

Health care employees, especially nurses, are often victims of workplace violence.

OBJECTIVE

The objective of this research is to study the frequency and degree of violence against nurses and to analyze correlations between various sources and types of violence.

METHODS

A survey was carried out using a representative sample of nurses in Slovenia. Data was collected using a questionnaire designed specifically for the purposes of the survey. The collected data was analyzed using descriptive, correlational and inferential statistics.

RESULTS

A total of 692 nurses participated in the survey. Verbal violence (n = 416) and physical violence (n = 180) were identified. The most frequent perpetrators of verbal violence were patients (listed as a source of violence by 39.3% of the respondents) and peers (39.6%), with the most forceful identified as physicians and patients. Physical violence against nurses was most often initiated by patients (20.8%) who were also the most forceful source in this category. Nurse leaders were found to be the most frequent and forceful sources of violence in terms of leadership level. A positive correlation between external (patient and relatives) and internal (physician and nurse) sources of violence was determined.

CONCLUSIONS

A better understanding of the association between different types and sources of violence may support the development of action-oriented violence management. Health care organisations should limit violence at its less severe levels and at its primary source.

A competency-based performance appraisal for nurse leaders

Introduction: An employee performance appraisal is used internationally to improve employee performance, productivity, efficiency and effectiveness in nursing care. The purpose of the study was to assess the performance and efficiency of nurse leaders at all levels of leadership, identify deficient areas for each individual leader and propose improvements. Methods: Two surveys were conducted in 15 Slovenian public hospitals. The sample from the first survey included 1311 nurses who assessed the level of competencies of their immediate superiors. The sample from the second survey included 236 nurse leaders. Data envelopment analysis is used in this study to develop a model of practice outputs and inputs to help identify the most efficient nurse leaders. Results: Significant differences exist in the performance appraisal among the leaders in nursing. A total of 203 (86 %) nurse leaders are defined as inefficient and could improve their leadership performance. On average, inefficient leaders could improve their behaviour most in the areas of generic leadership competencies (by 51.7 %) and interprofessional relationships (by 47.7 %). Discussion and conclusion: The areas with the worst performance are generic leadership competencies and interprofessional relationships where also the most significant improvements are possible. Nurse leaders and hospital managers can use the analysis results to determine in which areas the leaders in their organisation should improve the levels of their competencies.

The effects of education and training on self-esteem of nurse leaders

Introduction: A successful leader must have high self-esteem. The main aims of this study were to identify changes in the self-esteem of nurse leaders in Slovenia from 2001 to 2011 and to determine homogeneous groups of leaders with similar personal characteristics.Methods: The study used a version of a personal characteristics questionnaire with 16 self-descriptive statements. Two surveys were conducted among nurse leaders in Slovenian public hospitals, one in 2001 and the other in 2011. Relationships between variables were analysed using chi-square tests for categorical variables and the one-way analysis of variance for quantifiable variables. Factor analysis was used to determine groups of leaders with similar personal characteristics.Results: A total of 327 nurse leaders participated in the survey in 2001 and 296 filled in questionnaires in 2011. The analysis showed that the level of self-assessment of personal characteristics among nurse leaders in Slovenian public hospitals was significantly higher in 2011 than in 2001, and that differences among individual leaders decreased in most areas. Based on the assessments of personal characteristics, four groups of nurse leaders were established: task-oriented, knowledge and creativity oriented, relationship oriented and extroverted nurse leaders. In the 2011 data, the groups of personal characteristics were much more clearly defined. These groups were established in accordance with leadership theory and research from other fields.Conclusions: The positive effects of better education and training are visible in nurse leaders in terms of both their higher self-esteem and in the establishment of more homogeneous groups of leaders.

Unreported workplace violence in nursing

BACKGROUND

Workplace violence occurs on a frequent basis in nursing. Most violent acts remain unreported. Consequently, we do not know the actual frequency of the occurrence of workplace violence. This requires research of nurses' actions following workplace violence and identification of reasons why most victims do not report violent acts in the appropriate manner.

AIM

To explore violence in nursing as experienced by nurses in Slovenia.

METHODS

A survey was carried out with a representative sample of nurses in Slovenia. The questionnaire Workplace Violence in Nursing was submitted to 3756 nurses, with 692 completing the questionnaire.

RESULTS

A total of 61.6% of the nurses surveyed had been exposed to violence in the past year. Most victims were exposed to psychological (60.1%) and economic violence (28.9%). Victims reported acts of violence in formal written form in a range from 6.5% (psychological violence) to 10.9% (physical violence). The largest share of victims who did not report violence and did not speak to anyone about it were victims of sexual violence (17.9%). The main reason for not reporting the violence was the belief that reporting it would not change anything, followed by the fear of losing one's job.

CONCLUSIONS

Only a small share of the respondents reported violence in written form, the main reason being the victims' belief that reporting it would not change anything. This represents a severe criticism of the system for preventing workplace violence for it reveals the failure of response by leadership structures in healthcare organizations.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Professional associations and the education system must prepare nurses for the prevention of violence and appropriate actions in the event of violent acts. Healthcare organizations must ensure the necessary conditions for enabling and encouraging appropriate actions following violent acts according to relevant protocols.

Views of the Slovenian nursing profession regarding leadership

Introduction: New, up-to-date approaches to professionalism presuppose the formation of a nursing team in such a way that relationships are not based on classical hierarchical relationships between superiors and subordinates but on relationships of interdependence and acknowledgment of the role the individual plays in the team. The objective of this article is to present the competences required by nurses in top organizational leadership positions from two viewpoints: as seen by nurses in top leadership positions and as seen by nurses in subordinate positions.Methods: A descriptive research method using a questionnaire as the measuring instrument was used. The questionnaire was based on the competence model of leadership in public administration in Slovenia and was tested on various professional groups.Results: Statistically signifi cant differences were observed with regard to the majority of competences between nurses in top leadership positions and nurses in non-leadership positions. Therefore, the views regarding what competences nurses in leadership positions should have substantially differed within theprofessional group.Conclusions: The fi rst conclusion is therefore that education on leadership on both the theoretical and practical levels must be introduced into undergraduate study programmes of health colleges. With the help of factor analysis we formed fi ve subgroups within the professional group of nurses: three subgroups within the group of nurses in leadership positions and two subgroups within the group of nurses in nonleadershippositions. A special education programme should be prepared for each of these subgroups.