Perceptions of nursing service managers in the South African Military Health Service on their level of motivation

The process of transformation in the South African Military Health Services, has influenced the nursing service managers' level of motivation and the following research question is applicable: what are the perceptions of the nursing service managers within the South African Military Health Services on their level of motivation? The purpose with this study was to explore and describe the perceptions of nursing service managers on their level of motivation within these health services. A qualitative research design was utilized and four focus group interviews were conducted with 33 nursing service managers country wide. The transcribed interviews were exposed to a content analysis. The results confirm that the level of motivation amongst these nursing service managers is low. The demotivators relate mainly to the following: inadequate acknowledgement, job insecurity in relation to the future, problems with the process of integration, transformation and rationalization, problems with management, many labour related issues, poor/inadequate communication, inadequate support, increased work load, poor physical environment, negative publicity and poor self motivation. Although there were a few motivators identified, they were of less importance. These results were interpreted within Herzberg's motivation theory to identify the hygiene/maintenance factors and to assess whether the important motivators were in place. During any process of change, and/or when the level of motivation amongst employees is low, it is important to adequately manage the environment (hygiene/maintenance factors within the Herzberg theory). But it is even more important to ensure that the motivators are in place or to intensify them. It is therefore recommended that a motivation strategy, based on the Herzberg theory as well as the Hackman-Oldham job enrichment model, be developed, implemented and evaluated.     

A conceptual approach to the development of motivational strategies

Teachers in both general and professional education are well aware of the importance of motivation as the basis of effective teaching. Heidgerken maintains that a major problem that faces nursing educators is to select the right type of motivation and to know how to effect motivation. The authors propose a conceptual model for developing strategies to deal with motivational problems. This model is an application of Vroom's value/expectancy theory and Rotter's social learning theory, and is based on the premise that nursing faculty are in strategic positions to enhance student motivation for learning by manipulating variables that are believed to influence motivation. These suggested strategies include: enhancing student's need value by rewarding them with rewards that they value the most; increasing student's perceptions of a strong link between performance and rewards; providing students with consistent and clear role perceptions; improving student satisfaction towards learning.     

Motivation for health behaviours: a systematic review of the nursing literature

AIMS AND RATIONALE: This research review examines nursing and allied health studies exploring motivation for health behaviours to identify the state of understanding of this construct within nursing. This review contributes to nursing science by synthesizing nursing research regarding motivation for health behaviour. METHODS: Integrative research review methodology. FINDINGS: Problems of existing research include nonprobability sampling of heterogeneous populations, low statistical power, and colinearity. Studies identifying predictors of motivation explained large proportions of variance using regression. Motivation was not a significant predictor of health behaviours for over one-third of the studies. Overall, the studies suggest that either motivation is not being effectively measured because of a lack of conceptual clarity or that motivation is not an essential determinant of health behaviours. The latter cannot be verified until psychometric research advances current measurement of motivation to a higher level. LIMITATIONS; The literature for this review was accessed through the Cumulative Index of Nursing and Allied Health Literature (CINAHL) database. Databases for other disciplines were not included in this search. This work represents a first step towards understanding motivation for health behaviour as it is currently defined in the literature. Future studies are necessary to broaden this understanding beyond nursing. CONCLUSIONS: Motivation is a frequently cited rationale underlying the adoption and maintenance of health behaviours in research and practice. Motivation is complex and multidimensional, and clearer definitions for motivation are needed. Populations that have been underrepresented in motivation research need to be targeted in future research. Researchers and practitioners are challenged to examine carefully the role of motivation for health behaviours and explore other factors that may more strongly influence health behaviours.     

Creativity: a refinement of the concept for nursing practice

AIMS: This paper seeks to remove some of the ambiguity surrounding the conceptual meaning of creativity using techniques of concept refinement to advance the concept. BACKGROUND: Creativity is an essential component of nursing practice that occurs daily in nurse's interactions with clients, families and other nurses. Failure to acknowledge and encourage creativity in beginning nurses may hinder future development and innovations in nursing practice and in nursing science. In order to promote the development of creativity it is first necessary to clarify and refine the concept as it applies to nursing. DESIGN/METHODS: A comprehensive review of a variety of computer and online databases resulted in thousands of articles on creativity between the years 1966 and 1999. The final sample (n = 48) was obtained using both stratified random and purposive sampling techniques. A content analysis of the literature was conducted using methods identified by Morse and illustrated in the work of Hupcey et al. Having determined the concept to be partially mature, the concept was advanced using techniques of concept refinement. FINDINGS: Content analysis of the literature yielded three differing definitions for creativity: revelation, birth and reincarnation. Creativity occurs in the presence of intrinsic motivation and a nurturing environment. While value is often used to identify whether a product is creative, the value of the product cannot determine whether the process has occurred. The product produced determines evidence of the process of creativity. LIMITATIONS: Limitations of this investigation are the use of secondary sources and the relatively small sample size (n = 48). CONCLUSIONS: Refinement of the concept of creativity indicates that it is a process that may be developed and influenced by the environment and is recognized by the product produced. Further investigation is needed to explore methods and techniques for developing creativity in nursing.     

Motivation in nurse education practice: a case study approach

"There are three things to remember about education. The first is motivation. The second one is motivation. The third one is motivation" (Maehr and Meyer, 1997 p372). It is important to understand motivation and the reasons why nurses, including educators and clinicians, need to continually motivate their students both in the classroom and within clinical practice. Using relevant literature, the following case study explores the significant issues pertinent in motivating a student undertaking a Postgraduate Diploma in Specialist Nursing. A combination of motivational and learning theories are used in the process of assisting this student to learn from her recent assessment failure and to become re-motivated. There is a discussion of the significance of this case and the key issues drawn from it, which may assist nursing staff in supporting student nurses to remain motivated within the clinical area.     

Developing the research capacity of departments of nursing and midwifery based in higher education: a review of the literature

The purpose of this literature review is to identify those factors which might affect the research capacity of departments of nursing based in higher education, and to make recommendations based upon the findings to enable departments to develop their capacity to undertake research. There is a dearth of published research which directly addresses this issue and therefore publications were reviewed which related to: the impact on nurse educators of the integration of nursing into higher education; nurse educators' attitudes towards research and their research role; analysis of the results of the 1992 and 1996 Research Assessment Exercises and commentaries on them; developing research within nursing generally; and factors affecting research productivity within nursing and related disciplines. The papers were analysed according to the following themes: academic qualifications; research skills; time available for research; motivation to undertake research; a culture of research; subject specialization; subject areas for research; research quality; and a nursing research council. The conclusions are first, that whilst there is a dearth of literature which relates directly to research capacity development in academic departments of nursing, there is much advice which can be drawn upon. Second, the article concludes that the factors affecting research capacity development are numerous and complex and it is not something which can only take place at the departmental level. There are also issues which require consideration nationally, as well as factors which depend upon the individual academic, and these impact upon the research capacity of academic departments of nursing. The factors are summarized at the end of the paper in the conclusions and recommendations.     

Beginning at the bottom: evidence-based care of diaper dermatitis

Diaper dermatitis (DD), an acute inflammatory reaction of skin in the perineal area, is an extremely common pediatric condition. Nurses' practice of preventing and treating DD is inconsistent and often not evidence-based. In addition, a 2008 Skin Injury Prevalence Study at our hospital revealed that 24% of inpatients had DD. The authors developed a project to determine a consistent and evidence-based approach to DD prevention and treatment including the availability of products. A complete literature review was conducted in addition to benchmarking with other pediatric hospitals, consultation with topic experts, and evaluation of current nursing practice prior to revising the existing perineal skin care nursing standard. The evidence supports frequent diaper changes, use of super absorbent diapers, and protection of perineal skin with a product containing petrolatum and/or zinc oxide. As supported by the literature, we revised the standard to include improvements in practice as well as product updates for prevention and treatment. Hospital-wide implementation of the revised standard included training "Skin Care Champions" to educate staff and support practice improvements. Ongoing education and monitoring by the Skin Care Champions is necessary to further improve the prevention and treatment of DD for our patients.     

本科护生助产择业动机评价量表的构建及信效度检验*

目的: 构建本科护生助产择业动机评价量表,并进行信效度检验,以评估本科护生助产择业意愿。方法: 以期望-价值理论为理论框架,对护生助产择业动机相关文献进行回顾分析,结合小组讨论、专家咨询等方法构建本科护生助产择业动机评价量表。选取410名护生进行问卷调查,评价量表信效度。结果: 构建的本科护生助产择业动机评价量表包括期望分量表和价值分量表,期望分量表包含5个条目,Cronbach’s α系数为0.86,重测信度为0.69;价值分量表包含18个条目,提取了实用性、挑战性、代价、兴趣4个公因子,累计方差贡献率68.74%,Cronbach’s α系数为0.93,重测信度为0.72。结论: 本科护生助产择业动机评价量表具有良好的信效度,可作为评价护生助产择业意愿的有效研究工具。     

双因素理论在护理科研管理中的应用

如何提高护理人员护理科研水平,激发护理人员科研热情,促进护理科研发展,是关系到护理学科发展的一个重要内容,双因素理论为解决这一问题提供了新的思路。通过探讨护理科研中保健因素和激励因素的不同作用,提出：作为护理科研管理者,不仅应处理好科研中的保健因素,为护理人员创造良好的科研环境,更要注重激励因素在护理科研中的作用,最大限度地激发护理人员的科研热情和潜力。     

Clinical judgement and decision-making in nursing - nine modes of practice in a revised cognitive continuum

Title. Clinical judgement and decision‐making in nursing – nine modes of practice in a revised cognitive continuum Aim. This paper is a report of an evaluation of cognitive continuum theory and identification of revisions required for application to clinical judgement and decision‐making in nursing. Background. The importance of nurses’ developing and applying sound clinical judgement is reflected in an international classification of nursing practice. Cognitive continuum theory synthesizes rival and complementary approaches to decision theory in an accessible format, which has been applied in medicine, and various nursing scholars have advocated its use to enhance the effectiveness of nurses’ clinical judgement and decision‐making. Method. Parse’s structure and process criteria are applied in critiquing the relevance of cognitive continuum theory to nursing. Findings. Cognitive continuum theory illustrates how different judgement tasks are suited to different thought processes and how matching the two can optimize decision‐making. However, existing modes of inquiry applied to medicine emphasize experimental research, ignoring many alternative approaches used in nursing. A revised version of the cognitive continuum is developed, incorporating examples of nursing judgements and decisions, a broader evidence base, an ethical dimension, and evaluative competence criteria. Conclusion. The revised cognitive continuum promotes awareness of the nature and the variety of patient‐centred judgement tasks and decisions in nursing, how to select the most suitable intervention tactic from available options, and the fallibility of all forms of human judgement from intuitive/experiential to analytic/rational. Hence, it is recommended for use as an educational tool and practice guide to facilitate theory development and the practice of judgement and decision‐making in nursing.     

Boosting morale and improving performance in the nursing setting

AIM AND BACKGROUND: While the importance of morale is well researched in the nursing literature, strategies and interventions are not so prolific. The complexities of interpersonal relationships within the clinical domain, and the critical issues faced by nurses on a daily basis, indicate that morale, job satisfaction and motivation are essential components in improving workplace efficiency, output and communication amongst staff. Drawing on educational, organizational and psychological literature, this paper argues that the ability to inspire morale in staff is a fundamental indicator of sound leadership and managerial characteristics. EVALUATION AND KEY ISSUES: Four practical concepts that could be implemented in the clinical setting are proposed. These include: role preparation for managers, understanding internal and external motivation, fostering internal motivation in nursing staff, and the importance of attitude when investing in relationships.     

Back to the bedpans: the debates over preregistration nursing education in England

AIMS OF THE PAPER: This paper aims to examine the recent debates in both the general and professional press over the future of preregistration education in England, in the light of the sociological literature on the professions, and the nature of nursing knowledge. The literature on the Project 2000 reforms, although by now well worn, will also be discussed briefly. BACKGROUND/RATIONALE: The bulk of nursing education in England moved into higher education in the 1990s. Unlike other higher education in England, it is not funded by the Department for Education and Employment, but commissioned by the National Health Service (NHS), to which it is expected to be highly responsive. DESIGN/METHODS: This paper is based on a brief literature survey, plus policy documents and media reports. FINDINGS/CONCLUSION: It will be argued that the process of professionalization is not a straightforward one, and has its potential for reversals of fortune, and that nursing occupies a marginal place in higher education in England.     

护理学专业骨干教师胜任力评价的量化指标体系构建

目的 构建护理学专业骨干教师胜任力评价的量化指标体系。方法 通过文献分析及行为事件访谈,运用胜任力模型理论进行理论研究,初步编制胜任力指标框架,采用德尔菲专家咨询法确定条目,采用层次分析法确定指标权重。结果 理论研究及访谈确定了指标条目;21名专家完成专家咨询,2轮函询问卷的有效回收率为84%和100%,权威系数为0.86,协调系数分别为0.290、0.309,最终确定29个指标条目;层次分析确定一级指标中权重由高到低依次是技能、知识、动力、职业特质。结论 护理学专业骨干教师胜任力评价的量化指标体系设置合理,为主管部门遴选、考核教师提供科学依据,也可以为骨干教师自身发展提供参考。     

动机晤谈技术对苯丙胺类滥用者戒毒动机提升的研究

目的探讨动机晤谈技术对于苯丙胺滥用者戒毒动机提升的疗效。方法2013年1月一7月首次入住的苯丙胺类兴奋剂滥用者70例,使用随机数字表将患者随机分为试验组和对照组各35例,对照组给予常规治疗和护理,试验组在此基础上结合动机晤谈技术。两组患者均在人院第1周和第3周进行戒毒动机量表评定。结果治疗后两组患者戒毒动机5个维度评分均高于治疗前（P〈0．05）,且试验组优于对照组（P〈0．05）。结论动机晤谈技术对于提升苯丙胺类药物滥用者的戒毒动机有效可行。     

Timely detection of colorectal cancer in the elderly. Implications of the aging process

Increased age is a risk factor for colorectal cancer; however, there is a lack of literature that focuses on the early detection of colorectal cancer in the elderly. The nursing process provides the conceptual basis for this article, which discusses normal bowel function, aging changes in the bowel, and colorectal cancer. A nursing care plan for alterations in bowel elimination/constipation is presented as a model.     

Critical thinking: incorporation into the paramedic curriculum

The purpose of this paper is to present approaches to foster critical thinking skills within the context of the current paramedic curriculum. It reviews some of the definitions and concepts of critical thinking from selected adult education and nursing literature in an attempt to formulate a workable definition as it applies to paramedics. From that definition, elements are identified and incorporated to form a teaching model for use in presenting the curriculum content. Some sample teaching strategies based on revised objectives of the airway/ventilation section also are included.     

Nursing profession in Iran: An overview of opportunities and challenges

Aim:  Iran's health-care system has witnessed profound changes in the last decades. Despite its progress, the system has currently faced many challenges in one of the important subsystems, nursing. The present review article aimed to present an overview of the opportunities and challenges of the Iranian nursing system, based on recent literature.
Methods:  A broad search of the English and Persian-language literature was carried out, incorporating both electronic and manual components from 1999 to 2009. The results of the investigations among the searched literature are summarized.
Results:  The major challenges are nursing shortages, job dissatisfaction, poor social position of nurses, the gap between theory and practice, lack of community-based nursing care, lack of an appropriate student recruiting system, and shortages in the nursing educational curriculums.
Conclusion:  The authors believe that media, political and public support play a pivotal role in improving the image of nursing in society, increasing motivation among Iranian nurses, and promoting the sociocultural climate and the welfare of nurses, which will result in higher levels of quality of care as well as greater patient satisfaction.     

The development of a competency-based clinical performance examination model in maternity nursing for BSN graduates]

The purpose of the study was to establish a competency-based clinical performance examination model in maternity nursing for baccalaureate students. Action research was the main research methodology used in the study. A committee, consisting of nursing faculty, students and experienced obstetric nurses, was established to develop the model. Based on intensive literature reviews and standards of nursing practice in Taiwan, the first draft of the model, including the content and process, was created by the committee. The draft then was revised twice after expert review and pilot testing. The revised version of the model was formally implemented into the curriculum to examine the competencies of forty-one BSN students at the end of the perinatal nursing course. Responses from students, clinical examiners, clinical staff and clients were all gathered and integrated to refine the model. The model has content, expert and discriminative validity. The reliability of the model was proven by the high consistency in administration and scoring of the model among clinical examiners.