Influence of registered nurses' attitudes toward bariatric patients on educational programming effectiveness

BACKGROUND AND OBJECTIVE: This study describes registered nurses' (RNs') attitudes toward obese adult patients using the Attitudes Toward Obese Adult Patients Instrument. METHODS: Full-time RNs (N = 119) employed in a medical center, acute rehabilitation institution, and skilled nursing facility participated in the study. RESULTS: Findings revealed that RNs have positive attitudes toward obese adults. RNs were concerned about personal and patient safety. Respondents recognized the complex care needs of bariatric patients and the increased workload associated with meeting these demands. There were differences in attitudes between medical center RNs and acute rehabilitation RNs, possibly related to differences in workload and length of stay. CONCLUSIONS: The effectiveness of bariatric educational programming may be improved if RN attitudes and concerns are measured and addressed.     

Empathy, experience of burnout and attitudes towards demented patients among nursing staff in geriatric care

A non-anonymous questionnaire was distributed to all nursing staff (n = 557) including RNs, LPNs (psychiatric), LPNs (somatic) and nurses' aides, in one nursing home, one somatic long-term care clinic and one psychogeriatric clinic. Scales measuring empathy, burnout experience and attitudes towards demented patients were included in the questionnaire. The aim of the study was to compare levels of empathy, burnout experience and attitudes among different categories of nursing staff and to examine connections between empathy, burnout and attitudes. The nursing staff showed an overall figure of moderately well-developed empathy and the RNs showed the highest empathy. The RNs had a significantly lower degree of burnout compared to the nurses' aides and the LPNs. Of all respondents, 27.4% were assessed at risk from burnout. Overall, the staff showed a moderately positive attitude towards demented patients and the RNs were most positive. No linear correlation was found between empathy, burnout experience and attitudes. However, a weak negative correlation between burnout and empathy is in accordance with other authors who are suggesting that burnout experience leads to lower empathy in the nursing staff. The fact that the RNs showed the most positive attitudes towards demented patients and had the highest level of empathy compared to LPNs and nurses' aides could be related to lower degree of burnout assessed in the RNs. Qualitative and quantitative overload among the LPNs and nurses' aides connected to the growing number of demented patients in the institutions examined are discussed.     

Nurses' attitudes about the importance of families in nursing care: a survey of Swedish nurses

The purpose of this study was to investigate the attitudes of registered nurses (RNs) about the importance of involving families in nursing care. A sample of 634 randomly selected Swedish RNs completed the instrument, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA), and reported holding supportive attitudes about families. High scores were found for the subscales: family as a resource in nursing care, family as a conversational partner, family as a burden, and family as its own resource. Variables that predicted a less supportive attitude about involving families in nursing care included being a newly graduated nurse, having no general approach to the care of families at the place of work, and being a male nurse.     

Attitudes of registered nurses toward nurse practitioners

PURPOSE: Registered nurses (RNs) work closely with nurse practitioners (NPs) in all facets of patient care and often have a direct influence on the patient's perception of the professional who is directing the care, and a patient's perceptions may affect clinical outcomes. However, few studies have been conducted to measure RN acceptance of the NP. The authors surveyed RNs in southern Illinois to assess their attitudes concerning the level of care provided by NPs. Southern Illinois was chosen because of the limited number of NPs in the area and because of concerns that limited exposure might negatively influence RN attitudes about the NP role. DATA COLLECTION: A 26-item research questionnaire, previously used with school nurses, was modified to reflect RNs in general. Seven items related to demographic information, and 19 items created a five-response Likert-formatted scale (r = .93). The questionnaire was mailed to 500 randomly selected RNs from the 11 southernmost counties of Illinois. CONCLUSIONS: The results showed support of the NP role. RNs believed that NPs were knowledgeable, competent health care providers. RNs were also comfortable working with NPs and often consulted them for advice and information. They saw the role of the NP as a positive addition to the health care team. IMPLICATIONS FOR PRACTICE: One identified concern was that scores indicated RNs felt that they received limited respect from NPs. Although the scores were high in this category, some RNs had concerns that NPs might not respect or understand the difficulty of the RN role in providing patient care. NPs need to recognize their collegial and professional ties to RNs and should take time to provide positive feedback to RNs as they collaborate to provide health care. Such behavior would only solidify the health team approach.     

Menstrual Attitude Questionnaire: confirmatory and exploratory factor analysis with Turkish samples

Title. Menstrual Attitude Questionnaire: confirmatory and exploratory factor analysis with Turkish samples. Aim. This study is a report of an investigation of the psychometric properties of the Turkish version of the Menstrual Attitude Questionnaire. Background. Cultural, social and family environments influence women’s beliefs about and attitudes towards menstruation. Awareness of these beliefs and/or attitudes and their cultural origins is necessary to understand women and their reactions to menstruation when offering health care. Although the Menstrual Attitude Questionnaire has been used in several studies, the psychometric properties of the Turkish version have not been investigated. Methods. Confirmatory factor analyses were carried out with two different samples – high school (n = 650) and undergraduate university students (n = 569) – in Turkey in the spring semester of 2006. Exploratory factor analyses were then used to modify the factor structure. Results. Confirmatory factor analysis did not confirm the factor model reported in the United States of America. However, compared with British and Indian samples, Turkish attitudes showed better fit than both British and Indian samples with comparative fit index values of 0·776 and 0·797 for the high school and university samples respectively. Finally, exploratory factor analysis yielded a 28‐item measure for the high school sample and 31‐item measure for the university sample, with a 5‐factor solution. Reliability estimates of both scales were satisfactory, being 0·73 for the high school and 0·79 for the university sample. Conclusion. The modified 5‐factor Menstrual Attitude Questionnaire could be a useful tool for assessing menstrual attitudes among Turkish high school and university students. The overall score permits comparison with results from earlier studies using the original instrument.     

Nurses attitudes towards the importance of families in psychiatric care following an educational and training intervention program

This study measures the attitudes of the psychiatric nurses, after having received an education and training intervention program (ETI-PROGRAM) in family systems nursing, towards the importance of the families in their care. Nurses' knowledge of the impact that family nursing intervention can have on family members may increase positive attitudes towards families. However, little is known about the impact that education and training intervention can have on nurses' attitudes, towards families in clinical practice. Quasi-experimental design was used to assess the change in nurses' attitudes towards families in psychiatric care after the intervention, which included a one-day seminar on the Calgary family nursing conceptual frameworks and skills training with clinical vignettes of families from psychiatry. The Families Importance in Nursing Care - Nurses' Attitude questionnaire was used to evaluate nurses' attitudes. A total of 81 nurses (65%) working in psychiatric care responded to the questionnaire. Nurses with more than 15 years of work experience were significantly more supportive of families in their care compared with less experienced nurses. Out of the 81 nurses, 52 (64%) answered the questionnaire again 14 months later. Furthermore, psychiatric nurses saw families significantly less burdensome after having participated in the ETI-PROGRAM.     

Spiritual needs in cancer patients and spiritual care based on logotherapy

BACKGROUND: The suitability of Frankl's logotherapy for the spiritual care (psychotherapy) of cancer patients in Japan is suggested. Using Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp, Japanese version), the Purpose in Life test (PIL test, Japanese version), and WHO-Subjective Inventory (WHO-SUBI, Japanese version), we attempted to elucidate the complicated structure of spirituality in cancer patients in order to identify possible approaches to their spiritual care and means of evaluating such care. MATERIALS: Two hundred and ninety-eight cancer patients participated in the study. All three tests were taken at the same time, and the results were evaluated by principal component analysis. RESULTS: It was demonstrated that all the subscales employed in the present study could be represented by a two-dimensional structure (two principal components), and that the FACIT-Sp and PIL tests have similar contents. DISCUSSION: FACIT-Sp (Japanese version) is very similar in conception to the PIL test, which was prepared in accordance with logotherapy. The results suggest that this test can serve as an adequate evaluation scale for measuring the effectiveness of spiritual care based on Frankl's logotherapy.     

Canadian nurses' and respiratory therapists' perspectives on withdrawal of life support in the intensive care unit

PURPOSE: To describe perspectives of nurses (RNs) and respiratory therapists (RTs) related to end-of-life care for critically ill patients. METHODS: For patients who had life support withdrawn in 4 Canadian university-affiliated ICUs, RNs and RTs reported their comfort level with decision making and process for 14 aspects of end-of-life care. RESULTS: Ninety-eight patients had life support withdrawn. Responses were received from 96 (98.0%) bedside RNs and 73 (74.5%) RTs. Most RNs (85/94, 90.4%) and RTs (50/73, 68.5%) were very comfortable with decisions to withhold cardiopulmonary resuscitation or to withdraw life support (83/94, 88.3% of RNs and 56/73, 76.7% of RTs). Most RNs (range 71.3%-80.65%) and RTs (60.0%-70.8%) were very comfortable with ventilation/oxygen withdrawal and sedation. Among paired responses for 72 (73.5%) of 98 patients, RTs rated less favorably than RNs ( P < .05): the quality of the physician explanation of the life support withdrawal process, the availability of the physician, the peacefulness of the dying process, and the amount of privacy for families. Suggested improvements included earlier and more inclusive discussions, clearer plans, and better preparation of families and the ICU team for patients' deaths. CONCLUSIONS: Most RNs and RTs were comfortable with decision making and the process of life support withdrawal, but they suggested several ways to improve end-of-life care.     

AIDS: experiences and attitudes of nurses from rural communities in Pennsylvania and New York

In this study we determined rural nurses' educational preparation concerning AIDS, whether they thought their health care facilities and communities were prepared to care for persons with AIDS, their attitudes toward AIDS and homosexuality, and in what ways AIDS had or might affect their practice. A questionnaire, which included the Nurses' AIDS Attitude Scale (NAAS), was administered to 738 employed registered nurses in 9 rural counties in Pennsylvania and New York. Findings suggest that this sample held many negative attitudes towards AIDS and homosexuality and had specific educational needs, especially in the psychosocial domain. They thought rural physicians and health care facilities were not yet well prepared to care for persons with AIDS.     

Mental health nursing and physical health care: A cross‐sectional study of nurses' attitudes,practice, and perceived training needs for the physical health care of people with severe mental illness

Mental health nurses have a key role in improving the physical health of people with a serious mental illness, however, there have been few studies of their attitudes or the extent of their involvement in this work. The aim of this study was to examine mental health nurses' attitudes to physical health care and explore associations with their practice and training. A postal questionnaire survey including the Physical Health Attitude Scale for mental health nurses (PHASe) was used within a UK mental health trust. The 52% (n = 585) of staff who responded reported varying levels of physical health practice; this most frequently involved providing dietary and exercise advice and less frequently included advice regarding cancer screening and smoking cessation. Having received post‐registration physical health‐care training and working in inpatient settings was associated with greater reported involvement. More positive attitudes were also evident for nurses who had attended post‐registration physical health training or had an additional adult/general nursing qualification. Overall, the attitudes of mental health nurses towards physical health care appear positive and the willingness of nurses to take on these roles needs to be recognized. However, there are areas where nurses in our sample were more ambivalent such as cancer screening and smoking cessation.     

Development and evaluation of a self‐care assessment inventory for workers

Aim: To develop and evaluate a self‐care assessment inventory for workers (SCAI‐W). Methods: A study using a self‐care assessment inventory for workers consisting of 27 self‐care items, the Japanese version of the Beck Depression Inventory (BDI), and the Japanese version of the University of Wales Institute of Science and Technology Mood Adjective Checklist (JUMACL) was conducted. These questionnaires were distributed to 2297 workers. There were 893 valid responses (39.9%, 584 men and 309 women, mean age 37.2 ± 10.2 years). Results: Three primary and eight secondary factors were established for the conceptual structure of self‐care and validated by structural equation modeling. “Positive attitude” comprised the secondary factors, “hope” and “sense of fulfillment”, and was influenced by another secondary factor, “social support”. “Positive attitude” contributed to “attitude toward health”. “Attitude toward health” comprised the secondary factors, “care about one's health” and “correction of bad habits”. “Attitude toward health” influenced a primary factor, “everyday behavior”, comprised of “wakefulness”, “eating in moderation”, and “lack of self‐control”. The primary factors “positive attitude” and “everyday behavior” influenced the BDI scores. A multiple regression analysis indicated that JUMACL subscale scores (energetic arousal and tense arousal), demographic data (living alone, sex, and age) and health‐related data (exercise, smoking, body mass index, drinking more than three alcoholic drinks/day, and gambling) predicted the scores of the self‐care assessment inventory for workers. Conclusion: This assessment inventory could be a useful measure of workers' self‐care because it establishes a relationship between psychological and behavioral concepts that are important for health promotion.     

Nurse practitioner, nurse midwife and physician assistant attitudes and care practices related to persons with HIV/AIDS

Although multiple studies of nurses' attitudes toward people living with HIV/AIDS (PLWAs) can be found in the literature, little is known about the attitudes, beliefs and practices of nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs). A survey including a 21-item AIDS Attitude Scale measuring the constructs of Avoidance and Empathy was sent to 1,291 NPs, CNMs and PAs in Louisiana, Arkansas and Mississippi to describe their attitudes and care practices related to PLWAs. Respondents who were more comfortable treating PLWAs had significantly lower avoidance scores and significantly higher empathy scores than respondents with lower comfort levels in providing care. Greater than 80% of respondents indicated that they would provide health care to HIV-infected individuals. Respondents who referred HIV/AIDS patients for all care did so primarily due to lack of experience with HIV and the availability of more experienced providers. Avoidance and empathy scores were not found to be significantly associated with referral for care. This study suggests that this group of providers has relatively low avoidance and high empathy toward PLWAs and is willing to care for HIV-infected individuals.     

Factors Associated With Work Satisfaction of Registered Nurses

PURPOSE: To examine the factors that influence the work satisfaction of a national sample of registered nurses in metropolitan statistical areas (MSAs). DESIGN: A cross-sectional mailed survey design was used. The sample consisted of RNs randomly selected from 40 MSAs in 29 states; 1,907 RNs responded (48%). The sample of 1,538 RNs working in nursing was used for analysis. METHODS: The questionnaire included measures of work attitudes and demographic characteristics. The data were analyzed using ordinary least-squares regression. FINDINGS: More than 40% of the variance in satisfaction was explained by the various work attitudes: supervisor support, work-group cohesion, variety of work, autonomy, organizational constraint, promotional opportunities, work and family conflict, and distributive justice. RNs who were White, self-perceived as healthy, and working in nursing education were more satisfied. RNs that were more career oriented were more satisfied. Of the benefits options, only paid time off was related to satisfaction. CONCLUSIONS: Work-related factors were significantly related to RNs' work satisfaction.     

Knowledge, attitudes and practice among nursing staff concerning pressure ulcer prevention and treatment – a survey in a Swedish healthcare setting

The aim of this study was to investigate (i) attitudes among Registered Nurses (RNs) and Nursing Assistants (NAs) regarding pressure ulcer prevention, (ii) knowledge among RNs and NAs of pressure ulcer prevention and treatment, (iii) practice of risk assessment and documentation regarding pressure ulcers among RNs and NAs and (iv) to identify perceived possibilities and barriers in pressure ulcer prevention and treatment. In this cross-sectional study, a total of 230 questionnaires were distributed to an equal number of RNs and NAs in both municipality as well as hospital care settings. The response rate was 67% (n = 154). In general, all respondents displayed good knowledge on prevention and treatment of pressure ulcers and demonstrated a positive attitude towards this area of care. However, answers provided to some questions indicate that recent research findings and guidelines have not succeeded in reaching out to these occupational groups. Furthermore, only 37% (n = 55) of the participants said that they have an agreed strategy for the prevention of pressure ulcers in their unit. These shortcomings may affect the quality of care provided to the patient and lead to pressure ulcers developing as a consequence. Today, evidence-based methods for risk assessment are available but are not adopted and used in practice. The study highlights the need to further reduce the gap between research and practice.     

Level of nurse supportive supervision and its influencing factors in long-term care facilities

Quality of care provided by personal support workers (PSWs) in long-term care facilities (LTCFs) is associated with the supportive supervisory performance of registered nurses (RNs). To determine the level of supportive supervision of RNs and its influencing factors in LTCFs in East China, a cross-sectional survey was conducted in 12 LTCFs using self-designed sociodemographic questionnaires and the Chinese version of the Supportive Supervisory Scale. A total of 643 PSWs supervised by 260 RNs were surveyed. The average supportive supervision score was 59.60 ± 7.53, representing a moderate level of supervisory support. Supportive supervision was found to be positively correlated with the PSW's years of working, the RN's education, position, number of years in nursing, having access to managerial training as well as the RN/PSW ratio in the unit (p < 0.05). These factors can be modified to potentially influence the supportive capacity of nurse supervisors in LTCFs.     

Reliability and validity of the Algase Wandering Scale – version 2 for Japanese people with dementia

In Japan, where older people already make up more than 23% of the population and the proportion is still growing, the burden on those caring for people with dementia is an increasing problem. This burden is magnified by wandering behavior, a peripheral symptom. Thus, there is a need for an objective measure of wandering behavior to determine what constitutes effective care. In this study, we translated the Algase Wandering Scale – Version 2 into Japanese, and examined its reliability and validity. Ambulatory residents with dementia were selected from two nursing homes and two wards specializing in dementia care in hospitals in Japan. Nurses and care workers taking care of these residents answered questionnaires regarding the residents. From the results, the Algase Wandering Scale – Version 2, Japanese version, was examined for inter‐rater reliability, stability, internal consistency, and concurrent validity. The results of the analysis in the present study demonstrated that the Algase Wandering Scale – Version 2, Japanese version, has reliability and validity, and that it can measure the presence or absence of wandering and its severity. Surveys of residents with various wandering patterns in many facilities and verification of construct validity are warranted in the future.