Nurse entrepreneurs’ well‐being at work and associated factors

Aims and objectives. This study describes the well‐being at work of nurse entrepreneurs and owner‐managers of social care companies in Finland from the vantage point of health and working capacity, general coping and job satisfaction and identifies factors associated with well‐being. Background. In recent years, increasing numbers of nurses have been starting up in business in the social care sector. As yet, there has been only limited research into their well‐being at work. Design. Survey. Method. This study was conducted as part of a questionnaire survey among 335 social care entrepreneurs with different educational backgrounds. The sample for the study reported here consisted of those respondents who had a registered nurse degree (n = 84). The data were analysed by SPSS statistical software. Results. Most of the respondents rated their physical, mental, financial and social situation and working capacity as good. Less than half of the respondents had experienced stress during the past year. Over half felt their coping efficacy was better than it had been shortly after starting up in business. The respondents’ resources were consumed and strengthened by a range of different work‐related factors. The majority were satisfied with their job as an entrepreneur. Several background factors were associated with the results. Conclusions. Most of the nurse entrepreneurs reported being content with their well‐being at work. Nevertheless, the results also highlighted factors that could and should be addressed to improve the well‐being at work of entrepreneurs who struggle to cope. Relevance to clinical practice. The results provide useful information for the development of entrepreneurial training for nurses, for the design and provision of occupational health care services and for the enrichment of the content of the entrepreneur’s job.     

The cost‐effectiveness of quality improvement projects: a conceptual framework,checklist and online tool for considering the costs and consequences of implementation‐based quality improvement

In resource constrained systems, decision makers should be concerned with the efficiency of implementing improvement techniques and technologies. Accordingly, they should consider both the costs and effectiveness of implementation as well as the cost‐effectiveness of the innovation to be implemented. An approach to doing this effectively is encapsulated in the ‘policy cost‐effectiveness’ approach. This paper outlines some of the theoretical and practical challenges to assessing policy cost‐effectiveness (the cost‐effectiveness of implementation projects). A checklist and associated (freely available) online application are also presented to help services develop more cost‐effective implementation strategies.     

Job satisfaction and subjective well‐being among Czech nurses

The aim of the present study was to investigate the relationship between domains of the job satisfaction and components of subjective well‐being in nurses. A convenience sample of hospital nurses was recruited from six hospitals in Czech Republic. Data were collected using a set of questionnaires that included the McCloskey/Mueller Satisfaction Scale, the Positive Affect Scale, the Negative Affect Scale and the Personal Well‐being Index. We confirmed low association between job satisfaction and subjective well‐being of nurses. Satisfaction with extrinsic rewards, co‐workers and family/work balance accounted for only a small percentage of variance in cognitive component of subjective well‐being. Positive affect was predicted by interaction opportunities and scheduling. Negative affect was predicted by interaction opportunities and scheduling and intention to leave the actual workplace. Low percentage of the variance suggests that subjective well‐being is not strongly influenced by job satisfaction.     

An economic evaluation of water birth: the cost‐effectiveness of mother well‐being

Purpose To assess the cost‐effectiveness of water compared with normal land delivery. Methods A retrospective controlled study was conducted over a two‐year period in a Northern Italian hospital. The cohort included all the 110 women who completed a water birth and 110 women who had a land birth during the same period. The two groups were compared with respect to labour duration, perineal tear and newborn's health status. The economic evaluation adopted a cost‐effectiveness approach in relation to presence/absence of perineal tears. Results In the water delivery group 58 women (52.7%) experienced at least one perineal tear versus 80 (72.7%) in the traditional delivery group. The mean duration of labour was similar in the two groups. Neonatal well‐being, expressed as Apgar score, did not differ significantly among the two groups at the first minute (9.48 vs. 9.28) and was slightly higher at 5 minutes in the water delivery group (9.95 vs. 9.84; P = 0.0269). Water delivery was found to be both more costly [ΔC = €279; 95% confidence interval (CI): 262–296] and more effective in terms of avoided perineal tears. The incremental health care cost per avoided perineal tear because of water delivery was estimated of €1395.7 (95% CI: 1049.2–3608.5). Conclusion Water birth, as compared with traditional delivery, allows for an increase in maternal well‐being and is cost‐effective.     

The quest for well‐being: self‐identified needs of women in chronic pain

Scand J Caring Sci; 2011; 25; 81–91
The quest for well‐being: self‐identified needs of women in chronic pain Women suffer more chronic pain in most Western countries than men, with considerable consequences for the sufferers. The aim of this phenomenological research was to study self‐reported needs of women in chronic pain. The data consisted of ten in‐depth interviews, which lasted from 60 to 120 minutes each, with five women in chronic pain, aged 36–53. Twelve needs were identified in the study, which were categorized into three clusters of needs or major quests: The quest to learn to live with the pain, which involves the need for diagnosis; the need to find effective treatment and keep the pain tolerable; the need for helpful advice and information and the need to take care of self and for a different pace and a new life pattern. The quest for support, caring and connection which involves the need for someone close who cares; the need to be connected to others and have someone to care for; the need for practical support e.g. financial support and household assistance and the need for professional support and caring. Finally, the quest for normalcy which involves the need to avoid the sick role and maintain a sense of dignity; the need to focus on personal strengths and prevent discouragement and depression; the need to be involved in decision‐making regarding own care and treatment and the need to participate in family and social activities to fight isolation and loneliness. The overriding theme in all these quests is the quest for well‐being; physically, mentally, emotionally and socially. Conflicting needs created five major dilemmas in the women’s lives. Women in chronic pain may be seen in any clinical setting and health professionals need to be able to recognize their needs in order to be able to give effective care, to cooperate with them and empower them.     

Quality of life and well‐being of people receiving haemodialysis treatment in Scotland: A cross‐sectional survey

End‐stage renal disease is a complex, progressive and debilitating illness that affects patients’ quality of life, physical and mental health, well‐being, social functioning and emotional health. A cross‐sectional survey was carried out in renal dialysis centres in Scotland to assess patients’ health status and the impact of haemodialysis treatment on quality of life and well‐being. Participants scored considerably lower than the UK general population in all domains of health‐related quality of life, although mental health components were nearer to general population norms than physical health components. However, nearly half of the participants achieved a score on a general well‐being questionnaire that was indicative of stress and anxiety. Increasing age was associated with better overall mental health but worse physical functioning. Increasing levels of hope and support were associated with improved general well‐being.     

Chronic pain acceptance and affective well‐being: A coping perspective

This study examined the relationship between chronic pain acceptance and affective well‐being from a coping perspective. One hundred‐fifty patients from a multidisciplinary pain centre provided self‐report data including measures of pain acceptance, positive and negative affect, and accommodative flexibility. The bivariate and multiple correlation patterns were consistent with the assumption that pain willingness (the attitudinal component of pain acceptance including the recognition of the uncontrollability of pain) primarily reduces negative affect, whereas activity engagement (the behavioural component of pain acceptance including the pursuit of life activities despite pain) additionally produces positive affect. The data furthermore suggested activity engagement as a mediating link between pain willingness and positive affect. Moderation analyses showed that accommodative flexibility (the general readiness to adjust personal goals to situational constraints) facilitates both pain willingness and activity engagement – especially when average pain intensity is high. In sum, the results support the view that chronic pain patients’ well‐being is closely tied to the maintenance of life activities which presupposes an accepting attitude towards pain.