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Nicolas Gillet Evelyne Fouquereau Angélique Bonnaud-Antignac René Mokounkolo Philippe Colombat 《International journal of nursing studies》2013
Background
The importance of transformational leadership for nurses’ well-being is increasingly acknowledged. However, there is a paucity of research examining the mechanisms that may explain the relationships between transformational leadership and nurses’ quality of work life.Objectives
First, to examine two possible psychological mechanisms that link transformational leadership behaviors to nurses’ quality of work life. Second, to study the relationship between nurses’ quality of work life and their work engagement.Design
Cross-sectional study design.Settings
The study took place in 47 different hematology, oncology, and hematology/oncology units in France. Participants were nurses and auxiliary nurses.Participants
343 nurses completed the questionnaire. Surveys were sent to all nurses working in the units. 95% were female, the average age was 36.30 years.Methods
Nurses were asked to rate their supervisor's transformational leadership style and their perceptions of distributive and interactional justice in the unit. They were also asked to evaluate their own level of quality of work life and their work engagement.Results
Distributive justice and interactional justice were found to fully mediate the relationship between transformational leadership and nurses’ quality of work life. In addition, nurses’ quality of work life positively related to their work engagement.Conclusions
Transformational leaders may help ensure nurses’ quality of work life which in turn increases their work engagement. These leadership practices are thus beneficial for both employees and organization. 相似文献3.
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Elisabeth Carlson Margareta RämgårdIngrid Bolmsjö Mariette Bengtsson 《International journal of nursing studies》2014
Background
In Sweden, as well as in most industrialised countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialised in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care.Objective
The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work.Method
This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analysed in line with the tradition of naturalistic inquiry.Results
Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing. Three categories of professional work emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness.Conclusions
The findings are important as they represent positive alternatives to the somewhat prevailing view on elderly care as depressing and undemanding. Nurse educators might use the key aspects as good examples, thus influencing student nurses’ attitudes towards elderly care in a positive way. Elderly care agencies might find them helpful when recruiting and retaining nurses to a much needed area. 相似文献5.
Yafa Haron Sara Levy Mazal Albagli Ruth Rotstein Shoshana Riba 《International journal of nursing studies》2013
Background
Given the severe shortage of nurses in geriatric care in Israel and the planned expansion of their role in the care of older people, the Israel Ministry of Health's Nursing Division decided to investigate the readiness of current students to work in geriatrics.Objectives
To gather last-year student nurses’ views on geriatric nursing as a career choice and identify the factors behind those views.Design
A cross-sectional questionnaire study was designed.Settings and participants
486 students (70% of the total last-year student nurse population) across the whole range of study settings completed the questionnaire in 2011.Methods
On the basis of extensive data collection from focus groups of student nurses and working geriatric nurses a structured, self-administered questionnaire was compiled. The researchers distributed and collected the questionnaire in the students’ classrooms.Results
61% of the 486 respondents had no intention of working in geriatrics while 12% considered the prospect favourably. 27% of the respondents were prepared to consider geriatric nursing as a career choice only after advanced specialist training in that field. 69% said that the planned expansion of the powers of geriatric nurses would incline them more favourably to work in geriatrics.A relatively high proportion of those interested in working in geriatrics were men. The students’ appraisal of the content of their training programme and of the current state of geriatrics in Israel appeared not to influence career choice. Multiple regression analysis found that the factors most predictive of geriatric care as a career choice were a generally favourable attitude to older people, the expansion of nurse powers in the sector and previous experience in older people care. Studying on an academic programme as opposed to a diploma programme was a negative predictor.Conclusions
The non-influence of training programme content/design is the key finding. The chief recruitment effort should be invested in making the domain of geriatric nursing more attractive to nurses by improving its pay structure and expanding the powers of geriatric nurses to the level of Clinical Nurse Specialist, which would provide an attractive promotion track. 相似文献6.
Objectives
To examine nurses’ attitudes towards the use of physical restraints in geriatric care.Design
Systematic review and synthesis of qualitative and quantitative studies.Data sources
The following databases were searched: Medline, CINAHL, EMBASE, Psyndex, PsychInfo, Social SciSearch, SciSearch, Forum Qualitative Social Research (1/1990 to 8/2013). We performed backward and forward citation tracking to all of the included studies.Review methods
We included in the present review all qualitative and quantitative studies in English and German that investigated nurses’ attitudes towards the use of physical restraints in geriatric care. Two independent reviewers selected the studies for inclusion and assessed the study quality. We performed a thematic synthesis for the qualitative studies and a content analysis of the questionnaires’ items as well as a narrative synthesis for the quantitative surveys.Results
We included 31 publications in the review: 20 quantitative surveys, 10 qualitative and 1 mixed-method study. In the qualitative studies, nurses’ attitudes towards the use of physical restraints in geriatric care were predominately characterised by negative feelings towards the use of restraints; however, the nurses also described a perceived need for using restraints in clinical practice. This discrepancy led to moral conflicts, and nurses described several strategies for coping with these conflicts when restraints were used. When nurses were in doubt regarding the use of restraints, they decided predominantly in favour of using restraints. The results of the quantitative surveys were inconsistent regarding nurses’ feelings towards the use of restraints in geriatric care. Prevention of falls was identified as a primary reason for using restraints. However, the items of the questionnaires focussed primarily on the reasons for the use of restraints rather than on the attitudes of nurses.Conclusions
Despite the lack of evidence regarding the benefits of restraints and the evidence on the adverse effects, nurses often decided in favour of using restraints when in doubt and they used strategies to cope with negative feelings when they used restraints. A clear policy change in geriatric care institutions towards restraint-free care seems to be warranted to change clinical practice. The results of this review should also be considered in the development of interventions aimed at reducing the use of restraints. 相似文献7.
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Peter Van Bogaert Christoph Kowalski Susan Mace Weeks Danny Van heusden Sean P. Clarke 《International journal of nursing studies》2013
Aim
To explore the mechanisms through which nurse practice environment dimensions are associated with job outcomes and nurse-assessed quality of care. Mediating variables tested included nurse work characteristics of workload, social capital, decision latitude, as well as burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment.Background
Acute care hospitals face daily challenges to their efforts to achieve nurse workforce stability, safety, and quality of care. A body of knowledge shows a favourably rated nurse practice environment as an important condition for better nurse and patient outcome variables; however, further research initiatives are imperative for a clear understanding to support and guide the practice community.Design
Cross-sectional survey.Method
Grounded on previous empirical findings, a structural equation model designed with valid measurement instruments was tested. The study population was registered acute care nurses (N = 1201) in two independent hospitals and one hospital group with six hospitals in Belgium.Results
Nurse practice environment dimensions predicted job outcome variables and nurse ratings of quality of care. Analyses were consistent with features of nurses’ work characteristics including perceived workload, decision latitude, and social capital, as well as three dimension of burnout playing mediating roles between nurse practice environment and outcomes. A revised model adjusted using various fit measures explained 52% and 47% of job outcomes and nurse-assessed quality of care, respectively.Conclusion
The study refines understanding of the relationship between aspects of nursing practice in order to achieve favourable nursing outcomes and offers important concepts for managers to track in their daily work. The findings of this study indicate that it is important for clinicians and leaders to consider how nurses are involved in decision-making about care processes and tracking outcomes of care and whether they are able to work with physicians, superiors, peers, and subordinates in a trusting environment based on shared values. The involvement of nurse managers at the unit level is especially critical because of associations with nurse work characteristics such as decision latitude and social capital and outcome variables. Further practice and research initiatives to support nurses’ involvement in decision-making process and interdisciplinary teamwork are recommended. 相似文献9.
Background
The population is ageing globally. Older people are more likely to have chronic diseases and disabilities and have contact with health services. Attitudes of healthcare professionals affect the quality of care provided and individual career preferences.Aim
To examine the international research relating to registered and student nurses’ attitudes towards older people and the potential underpinning variables.Methods
A systematic search of 8 databases covering English and Chinese language publications since 2000 was undertaken which identified 25 papers.Findings
Reported attitudes towards older people were inconsistent with positive, negative and neutral attitudes being noted across registered and student nurses and appear to be slightly less positive since 2000. A range of variables have been examined as potential predictors of nurses’ attitudes with age, gender and education level being investigated most frequently but none were consistent predictors. Preference to work with older people and knowledge of ageing appeared to be associated with positive attitudes towards older people.Conclusions
There is a growing need for registered nurses committed to working with older people, however, there is a dearth of well designed studies which investigate both the attitudes of registered and student nurses and the associated factors, and test interventions to inform workforce strategies. 相似文献10.
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Lina Daouk-Öyry Abdel-Latef Anouze Farah Otaki Nuhad Yazbik Dumit Ibrahim Osman 《International journal of nursing studies》2014
Background
Absenteeism and turnover among healthcare workers have a significant impact on overall healthcare system performance. The literature captures variables from different levels of measurement and analysis as being associated with attendance behavior among nurses. Yet, it remains unclear how variables from different contextual levels interact to impact nurses’ attendance behaviors.Objectives
The purpose of this review is to develop an integrative multilevel framework that optimizes our understanding of absenteeism and turnover among nurses in hospital settings.Methods
We therefore systematically examine English-only studies retrieved from two major databases, PubMed and CINAHL Plus and published between January, 2007 and January, 2013 (inclusive).Findings
Our review led to the identification of 7619 articles out of which 41 matched the inclusion criteria. The analysis yielded a total of 91 antecedent variables and 12 outcome variables for turnover, and 29 antecedent variables and 9 outcome variables for absenteeism. The various manifested variables were analyzed using content analysis and grouped into 11 categories, and further into five main factors: Job, Organization, Individual, National and inTerpersonal (JOINT). Thus, we propose the JOINT multilevel conceptual model for investigating absenteeism and turnover among nurses.Conclusions
The JOINT model can be adapted by researchers for fitting their hypothesized multilevel relationships. It can also be used by nursing managers as a lens for holistically managing nurses’ attendance behaviors. 相似文献12.
Background
Low competence levels among nursing staff have been associated with lower quality of older people care. However, interventions to improve staff competence have not always been evaluated for their impact on the quality of older people care. An educational intervention in the form of a workplace “toolbox” was shown to have positive effects on nursing staff competence and work satisfaction, but had no effects on care recipients’ or their family members’ ratings of quality of care. It was therefore of interest to investigate whether the intervention had any effect on nursing staff ratings of quality of care.Objectives
The aim of the study was to evaluate the possible effects of an educational “toolbox” intervention on nursing staff ratings of quality of care.Design
A prospective, non-randomized, controlled intervention.Participants and settings
Nursing staff in two municipal older people care organizations in Sweden.Methods
Practical instruments and educational materials for improving staff competence and work practices were collated in a workplace “toolbox” and introduced in the intervention organization in February of 2003. Nursing staff ratings of quality of care were measured pre- and post-intervention by questionnaire and compared to nurses’ quality ratings in a reference organization, where no toolbox was introduced.Results
Nursing staff ratings of quality of care improved significantly over time in the intervention organization. No improvements were found in the reference organization.Conclusions
Compared to a reference municipality, nursing staff ratings of quality of care improved in the organization where the toolbox was introduced. Competence development measures may have a positive impact on nursing staff's ratings of quality, but not on the quality ratings of care recipients and their family members. Further research is needed to understand the differences in these stakeholders’ perceptions. 相似文献13.
Background
Research on Indian nurses has focused on their participation as global migrant workers for whom opportunities abroad act as an incentive for many to migrate overseas. However, little is known about the careers of Indian nurses, or the impact of a globalized health care market on nurses who remain and on the profession itself in India.Objectives
To explore nurses’ accounts of entry into nursing in the context of the globalisation of the nursing profession in India, and the salience of ‘migration’ for nurses’ individual careers.Design
Qualitative interview study (n = 56).Settings and participants
The study drew on interviews with 56 nurses from six sites in Bangalore, India. These included two government hospitals, two private hospitals, a Christian mission hospital, a private outpatient clinic and two private nursing colleges. Participants were selected purposively to include nurses from Christian and Hindu backgrounds, a range of home States, ages and seniority and to deliberately over-recruit (rare) male nurses.Methods
Interviews covered how and why nurses entered nursing, their training and career paths to date, plans for the future, their experiences of providing nursing care and attitudes towards migration. Data analysis drew on grounded theory methods.Results
Nursing is traditionally seen as a viable career particularly for women from Christian communities in India, where it has created inter-generational ‘nurse families’. In a globalizing India, nursing is becoming a job ‘with prospects’ transcending traditional caste, class and gender boundaries. Almost all nurses interviewed who intended seeking overseas employment envisaged migration as a short term option to satisfy career objectives – increased knowledge, skills and economic rewards – that could result in long-term professional and social status gains ‘back home’ in India. For others, migration was not part of their career plan: yet the increases in status that migration possibilities had brought were crucial to framing nursing as a ‘suitable job’ for a growing number of entrants.Conclusions
The possibility of migration has facilitated collective social mobility for Indian nurses. Migration possibilities were important not only for those who migrate, but for improving the status of nursing in general in India, making it a more attractive career option for a growing range of recruits. 相似文献14.
Background
Variations in nursing practice and communication difficulties pose a challenge for the successful integration into the workforce of immigrant nurses. Evidence for this is found in cultural clashes, interpersonal conflicts, communication problems, prejudiced attitudes and discrimination towards immigrant nurses. While the evidence shows that integrating immigrant nurses into the nursing workforce is shaped by factors that are socially constructed, studies that examine social structures affecting workforce integration are sparse.Objectives
The aim of this study was to examine interplaying relationships between social structures and nurses’ actions that either enabled or inhibited workforce integration in hospital settings.Design
Giddens’ Structuration Theory with double hermeneutic methodology was used to interpret 24 immigrant and 20 senior nurses’ perceptions of factors affecting workforce integration.Results
Four themes were identified from the data. These were: (1) employer-sponsored visa as a constraint on adaptation, (2) two-way learning and adaptation in multicultural teams, (3) unacknowledged experiences and expertise as barriers to integration, and (4) unquestioned sub-group norms as barriers for group cohesion. The themes presented a critical perspective that unsuitable social structures (policies and resources) constrained nurses’ performance in workforce integration in the context of nurse immigration. The direction of structural changes needed to improve workforce integration is illustrated throughout the discussions of policies and resources required for workforce integration at national and organisational levels, conditions for positive group interactions and group cohesion in organisations.Conclusion
Our study reveals inadequate rules and resources used to recruit, classify and utilise immigrant nurses at national and healthcare organisational levels can become structural constraints on their adaptation to professional nursing practice and integration into the workforce in a host country. Learning from each other in multicultural teams and positive intergroup interaction in promoting intercultural understanding are enablers contributing to immigrant nurses’ adaptation and workforce integration. 相似文献15.
Objectives/background
Based on structure-process-outcome approach, this study examined the association of registered nurse (RN) staffing hours and five quality indicators, including two process measures (catheter use and antipsychotic drug use) and three outcome measures (pressure ulcers, urinary tract infections, and weight loss).Setting/participants
We used data on resident assessments, RN staffing, organizational characteristics, and market factors to examine the quality of 195 nursing homes operating in a rural state of United States — Colorado.Design/methods
Two-stage least squares regression models were performed to address the endogenous relationships between RN staffing and the outcome-related quality indicators, and ordinary least squares regression was used for the process-related ones. This analysis focused on the relationship of RN staffing to nursing home quality indicators, controlling for organizational characteristics, resources, resident casemix, and market factors with clustering to control for geographical differences.Results
Higher RN hours were associated with fewer pressure ulcers, but RN hours were not related to the other quality indicators.Conclusions
The study finding shows the importance of understanding the role of ‘nurse staffing’ under nursing home care, as well as the significance of associated/contextual factors with nursing home quality even in a small rural state. 相似文献16.
K. Balzer L. Kremer A. Junghans R.J.G. Halfens T. Dassen J. Kottner 《International journal of nursing studies》2014
Background
Nurses’ clinical judgement plays a vital role in pressure ulcer risk assessment, but evidence is lacking which patient characteristics are important for nurses’ perception of patients’ risk exposure.Objectives
To explore which patient characteristics nurses employ when assessing pressure ulcer risk without use of a risk assessment scale.Design
Mixed methods design triangulating observational data from the control group of a quasi-experimental trial and data from semi-structured interviews with nurses.Setting
Two traumatological wards at a university hospital.Participants
Quantitative data: A consecutive sample of 106 patients matching the eligibility criteria (age ≥18 years, no pressure ulcers category ≥2 at admission and ≥5 days expected length of stay). Qualitative data: A purposive sample of 16 nurses.Methods
Quantitative data: Predictor variables for pressure ulcer risk were measured by study assistants at the bedside each second day. Concurrently, nurses documented their clinical judgement on patients’ pressure ulcer risk by means of a 4-step global judgement scale. Bivariate correlations between predictor variables and nurses’ risk estimates were established. Qualitative data: In interviews, nurses were asked to assess fictitious patients’ pressure ulcer risk and to justify their risk estimates. Patient characteristics perceived as relevant for nurses’ judements were thematically clustered. Triangulation: Firstly, predictors of nurses’ risk estimates identified in bivariate analysis were cross-mapped with interview findings. Secondly, three models to predict nurses’ risk estimates underwent multiple linear regression analysis.Results
Nurses consider multiple patient characteristics for pressure ulcer risk assessment, but regard some conditions more important than others. Triangulation showed that these are measures reflecting patients’ exposure to pressure or overall care dependency. Qualitative data furthermore indicate that nurses are likely to trade off risk-enhancing conditions against conditions perceived to be protective. Here, patients’ mental capabilities like willingness to engage in one owns care seem to be particularly important. Due to missing information on these variables in the quantitative data, they could not be incorporated into triangulation.Conclusions
Nurses’ clinical judgement draws on well-known aetiological factors, and tends to expand conditions covered by risk assessment scales. Patients’ care dependency and self-care abilities seem to be core concepts for nurses’ risk assessment. 相似文献17.
Marieke Kroezen Liset van Dijk Peter P. Groenewegen Marlies de Rond Anke J.E. de Veer Anneke L. Francke 《International journal of nursing studies》2014
Background
Over the last two decades, the number of countries where nurses are legally permitted to prescribe medication has grown considerably. A lack of peer support and/or objections by physicians can act as factors hampering nurse prescribing. Earlier research suggests that physicians are generally less supportive and more concerned about nurse prescribing than nurses are. However, direct comparisons between doctors’ and nurses’ views are scarce and are often based on small sample sizes.Objectives
To gain insight into the views of Dutch registered nurses (RNs), nurse specialists (with a master's in Advanced Nursing Practice) and physicians on the consequences of nurse prescribing.Design
Survey study.Participants
Survey questionnaires were sent to national samples of RNs, nurse specialists and physicians.Methods
The questionnaire addressed, among others, respondents’ general views on the consequences of nurse prescribing for the quality of care, the nursing and medical professions, and the relationship between the medical and nursing professions.Results
The net response rate was 66.0% for RNs (n = 617), 28.3% for nurse specialists (n = 375) and 33.7% for physicians (n = 265). It was found that all groups agreed that nurse prescribing benefits nurses’ daily practice and the nursing profession. There were few concerns about negative consequences for physicians’ practice and the medical profession. Nurse specialists gave significantly (P < 0.05) more positive scores on most items than RNs and physicians. We found relatively little difference in views between RNs and physicians. It was only on issues surrounding the quality of care and patient safety that doctors showed more concerns, albeit mild, than RNs and nurse specialists.Conclusions
RNs, nurse specialists and physicians generally hold neutral to moderately positive views on nurse prescribing. This is beneficial for the implementation and potential success of nurse prescribing in practice, as a lack of peer support and/or objections from physicians can be a hampering factor. However, concerns about the consequences of nurse prescribing for the quality of care and patient safety remain a point for attention, especially among physicians. 相似文献18.
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Fengsong Gao Peter Newcombe Cheryl Tilse Jill Wilson Anthony Tuckett 《International journal of nursing studies》2014
Background
Nurse turnover in the residential aged care industry is a pressing issue. Researchers have shown ongoing interest in exploring how the factors that are amendable to change in aged care policy, regulation and funding and in organizational procedures (e.g. job demands, coping resources and psychological health of nurses) impact on turnover. However, the findings are mixed.Objective
This study tested two theoretical models of turnover to examine the structural relationships among job demands, coping resources, psychological health and turnover of residential aged care nurses. Although many previous studies operationalized turnover as intention to leave, the present study investigated actual turnover by following up with the same individuals over time, and thus provided more accurate predictive models of turnover behaviour.Design and methods
The sample, 239 Australian residential aged care nurses, came from the Nurses and Midwives e-cohort Study. Job demands, coping resources, and psychological health were measured using standardized instruments. Structural equation modelling was used to test the measurement and structural models.Results
Controlling for a number of workforce and individual characteristics, coping resources (measured by job control, supervisor support, and co-worker support) were negatively and directly associated with turnover. Additionally, the findings supported the Job Demand-Control-Support model in that higher coping resources and lower job demands (indicated by psychological demands, physical demands, and effort) were related to better psychological health (measured by vitality, social functioning, role emotional, and mental health), and higher job demands were related to lower coping resources.Conclusions
Findings suggest that aged care policy makers and service providers might consider increasing coping resources available to nurses and minimizing job demands of care work to reduce turnover and improve nurses’ psychological health. Moreover, findings from this Australian study may provide valuable practical and policy implications for other developed countries. 相似文献20.
Betsie G.I. van Gaal Lisette Schoonhoven Joke A.J. Mintjes George F. Borm Theo van Achterberg 《International journal of nursing studies》2010,47(9):1117-1125