The relationship between structural empowerment and psychological empowerment for nurses: a systematic review

wagner j.i.j., cummings g., smith d.l., olson j., anderson l. & warren s. (2010) Journal of Nursing Management 18 , 448–462
The relationship between structural empowerment and psychological empowerment for nurses: a systematic review Aim To describe the findings of a systematic review examining the relationship between structural empowerment and psychological empowerment for registered nurses (RNs). Background Workplace empowerment research reveals a link between empowerment and positive work behaviours and attitudes. Research demonstrating the essential relationship between structural empowerment and psychological empowerment will provide direction for future interventions aimed at the development of a strong and effective health care sector. Methods Published research articles examining structural empowerment and psychological empowerment for nurses were selected from computerized databases and selected websites. Data extraction and methodological quality assessment were completed for the included research articles. Results Ten papers representing six studies reveal significant associations between structural empowerment and psychological empowerment for RNs. Implications for nursing management Creation of an environment that provides structural empowerment is an important organizational strategy that contributes to RNs’ psychological empowerment and ultimately leads to positive work behaviours and attitudes. Critical structural components of an empowered workplace can contribute to a healthy, productive and innovative RN workforce with increased job satisfaction and retention.     

The influence of nursing leadership on nurse performance: a systematic literature review

brady germain p. & cummings g.g. (2010) Journal of Nursing Management 18, 425–439
The influence of nursing leadership on nurse performance: a systematic literature review Aim The aim was to explore leadership factors that influence nurse performance and particularly, the role that nursing leadership behaviors play in nurses’ perceptions of performance motivation. Background Nurse performance is vital to quality patient care outcomes and nursing leadership behaviors have been linked to nurse performance. Evaluations A review of research articles that examined the factors that nurses perceived as influencing their motivation and performance was conducted. Eight studies were included in the final analysis. Key issues Nurses’ perceptions of factors that affect their motivation and ability to perform were grouped into five categories using content analysis: autonomy, work relationships, resource accessibility, nurse factors, and leadership practices. Nursing leadership behaviors were found to influence both nurses’ motivations directly and indirectly via other factors. Conclusion The review suggests that nurse performance may be improved by addressing nurse autonomy, relationships among nurses, their colleagues and leaders, and resource accessibility. Implications for nursing management Nursing managers and leaders may enhance their nurses’ performance by understanding and addressing the factors that affect their ability and motivation to perform.     

Predictors of nurse absenteeism in hospitals: a systematic review

Aim  This study aimed to identify and examine predictors of short-term absences of staff nurses working in hospital settings reported in the research literature.
Background  Front-line staff nurse absenteeism contributes to discontinuity of patient care, decreased staff morale and is costly to healthcare.
Evaluation  A systematic review of studies from 1986 to 2006, obtained through electronic searches of 10 online databases led to inclusion of 16 peer-reviewed research articles. Seventy potential predictors of absenteeism were examined and analysed using content analysis.
Key issue  Our findings showed that individual 'nurses' prior attendance records', 'work attitudes' (job satisfaction, organizational commitment and work/job involvement) and 'retention factors' reduced nurse absenteeism, whereas 'burnout' and 'job stress' increased absenteeism. Remaining factors examined in the literature did not significantly predict nurse absenteeism.
Conclusions  Reasons underlying absenteeism among staff nurses are still poorly understood. Lack of robust theory about nursing absenteeism may underlie the inconsistent results found in this review. Further theory development and research is required to explore the determinants of short-term absenteeism of nurses in acute care hospitals.
Implications for nursing management  Work environment factors that increase nurses' job satisfaction, and reduce burnout and job stress need to be considered in managing staff nurse absenteeism.     

Tuberculous cerebrovascular disease: A review

Cerebrovascular complications of tuberculous meningitis are common, and may represent its most serious legacy. They present in clinically diverse ways, and continue to develop during the initial stages of treatment. Magnetic resonance imaging is the imaging modality of choice in detecting brain infarcts, typically revealing multiple or bilateral lesions in the territories of the middle cerebral artery perforating vessels. Vessel pathology appears to be a consequence of its immersion in the local inflammatory exudate. Infiltrative, proliferative and necrotising vessel pathologies have been described, but the relative contributions of each and of luminal thrombosis to brain damage remain unclear. There is some evidence that vasospasm may mediate strokes early in the course of the disease and proliferative intimal disease later strokes. Anti-tuberculous chemotherapy appears to be relatively ineffective in preventing vascular complications, perhaps suggesting an immune mechanism. However, a preventive role for corticosteroids remains to be proven. Study of the molecular pathogenesis of TBM vasculopathy is in its infancy. This review focuses in particular on pathogenetic aspects of tuberculous cerebrovascular disease, with a view to its future targeted prevention.     

Genetics and personality traits in patients with social anxiety disorder: a case-control study in South Africa.

BACKGROUND: Social anxiety disorder (SAD) is among the most common of all psychiatric disorders with lifetime prevalence estimates ranging from 7% to 13%. Although there is evidence that SAD has a strong familial basis, there are few studies of potential candidate genes. In addition to a genetic association, there is also the possibility that temperamental risk factors for the disorder may be genetically transmitted. Against this background, our aims were threefold: i.) to compare patients and controls with respect to personality traits, ii.) to genotype a subgroup of these participants to investigate the role of genes encoding components of serotonergic (5-HT) and dopaminergic (DA) pathways in patients with SAD and iii.) to compare differences in temperament dimensions between carriers of different (dominant vs. recessive) alleles for selected polymorphisms in SAD patients. METHODS: Sixty-three patients (n=63; 35 male, 28 female) with a DSM-IV diagnosis of generalized SAD and SPIN-scores >18, and age-matched control participants (n=150; 31 male, 119 female) were included in the study. The Temperament and Character Inventory (TCI) was used to measure behaviours associated with specific personality dimensions (i.e. temperament/character). DNA was extracted and genotyped to investigate the role of select candidate genes encoding components in serotonergic and dopaminergic pathways in mediating the development of SAD. To achieve this, the frequency of variants in 5-HT and DA genes was compared between a Caucasian subset of SAD patients (n=41) and a convenience sample of Caucasian controls (n=88), using case-control association analyses. We also investigated the frequency of variants in 5-HT and DA-related genes across temperament characteristics in SAD patients, using analyses of variance (ANOVA). RESULTS: Patients scored significantly higher on harm avoidance (p<0.001) but lower on novelty seeking (p=0.04) and self-directedness (p=0.004) compared to controls. In the Caucasian subset, there was a difference between patients and controls in distribution of the 5-HT(2A)T102C polymorphism, with significantly more patients harboring T-containing genotypes (T-containing genotypes: [T/T+T/C] vs. [C/C]) (chi2=7.55; p=0.012). Temperament dimensions did not, however, differ significantly between carriers of different (dominant vs. recessive) alleles for the 5-HT(2A)T102C polymorphism in SAD patients. CONCLUSIONS: The results suggest a possible role for the 5-HT(2A)T102C polymorphism in the development of SAD. To date genetic findings in SAD have been inconsistent; nevertheless, serotonergic variants, and their associations with temperaments (e.g. reward dependence) deserve further exploration, in the hope that endophenotypes relevant to SAD can ultimately be delineated.