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This study was conducted to determine the relationships between nurses’ competency, motivation, and stress levels in disaster management, as well as to shed light on the establishment of effective disaster management programs.
Methods
In our research we used a correlational, descriptive, cross-sectional design. The sample of the study was composed of 498 nurses working in Turkey. The “Descriptive and Professional Characteristics and Disaster Experiences of Nurses” form, the “Competencies for Disaster Nursing Management Questionnaire,” the “Perceived Stress Scale,” and the “Nurses Job Motivation Scale” were used in data collection.
Results
Nurses’ disaster management competency and motivation levels were found to be adequate, and their stress levels were found to be moderate. A weak positive correlation was found between disaster management competency and motivation, but a weak negative correlation was found between stress levels. Age, education level, experience level, training in disaster nursing, and knowledge of duties and responsibilities in disasters were associated with significant differences in terms of disaster competency and its dimensions, motivation, and stress levels.
Conclusions
The study found that nurses’ disaster experiences impacted their competency, feeling of preparedness, and stress and motivation levels, and motivation was found to be a predictor of increasing competency.
In 2022, assisted suicide (AS) was legalized in Austria. We aimed to investigate the experiences and attitudes of palliative care (PC) and hospice nurses toward AS in Austria after the first year of implementation of the new law.
Methods
A cross-sectional survey was distributed online to nurses in every known specialized and general hospice and PC units in Austria (n = 255 units). The questionnaire included sociodemographic characteristics, the Assisted Suicide Attitude Scale, the Comfort Discussing Assisted Suicide Scale, and questions on recent experiences with AS requests. We used Spearman’s correlation coefficient for determining associations between sociodemographic characteristics and attitudes toward AS, as well as comfort discussing AS. For comparison of frequencies, we applied ꭓ2 tests. We computed a linear regression model to examine predictors for attitudes toward AS.
Results
The total sample were N = 280 nurses. More than half (61.2%) indicated that they had cared for a patient who expressed a wish for AS within the first year of implementation. Though responses varied widely, more nurses expressed support for AS than those were opposed (50.36% and 31.75%, respectively). Factors that statistically contributed to more reluctance toward AS in the regression model were older age, religiousness, and experience of working with patients expressing a wish for AS.
Significance of results
This work provides valuable insight into nurses’ perceptions toward the legislation of AS in the first year since the new law was passed. The results can inform the future development of the AS system and support for nurses in end-of-life care, and critically contribute to international discussions on this controversial topic.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
Since the World Health Organization (WHO) declared a pandemic on 11 March 2020, there has been much research examining the effects of working during COVID-19 on different sectors of the healthcare workforce. This chapter explores the detailed narratives of nurses’ experiences of COVID-19 in the ICON qualitative research. The participants were from a wide range of working environments and were asked about the possible impacts of working during the pandemic on their psychosocial and emotional wellbeing. It concludes that nurses provided the most care 24 hours a day/7 days a week for patients during the COVID-19 pandemic. The study showed that nurses continued to put patients’ needs first, often to the detriment of their own health. It outlines valuable lessons in the form of structural, organizational, and team learning to support psychosocial wellness in emergencies and disease outbreaks such as the COVID-19 pandemic.
Edited by
Rachel Thomasson, Manchester Centre for Clinical Neurosciences,Elspeth Guthrie, Leeds Institute of Health Sciences,Allan House, Leeds Institute of Health Sciences
Liaison mental health nurses are the single largest professional group in consultation-liaison psychiatry. Liaison nurses frequently work as part of large, multidisciplinary teams but they regularly make independent admission and discharge recommendations. Liaison nurses require a large repertoire of competencies to fulfil such roles and understandably this comes from a variety of post-registration experiences. This chapter sets out the competencies required of liaison mental health nurses. The chapter also outlines the unique and important role a nurse consultant can play in a liaison team. Liaison mental health nursing continues to expand as a professional group within consultation-liaison mental healthcare. Mental health nursing has a workforce shortage, and this chapter also looks at how to develop or ‘grow your own’ liaison nurses by employing nurses at the point of registration and developing sound liaison nurses over a 12- to 18-month period.
Childhood immunisation is a critically important public health initiative. However, since most vaccines are administered by injection, it is associated with considerable pain and distress. Despite evidence demonstrating the efficacy of various pain management strategies, the frequency with which these are used during routine infant vaccinations in UK practice is unknown.
Aim:
This study aimed to explore primary care practice nurses’ (PNs) use of evidence-based pain management strategies during infant immunisation, as well as barriers to evidence-based practice.
Methods:
A questionnaire was developed and distributed to nurses throughout the UK via convenience sampling in paper and online formats. Questions assessed the frequency of pain management intervention use during infant immunisation and barriers to their use.
Findings:
A total of 255 questionnaire responses were received. Over 90% (n = 226) of respondents never used topical anaesthetics or sweet solutions during immunisations, while 41.9% advised breastfeeding occasionally (n = 103). Parent-/caregiver-led distraction was the most frequently used intervention, with most nurses using it occasionally (47.9%, n = 116) or often (30.6%, n = 74). Most practices had no immunisation pain management policy (81.1%, n = 184), and most PNs’ previous training had not included pain management (86.9%, n = 186). Barriers to intervention use included lack of time, knowledge and resources. Excluding distraction, pain management strategies were infrequently or never used during infant immunisation. Key barriers to using evidence-based strategies were lack of time, knowledge and resources.
Dementia is a progressive brain disorder that affects memory, thinking and behaviour. It is a major global public health concern, with an estimated 55 million people worldwide living with the condition. In the UK, there is an estimated 944,000 people with dementia. This number is expected to double by 2050. Dementia is a major cause of disability and dependency, and it places a significant burden on families and carers. The current level of dementia education in pre-registration nursing programmes in the UK is inadequate. There are no pre-registration nursing educational programmes that offer dementia as a speciality. This is a major concern, as nurses are the primary providers of care to people with dementia. This article argues that dementia should be established as a branch of pre-registration nursing education that leads to a Registered Nurse (RN) – Dementia. This could help to address the shortage of specialist dementia nurses in the country. This article provides an important suggestion for countries with a shortage of specialist dementia nurses to consider establishing a stand-alone pre-registration branch of dementia nurse education. This would result in a more specialised workforce with the skills and knowledge to provide high-quality care to people with dementia.
This study aimed to conduct a Turkish validity and reliability study of the Palliative Care Spiritual Care Competency Scale.
Methods
The sample of the study consisted of 354 nurses. In the first stage, the forward–backward translation method was used to develop the Turkish version of the Palliative Care Spiritual Care Competency Scale. The comprehensibility, purposefulness, cultural appropriateness, and discrimination of the scale items were evaluated with content validity. Confirmatory factor analysis (CFA) was applied to examine the construct validity of the scale. To evaluate the ability of the scale to give consistent results at different time intervals, the relationship between the scores obtained from the first and second applications was examined with the intraclass correlation coefficient (ICC). The reliability of the scale was evaluated with the Cronbach’s alpha reliability coefficient and item-total score correlation coefficients.
Results
The content validity index of the Palliative Care Spiritual Care Competency Scale was found to be 0.98 after expert opinion was obtained. The goodness-of-fit values of the scale were χ2/sd: 3.125; GFI: 0.915; AGFI: 0.875; IFI: 0.926; TLI: 0.905; CFI: 0.925; RMSEA: 0.078; SRMR: 0.054. As a result of CFA, some items were removed from the scale, and a Turkish version of the scale consisting of 14 items and three sub-dimensions was developed. The reliability of the scale over time was evaluated with the test-retest method, and it was found that the inter-response agreement was very good (ICC: 0.981; p < 0.001). The Cronbach’s alpha reliability coefficient of the scale was 0.89 and the Cronbach’s alpha reliability coefficient of the subscales ranged between 0.78 and 0.85.
Significance of results
It was determined that the Turkish version of the Palliative Care Spiritual Care Competency Scale is a short, easy-to-understand, and psychometrically sound measurement tool that can be safely applied to Turkish nurses.
Chapter 3 describes the emergence of merit as a store of value. For professionals, merit was first earned and demonstrated in educational contexts, then ‘cashed in’ for access to professional pathways. There, further merit was accumulated doing virtuous work, and rapidly reinvested in advancement upwards. Each step on the career ladder was ‘earned’ by demonstrating one’s increasing merit, and directly translated into material and social benefits. Merit was built from conceptions of virtue that were already deeply gendered and which were becoming entangled with emerging ideas about race. As merit became the currency with which the professional class purchased and managed their influence, this systematized multiple, intersecting forms of inequality. As they structured career ladders, the professional class also built a ladder through society, so that each person’s class and financial status, from the rich and powerful to the poorest and most marginalized, seemed to be earned. This opened the opportunity for the professional class to extract moral and financial value from women, people of colour, and the working class, bolstering their own status and class identity.
To explore nurses’ experiences with, and barriers to, obesity healthcare in rural general practice.
Background:
Obesity is a significant health risk worldwide, which can lead to many other physical and psychosocial health issues that contribute to a poor quality of life. Primary care is considered the most suitable context to deliver obesity management healthcare across the world, including New Zealand, which reportedly has 34% of all adults (and 51% Indigenous Māori) classed as obese. Nurses in primary care have a significant role in the multidisciplinary team and deliver obesity healthcare in general practice contexts. Yet, there is little focus on the nurse perspective of weight management, specifically in rural areas where medical staff and resources are limited, and obesity rates are high.
Methods:
This was a qualitative research design. Semi-structured interviews with 10 rural nurses from indigenous and non-indigenous health providers were analyzed guided by Braun and Clarke (2006) approach to thematic analysis.
Findings:
Three themes were identified: limitations of a nurse role; patient-level barriers; and cultural barriers. Nurses reported experiencing significant barriers to delivering effective weight management in their practice due to factors outside the scope of their practice such as patient-level factors, social determinants of health, rural locality restrictions, and limitations to their role. While this study highlights that practice nurses are versatile with an invaluable skill repertoire, it also demonstrates the near impossibility for rural nurses to meet their rural patient’s complex weight management needs, as there are many social determinants of health, sociocultural, and rural locality factors acting as barriers to effective weight management. Nurses experienced a lack of systemic support in the form of time, resources, funding, and effective weight management referral options. Future investigation should look to address the unique rural weight management healthcare needs that experience many barriers.
This study aimed to determine the effect of psychological first-aid (PFA) E-learning on the competence and empathy of nurses in disasters.
Methods:
In a randomized controlled trial, 50 nurses were randomly assigned to 2 intervention and control groups, and psychological first-aid training sessions were implemented for the intervention group. The data were collected using the personal information form, a researcher-made questionnaire to measure competence, and the Davis Empathy Questionnaire.
Results:
Two groups were homogeneous in terms of competency (P = 0.691) and empathy (P = 0.363) in the preintervention phase. The intervention group had more competence in the next stage than before the intervention (P < 0.0001). In the post-intervention phase, the intervention group had more competence compared with the control group (P < 0.0001). The overall effect size of PFA E-learning training on the nurses’ competency was 1.9. Regarding empathy, in the post-intervention phase, the subscale of personal distress (P = 0.014) was significantly lower in the intervention group and the perspective-taking subscale was higher than in the control group (P < 0.0001). However, there was no significant difference between the groups in terms of all scores of empathy and the subscale of empathic concern (P > 0.05). The overall effect size of PFA E-learning training on the nurses’ empathy was 0.44.
Conclusions:
It is suggested to provide training, including a PFA E-learning model, for nurses and other therapists in disaster situations.
Based on previous qualitative studies, it was hypothesised that dissimilarities in beliefs about illness, which influence healthcare-seeking behaviour, exist between foreign- and native-born persons diagnosed with type 2 diabetes living in Sweden (in the following termed ‘Swedish-born’).
Background:
Beliefs about illness are individual, culturally related, based on knowledge, and guide health-related behaviour, and thus have an impact on health. The question is whether beliefs differ between foreign- and native-born persons diagnosed with type 2 diabetes. No previous comparative studies have been found on this. Based on previous qualitative studies, it was hypothesised that dissimilarities in beliefs about illness, which influence healthcare-seeking behaviour, exist between foreign- and native-born (Swedish) persons diagnosed with type 2 diabetes living in Sweden.
Methods:
Cross-sectional survey, 138 participants, comprising 69 foreign- and 69 Swedish-born persons aged 33–90 vs 48–91 years. Data were analysed with descriptive and analytic statistics.
Findings:
Beliefs about illness differed between foreign- and Swedish-born persons concerning causes of diabetes and healthcare-seeking behaviour. Foreign-born persons more often than Swedish-born persons reported uncertainty or lack of knowledge about whether heredity (67% vs 90%, P = 0.002) and pancreatic disease (40% vs 62%, P = 0.037) could cause diabetes. To a higher extent than Swedish-born persons, they reported that emotional stress and anxiety could cause the disease. Furthermore, they claimed they had sought care due to diabetes during the last 6 months to a higher extent than Swedish-born persons (30% vs 4%, P = 0.000).
The findings confirmed that dissimilarities in beliefs about illness, including the causes of diabetes and healthcare-seeking behaviour, exist between foreign- and Swedish-born persons with type 2 diabetes.
This scoping review explored the main environmental factors in the workplace that contribute to nursing resilience in respiratory infectious pandemic events.
Background:
There is strong evidence in the literature about the influence of individual factors on nurses’ resilience and a growing interest on the impact of the workplace environment on these factors. Therefore, a review that synthesizes environmental factors that support nurses’ resilience in pandemic events is timely.
Method:
A scoping review of publications written in English, Spanish, and Portuguese of registered publications until December 2020 in MEDLINE, Embase, PubMed, Scopus, SciELO, CINAHL, WoS, BVS, and APA identified 10,767 potential papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines were used during the literature review process. The Health Services Workplace Environmental Resilience Model (HSWERM) was used to guide exploration and synthesis.
Results:
Thirty-two (32) publications met inclusion criteria. Most of the HSWERM workplace factors were mentioned in the literature. The main workplace environmental factors that were identified included communication, inter-professional collaboration, access to equipment, targeted training, and supporting well-being.
Conclusions:
Recognition of these key environmental factors in the workplace will help to implement more effective actions to promote resiliency prior to and during emergency situations. It will also enable managers to include, in any preparation planning, contingencies to protect these factors with the view of sustainable resilience of nursing staff throughout the emergency event.
The aim of the study was to determine in adults the risk perception for cardiovascular disease (CVD) and the associated factors.
Background:
CVDs are the leading cause of death globally. In adults, perceptions related to the risk for CVDs have a considerable effect on decision-making processes related to one’s own health.
Methods:
A cross-sectional study was conducted with 453 adult people from April to June 2019 in İzmir, Turkey. Data were collected with a sociodemographic characteristics questionnaire, perception of risk of heart disease scale (PRHDS), and health perception.
Findings:
The mean PRHDS score of adults was 48.88 ± 8.12. The risk perception for CVD was influenced by variables that were age, gender, education, marital status, employment status, health perception, familial cardiovascular disease history, chronic disease status, smoking status, and body mass index. Although CVDs are the most prominent cause of disease-related death in the world, risk perception for CVD was found to be low among the individuals included in this study. This finding indicates the importance of informing individuals about CVD risk factors, raising awareness, and training.
This innovation in simulation evaluated the effectiveness of a time sensible, low-cost simulation on prelicensure nursing students’ knowledge and confidence in responding to public health emergencies.
Method:
One hundred eighty-two nursing students, in groups of 5, participated in a 75-min emergency preparedness disaster simulation. A mixed methods design was used to evaluate students’ knowledge and confidence in disaster preparedness, and satisfaction with the simulation.
Results:
Students reported an increase in knowledge and confidence following the disaster simulation and satisfaction with the experience.
Conclusions:
Prelicensure nursing programs can replicate this low cost, time sensible disaster simulation to effectively educate students in emergency preparedness.
This study examined the relationship between moral distress, individual and professional values in oncology nurses.
Methods
Employing structural equation modeling, a descriptive-correlational study was conducted among 116 oncology nurses. Data were collected using the Moral Distress Scale-Revised Adult Nurses, the Nursing Professional Values Scale, and the Values Scale.
Results
The mean moral distress frequency was evaluated as low (1.6 ± 0.7) and the intensity as moderate (1.9 ± 0.8). Both the Nursing Professional Values Scale and Values Scale subdimension mean scores were at levels evaluated as high. There was no specific value that stood out from the others. Structural equation modeling analysis showed that individual values were found to have a direct and negative significant effect on moral distress intensity (β = −0.70, p < 0.01) and frequency (β = −0.58, p <0.01) and professional values had a direct positive and significant effect on moral distress intensity (β = 0.37, p < 0.05) and frequency (β = 0.25, p < 0.05).
Significance of results
It is believed that more national and international studies need to be conducted to examine the relationship between the moral distress concept and values. While individual values were found to have a direct and negative significant effect on moral distress, professional values had a direct positive and significant effect on moral distress.
This article examines the impact of the neoliberal restructuring of health services on female nurses in Turkey. It provides a qualitative analysis of work–family conflict, establishing that not only work but also family life has become more precarious. The contours of precariousness of both work and family are analysed through interviews with 50 female nurses working full time in different areas of health service provision. The findings suggest that the neoliberal restructuring of health services has led to staffing deficits along with workload intensification, unpredictable work schedules and poor organisational support. This has increased work–family conflict, defined as a form of precariousness because it heightens the difficulties, risks and insecurities entailed in balancing family-related expectations with increasing work demands for female nurses. This precariousness makes spousal support critical if nurses are to be able to address work–family conflict and leads to nurses’ compliance with unfavourable working conditions as a way to resolve the mutual interference of family and work. The increased subordination of life to work has resulted from the neoliberal managerialisation of health services, creating precarisation in the lives of female nurses.
Schloendorff v. Society of New York Hospitals is a 1914 New York Court of Appeals decision frequently cited as the foundational case establishing a patient’s common-law right to bodily autonomy. But Judge Benjamin Cardozo’s assertion that “every human being of adult years and sound mind has a right to determine what shall be done with his own body” was mere dicta. In affirming a directed verdict for the hospital where the plaintiff’s uterus was removed without her consent, Cardozo deemed a nurse’s awareness of the patient’s objection to surgery insufficient to put the hospital on notice that an independent-contractor surgeon was planning a non-consensual hysterectomy. In her feminist judgment, Professor Kelly Dineen unearths a treasure trove of contemporaneous sources that establish the nursing function as an independent basis for duties to patients for which the hospital may be held vicariously liable. In her commentary, Professor Danielle Pelfrey Duryea situates the case within the emergence of “modern nursing” as a devalued feminine counterpart to masculine, valorized “modern medicine."
To improve psychosocial care for oncology inpatients, we implemented screening for distress by means of distress thermometer (DT) at the Comprehensive Cancer Centre Zurich in 2011. Since then, several screening barriers have been reported regarding the application of the DT. This study aimed to evaluate the distress screening process between 2012 and 2016 to identify barriers preventing sustainability.
Methods
In this sequential explanatory mixed methods study, we synthesized the results of 2 quantitative retrospective descriptive studies and 1 qualitative focus group study. To compare and analyze the data, we used thematic triangulation.
Results
Nurses screened 32% (N = 7034) of all newly admitted inpatients with the DT, and 47% of the screenings showed a distress level ≥5. Of these cases, 9.7% were referred to psycho-oncological services and 44.7% to social services. In 15.7% of these cases, nurses generated a psychosocial nursing diagnosis. In focus group interviews, nurses attributed the low screening rate to the following barriers: adaptation to patients’ individual needs, patient-related barriers and resistance, timing, communication challenges, established referral practice, and lack of integration in the nursing process.
Significance of results
To improve distress screening performance, the screening process should be tailored to patients’ needs and to nurses’ working conditions (e.g., timing, knowledge, and setting-specific factors). To gain more evidence on distress management as a basis for practical improvements, further evaluations of distress screening are required.
This study was conducted to provide basic data for preparing a disaster nursing education program. It examined the degree of nursing students’ disaster awareness, disaster preparedness, willingness to participate in disaster response, and disaster nursing competency, aiming to determine the relationship between these attributes.
Methods:
This was a descriptive research study. The participants were 163 nursing students. The data collected from the participants were analyzed via descriptive statistics and Pearson’s correlation coefficients.
Results:
Disaster awareness showed a positive correlation with a willingness to participate in a disaster response. Further, disaster preparedness and willingness to participate in a disaster response showed a positive correlation with disaster nursing capacity. Disaster awareness did not show a significant correlation with disaster preparedness and disaster nursing competency. Last, disaster preparedness did not show a significant correlation with willingness to participate in a disaster response.
Conclusions:
It is necessary to improve nursing students’ disaster awareness, disaster preparation, disaster response participation willingness, and disaster nursing competency. It is imperative to develop disaster nursing education programs to strengthen students’ capabilities in a comprehensive manner.
Neuromonitoring is a shared responsibility in the ICU with several key roles for bedside nursing staff, including the identification and reporting of trends. Nursing staff should be familiar with equipment and supplies needed for neuromonitoring as well as troubleshooting common artifacts and problems. Guideline development and ongoing education are essential to the success of any neuromonitoring program. This chapter provides suggested pathways for integrating bedside neuromonitoring into clinical practice and discussion of day-to-day nursing roles and responsibilities related to bedside monitoring. Multiple modalities, including EEG, aEEG, QEEG, and NIRS, are discussed.