Background The number of clinical nurses in China experiencing professional burnout is increasing yearly, posing a serious challenge to the public health sector. Implementing effective intervention ...strategies is key to reducing the level of occupational burnout. At present, training aimed at alleviating occupational burnout among clinical nurses is very limited, with common training programs focusing on addressing external factors of occupational burnout rather than the internal cognitive issues of clinical nurses. Self-efficacy and future time perspective are both aspects of an individual’s internal self-cognition. Meanwhile, the relationship between clinical nurses’ self-efficacy, future time perspective, and occupational burnout is not clear, and further research is needed to verify this. Objective This study aims to reveal the relationship between clinical nurses’ self-efficacy, future time perspective, and occupational burnout, and to explore the mediating role of future time perspective between self-efficacy and occupational burnout among clinical nurses, providing a scientific reference for training directions to improve occupational burnout. Methods This study used a cross-sectional design, conducting a questionnaire survey with 529 practicing clinical nurses using the General Demographics Questionnaire (GDQ), the General Self-Efficacy Scale (GSES), the Zimbardo Time Perspective Inventory (ZTPI), and the Maslach Burnout Inventory-General Survey (MBI-GS). SPSS software version 26.0 was used to analyze the correlation between variables, and AMOS 26.0 was used to test the mediation effect. Results Clinical nurses’ self-efficacy had a negative predictive effect on occupational burnout (r = −0.503, p < 0.001). Future time perspective showed significant differences in regression coefficients on both the paths of self-efficacy (r = 0.615, p < 0.001) and occupational burnout (r = −0.374, p < 0.001). Future time perspective played a partial mediating role between self-efficacy and occupational burnout, accounting for 33.8% of the total effect. Conclusion This study suggests a significant correlation between clinical nurses’ self-efficacy, future time perspective, and occupational burnout. Self-efficacy can directly affect occupational burnout in clinical nurses and can also indirectly affect occupational burnout through the future time perspective.
Background: There may be a lack of self-efficacy or confidence in some nurses in the use of evidence-based practice (EBP) especially in a new hospital with nurses who are early in their careers. The ...aim of this study was to measure self-efficacy and outcomes expectations of nurses in the area of EBP in a new non-replacement hospital on the Magnet® designation journey. Methods: The study design was a cross-sectional survey using a 28-item questionnaire measuring the total level of self-efficacy in undertaking the 5 steps of EBP of direct patient care nurses. Results: 66 surveys were returned with 6(9%) men and 60(91%) women. Years of experience and certification showed no significant differences in confidence. For all but one subscale, the median level of confidence increased as the education level increased. For total self-efficacy (p=.021) and the subscales of problem identification (p=.044), finding evidence (p=0.17), appraising evidence (p=.042), applying evidence (p=.034), and outcome expectation (p=.039) those with higher education had higher self-efficacy. Similarly, those with either research training, EBP training or literature review training all had higher self-efficacy scores than those without training. Some subscales had lower median scores than others, indicating that, nurses in general were less confident in their EBP capacities. Discussion: As expected, all subscales showed significantly higher median confidence in the groups with EBP training, literature search training, and computer training compared to the groups without training. Consideration, as part of an orientation to a practice setting, should be made to training and education about EBP.
Background
Hospital ethical climate has important implications for clinical nurses’ service behavior; however, the relationships are complicated by the fact that five types of ethical climate ...(caring, law and code, rules, instrumental, and independence) can be combined differently according to their level and shape differences. Recent developments in person-centered methods (e.g., latent profile analysis (LPA)) have helped to address these complexities.
Aim
From a person-centered perspective, this study explored the distinct profiles of hospital ethical climate and then examined the relationships of the profiles with clinical nurses’ service behavior (both in-role and extra-role service behavior).
Research design
A quantitative study was conducted using cluster random sampling. Latent profile analysis and binary coded hexadecimal (BCH) analysis were conducted using Mplus 8.2.
Participants and research context
A total of 871 clinical nurses in China were surveyed using the Ethical Climate Scale and Nurses’ Service Behavior Questionnaire.
Ethical considerations
Ethical approval was obtained from the IRB of the First Affiliated Hospital of Jinan University (No. KY-2020-090).
Results
A four-profile hospital ethical climate model provided the best fit for the data. The four different profiles not only varied in level, but also in shape: high normative and low egoism (45.8%), high ethical climate (19.9%), low ethical climate (3.6%), and moderate ethical climate (30.8%). These profiles differentially predicted clinical nurses’ overall, in-role, and extra-role service behaviors.
Conclusions
The results reveal new insights into the nature of hospital ethical climate and how different clinical nurses in these profiles can be best managed to accomplish different forms of service behavior.
This study aimed to further understand and compare the phenomenon of workplace bullying (WPB) among clinical nurses in various sociocultural contexts. The study sought to determine appropriate ...interventions, examining how said interventions should be delivered at individual, work-unit, and institutional levels. Qualitative meta-synthesis was chosen to achieve the study aims. Individual qualitative research findings were gathered, compared, and summarized using the thematic analysis suggested by Braun and Clark. Based on the predefined analytic points, the findings included the following themes: horizontal yet vertical violence, direct and indirect violence on victims, nurses feed on their own, accepting and condoning WPB embedded in ineffective work systems, and rippling over the entire organization. The results showed that the phenomenon of workplace bullying shares quite a few attributes across cultures in terms of the characteristics, types, perpetrators, subjects, and consequences. The findings suggest that interventions to change and improve organizational work culture must be developed and implemented.
The aim of this study is to investigate the level of burnout of clinical nurses and to examine the influence of personal and environmental factors on nurse burnout. A total of 717 full‐time nurses ...from six hospitals in Tianjin, China, completed five questionnaires: a demographic questionnaire, the Maslach Burnout Inventory, the General Self‐Efficacy Scale, the Practice Environment Scale of the Nursing Work Index and the Nurse Job Stressor Scale. The participants had moderate levels of emotional exhaustion (mean score 23.95 ± 11.11) and depersonalization (mean score 7.90 ± 6.58) and a high level of reduced personal accomplishment (mean score 27.51 ± 10.96). Both personal and environmental factors were correlated with nurse burnout; however, personal factors played bigger roles in predicting personal accomplishment, whereas environmental factors played bigger roles in predicting emotional exhaustion and depersonalization. In order to reduce nurse job burnout effectively, administrators should pay more attention to the improvement of nurses' self‐efficacy and professional nursing practice environment and the reduction of stressors.
In the Democratic Republic of the Congo (DRC), the object-based approach (OBA) still remains mainstream in the basic nursing education program, despite the intention of the Ministry of Public Health ...to expand the competency-based approach (CBA) nationwide. This study aimed to compare the clinical competency of nurses trained with CBA and OBA. A cross-sectional, mixed study was conducted. We developed a self-assessment questionnaire consisting of an individual demographic information, a clinical competency assessment scale and the General Self-efficacy Scale. Nurses trained with CBA or OBA and currently working in health facilities with two to five years of clinical experience were purposively selected from ten cities across nine provinces in the DRC. We also conducted key informant interviews with the clinical supervisors at health facilities. In a comparison of 160 nurses trained with CBA and 153 with OBA, 3 competency domains ("establishing professional communication", "making decisions about health problems", and "performing nursing interventions") of the 5 domains required for nurses had significantly higher scores in the CBA group. The key informant interviews supported these results while revealing various issues in the basic nursing education program. The results support the strategic direction of the Ministry of Public Health in the DRC to expand CBA. Collaboration among education institutions, health facilities, and administrative bodies is crucial for clinical nurses to fully engage their competencies for the population. Other low- and middle-income countries with scarce resources can refer to the developed and implemented competency assessment method applied in this study.
This study aimed to translate and validate of the Chinese version of the Occupational Low Back Pain Prevention Behaviors Questionnaire among clinical nurses.
A total of 1,186 clinical nurses were ...recruited from three provinces in northeast China. The reliability of the translated questionnaire was measured by internal consistency, split-half reliability, and test-retest reliability. The validity of the translated questionnaire was evaluated by content validity index, exploratory factor analysis and confirmatory factor analysis.
The Cronbach's α value of the questionnaire was 0.891, and the coefficient values for the six domains ranged between 0.804 and 0.917. The split-half reliability and test-retest reliability were 0.663 and 0.734, respectively. Furthermore, the content validity index of the questionnaire was 0.938. The 6-factor structure, supported by the eigenvalues, total variance explained, and scree plot accounted for 63.038% of the total variance. In the confirmatory factor analysis, as the results of model fitting, χ
/df = 3.753, RMSEA = 0.048, GFI = 0.929, AGFI = 0.913, TLI = 0.934, IFI = 0.943, CFI = 0.943, PGFI = 0.759, PNFI = 0.807.
The Chinese version of the Occupational Low Back Pain Prevention Behaviors Questionnaire had suitable reliability and validity among clinical nurses. Under the high prevalence of occupational low back pain, the questionnaire can provide a reference for developing educational intervention plans among clinical nurses.
Background
When staffing legislation was introduced, New Jersey nurse leaders recognized from the research and their years of clinical leadership experience that the work environment is a ...multidimensional concept and that staffing is not the only variable related to nurse and patient outcomes. Thus, an understanding of what nurses need in their hospital environment to practice nursing effectively was sought.
Aims
The aim of this study was to examine the evidence regarding clinical nurses’ perception of what they need to practice nursing effectively in the acute care hospital environment.
Methods
The following population, intervention, comparison, outcome question was used to search the literature databases PubMed, CINAHL, Johanna Briggs, and the Sigma Theta Tau Henderson Library: In the hospital environment what do nurses perceive as needed to practice nursing effectively? Specific search criteria and the Johns Hopkins nursing guidelines and tools were used to identify relative studies.
Results
The final review, which addressed what nurses in the hospital environment need to practice nursing effectively, included 25 articles: 20 were an evidence level III, and five were evidence level II. From this review, five key concepts were identified: Leadership, autonomy/decision making, respect/teamwork, resources/staffing, and organizational commitment to nursing.
Linking Evidence to Action
This integrative review, which explored nurses’ perceptions of what is needed to provide effective quality care, identified that providing quality care is multifactorial in nature. Resources, including but not limited to staffing, and leadership were identified as important by nurses as a key factor in supporting quality care. Nurses must be provided with resources and infrastructure to do their jobs, in an environment supported by authentic transformational leadership.
To explore nurses' knowledge, skills and personal attributes for competent health education practice and their association with potential influencing factors.
Clinical nurses are expected to perform ...effective health education interventions, but they do not feel competent. The self-assessment of the health education competence and its conditional factors is paramount for professional development.
A cross-sectional study.
A total of 458 clinical nurses from two health specialized centers in Spain participated in this study. Data were collected using the Nurse Health Education Competence Instrument and a second self-report questionnaire from January to February 2019. Descriptive statistics, t-test, analysis of variance, Pearson’s and Spearman’s correlation and multiple linear regression were used to analyse the data. The STROBE guideline was used
The mean scores of the knowledge (70.10 ± 15.11), skills (92.14 ± 15.18) and personal attributes scales (32.32 ± 5.89) were found to be low to moderate. The main influencing factors for the health education implementation were lack of education and training (71.4%), lack of time (67.5%) and high workload (67.3%). Nurses with higher educational level and perceived self-efficacy for competently providing health education, more extensive professional experience and previous training in health education rated higher in knowledge, skills and personal attributes. Age and years of experience were negatively correlated with knowledge scores, but positively with the rest of domains of the competence and self-efficacy. The regression models for the overall health education competence’s domains were significant (p < 0.001) with R2 values ranging from 28.0% to 49.3%. Self-efficacy, previous health education training and working in intensive care units were found to be significant in all cognitive, psychomotor and attitudinal scales.
Clinical nurses reported on some skills and personal attributes for health education practice, but they seem to lack health education knowledge necessary for a competent practice. This study suggested that effective education and training and supportive organizational cultures are key to enhance nurses’ health education competence. Identifying nurses’ educational needs on the main domains of the competence and its intrinsic/extrinsic influential factors may assist in both planning and organizing tailored training strategies and in promoting appropriate environments to support a high-quality health education practice
Nurses’ knowledge, skills and attitudes about health education competence are low to moderate. Training and organizational support are key.
A qualitative descriptive approach with conventional content analysis was applied. Twenty interviews with clinical supervisors who oversaw both CBE- and OBE-trained nurses, 22 focus group discussions ...(FGDs) with CBE-trained nurses, and 21 FGDs with OBA-trained nurses currently working in health facilities were conducted. Participants of the FGDs were selected from the participants of the DRC self-assessment competency comparison study where there was no statistically significance between CBE- and OBE-trained nurses in the demographic characteristics. Data were analysed in terms of the competencies identified by the Ministry of Health. The supervisors recognised that the CBE-trained nurses had stronger competencies in professional communication, making decisions about health problems, and engaging in professional development, but were weak in clinical skills. This study identified challenges for supervisors in assuring standardised care in health facilities with OBE- and CBE-trained nurses, as well as barriers for CBE-trained nurses as a minority in the workplace in demonstrating their competencies. The study results support the Ministry of Health's policy to expand CBE in pre-service education programmes but reveal that its slow implementation impedes full utilisation of the acquired competencies at health facilities. Implementation could be accelerated by strengthening cooperation among the Ministry of Health's three human resource departments, and developing and implementing a well-planned, legally binding, long-term CBE reform strategy, including an approach to the Continuing Professional Development system.
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