Background:
Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. ...Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.
Objectives:
The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.
Methodology:
A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.
Ethical consideration:
The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.
Results:
The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p < 0.05) of nurses 57% (n = 135) with low ethical competence. There was no significant association between respondents’ demographic variables and level of ethical competence (p > 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.
Conclusion:
The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence.
Objetivo: Determinar la utilización de evidencia científica disponible por el profesional de enfermería para planificar los cuidados otorgados. Metodología: Búsqueda en bases de datos: Proquest, ...Pubmed, Science Direct, Medline. Se seleccionó nueve artículos para análisis, publicados entre los años 2011 y 2021 en idiomas inglés y español, ajustados a requerimientos PRISMA. Resultados: Se obtuvieron 356 investigaciones, de las cuales 9 cumplieron con criterios de selección. Los artículos incluidos no miden el nivel de utilización de la Enfermería Basada en Evidencia (EBE) para la planificación de los cuidados, sin embargo, se describen factores facilitadores y barreras para su implementáción. Conclusión: La evidencia disponible no es suficiente para determinar la utilización de la evidencia en los cuidados otorgados por parte del profesional de enfermería. Se describen barreras de tipo personales y organizacionales para su utilización. Para lograr una adecuada implementáción de la EBE es necesario contar con estrategias efectivas en los entornos clínicos y esfuerzos multidisciplinarios para su utilización. Es necesario la realización de estudios de mayor calidad, para generar datos confiables que evidencien cómo impacta el conocimiento, el nivel de formación en investigación y el apoyo institucional en la utilización de la EBE en la práctica clínica.
The prevalence of burnout, depression, and anxiety among Chinese nurses was 34%, 55.5%, and 41.8% respectively. Mental health problems have significant impacts on their personal well-being, work ...performance, patient care quality, and the overall healthcare system. Mental health is influenced by factors at multiple levels and their interactions.
This was a descriptive qualitative study using phenomenological approach. We recruited a total of 48 nurses from a tertiary hospital in Changsha, Hunan Province, China. Data were collected through focus group interviews. Audio-recorded data were transcribed and inductively analysed.
Four major themes with 13 subthemes were identified according to the social ecological model: (1) individual-level factors, including personality traits, sleep quality, workplace adaptability, and years of work experience; (2) interpersonal-level factors, encompassing interpersonal support and role conflict; (3) organization-level factors, such as organizational climate, organizational support, career plateau, and job control; and (4) social-level factors, which included compensation packages, social status, and legislative provision and policy.
Our study provides a nuanced understanding of the multifaceted factors influencing nurses' mental health. Recognizing the interconnectedness of individual, interpersonal, organizational, and social elements is essential for developing targeted interventions and comprehensive strategies to promote and safeguard the mental well-being of nurses in clinical settings.
The larger study was registered with Chinese Clinical Trial Registry: ChiCTR2300072142 (05/06/2023) https://www.chictr.org.cn/showproj.html?proj=192676 .
This study is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ).
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.
Aim
To describe academic nurses' experiences engaging clinical nurses in utilizing and implementing developmental and research‐based knowledge in hospital settings.
Methods
This study used a ...descriptive qualitative design. Fourteen academic nurses at Masters or PhD level from three different regions of Denmark participated in the study, relating their successful experiences engaging clinical nurses in utilizing and implementing developmental and research‐based knowledge. Data were collected in February 2020 through qualitative semi‐structured interviews and analysed using a qualitative manifest content analysis.
Results
The main theme revealed was that academic nurses were ‘Working towards creating a practice‐related culture for research’ to engage clinical nurses. This was supported by three subthemes: ‘Focusing on evidence‐based practice knowledge’, ‘Facilitating knowledge through a pedagogical approach’ and ‘Aiming for future changes’.
Conclusions
The academic nurses experienced their engagement of clinical nurses and the subsequent change of practice in patient care and nurses' workflows in the department settings, as successful due to the academic nurses' pedagogical actions to educate clinical nurses and due to the academic nurses' practice‐related approach to research and implementation.
Summary statement
What is already known about this topic?
Nurses who utilize research and work with evidence‐based practice are more satisfied with their work, have better patient outcomes and become advocates for patients as they focus on improving the quality of patient care.
Engaging nurses in nursing research can be a difficult task due to barriers to research utilization. However, most nurses have positive attitudes towards research.
Knowledge is needed about how nurses have been successfully engaged in utilizing and implementing developmental and research‐based knowledge.
What this paper adds?
Academic nurses have successfully engaged clinical nurses in research and development by creating a practice‐related research culture.
Engaging clinical nurses in research and development can be improved by focusing on evidence‐based knowledge to solve practical problems in nursing.
Facilitating knowledge of research through pedagogical actions of education and involvement is often more important than the academic knowledge itself.
The implications of this paper:
Engaging clinical nurses in research and development depends upon making practice‐related research culture a natural part of daily nursing practice.
Dual management, consisting of two head nurses—one for practice and one for research—should be established to improve academic nurses' authority to implement changes in nursing practice.
Workplace social capital refers to relationship networks formed by individuals in an organization through long-term mutually beneficial interactions and cooperation with members. These relationship ...networks can create value and resources for organizations and individuals. This current study aimed to explore the potential impact of workplace social capital on the association between perceived stress and professional identity in clinical nurses during the COVID-19 outbreak.
In this cross-sectional study, 308 Chinese clinical nurses filled out the Chinese Workplace Social Capital Scale, the Chinese Perceived Stress Scale, and the Chinese Nurse's Professional Identity Scale. Descriptive analysis, independent samples t test, analysis of variance, Pearson correlation analyses, and bootstrap method were performed to analyze the data.
Perceived stress was negatively correlated with professional identity (r = -0.455, p < .001). Workplace social capital was not found to moderate the relationship between perceived stress and professional identity (95% CI -0.03 to- 0.06, p = .47 > .05). Instead, it mediated that relationship (95% CI -0.61 to -0.19, p < .05), and its mediating effect was -0.37.
In the early stages of the COVID-19 outbreak, workplace social capital among the investigated clinical nurses failed to buffer the negative impact of perceived stress on professional identity, but it did play a part in mediating perceived stress and professional identity. A healthy workplace should be provided to clinical nurses to improve their professional identity, while lowering perceived stress.
Purpose: The purpose of this study was to identify the influence of perioperative nursing experience on career development of clinical nurses.Methods: Data were generated through semi-structured ...formal interviews with 11 clinical nurses. The nurses were assigned to an operating room as new graduates and had more than 3 years of perioperative nursing experience. Following this, they worked in a department outside an operating room. The contents of interviews were analyzed qualitatively.Results: Eight categories emerged from the data analysis: considering a different career path by perioperative nursing experience, making use of nursing knowledge and techniques learned in the operating room in a new ward, anticipating situations in advance, acting imperturbably regardless of the situation, experiencing difficulty and lacking the skills needed at the time of job rotation, lacking confidence in other areas of nursing at the time of job rotation, striving to overcome the difficulties of working in a new ward, and experiencing growth as a nurse as a result of job rotation.Conclusion: Nurses with perioperative nursing experience considered their career path based on their experiences in the operating room. They faced difficulties at the time of job rotation because their experience was limited to the operating room. However, their experience was also a strength that they could use in other areas of nursing and had a positive influence on their subsequent work.
Nurses are more likely to experience anxiety following the coronavirus 2019 epidemic. Anxiety could compromise nurses' work efficiency and diminish their professional commitment. This study aims to ...investigate nurses' anxiety prevalence and related factors following the pandemic in multiple hospitals across China.
An online survey was conducted from April 16 to July 3, 2023, targeting frontline nurses who had actively participated in China. Anxiety and depression symptoms were assessed using the Self-rating Anxiety Scale and the Self-rating Depression Scale (SDS), respectively. Multivariable logistic regression analysis was employed to identify factors linked with anxiety.
A total of 2,210 frontline nurses participated in the study. Overall, 65.07% of participants displayed clinically significant anxiety symptoms. Multivariable logistic regression revealed that nurses living with their families 2.52(95% CI: 1.68-3.77) and those with higher SDS scores 1.26(95% CI: 1.24-1.29) faced an elevated risk of anxiety. Conversely, female nurses 0.02(95% CI: 0.00-0.90) and those who had recovered from infection 0.05(95%CI: 0.07-0.18) demonstrated lower rates of anxiety.
This study highlights the association between SDS score, gender, virus infection, living arrangements and anxiety. Frontline nurses need to be provided with emotional support to prevent anxiety. These insights can guide interventions to protect the mental well-being of frontline nurses in the post-pandemic period.
Purpose: This study was aimed to examine the impact of self-esteem and self-efficacy on resilience among female senior clinical nurses.Method: Self-administered questionnaires were distributed among ...1,551 non-managerial senior clinical nurses. The questionnaire consisted of personal background information, the Japanese version of Rosenberg’s Self-esteem Scale, the Japanese version of the Generalized Self-Efficacy Scale, and the Adolescent Resilience Scale consisting of three factors (“novelty seeking”, “emotional regulation”, and “positive future orientation”). Data analyses were conducted using path analysis.Results: 684 valid answers were returned (valid response rate = 44.1%). The path coefficient was 0.44 for “novelty seeking” and 0.26 for “positive future orientation” from self-efficacy, and 0.34 for “positive future orientation” from self-esteem (p < 0.001). The fitness indexes of the model were good (GFI = 1.00, AGF = 0.996, CFI = 1.00, RMSEA < 0.001).Conclusion: In female senior clinical nurses, self-esteem and self-efficacy have been verified to affect resilience.
Clinical nurses' (CNs) ethical competence (EC) is essential for nursing practice because it facilitates high-quality care to patients.To develop ethically competent nurses, factors that positively ...affect EC must be explored and promoted. Few studies have explored ethical issues in Malawi and the aim of this study was to explore the factors that affect EC.
This study used a qualitative exploratory design to collect data through in-depth interviews from 10 key informants (KI) and 9 focus group discussions (FGD) in the selected government, CHAM and private hospitals in Malawi. It was conducted between April and May 2019.Data were analysed manually using thematic content analysis. The data were coded, and words with similar meaning were organized into categories from which themes and sub themes were developed. The themes and sub themes are reported as the results of the study.
One major theme emerged from the thematic content analysis namely: systems influencing EC among nurses in Malawi. The study has identified continuing professional development in ethics, supportive supervision, availability of resources and leadership to be among the major factors that facilitate EC. Factors that hinder EC among the nurses included; inadequate supervision, inadequate resources, lack of teamwork, increased workload coupled with inadequate nursing staff.
This study has exposed the factors that influence EC in health facilities and shown that nurse leaders are key to enhancing EC through continuing ethics education, supportive supervision, staffing and provision of resources. Therefore, all the stakeholders in nursing should support the efforts to remove the factors that hinder EC in the health facilities.
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