Globally nurses and midwives are working hard to detect cases of COVID‐19, to save lives or give comfort in the face of death, to educate themselves and the public about protective measures to stop ...the viral spread, while still caring for those not infected with the virus. In many countries nurses are working under virtual siege from this pandemic, with not enough resources or personal protective equipment, overwhelming numbers of patients, staff shortages, underprepared health systems and supply chain failures. Nurses and other health and emergency workers are suffering physical and emotional stress, and moral distress from conflicting professional values. They are faced with unpalatable and complex ethical issues in practice, with moral conflicts, high levels of acuity and patient deaths, and long working hours. A rising number of nurses are infected with SARS‐CoV‐2 or dying in the line of duty. Nurses need strong moral courage, stamina and resilience to work on the front lines of the pandemic, often while separated from their loved ones.
Purpose
The purpose of this study was to investigate the effect of nurse burnout on nurse‐reported quality of care and patient adverse events and outcomes in Thai hospitals.
Methods
Cross‐sectional ...analysis of data from 2,084 registered nurses working in 94 community hospitals across Thailand. Data were collected through survey questionnaire, including the Maslach Burnout Inventory (MBI), which measures of nurse perceived quality of care and patient outcomes. Multiple logistic regression modeling was performed to explore associations between nurse burnout on quality of care and patient outcomes.
Findings
Thirty‐two percent of nurses reported high emotional exhaustion, 18% high depersonalization, and 35% low personal accomplishment. In addition, 16% of nurses rated quality of care on their work unit as fair or poor, 5% reported patient falls, 11% reported medication errors, and 14% reported infections. All three subscales of the MBI were associated with increased reporting of fair or poor quality of care, patient falls, medication errors, and infections. Every unit of increasing emotional exhaustion score was associated with a 2.63 times rise in reporting fair or poor quality of care, a 30% increase in patient falls, a 47% increase in medication errors, and a 32% increase in infection.
Conclusions
Findings clearly indicate that nurse burnout is associated with increased odds of reporting negative patient outcomes. Implementing interventions to reduce nurse burnout is critical to improving patient care in Thai hospitals.
Clinical Relevance
Hospital administrators, nurse managers, and health leaders urgently need to create favorable work environments supporting nursing practice in order to reduce burnout and improve quality of care.
Aim
To provide an updated definition of the concept of nurses’ workplace social capital that addresses changes in the contemporary nursing workforce.
Background
Social capital explains the components ...of a constructive work environment. Advancements in psychology of workplace and changes in the demographic structure of nursing workforce call for a revised version of nurses’ workplace social capital.
Method
Walker and Avant's approach was implemented. Data were compiled from ‘Medline’ and ‘CINAHL’, ‘Google’ search engine, book chapters and expertise of nursing academicians.
Results
Nurses’ workplace social capital is a relational network that is configured by interactions among healthcare professionals. Although, various attributes influence these interactions, Relational Network, Trust, Shared Understanding, Reciprocity and Social Cohesion are considered as the major attributes. A healthy relational network creates a healthy workplace which can be further fortified by effective communication, active group engagements and a supportive leadership.
Conclusions
Results of our concept analysis should establish a theoretical groundwork for nurse leaders to better build and more effectively lead the contemporary nursing workforce.
Implication for Nursing Management
Leaders’ dedication to workplace social capital is the tenet of a constructive workplace, which in return can support nurses to flourish in their clinical and the other professional responsibilities.
Chemical compounds from plants have been used as a medicinal source for various diseases. Aromachology is a unique field that studies the olfactory effects after inhaling aromatic compounds. ...Aromatherapy is a complementary treatment methodology involving the use of essential oils containing phytoncides and other volatile organic compounds for various physical and mental illnesses. Phytoncides possess an inherent medicinal property. Their health benefits range from treating stress, immunosuppression, blood pressure, respiratory diseases, anxiety, and pain to anti-microbial, anti-larvicidal, anti-septic, anti-cancer effects, etc. Recent advancements in aromatherapy include forest bathing or forest therapy. The inhalation of phytoncide-rich forest air has been proven to reduce stress-induced immunosuppression, normalize immune function and neuroendocrine hormone levels, and, thus, restore physiological and psychological health. The intricate mechanisms related to how aroma converts into olfactory signals and how the olfactory signals relieve physical and mental illness still pose enormous questions and are the subject of ongoing research. Aromatherapy using the aroma of essential oils/phytoncides could be more innovative and attractive to patients. Moreover, with fewer side effects, this field might be recognized as a new field of complementary medicine in alleviating some forms of physical and mental distress. Essential oils are important assets in aromatherapy, cosmetics, and food preservatives. The use of essential oils as an aromatherapeutic agent is widespread. Detailed reports on the effects of EOs in aromatherapy and their pharmacological effects are required to uncover its complete biological mechanism. This review is about the evolution of research related to phytoncides containing EOs in treating various ailments and provides comprehensive details from complementary medicine.
Aromatherapy is one of the complementary therapies to improve health. The aromatic essential oils have been used in the treatment procedure through inhalation of essential oil vapor, massage, and ...herbal bathing. Litsea species are generally used in traditional medicine, and Litsea cubeba (Lour.) Persoon is a potent fumigant plant, used in cosmetics and foods as essence. The chemical composition of the essential oil of different parts of L. cubeba has been found to be varied. L. cubeba essential oil (LEO) is known for the treatment of cognition-associated discomforts. The current study assessed the impact of inhalation of LEO on mood states and salivary cortisol levels of healthy people. Fifteen healthy volunteers were involved in the study. The Profile of Mood States (POMS) Questionnaire and ELISA methods were employed to determine the mood states and salivary cortisol level, respectively. (-)-β-pinene, β-citral, cis- and trans-citral, citronellal, limonene, linalool, and 6-methyl-5-hepten-2-one were detected in LEO by GC-MS analysis. The heart rate and blood pressure were not affected significantly during LEO exposure. The inhalation of LEO significantly improved the total mood disturbance and reduced the confusion among the healthy human subjects. LEO inhalation reduced the salivary cortisol level at a notable level. The results of the current study warrant further studies on the beneficial effect of LEO aromatherapy in healthy and diseased subjects to uncover the therapeutic nature of the L. cubeba plant.
The study aimed to compare nurses’ quality of life and investigate key determinants among Asian countries with different economic status. A cross-sectional survey was conducted across five Asian ...countries (Japan, Singapore, Malaysia, Thailand, and Bhutan). Quality of life (WHOQOL-BREF), job stress (National Institute of Occupational Safety and Health questionnaire), and demographic data were assessed. Stepwise multivariate linear regression analysis was performed to identify the key determinants of quality of life. Participants were 3,829 nurses (response rate: 82%) with a mean age of 33 ± 10 yr and majority were women (92%). Regarding quality of life, Bhutan yielded the highest scores, followed by Malaysia, Thailand, Singapore, and Japan, and these results were statistically significant. The key determinants that were significantly related to quality of life were “stress coping ability,” “life satisfaction,” “Japan,” “social support,” “job stress,” and “Singapore” (adjusted R2=0.46). In conclusion, nurses’ quality of life differs across Asian countries and is not linked to the country’s economic development. To maintain a good quality of life for nurses, an international exchange program like international nursing conferences for work environment and staff coping strategies is recommended to broaden institution’ minds and share experiences and exchange views to be able to realize their own problems and discover global solutions to them.
Abstract
Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration. Readiness ...for advance care planning is a patient’s preparedness to engage in advance care planning. This review aims to develop the conceptual framework for advance care planning readiness for Chinese older people. The current knowledge from the published studies was identified and synthesized by an integrative review. The conceptual framework was developed based on the social-ecological model and the theory of planned behavior. The factors from the social environment/community, health care professionals, and individual/family layers were defined. These factors may influence an individual’s medical decision-making, which in turn triggers individual behavioral mechanisms that arise from interactions between motivations, attitudes, and beliefs. Relevant factors should be considered when assessing the behavior of personnel engaged in advance care planning or formulating appropriate intervention measures to improve advance care planning participation in China. This framework can be used to guide studies that explore how the social/familial/individual factors predict the readiness for advance care planning among Chinese older people, and to design intervention studies to test the effect of family function on the readiness for advance care planning.
Primary health care (PHC) is usually the initial point of contact for individuals seeking to access health care and providers of PHC play a crucial role in the healthcare model. However, few studies ...have assessed the knowledge, ability, and skills (capacity) of PHC providers in delivering care. This study aimed to identify the capacity of PHC providers in countries of the Southeast and East Asian Nursing Education and Research Network (SEANERN).
A multi-national cross-sectional survey was performed among SEANERN countries. A 1-5 Likert scale was used to measure eight components of knowledge, ability, and skill of PHC providers. Descriptive statistics were employed, and radar charts were used to depict the levels of the three dimensions (knowledge, skill and ability) and eight components.
Totally, 606 valid questionnaires from PHC providers were returned from seven countries of SEANERN (China, Myanmar, Indonesia, Thailand, Vietnam, Cambodia, and Malaysia), with a responsive rate of 97.6% (606/621). For the three dimensions the ranges of total mean scores were distributed as follows: knowledge dimension: 2.78~3.11; skill dimension: 2.66~3.16; ability dimension: 2.67~3.06. Furthermore, radar charts revealed that the transition of PHC provider's knowledge into skill and from skill into ability decreased gradually. Their competencies in four areas, including safe water and sanitation, nutritional promotion, endemic diseases prevention, and essential provision of drugs, were especially low.
The general capacity perceived by PHC providers themselves seems relatively low and imbalanced. To address the problem, SEANERN, through the collaboration of the members, can facilitate the appropriate education and training of PHC providers by developing feasible, practical and culturally appropriate training plans.
Purpose: To determine the impact of nurse work environment and staffing on nurse outcomes, including job satisfaction and burnout, and on quality of nursing care.
Design: Secondary data analysis of ...the 2007 Thai Nurse Survey.
Methods: The sample consisted of 5,247 nurses who provided direct care for patients across 39 public hospitals in Thailand. Multivariate logistic regression was used to estimate the impact of nurse work environment and staffing on nurse outcomes and quality of care.
Findings: Nurses cared for an average of 10 patients each. Forty‐one percent of nurses had a high burnout score as measured by the Maslach Burnout Inventory; 28% of nurses were dissatisfied with their job; and 27% rated quality of nursing care as fair or poor. At the hospital level, after controlling for nurse characteristics (age, years in unit), the addition of each patient to a nurse's workload was associated with a 2% increase in the odds on nurses reporting high emotional exhaustion (odds ratio OR 1.02; 95% confidence interval CI 1.00–1.03; p < .05). Nurses who reported favorable work environments were about 30% less likely to report fair to poor care quality (OR 0.69; 95% CI 0.48–0.98; p < .05) compared with nurses who reported unfavorable work environments. The addition of each patient to a nurse's workload was associated with a 4% increase in the odds on nurses reporting quality of nursing care as fair or poor (OR 1.04; 95% CI 1.02–1.05; p < .001).
Conclusions: Improving nurse work environments and nurse staffing in Thai hospitals holds promise for reducing nurse burnout, thus improving nurse retention at the hospital bedside as well as potentially improving the quality of care.
Clinical Relevance: Nurses should work with management and policymakers to achieve safe staffing levels and good work environments in hospitals throughout the world.
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