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Aim and Objective: The purpose of this study was to generate a conceptual definition and theory of grief for nurses working on the frontlines during the COVID-19 pandemic using grounded theory methodology., Background: The COVID-19 pandemic has had a negative impact on nurses working on the frontlines. The increasing flow of diagnosed COVID-19 cases, diverse unknowns and demands in the treatment of patients with COVID-19, and depression related to countless deaths can trigger grief experiences., Design: A mixed methods approach, including the qualitative method of grounded theory and a quantitative 30-question survey, was used in this study., Methods: Eight focus group sessions were conducted with registered nurses working on the frontlines during the pandemic. Sessions were audio recorded and analysed using constant comparative data analysis. Following the interviews, a survey including demographics and self-report inventories was completed by participants. The COREQ checklist was used to assess study quality., Results: Major concepts that emerged include 'facing a new reality', 'frustrations', 'stress' and 'coping'. Core concepts were combined into a conceptual definition of grief and a grounded theory of the experience of nurses working on the frontlines during the pandemic. Cross comparisons of qualitative and quantitative findings were made and compared with the literature., Conclusions: This study provides a better understanding of the grief experience of nurses working on the frontlines during the COVID-19 pandemic. It is necessary to recognise professional grief and develop intervention strategies that lead to grief reconciliation., Relevance to Clinical Practice: Findings provide useful insights for healthcare administrators to provide support and develop interventions to reduce frustrations and stress of frontline registered nurses., Patient or Public Contribution: This study design involved registered nurses participating in focus group sessions. Participants detailed their experience working on the frontlines of the COVID-19 pandemic with patients, family and hospital administration., (© 2022 John Wiley & Sons Ltd.)

Purpose: The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT)., Design/methodology/approach: A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants' responses to the question "please tell us about the impact of your overall experience", which culminated in a combined corpus of 75,053 words., Findings: Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact., Research Limitations/implications: This in-depth qualitative evaluation of participants' feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice., Originality/value: Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments., (© Carmel Bond, Gemma Stacey, Greta Westwood and Louisa Long.)

Aim: This study explores perceptions of Continuing Professional Development (CPD) opportunities among stakeholders in the profession of nursing in Nepal., Design: Qualitative study using focus group discussions (FGDs)., Methods: Eight FGDs were conducted in three major cities of Nepal with nursing stakeholders including nurse managers, matrons and directors/managers of private and public nursing colleges, representatives of nursing organizations, government officials, nursing academics and practitioners from the government and private sectors. The data were analysed thematically using Creswell's six steps of analysis and the Standards for Reporting Qualitative Research (SRQR) guideline was followed., Results: The study generated three major themes: (a) policy level including the national situation of CPD, political influence and training guided by the policy; (b) organizational level incorporating perceptions towards forms of CPD, staff shortage, poor staff retention, seniority for training, financial constraints and lack of continuity of training; and (c) individual level including motivation for training and lack of relevant training., (© 2023 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Objective/Aim : To examine the experiences of culturally safe mentoring programmes described by Aboriginal and Torres Strait Islander nurses and midwives in Australia. Design : A systematic scoping review. Data Sources : The following databases were accessed: CINAHL Plus with Full Text (EBSCO), EMCARE (Ovid), MEDLINE (Ovid), INFORMIT (Health Collection/Indigenous Collection) and SCOPUS. Support relating to key words and appropriate databases was provided by a university librarian. Review Methods : Search terms across databases were sourced from 1997-2021, identifying a total of 161 papers. Title/abstract searches were screened against the inclusion/exclusion criteria, resulting in 18 papers reaching full-text review. Of the 18 full-text papers reviewed, six were eligible for inclusion in the final review. Results/Findings : Culturally safe mentorship was a positive experience for Aboriginal and Torres Strait Islander nurses and midwives. Thematic discussion identified three key themes: Mentorship as a way forward, Culture in mentorship, and Cultural safety's role in mentorship . Discussion : Culturally safe mentoring has been a key recommendation in the nursing literature for over 20 years. There is limited knowledge on what constitutes an effective programme as mentoring programmes have not been empirically evaluated or reviewed. Conclusion : This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability. Impact Statement : This review indicates that culturally safe mentoring has been a key recommendation in nursing literature for over 20 years. This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability. However, there is limited knowledge of what constitutes an effective programme, as mentoring programmes have not been empirically evaluated or reviewed providing an opportunity for further research. Plain Language Summary : Little is known about Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. However, mentoring programme are seen as a key workforce retention strategy. This scoping review aims to explore and interpret Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. This review concludes that mentoring programmes require content in Cultural Safety and that programmes need to be empirically evaluated.

Aims and Objectives: To examine if the professional support that fathers received from midwives and child health nurses was associated with improvements in fathers' coparenting. A secondary aim was to investigate if there were any support differences between fathers based on parity., Background: Stronger coparenting is associated with improved maternal, paternal and child health. It is unclear if routine prenatal and postnatal professional support is associated with improved coparenting in fathers of infants., Design: Cross-sectional online survey., Methods: In total, 612 fathers of infants (aged 0-24 months) completed baseline data between November 2018 and March 2020. Socio-demographics, pregnancy control variables, social support, professional support, being invited to attend and attending three specific visits for fathers, respectively, and the fathers' coparenting relationship, using the Brief Coparenting Relationship Scale, were assessed. The STROBE checklist was used as the reporting guideline for this study., Results: Fathers' attendance at child health visits, support from the prenatal and postnatal midwife, respectively, and total support from the child health nurse, are associated with more positive coparenting. Primiparous fathers reported more received social and professional support, as well as a more positive coparenting relationship than multiparous fathers., Conclusions: Receiving clinical support from both midwives and child health nurses is associated with fathers' positive coparenting. All fathers should be invited and encouraged to attend prenatal, postnatal and child health visits to further support their coparenting relationship. Relative to primiparous fathers, multiparous fathers may require targeted and additional clinical support regarding their coparenting relationship., Relevance to Clinical Practice: With fathers becoming more involved in childrearing, having stronger coparenting skills can help them better adapt to their parental roles. Our findings help understand how routine professional support from midwives and child health nurses are experienced among new fathers and that multiparous fathers are in further need of coparenting support., (© 2022 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Aim: The aim of this paper is to describe the strategies used by nurses and midwives to cope with experiences of dealing with perinatal death and maintain their satisfaction at work., Design: Systematic literature review, in accordance with the PRISMA Declaration., Data Sources: (2000-2021) Web of Science, PubMed, Scopus, CINALH and Dialnet, for articles in English and Spanish from the period between January 2000 and March 2021., Review Methods: The outcome of the review was the perceptions of nurses and midwives who have cared for people in a situation of perinatal loss., Results: Thirteen studies were identified that evaluated the attitudes, experiences and needs of these healthcare professionals. The combined size of all samples was 2196 participants., Conclusions: The negative effects on these professionals' satisfaction with their situation at work could be mitigated by covering their needs for knowledge, experience, and emotional and technical skills to deal with such events., Impact: As potential protective factors against dissatisfaction in nurses and midwives during perinatal death experiences, we identified older age and experience in perinatal care and coping strategies based on communicating one's feelings to peers, empathetic listening to the families cared for, training and institutional support. No Patient or Public Contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Midwives (M) and obstetric nurses (ON) play a critical role in providing healthcare for pregnant patients at all stages of pregnancy, and ongoing training and education are essential to ensure the best outcomes. This longitudinal quantitative research study aimed to assess the impact of an educational program on the knowledge, attitudes, and practices of 125 midwives and obstetric nurses regarding care for patients with gestational diabetes and pregnancy-induced hypertension. The original questionnaire consisted of 56 items grouped into 3 subscales assessing knowledge (15 items), attitudes (18 items), and practices (23 items). The questionnaire was administered at three distinct intervals during the educational program: pre-test, post-test, and follow-up at three months. The data were analyzed using ANOVA and Pearson correlation coefficients to determine the significance of the differences between the 3 moments of the administration of the questionnaire. There was a significant increase in the level of knowledge, attitudes, and practices of midwives and obstetric nurses following the training module, which was sustained at 3 months after completion compared to pre-training. The comparative analysis of the total scores for every 3 sets of items revealed the positive impact of the educational program on the level of knowledge, attitudes, and practices of midwives and obstetric nurses., Competing Interests: The authors declare no conflict of interest., (©2023 JOURNAL of MEDICINE and LIFE.)

Aim: This study determined the prevalence and key determinants of burnout among nurses and midwives in Kumasi, Ghana., Design: Hospital-based cross-sectional study., Method: A questionnaire was used to obtain data from 391 nurses and midwives at a tertiary hospital in Kumasi, Ghana using simple random sampling., Results: About 84.4% of the participants were females. The majority of the study participants experienced low burnout for all dimensions (58% in emotional exhaustion, 55.5% poor personal accomplishment and 38.3% depersonalization). Multiple regression analysis revealed that high emotional exhaustion was independently predicted by post-graduate education (β = 6.42, p = .003), lack of support from management (β = 2.07, p = .024), dislike for leadership style, (β = 3.54, p < .001) and inadequate number of staff (β = 2.93, p = .005). Age (β = 0.35, p = .004), lack of support from management (β = 1.60, p = .012), and inadequate number of staff (β = 1.49, p = .034) independently predicted high depersonalisation. Female sex (β = 4.36, p < .001) and years of practice (β = -0.26, p < .001) independently predicted low personal accomplishment., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: The purpose of this study was to explore the perceived benefits and challenges of online distance education and computer-based testing (CBT) among registered nurses and midwives in a sample of government-owned health facilities and health training institutions in Ghana., Design: Exploratory descriptive qualitative design., Methods: Individual semi-structured interviews were conducted with 45 participants (i.e. 25 nurses and 20 midwives). The data were manually processed and analysed using Braun and Clarke's thematic analysis approach (November 2019-February 2020)., Results: Nurses and midwives prefer online distance education for three reasons: convenience, cost-effectiveness and learning centre proximity to the workplace. The course schedule's flexibility allowed participants to work and study simultaneously. Others acknowledged online distance education as a viable option for overcoming the challenges of obtaining study leave. However, the lack of recognition of certificates by some employers, poor Internet connectivity and perceived excessive course load were noted as deterrents. Regarding the CBT, many of the participants said that it was useful. Among the advantages of CBT are: (1) a decrease in examination malpractices, (2) a decrease in examination costs and (3) a rise in students' interest in information, communication and technology (ICT). This finding emphasizes the necessity of integrating ICT into nursing and midwifery education and examinations, as well as maximizing its benefits., (© 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Introduction: the World Health Organization (WHO) declared COVID-19 a pandemic in January 2020, which has spread to many countries, including Zambia. Zambia has had challenges in providing personal protective equipment (PPEs) to nurses and midwives. The study's objective was to assess the availability and accessibility of PPEs among nurses and midwives caring for women in the general hospitals in Lusaka, Zambia., Methods: a cross-sectional analytical study design was conducted at five general hospitals in Lusaka on 162 nurses and midwives between February and April 2021, selected by purposive sampling of study sites and simple random sampling to select the participants. Data was collected using a semi-structured self-administered questionnaire and analyzed in STATA version 13. Chi-square and Fisher's exact test were used to test associations between the independent variables and the outcome, and a multivariable logistic regression was used to investigate the predictors of accessing PPEs., Results: out of the 162 who participated in the study, 48.8% were nurses, while 51.2% were midwives. Only 10% (16/160) of the participants reported having enough PPEs at work. Age, marital status, PPE use, employment duration, and protection confidence were associated with accessibility (P<0.05)., Conclusion: overall, there was an inadequate provision of PPEs in the health facilities putting the nurses and midwives at a high risk of acquiring COVID-19. Policymakers need a deliberate move to make the availability and accessibility of PPEs a reality during the pandemic., Competing Interests: The authors declare no competing interests., (Copyright: Sebean Mayimbo et al.)

Aims: To use nurses' descriptions of what would have improved their working lives during the first peak of the COVID-19 pandemic in the UK., Design: Analysis of free-text responses from a cross-sectional survey of the UK nursing and midwifery workforce., Methods: Between 2 and 14 April 2020, 3299 nurses and midwives completed an online survey, as part of the 'Impact of COVID-19 on Nurses' (ICON) study. 2205 (67%) gave answers to a question asking for the top three things that the government or their employer could do to improve their working lives. Each participants' response was coded using thematic and content analysis. Multiple response analysis quantified the frequency of different issues and themes and examined variation by employer., Results: Most (77%) were employed by the National Health Service (77%) and worked at staff or senior staff nurse levels (55%). 5938 codable responses were generated. Personal protective equipment/staff safety (60.0%), support to workforce (28.6%) and better communication (21.9%) were the most cited themes. Within 'personal protective equipment', responses focussed most on available supply. Only 2.8% stated that nothing further could be done. Patterns were similar in both NHS and non-NHS settings., Conclusions: The analysis provided valuable insight into key changes required to improve the work lives of nurses during a pandemic. Urgent improvements in provision and quality of personal protective equipment were needed for the safety of both workforce and patients., Impact: Failure to meet nurses needs to be safe at work appears to have damaged morale in this vital workforce. We identified key strategies that, if implemented by the Government and employers, could have improved the working lives of the nursing and midwifery workforce during the early stages of the COVID-19 pandemic and could prevent the pandemic from having a longer-term negative impact on the retention of this vital workforce., Patient or Public Contribution: No Patient or Public Contribution, due to the COVID-19 Pandemic, urgency of the work and the target population being health and social care staff., (© 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: Parents who experience involuntary pregnancy loss encounter nurses and midwives when requiring care. But the environment in which this attention is provided turns it into a stressful and challenging event that favours the concealment of emotions. Literature supports the development of compassion in nurses and midwives who tend to parents who experience pregnancy losses., Aim: To synthesise the emotional experiences of midwives and nurses when caring for parents who have suffered an involuntary pregnancy loss., Method: This is a synthesis of qualitative studies following Noblit and Hare's interpretive meta-ethnography. Eleven studies met the research objective and inclusion criteria., Results: An overarching metaphor, 'Unravelling the grief of loss', accompanied by four major themes provided interpretive explanations to the experiences of midwives and nurses in caring for involuntary pregnancy losses: 'Pulling the thread' - looking for the meaning of loss; 'Yarn entanglement degree' - determinants for grief expression; 'Detangling tools' - focusing on the loss; and 'Fraying the thread' - moving away from the loss., Discussion: The provision of whole care to these parents requires midwifery and nursing training and continued education. Furthermore, the organisational culture should prioritise the health and well-being of midwives and nurses., Conclusion: Midwives and nurses encounter the parents' loss in care and personally in various ways and give meaning to the loss conditioned by personal and professional determinants. They unravel the grief of loss by looking for the meaning, expressing their grief, focusing and moving away from the loss., (© 2021 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.)

Aims: To measure registered nurses', registered midwives', and nursing and midwifery students' current levels of knowledge, attitude and practices related to intimate partner violence., Background: Nurses and midwives whether registered or students need to be confident and competent in identifying and responding to intimate partner violence., Design: A cross-sectional survey., Methods: Data were collected through online surveys using the Physician Readiness to Manage Intimate Partner Violence Survey. Descriptive and inferential statistics were used to analyse the data., Results: Nursing and midwifery students were less knowledgeable and prepared than nurses and midwives. Midwives had more positive attitudes compared with nurses towards women experiencing intimate partner violence., Conclusions: Heath care institutions and regulatory bodies should provide resources and support to nursing and midwifery professionals. Personal experiences of domestic abuse and professional experience of supporting victims of domestic abuse/intimate partner violence affected practitioner's abilities to identify and manage intimate partner violence., Implications for Nursing Management: Nurse and midwifery managers can ensure that clinical and organisational policies and protocols are revisited and updated regularly and that interdisciplinary collaboration is promoted and emphasized for prompt identification and management of intimate partner violence., (© 2021 John Wiley & Sons Ltd.)

The current study on the intention to leave the organization among nurses and midwives aligns with the broader direction of research on the consequences of demanding jobs. This is particularly important in the context of the COVID-19 pandemic, which began in 2020 and is ongoing. The aim of the current study was to identify the levels of intention to leave the organization and job satisfaction in a sample of 390 Polish nurses and midwives. A multiple stepwise linear regression was carried out to establish which variables are predictors of job satisfaction and intention to leave the organization. The following measures were used in the study: Nurses' Occupational Stressor Scale, The Brief Resilience Coping Scale, The Turnover Intention Scale, The Job Satisfaction Scale, and an occupational questionnaire (number of workplaces, weekly number of evening and night shifts, working at a unit dedicated to treating COVID-19, working as a supervisor/executive). The current study showed that almost 25% of the sample reported high turnover intention, and a similar proportion reported low job satisfaction. Resilience was related to nurses' job satisfaction. In the predictive models for job satisfaction, the organizational factor of the number of workplaces was significant (positively related), while job experience was a negative predictor of intention to leave. The practical implications of the results and the need to continue research on this topic are also discussed.

Aim: To explore the experiences of female registered nurses (RNs), who encounter workplace gender discrimination in nursing., Design: This study used a qualitative exploratory design informed by feminist perspectives and was underpinned by social constructionism., Methods: Women who were RNs (N = 10) and employed in New South Wales (NSW) were purposively selected to convey their experiences of workplace gender discrimination. Data were collected through semi-structured interviews, between April and July 2020. Analysis was guided by the work of Anderson and Jack (Women's words; 1991) who recommend three ways of listening. Interviews were transcribed verbatim and Braun and Clarke's (Qualitative Research in Psychology, 3, 77-101; 2006) six-step guide was used to develop themes., Results: Thematic analysis revealed five overarching themes: It's a man's world; Gender stereotypes; Being a woman and nurse; Reluctance to call out gender discrimination and The status quo. Findings from this study highlighted that participants believed men's career progression in nursing were favoured over women., Conclusion: Findings from this research highlight that socially constructed gendered norms continue to form the basis of inequality for women in the workplace. Fostering and sustaining workplace cultures that support family and work life balance, and that do not discriminate against women, is fundamental to ensuring equality for women., Impact: There is limited qualitative research into women's experiences of workplace gender discrimination in nursing. This research highlights the need for workplace strategies to be implemented to ensure women are better supported and equally represented in leadership positions and advanced practice roles in nursing. All nurses should be given equal consideration based on experience and qualifications. Career development and progression opportunities should be fair, equitable and transparent with clearly documented criteria., (© 2021 John Wiley & Sons Ltd.)

Aims: To explore nurses' and midwives' perspectives of safety climate in Austrian hospitals as measurable elements of safety culture and to identify areas of quality improvement., Background: Due to close contact with patients, nurses and midwives play a vital role in ensuring patient safety., Method: An online survey among 713 nurses and midwives was conducted, using the 19-item Safety Climate Survey (SCS). To answer the survey, a 5-point Likert scale was provided with higher ratings indicating a more positive safety climate., Results: Results demonstrate a positive safety culture (MD 4.09, SD 0.53). Significant group differences in overall safety climate score could be found regarding nurses and midwives in managerial positions, between gender and participants age with low effect size. High item missing rates focus aspects on management/leadership, institutional concerns, leadership by physicians, and handling of adverse events. In addition, these items present the lowest ratings in safety climate., Conclusion: Results indicate potentials for optimization in the areas of leadership communication and feedback, the handling of safety concerns, and visibility or improvement of patient safety strategies., Implications for Nursing Management: A regular, standardized safety climate measurement can be a valuable tool for nurse managers and (political) decision-makers to manage patient safety initiatives., (© 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.)

Background: Nurses are expected to make and implement autonomous decisions to provide patients with excellent quality nursing while practicing complex, high-level care. However, studies have shown that nursing practice based on autonomous decision-making is difficult, and a gap exists between decision-making and implementation., Research Question/aim/objectives: This study aims to clarify trends among nursing professionals who recognize they are practicing ethical behavior in their nursing practice., Research Design/participants and Research Context: We surveyed the basic attributes of and used the Ode's Ethical Behavior Scale for Nurses with 3467 nursing professionals working at 34 hospitals in suburban cities of Japan and investigated the relationships among these factors., Ethical Considerations: This study was approved by the appropriate research ethics committee. The Ethical Behavior Scale for Nurses was used with the authors' permission., Findings/results: Significant differences were found in the mean "ethical behavior" scores between nurses and licensed practical nurses and midwives and licensed practical nurses. Mean scores for the "justice" subscale differed significantly between the low experience group and mid-level experience group and between the high experience group and mid-level experience group. Significant differences were also found in the mean scores between those with ethics education experience and those without, those with ethics training experience and those without, and those with ethics conference experience and those without., Discussion: Midwives and nurses had higher ethical behaviors than licensed practical nurses. Nursing professionals with low and high experience had higher justice scores than those with mid-level experience. Finally, nursing professionals with ethics education, training, or conference experience had higher ethical behavior than those without such experience., Conclusion: Nursing professionals who recognize they are practicing ethical behavior tend to be midwives or nurses with low or high levels of experience who attended ethics education, training, or conferences.

Nurses and midwives are integral to public health promotion; in the UK, they are advised to act as role models by their governing body, but overweight or obesity rates are high. We explored whether obesity and dietary habits are related to attitudes towards healthy role modelling and health promotion practice. A total of 346 pre-registered UK nurses and midwives (92.6% female; 18-53 years) completed an online survey. Items included body composition, dietary habits assessed by the Lifestyle Behaviour Questionnaire (LBQ), attitudes towards being role models for health (RA: role attitudes) and attitudes toward health promotion practice (ATHPP): 33.8% of the sample self-reported as overweight or obese; 67.6% did not consume 5-a-day portions of fruit/veg; 31.5% reported a healthy diet; and 89.6% believed their diet could be healthier. Positive RA was significantly linked to health promotion engagement (HP) (ß = 0.33, p < 0.001). Positive ATHPP was significantly predicted by lower BMI (ß = -0.08, p = 0.078), positive RA (ß = 0.67, p < 0.001), lower HP (ß = -0.25, p < 0.001) and male gender (ß = 0.09, p = 0.02). Greater confidence in patients valuing healthcare professional's advice was predicted by healthier diet (ß = 0.11, p = 0.03), lower BMI (ß = -0. 16, p < 0.01), more positive RA (ß = 0.14, p < 0.01) as well as HP engagement during training (ß = 0.20, p < 0.01). One's own motivation to promote health, similarly to ATHPP, was predicted by RA (ß = 0.17, p = 0.001) and previous HP engagement (ß = 0.39, p < 0.001). Findings show that overweight and obesity are prevalent in pre-registered nurses and midwives; the majority did not consume a healthy diet. Individual's body composition, diet and attitudes towards role modelling are positively associated with their attitudes towards, and confidence in, health promotion practice. Experiences of health promotion practice during training can have either a positive or a negative influence on attitudes. Mentors and educators could actively promote healthy lifestyles for pre-registered nurses and midwives and facilitate more opportunities for health promotion practice during placements, which includes time for reflection.

Aim: To identify factors influencing healthcare professionals' engagement in health behaviour conversations with patients., Design: Cross-sectional survey., Methods: Between April and June 2019, an online survey of 1338 nurses, midwives and healthcare support workers was conducted. The survey assessed whether staff felt comfortable initiating health behaviour conversations with patients about five behaviours (reducing alcohol intake; stop smoking; being more active; reducing their weight; and improving their diet) and barriers to conversation initiation. Health professionals' own health-related behaviours, self-rated health and mental wellbeing, and socio-demographic characteristics were recorded. Logistic regression models were built to assess factors associated with feeling comfortable initiating health behaviour conversations for each topic., Result: Less than 50% of respondents reported feeling comfortable initiating health behaviour conversations with patients. Female staff, young professionals (18 to 29 years), those in lower staff grades and those with poorer health and low mental wellbeing were less likely to report feeling comfortable having health behaviour conversations across all topics. Those who did not adhere to physical activity and dietary guidelines were less likely to initiate a conversation about being more active and having a healthy diet, respectively. Not having time to discuss the topic, suitable space to hold a conversation, and feeling worried about offending/upsetting patients were the main barriers reported., Conclusion: Around 6 in 10 members of the nursing, midwifery and healthcare support workforce in Wales potentially do not feel comfortable to initiate a health behaviour conversation with patients about health and wellbeing. Feeling less comfortable to initiate a conversation was associated with staff demographics and organizational factors., Impact: We identified those less likely to initiate health behaviour conversations as well as personal and organizational barriers to initiation. This will help to target and tailor interventions to ensure staff are equipped and enabled to hold health behaviour conversations with patients., (© 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: To evaluate the effectiveness of nurses and midwives-led psychological interventions on the perinatal depressive symptoms., Design: A systematic review and meta-analysis based on the PRISMA guidelines., Methods: Six databases were searched, including PubMed, MEDLINE, Cochrane Library, EMBASE, Web of Science and CINAHL. The search date range was before 30 September 2019. We used the Cochrane risk of bias tool to evaluate the quality of the included studies and Review Manager software 5.3 to conduct a meta-analysis. The data were pooled using a random-effect model., Results: Studies (N = 827) were retrieved with 12 studies included. Psychological interventions provided by nurses and midwives have a significant effect on reducing perinatal depressive symptoms (RR: 0.72, 95% CI [0.64-0.82]). Among the approaches of psychological intervention, supportive counselling was the most effective (RR: 0.58, 95% CI [0.42-0.80]). The best intensity of intervention was six to eight sessions (RR: 0.66, 95% CI [0.55-0.79])., (© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.)

Aim: To synthesize qualitative evidence on nurses' and midwives' experiences in the provision of surgical abortion care. We address three specific questions: (a) what are the experiences of nurses and midwives in surgical abortion care? (b) what are their responses and coping strategies? (c) what are the deficiencies in surgical abortion care?, Design: Qualitative studies were synthesized using Thomas and Harden's qualitative thematic synthesis method., Data Sources: Electronic databases, including PubMed, Embase, CINAHL, PsycINFO, Scopus and Web of Science were searched. Grey literature using ProQuest was searched. The databases were searched from inception to 5 August 2020., Review Methods: The SPIDER (Sample, Phenomenon of Interest, Design, Evaluation and Research type) search tool was used in the literature search. Data synthesis was conducted using the three-stage thematic synthesis method described by Thomas and Harden., Results: 966 studies were identified in the initial search and 18 studies were included. Four analytical themes were generated: 'Providing abortion care requires high emotional labour'; 'Professionalism of abortion care providers'; 'Initiatives in professional development' and 'Improving directions for high-quality abortion care'., Conclusion: Nurses and midwives indicated that they require support to enhance psychological health and improve professional skills. Hospital managers should organize regular debriefing or structured group workshops for exchange of practical experiences and strengthening emotional support. More research is required to establish comprehensive training related to abortion care for nurses and midwives. The findings demonstrate that optimization of abortion services should start from hospital management models, pain management and bereavement care., Impact: Understanding the experiences of nurses and midwives in abortion provision will inform future clinical practice in surgical abortion care, which would be helpful in improving the professionalism and confidence of abortion providers. Our findings have implications for the training, development of policies and standards for surgical abortion care for nurses and midwives., (© 2021 John Wiley & Sons Ltd.)

Objectives: To provide a comprehensive cross-sectional overview of published studies on perinatal bereavement care education programmes developed and tested with nurses and midwives., Design: A scoping review following the Arksey and Malley's framework., Data Sources: Eight electronic databases were searched in December 2020 without restriction on language and publication date: PubMed, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science, Scopus and ProQuest., Review Methods: All identified studies were reviewed by two reviewers based on the article title and abstract screening. Full-text articles were assessed according to the inclusion criteria. Original studies that reported on perinatal bereavement care education for nursing and midwifery students or clinical nurses and midwives were included., Results: Eighteen studies out of 817 articles were included. Perinatal bereavement care knowledge and skills, improvement in clinical skills in abortion care and psychological support for nurses and midwives are three core elements of the education content. Workshops and debriefing are the most frequently used formats. The duration mostly ranges from a half day to 3 days. Knowledge, confidence, satisfaction and relevant psychological variables such as posttraumatic stress symptoms are frequently used to evaluate the education programme's effectiveness. Most studies chose to use self-designed questionnaires as measurement tools. Nurses and midwives reported both positive experiences and improvement suggestions for perinatal bereavement care education programmes., Conclusions: This scoping review highlights the benefits of implementing education programmes for preparing nurses and midwives for perinatal bereavement care in the context of universities and hospitals. Longitudinal randomized controlled trials or quasi-experiments could further investigate the effectiveness of a more enhanced perinatal bereavement care education programme with a longer intervention time using valid and reliable evaluation tools., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Aims: To synthesise the existing literature, which focuses on the impact of critical incidents on nurses and midwives, and to explore their experiences related to the support they received in the current healthcare environment to move on from the event., Design: Systematic review and qualitative synthesis., Data Sources: The electronic databases CINAHL, MEDLINE, PsycINFO, PubMed, Embase and Nursing and Allied Health (ProQuest) were systematically searched from 2013-2018, and core authors and journals identified in the literature were manually investigated., Review Methods: Qualitative studies of all research design types written in English were included according to the PRISMA reporting guidelines. The methodological quality of included studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research., Results: A total of 7,520 potential publications were identified. After removal of duplicate citations, study selection and appraisal process, 11 qualitative primary research papers progressed to the meta-synthesis by meta-aggregation. The 179 findings and sub-findings from the included studies were extracted, combined and synthesised into three statements addressing three different aspects within the context of critical incidents: the experiences of the impact, the perceptions of support and the ability to move on., Conclusion: This review illuminated that moving-on after critical incidents is a complex and wearisome journey for nurses and midwives. More attention should to be drawn to second victims within general nursing and midwifery practice to strengthen their ability to navigate the aftermath of critical incidents and reclaim the professional confidence indispensable to remain in the workforce., (© 2020 John Wiley & Sons Ltd.)

Objectives: This study aimed to examine the attitudes and awareness of Iranian clinical nurses and midwives towards telenursing and telehealth also referred to as e-health., Methods: The cross-sectional study was conducted from February to August 2019 in Iran. Nurses and midwives were randomly recruited from hospitals affiliated with Mashhad University of Medical Sciences in Mashhad, Iran using a stratified cluster random sampling method. Data were collected using a reliable and valid Persian-language questionnaire consisting of 32 close-ended survey items to examine Internet/computer access, daily Internet use and awareness of and general attitude towards telehealth and telenursing; statistical analyses were performed., Results: A total of 523 nurses and midwives were included in this study (response rate: 94.4%). The mean age and duration of clinical practice were 33.36 ± 7.46 and 8.88 ± 6.73 years, respectively. The majority of participants recognised the definition of telenursing (66.7%) and telehealth (80.1%). A positive attitude towards telenursing and telehealth was reported by 73.0% of the participants. Clinical nurses and midwives with a master's degree were more aware of the definition of telehealth compared to those with undergraduate bachelor degrees ( P = 0.03). Additionally, midwives significantly more frequently presented a positive attitude towards telehealth and telenursing compared to nurses (86.2% versus 71.2%; P = 0.01)., Conclusion: The positive attitude of the current participants was an important factor in the promotion of telenursing and telehealth. The implementation of educational and infrastructure developmental programs can help speed up executional processes in these fields., Competing Interests: CONFLICT OF INTEREST The authors declare no conflicts of interest., (© Copyright 2021, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Aim: To determine the impact of the Best Practice Spotlight Organization® initiative on nurses' perception of their work environment and their attitudes to evidence-based practice., Design: Quasi-experimental, multicentre study. The intervention is the participation in Best Prectice Spotilight Organizations to implement Best Practice Guidelines., Methods: The study will include seven centres in the interventional group and 10 in the non-equivalent control group, all of them belonging to the Spanish national health system. The Practice Environment Scale of the Nursing Work Index, and the Health Sciences Evidence-Based Practice Questionnaire will be administered to a sample of 1,572 nurses at the beginning of the programme and at 1 year. This 3-year study started in April 2018 and will continue until December 2021. Statistical analyses will be carried out using the SPSS 25.0. This project was approved by the Drug Research Ethics Committee of the Parc de Salut Mar and registered in Clinical Trials., Discussion: The study findings will show the current state of nurses' perception of their work environment and attitudes to evidence-based practice, and possible changes in these parameters due to the programme., Impact: The findings could provide a strong argument for health policymakers to scale up the Best Practice Spotlight Organization® initiative in the Spanish national health system., (© 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: Good attitude on collaborative care between nurses and midwives with physicians is crucial for better team working. This further enables those vital health care professionals to provide quality and improved care for their clients., Objective: To assess the attitude of nurses and midwives towards collaborative care with physicians in Jimma University medical center, Jimma, South West Ethiopia., Methodology: The institution-based cross-sectional study was conducted from March 20 to April 8, 2019, using a semi-structured and standardized questionnaire. Study units were selected by simple random sampling using the lottery method. A total of 410 participants were included in the study. Data were entered into Epi data version 4.2 and exported to statistical packages for social sciences version 23 for cleaning and further analysis. Descriptive statistics were presented with tables, figures, and narratives. The level of significance was set at a p value of less than 0.05 in multivariable logistic regression., Results and Conclusion: More than five out of ten, 234 (57.2%) of participants had a good (good attitude is defined in the operational definition section of methodology) attitude towards collaborative care with physicians, and the rest 175 (42.8%) poor attitude toward it. Participants had the highest median score in the shared education and teamwork (26.0) subscale and midwives were found to have higher mean rank scores compared to nurses. It was only in the nurse's/midwife's autonomy subscale that a statistically significant difference was found (Z = - 2.92, p value = 0.003). More generally, more than have of the participants had a good attitude on providing care collaboratively with physicians, though a significant proportion of nurses and midwives also rate collaborative care provision with physicians as poor., Recommendations: The findings of this study suggested that interventions are needed to be taken to improve nurse's and midwife's attitudes on the provision of collaborative care with physicians. Enhancement of shared education, cooperation rather than dominance and caring attitude are all vital. These all could in turn enhance the quality of care provided for clients.

The World Health Organization has designated 2020 as the Year of the Nurse and Midwife. With a predicted shortfall of more than nine million nurses and midwives by 2030, the World Health Organization has recognized the urgency of tackling the approaching workforce issues head on. The activities planned should provide a once in a generation opportunity to promote the nursing profession and address crucial issues, such as recruitment and retention, professional development and pay and conditions. The International Council of Nurses is working closely with its National Nursing Associations around the world and other key nursing and health organizations, to create a long-lasting legacy that will raise the profile of the profession with the public, boost its professional status, and make it sustainable in the future., (© 2019 International Council of Nurses.)

Aim: To explore the differences in perceived importance and actual performance of clinical leadership for all grades of nurses and midwives engaged in clinical practice., Background: Clinical leadership is central to the provision of person-centred care. However, little is known about how nurses and midwives perceive this in practice., Methods: Data were collected on a sample of nurses and midwives in the Republic of Ireland, using a cross-sectional study design (n = 324). The clinical leadership needs analysis instrument was used to measure perceived importance and performance of clinical leadership in practice. Grades of nurses/midwives included; staff, manager, advanced practitioner and senior manager., Results: Senior managers were more likely to report significantly higher scores than staff grades for perceived importance of Technology & Care Initiatives (p < .01) and Financial & Service Management (p = .02). Performance of Staff & Care Delivery was significantly higher for senior managers than staff grades [F(5,309) = 6.06 p < .01]., Conclusion: There was a mismatch between the perceived importance and actual performance of clinical leadership in practice between different grades of staff., Implications for Nursing Management: Leadership training for all grades and mentoring of staff grades can promote the building of confidence and empower staff in leading clinical practice., (© 2019 John Wiley & Sons Ltd.)

Insight into the involvement and professional development needs (PDNs) of non-mental health nurses and midwives with respect to promoting maternal mental health is necessary to integrate mental health services into primary healthcare delivery. Using a cross-sectional survey and self-report methodology, the study investigates the involvement, PDNs, knowledge and attitudes of 309 nurses and midwives in promoting maternal mental health in Ghana. Data were analyzed using descriptive and inferential statistics, namely Analysis of Variance, bivariate and logistic regression, and cluster analysis. The results showed that the majority of the participants (94%) indicated they were involved in promoting maternal mental health. Knowledge about maternal mental health correlated significantly with involvement in promoting maternal mental health (p < .05), whereas attitude towards maternal mental health did not. An overwhelming proportion of the participants (83%-94%) expressed profound interest in professional development education across a range of maternal mental health areas. Enhancing the mental health knowledge-base of nurses and midwives could contribute significantly to promoting maternal mental health., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Nurses and midwives are the largest component of the health workforce in many countries. The World Health Organization (WHO) together with its partners facilitates the joint development of strategic policy guidance for countries to support the optimization of their nursing and midwifery workforce. The Global Strategic Directions for Strengthening Nursing and Midwifery 2016-2020 (SDNM) is a global policy guidance tool that provides a framework for Member States, the WHO and its partners to adapt, develop, implement and evaluate nursing and midwifery policy interventions in Member States. As part of the broader monitoring and accountability functions of the WHO, assessing the progress of the SDNM implementation at a country level is key to ensuring that countries stay on track towards achieving universal health coverage (UHC) and the sustainable development goals (SDGs)., Methods: This is a cross-sectional mixed methods study involving the analysis of quantitative and qualitative data on the implementation of country-level interventions in the SDNM. Data was provided by government chief nursing and midwifery officers or their representatives using an online self-reported questionnaire. The quantitative data was assessed using a three-level scale and descriptive statistics while qualitative comments were analysed and presented narratively., Results: Thirty-five countries completed the survey. Summing up the implementation frequency of interventions across all thematic areas, 19% of responses were in the category of "completed"; 55% were reportedly "in progress" and 26% indicated a status of "not started". Findings reveal a stronger level of implementation for areas of nursing and midwifery development related to enhancing regulation and education, creating stronger roles for professional associations and policy strengthening. Leadership and interprofessional collaboration are intervention areas that were less implemented., Conclusion: Monitoring and accountability of countries' commitments towards implementing nursing and midwifery interventions, as outlined in the SDNM, contributes to strengthening the evidence base for policy reforms in countries. This stock-taking can inform policy- and decision-makers' deliberations on strengthening the contributions of nurses and midwives to achieving UHC and the SDGs.

There is a high prevalence of smoking among nursing personnel, despite the fact that nursing is a health care profession. In Japan there are 4 types of licensed nursing professionals. However, the prevalence of smoking among different types of licensed personnel has not been clarified. We attempted to clarify the prevalence of smoking among the various types of licensed nursing personnel and the factors associated with it. Among the members of the Japanese Nursing Association, 6000 nurses were randomly selected. The participants were sent a questionnaire on smoking habits, personal characteristics, lifestyle habits, and employment status by mail. Current smokers accounted for 1.3% of public health nurses, 4.0% of midwives, 8.2% of registered nurses, and 16.3% of assistant nurses. The license type of nursing personnel was a factor significantly associated with current smoking.

Aim: To explore nurses' and midwives' experiences of urinary symptoms at work., Background: Lower urinary tract symptoms are common in female nurses and midwives. There is limited understanding of the relationship between urinary symptoms, bladder health practices, and work., Design: Qualitative design providing in-depth exploration of nurses' and midwives' experiences of urinary symptoms at work through focus group discussions., Methods: Twelve focus groups were held July-September 2016 with 96 Registered Nurses and midwives working at two tertiary-referral hospitals in urban New South Wales, Australia. A semi-structured question schedule was used. An inductive process guided thematic analysis of data using a socioecological framework of health behaviours., Results: Nurses' and midwives' experiences of urinary symptoms at work primarily relate to delaying voiding. This practice is explained by a work culture of "patient-first" care at expense of self-care, relationships in the nursing team, demands of the nursing role, and inadequacy of workplace amenities. The first two themes reflect cultural and social caring dilemmas central to nursing. The second two themes identify issues with workforce management and physical workplace environments., Conclusion: Nurses' and midwives' urinary symptoms and behaviours in response to sensory cues for bladder emptying are dependent on several socioecological influences. Occupational health initiatives in the workforce are required to break cultural norms that deter self-care and to promote work environments that support healthy bladder practices. Workforce management and physical workplace environments are key influences on nurses' timely and dignified access to amenities., (© 2019 John Wiley & Sons Ltd.)

Background: Although patient safety and quality are cornerstones of healthcare practice, evidence is limited of the knowledge, skills and competence of practicing nurses and midwives in Ireland., Objectives: To investigate the perceptions of nurses and midwives regarding their continuing professional development-based preparedness for, and participation in quality and safety in the clinical setting., Design: A cross-sectional survey was undertaken across the Republic of Ireland in 2016 examining nurses and midwives' perceptions of their knowledge and skills in quality and safety methods and tools, their views of competence in this field using the domains from the Quality and Safety Education for Nurses (QSEN) framework (person-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), and their participation in practice related to their access to quality and safety data., Settings: 12 Health Service Executive (HSE) Centers of Nursing and Midwifery Education (CNMEs) in Ireland PARTICIPANTS: Practicing nurses and midwives (n = 654) working in acute hospitals and community healthcare organizations who were undertaking continuing professional development (CPD) education at the time of data collection (March-April 2016)., Methods: Survey methodology. 1787 surveys were distributed. Data were analyzed by IBM Statistical Package for the Social Sciences., Results: A response rate of 37% (n = 654/1787) was achieved. While respondents were highly trained academically, many reported a lack of confidence in quality and safety methods and tools and QSEN competencies. Frontline staff nurses and midwives reported they were less prepared than their mid and senior level colleagues. Significant numbers indicated they were not engaged in quality and safety in practice., Conclusions: This first nationwide study in Ireland has discovered that nurses and midwives perceive gaps in their preparedness to engage in quality improvement and patient safety in practice. To safeguard patient care, priority should be given to ensuring front-line staff are appropriately educated, have access to data, and time to competently participate in the continuous improvement of patient care., (Copyright © 2019. Published by Elsevier Ltd.)

Aim: The aim of this study is to report the development and psychometric testing of the clinical leadership needs analysis instrument (CLeeNA)., Background: Limited emphasis is placed on the clinical leadership needs of nurses and midwives that are fundamental to supporting the delivery of high quality, safe patient care., Methods: A development and validation study of CLeeNA was undertaken using cross-sectional data. A sample of 324 registered nurses and midwives completed the questionnaire using a 7-point adjectival scale. Principal component analysis was conducted to explore scale grouping of items (n = 103 items)., Results: Principal component analysis, item reduction and parallel analysis on the items of the instrument resulted in seven factors consisting of 56 items. These factors were identified as: Staff and Care Delivery; Technology and Care Initiatives; Self and Team Development; Standards of Care; Financial and Service Management; Leadership and Clinical Practice; Patient Safety and Risk Management., Conclusion: The identified factors are reflective of an ever-changing health care environment., Implications for Nursing Management: Potentially, after further testing, this instrument could be used by nursing management and educators to measure clinical leadership needs, inform the design of clinical leadership training programmes and provide valuable information about health care leadership development., (© 2018 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.)

Background: The article presents the Polish adaptation of the Conditions for Work Effectiveness Questionnaire II (CWEQ II), developed by Laschinger et al. The Conditions for Work Effectiveness Questionnaire II measures structural empowerment and is widely used in the research conducted among nurses and midwives. Structural empowerment is the ability to mobilize all available opportunities, information, resources and support in an organization. It refers to creating conditions which allow for individual development and provide access to decision-making processes. The aim of the study was to test psychometric properties of the Polish version of the CWEQ II and to verify the factor structure of structural empowerment in the Polish sample., Material and Methods: The participants were 279 nurses and midwives employed in hospitals and clinics. Items were translated from the original English version using the back-translation method., Results: The confirmatory factor analysis confirmed the best fit of the 6-factor model. The scales exhibit high internal consistency and satisfactory validity., Conclusions: In effect of the study, the Polish adaptation of the tool has been obtained, which shows satisfactory psychometric properties, suitable for evaluation of the level of empowerment in the case of nurses and midwives. Med Pr 2018;69(5):547-560., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Background: Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion., Method: We conducted a systematic review of ethical arguments asking, "What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?" We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000-2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection., Results: Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one (81) narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, "moral reasons" contained the largest number of narrow reasons (n =  58). The reasons and their associated mentions in this category outnumber those in the sum of the other three categories., Conclusions: We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals.

Objectives: To investigate the influence of work-related characteristics, health, health behaviours and symptoms on ingestible biologically-based Complementary and Alternative Medicine (CAM) use within the Australian nursing and midwifery workforce., Background: CAM use is widespread worldwide, but there is little research into nurses' and midwives' personal use of ingestible CAM in Australia., Methods: An online survey in 2014-15 used validated instruments and items to examine use of ingestible biologically-based CAM (herbs, foods and vitamins, minerals, amino acids, enzymes and other supplements), and the health and work-related characteristics of 5041 nurses and midwives recruited through the New South Wales Nurses and Midwives Association and professional networks., Results: A small proportion of nurses (6.8%) identified as personal CAM users. Most were female, older, worked in foundational roles (frontline Registered and Enrolled Nurses/Midwives) and used one CAM, most commonly a multivitamin, although Vitamin D, Fish Oil, Calcium and Glucosamine±Chondroitin were also common. In comparison to non-users, CAM users were less likely to take sick days or indulge in risky drinking, but more likely to be symptomatic (with stiff joints, bodily/joint pain, severe tiredness, allergies, indigestion/heartburn), diagnosed with osteoarthritis and to adhere to healthy diet recommendations., Conclusions: Findings showed a credible pattern of front line workers with physically demanding workloads that impact their physical health and are linked to frequent symptoms, using CAM treatments and achieving some success in being able to continue working and avoid sickness absence. Further investigation is warranted to protect and maintain the health of the nursing and midwifery workforce., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Aims: To determine the prevalence and severity of urinary incontinence (UI) in a group of female nurses and midwives, and to examine the relationship between UI, work and intention to leave current job., Methods: An electronic survey "Fit for the future" was distributed to nurses and midwives in NSW, Australia between May 2014 and February 2015. UI was investigated using the International Consultation on Incontinence UI-Short Form. Examined work characteristics included: work role, location, setting, contract, shift, job satisfaction, and plans to leave current job. Logistic regression modelling was performed to determine whether the severity of UI had an independent effect on intention to leave., Results: Of 5041 survey responses, 68.5% answered the question on urine leakage. Of the included female sample (n = 2,907) the prevalence of UI was 32.0% (95% CI: 30-34%): of these 40.5% experienced moderate and 4.4% "severe or very severe" symptoms. UI was more likely to be reported in nurses or midwives working part-time or days only (not shifts). Those with "severe or very severe UI" were more likely to indicate an intention to leave at 12 months (OR: 2.68; 95% CI: 1.18-6.06) than those with slight or moderate symptoms, after accounting for age, body mass index, parity, pelvic organ prolapse, anxiety, depression, work contract, shift, and job satisfaction., Conclusions: UI is a condition of high prevalence and significant severity in female nurses and midwives. In this workforce, severe UI was associated with intentions related to future employment., (© 2017 Wiley Periodicals, Inc.)

Aim: The aim of this study was to systematically review evidence relating to clinical supervision for nurses, midwives and allied health professionals., Background: Since 1902 statutory supervision has been a requirement for UK midwives, but this is due to change. Evidence relating to clinical supervision for nurses and allied health professions could inform a new model of clinical supervision for midwives., Design: A systematic review with a contingent design, comprising a broad map of research relating to clinical supervision and two focussed syntheses answering specific review questions., Data Sources: Electronic databases were searched from 2005 - September 2015, limited to English-language peer-reviewed publications., Review Methods: Systematic reviews evaluating the effectiveness of clinical supervision were included in Synthesis 1. Primary research studies including a description of a clinical supervision intervention were included in Synthesis 2. Quality of reviews were judged using a risk of bias tool and review results summarized in tables. Data describing the key components of clinical supervision interventions were extracted from studies included in Synthesis 2, categorized using a reporting framework and a narrative account provided., Results: Ten reviews were included in Synthesis 1; these demonstrated an absence of convincing empirical evidence and lack of agreement over the nature of clinical supervision. Nineteen primary studies were included in Synthesis 2; these highlighted a lack of consistency and large variations between delivered interventions., Conclusion: Despite insufficient evidence to directly inform the selection and implementation of a framework, the limited available evidence can inform the design of a new model of clinical supervision for UK-based midwives., (© 2017 John Wiley & Sons Ltd.)

Evidence suggests that black and minority ethnic (BME) midwives are more likely to face fitness to practise hearings than white registrants and BME NHS staff are less likely to be in senior positions. This literature review critically evaluates the literature published since a systematic review on the topic was conducted in 2005. It found that BME nurses and midwives, especially those who registered abroad and subsequently came to live and work in the UK are 'underemployed' and consequently expressed feelings of loss of self-confidence. This was further compounded by accounts of excessive scrutiny and punishment. Many felt excluded from white networks of power and opportunities for staff development and promotion. The literature also describes experiences of covert as well as overt racism between the white majority and BME staff as well as 'horizontal racism' between BME staff of differing ethnicities.

Background: As part of efforts to inform the development of a global human resources for health (HRH) strategy, a comprehensive methodology for estimating HRH supply and requirements was described in a companion paper. The purpose of this paper is to demonstrate the application of that methodology, using data publicly available online, to simulate the supply of and requirements for midwives, nurses, and physicians in the 32 high-income member countries of the Organisation for Economic Co-operation and Development (OECD) up to 2030., Methods: A model combining a stock-and-flow approach to simulate the future supply of each profession in each country-adjusted according to levels of HRH participation and activity-and a needs-based approach to simulate future HRH requirements was used. Most of the data to populate the model were obtained from the OECD's online indicator database. Other data were obtained from targeted internet searches and documents gathered as part of the companion paper., Results: Relevant recent measures for each model parameter were found for at least one of the included countries. In total, 35% of the desired current data elements were found; assumed values were used for the other current data elements. Multiple scenarios were used to demonstrate the sensitivity of the simulations to different assumed future values of model parameters. Depending on the assumed future values of each model parameter, the simulated HRH gaps across the included countries could range from shortfalls of 74 000 midwives, 3.2 million nurses, and 1.2 million physicians to surpluses of 67 000 midwives, 2.9 million nurses, and 1.0 million physicians by 2030., Conclusions: Despite important gaps in the data publicly available online and the short time available to implement it, this paper demonstrates the basic feasibility of a more comprehensive, population needs-based approach to estimating HRH supply and requirements than most of those currently being used. HRH planners in individual countries, working with their respective stakeholder groups, would have more direct access to data on the relevant planning parameters and would thus be in an even better position to implement such an approach.

Background: The objectives of this study were to understand the labour market dynamics among health workers, including their preferences and concerns, and to assess the skills, competence and performance (i.e. the 'know-do gap') of doctors working in Timor-Leste., Methods: This cross-sectional survey was implemented in all 13 districts of Timor-Leste in 2014. We surveyed 443 health workers, including 175 doctors, 150 nurses and 118 midwives (about 20% of the health workers in the country). We also observed 632 clinical consultations with doctors, including 442 direct clinical observations, and tested 190 vignettes., Results: The study highlights some positive findings, including the gender balance of health workers overall, the concentration of doctors in rural areas, the high overall reported satisfaction of staff with their work and high motivation, the positive intention to stay in the public sector, the feeling of being well prepared by training for work, the relatively frequent and satisfactory supervisions, and the good attitudes towards patients as identified in observations and vignettes. However, some areas require more investigations and investments. The overall clinical performance of the doctors was very good in terms of attitude and moderate in regard to history taking, health education and treatment. However, the average physical examination performance score was low. Doctors performed better with simulated cases than the real cases in general, which means they have better knowledge and skills than they actually demonstrated. The factors that were significantly associated with the clinical performance of doctors were location of the health facility (urban doctors were better) and consultation time (cases with more consultation time were better). Regression analysis suggests that lack of knowledge was significantly associated with lack of performance, while lack of motivation and equipment were not significant., Conclusions: The survey provides essential information for workforce planning and for developing training policies and terms and conditions that will attract and retain health workers in rural service. Improving the work environment and performance of doctors working in rural health facilities and ensuring compliance with clinical protocols are two priority areas needed to improve the performance of doctors in Timor-Leste.

Aim: To report a simultaneous and evolutionary analysis of the concepts of joy and long-term happiness., Background: Joy and happiness are underrepresented in the nursing literature, though negative concepts are well represented. When mentioned in the literature, neither joy nor happiness is adequately defined, explained, or clearly understood. To promote further investigation of these concepts in nursing and to explore their relationship with health and healing, conceptual clarity is an essential first step., Design: Concept analysis., Data Sources: The following databases were searched, without time restrictions, for articles in English: Academic Search Complete, Anthropology Plus; ATLA Religious Database with ATLASerials; Cumulative Index of Nursing and Allied Health Literature (CINAHL); Education Research Complete; Humanities International Complete; Psych EXTRA; and SocINDEX with Full Text. The final sample size consists of 61 articles and one book, published between 1978-2014., Method: An adapted combination of Rodgers' Evolutionary Model and Haase et al.'s Simultaneous Concept Analysis (SCA) method., Results: Though both are positive concepts, joy and happiness have significant differences. Attributes of joy describe a spontaneous, sudden and transient concept associated with connection, awareness, and freedom. Attributes of happiness describe a pursued, long-lasting, stable mental state associated with virtue and self-control., Conclusion: Further exploration of joy and happiness is necessary to ascertain their relationship with health and their value to nursing practice and theory development. Nurses are encouraged to consider the value of positive concepts to all areas of nursing., (© 2016 John Wiley & Sons Ltd.)

Aim: The study was conducted to determine the issues about which nurses and midwives remain silent and the reasons for it and the perceived results of silence., Background: Organisational silence is a vitally important issue in the health sector, due to the risks and mistakes that are not reported, and proposals for improvement that are not made., Method: The sample of this descriptive survey, which investigated a cause and effect relationship, was 159 nurses and midwives. The data were collected using a questionnaire and the organisational silence scale., Findings: Of the study participants, 84.9% were nurses and 15.1% were midwives. Of all participants 88.7% were women. 8.8% of participants stated that they never remained silent about issues related to work and the workplace. Respondents most often remained silent about issues related to ethics and responsibility. 'Limited improvement and development' was frequently mentioned as a perceived result of organisational silence., Conclusion: Our study determined that organisational silence is quite common among nurses and midwives., Implications for Nursing Management: Activities that raise the awareness of hospital administrations and employees about preventing the factors that cause and maintain silence in hospitals should be planned., (© 2016 John Wiley & Sons Ltd.)

Background: Health professionals, particularly doctors, nurses and midwives, are in high demand worldwide. Therefore, it is important to assess the future plans and likelihood of return of emigrating health professionals. Nevertheless, health professionals are, by definition, a difficult population to track/survey. This exploratory study reports on the migration intentions of a sample of doctors, nurses and midwives who had emigrated from Ireland, a high-income country which has experienced particularly high outward and inward migration of health professionals since the year 2000., Methods: Health professionals who had emigrated from Ireland were identified via snowball sampling through Facebook and invited to complete a short online survey composed of closed and open response questions., Results: A total of 388 health professionals (307 doctors, 73 nurses and 8 midwives) who had previously worked in Ireland completed the survey. While over half had originally intended to spend less than 5 years in their destination country at the time of emigration, these intentions changed over time, with the desire to remain abroad on a permanent basis increasing from 10 to 34 % of doctor respondents. Only a quarter of doctors and a half of nurses and midwives intended to return to practice in Ireland in the future., Conclusions: The longer health professionals remain abroad, the less likely they are to return to their home countries. Countries should focus on the implementation of retention strategies if the 'carousel' of brain drain is to be interrupted. This would allow source countries to benefit from their investments in training health professionals, rather than relying on international recruitment to meet health system staffing needs. Improved data collection systems are also needed to track the migratory patterns and changing intentions of health professionals. Meanwhile, social networking platforms offer alternative methods of filling this information gap.

Background and Objective: people with learning disabilities (LD) are increasingly likely to become parents and are entitled to have access to the right support to be able to be suitable parents. However, access to such support is affected by limited resources, attitudes towards people with LD becoming parents, and lack of training regarding caring for parents with learning disabilities for midwives. A learning disability (LD) is defined as a significantly reduced ability to understand new or complex information, to learn new skills (impaired intelligence), reduced skills to cope independently with everyday life, has an impact on most areas of a person's life and the difficulties started in early childhood. Little research has explored health professionals' experiences of their support of people with LD during their journey to become parents. Midwives are often the first professionals pregnant women come into contact with and therefore are key professionals in the support system for parents with LD. The principle objective of the current research is to develop an understanding of midwives' experiences of caring for women with a LD., Design: the study explored midwives׳ experiences of caring for women with LD using an Interpretative Phenomenological Approach (IPA)., Participants: nine qualified midwives employed by a single NHS trust participated in the study., Measurements and Findings: a semi-structured interview schedule was utilised during one-to-one interviews with the midwives. The interview transcripts were analysed using IPA stages. Four superordinate themes were identified., Key Conclusions: The midwives reported receiving a lack of LD training and faced significant time constraints, which left them feeling that they could not spend the necessary time with the women to meet their pregnancy needs. The midwives felt unsupported in their attempts to deliver adequate midwifery care, speaking about a lack of accessible support for pregnant women with LD. They were left feeling responsible to fill the gaps in service provision. The midwives were dedicated in delivering adequate care to help give women with LD a positive experience of childbearing. They felt a safeguarding process (child protection) was an inevitable part of women with LD's pregnancy experience yet were aware that the right support at the right time could improve parenting capacity., Implications for Practice: it is recommended that training on working with and providing services for people with LD is made available to qualified and student midwives as well as accessible resources, professional support and supervision., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Aim: To explore the experiences of Australian nurses and midwives who perceived themselves as resilient. The focus of this paper is to report the strategies used by a group of nurses and midwives to develop and maintain their resilience, despite encountering serious workplace adversity., Background: Despite the potentially adverse effects of nursing work, many nurses and midwives thrive through exercising self-efficacy and coping skills. The relationship between thriving and resilience is clear, as resilience refers to the ability to cope well with adversity and change., Methods: The participants were part of an instrumental, collective case study investigation of personal resilience amongst nurses and midwives. Prior to an innovative, work-based intervention including workshops and mentoring, participants were interviewed to collect baseline perceptions and experiences of personal resilience and workplace adversity. Interview transcripts were analysed thematically., Results: Participants attributed their ability to thrive in the workplace to three major influences: support networks, personal characteristics and ability to organise work for personal resilience., Conclusions: Participant insights contributed to a deeper understanding of personal resilience and highlight future initiatives to enhance the ability of nurses and midwives to thrive within health organisations and systems., Implications for Nursing Management: It is vital that resilience-enhancing initiatives, such as peer mentoring and tailored work options to increase autonomy, are implemented at earlier career phases., (© 2015 John Wiley & Sons Ltd.)

Background: Researchers are increasingly using grounded theory methodologies to study the professional experience of nurses and midwives., Aim: To review common grounded theory characteristics and research design quality as described in grounded theory studies of coping strategies used by nurses and midwives., Methods: A systematic database search for 2005-2015 identified and assessed grounded theory characteristics from 16 studies. Study quality was assessed using a modified Critical Appraisal Skills Programme tool., Findings: Grounded theory was considered a methodology or a set of methods, able to be used within different nursing and midwifery contexts. Specific research requirements determined the common grounded theory characteristics used in different studies. Most researchers did not clarify their epistemological and theoretical perspectives., Conclusion: To improve research design and trustworthiness of grounded theory studies in nursing and midwifery, researchers need to state their theoretical stance and clearly articulate their use of grounded theory methodology and characteristics in research reporting.

Objective: The aim of this study was to examine the contribution of nurses and midwives to the education of medical colleagues in the clinical context., Methods: The research design was a cross-sectional survey using an online questionnaire. A subsample of 2906 respondents, from a total of 4763 nurses and midwives participating in a web-based study, had taught doctors in the 12 months prior to the survey. The questionnaire generated mainly categorical data analysed with descriptive statistics., Results: In the group of respondents who taught doctors (n =2906), most provided informal teaching (92.9%, n=2677). Nearly a quarter (23.9%, n=695) self-rated the amount of time spent teaching as at least moderate in duration. The most common named teaching topics were documentation (74.8%, n=2005) and implementing unit procedures (74.3, n=1987), followed by medication charting (61.9%, n=1657) and choosing correct medications (55.8%, n=1493). Respondents felt their contributions were unrecognised by the doctors and students they taught (43.9%, n=1256)., Conclusions: Educational contributions while unrecognised could be considered positively by the respondents. However, discussion of teaching responsibilities is necessary to support the development of teaching protocols and supervision responsibilities as respondents reported teaching clinical medical tasks related to medications, consent and other skills within the medical domain. Study limitations include the nature of self-reported responses which cannot be validated and data drawn from a survey concluded in 2009.