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Aim: To explore the attitudes of healthcare workers towards COVID-19 vaccines., Design: A qualitative descriptive design was used., Methods: Five focus groups were conducted between October and November 2021, with a total of 30 nurses from different contexts in Northern Italy. Thematic analysis was used to analyse the transcripts., Results: Three main themes were identified: 'favourable', 'unsure' and 'contrary to' COVID-19 vaccines. The favourable position was underpinned by trust in science, research and vaccination; protection for themselves, their families, patients and the population; duty as professionals; necessity to set an example for others. Participants who were unsure had doubts about the composition, safety and efficacy of the vaccine and were sometimes afraid that media provided incomplete information. The main reason why nurses were against was the feeling that being forced to vaccinate perceived as blackmail. Favourable or unsure nurses struggled to deal with those who were against and developed a series of emotions that ranged from respect and attempt to rationalize, to frustration and defeat., Conclusions: Identifying the areas of hesitation is essential to understand what affects the choices of acceptance, delay or refusal of vaccination. The issues that emerged regarding proper communication within the vaccination campaign highlights the key importance of adequate vaccination strategies., Implication for the Profession And/or Patient Care: Understanding attitudes towards vaccine and related motivations among healthcare workers could help develop more specific and targeted vaccination campaigns that can ensure proper vaccination coverage rates and avoid hesitancy or refusal., Impact: Healthcare workers experiences of COVID-19 vaccines, their views and know how they feel during COVID-19 vaccinations. Healthcare workers had three different positions in COVID-19 vaccination. This research will guide and target future vaccination campaigns., Reporting Method: The study is reported using the Standards for Reporting Qualitative Research (SRQR)., Patient or Public Contribution: No Patient or Public Contribution., (© 2024 John Wiley & Sons Ltd.)

Objective: To determine the relationship between spiritual care and patient advocacy across three generations of nurses working in intensive care units., Design: Cross-sectional survey., Methods: Data collection took place from July to August 2022 with 120 nurses in Turkey. Data collection tools included the Spiritual Caregiving Competency Scale, the Spirituality and Spiritual Care Assessment Scale, and the Patient Advocacy Scale for Nurses. Data on nurses' demographics were evaluated using descriptive statistical methods (number, percentage, mean, standard deviation). Independent sample t-test, one-way ANOVA, Pearson correlation, and linear multiple regression analysis were used to evaluate the relationships between variables, with results reported as 95% confidence intervals (CI)., Results: More than half of the nurses were from Generation Y (39.2 %) and Generation Z (42.5 %). Generation Z's mean patient advocacy score (156.96 ± 23.16) was statistically significantly higher than Generation X's (139.32 ± 34.26). We determined that the spiritual competence scale communication sub-dimension score of Generation Y nurses working between 1-10 years was higher than that of Generation Z nurses. Additionally, as the patient advocacy scores of all generations increased, so did spiritual competence scores., Conclusion: The study found differences in patient advocacy and spiritual care competencies between generations. Thus, we recommend organizing courses, seminars, and in-service training on patient advocacy and spiritual care for intensive care nurses., Implications for Clinical Practice: This study estimates nurses' spiritual care competencies and patient advocacy levels from different generations and sheds light on the literature to eliminate differences in care between generations in nursing practices that evolve and change over time. It is recommended that courses, seminars, in-service training, spiritual activities, and interactive meetings be organized to encourage the participation of intensive care nurses to minimize the differences in spiritual care and patient advocacy among all generations of intensive care nurses., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: The present study was aimed at investigating the quality of pain management evaluated by inpatients in surgical clinics, and pain-related knowledge and attitudes of nurses working in surgical clinics, surgical units, or emergency services., Methods: The study was conducted as a descriptive and cross-sectional study. The study data were collected from inpatients in surgical clinics (N = 306), and from nurses working in surgical clinics, surgical units, or emergency services (N = 57) between January 2020 and September 2020. The Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) and Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) were the tools used for data collection., Results: The mean scores the participants obtained from the severity of worst pain, pain relief, and satisfaction with pain treatment components of the APS-POQ-R were 6.14 ± 2.59, 59.28 ± 22.26, and 8.99 ± 1.62, respectively. There were significant differences between many components of the APS-POQ-R in terms of such variables as age, sex, undergoing previous surgery, presence of pain before surgery, surgery performed, and type of anesthesia (p < .05). The mean score the participants obtained from the NKASRP was 15.35 ± 3.87., Conclusions: It was concluded that the patients' pain was relieved moderately, that they were very highly satisfied with pain treatment, and that the nurses' pain-related knowledge and attitude levels were below the moderate level., Clinical Implications: Nurses should support patients whose in-bed activities were prevented due to pain, involve them in pain treatment decisions, advise them about pain treatment options, and encourage them to use nonpharmacological methods., Competing Interests: Declaration of competing interest While conducting the study, we did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (Copyright © 2024. Published by Elsevier Inc.)

Background: The use of primary healthcare and health promotion services is low among immigrants compared with native citizens. Immigrants are at risk of developing chronic diseases due to genetics, nutrition and a sedentary lifestyle. Registered nurses play an integral role in teaching, counselling for a healthy lifestyle and care coordination in primary healthcare., Aim: We aimed to explore the perceptions of registered nurses on healthy lifestyle counselling for preventing type 2 diabetes and other chronic diseases among immigrants in the primary healthcare setting., Design: We performed a qualitative descriptive study using focus group interviews., Methods: Data were collected with semi-structured focus group interviews with a total of 23 registered nurses working in primary healthcare. We recruited the participants by using the purposive sampling method in the primary healthcare setting of four municipalities in Finland. Interviews were audio-recorded, transcribed verbatim and analysed with qualitative inductive content analysis., Results: The participants' perceptions were related to (1) uniform counselling practice for both immigrants and native citizens, (2) challenges in counselling immigrants, (3) understanding cultural factors influencing immigrant counselling, (4) the need to improve immigrant counselling and (5) utilizing insights from practical experience to improve the counselling service., Conclusions: Developing a culturally sensitive health promotion service is suggested to support the health of immigrants. Moreover, both migrant communities and healthcare professionals should be involved in co-designing and implementing health promotion projects through a community-based participatory approach., Impact: Our study contributes to healthcare practice and management by underscoring the need for culturally tailored health promotion services for the at-risk group of immigrants in primary healthcare. Cultural competence in nursing education needs to be reinforced. The provided recommendations inform researchers and policymakers about the health disparities and health needs of immigrants., Public Contribution: Healthcare professionals were consulted in the study design., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: Facial-protective equipment (FPE) use increased during the SARS-CoV-2 pandemic. This study explored factors influencing home care personal support workers' (PSWs) and nurses' self-reported adherence to FPE., Methods: A cross-sectional, electronic, survey was distributed to PSWs and nurses (1,108 complete responses) at 3 home care agencies in Ontario, Canada, in May to June 2022. Descriptive, bivariate, and multivariable analysis were used to assess individual, environmental, and organizational factors influencing adherence., Results: Among participants (786 PSWs, 322 nurses), 64% reported being adherent to both respiratory and eye FPE (Respiratory: 96%, Eye: 64%). Higher adherence was associated with facility-based work; better knowledge of FPE; prepandemic FPE use; good availability and convenient access; strong organizational support for health and safety; and Caribbean identity. Lower adherence was found for men; nurses with 2-year diplomas; shorter length of employment; communal transportation; and experiencing negative mental health effects from workplace infectious disease exposure., Discussion: Agencies should prioritize increasing providers' knowledge of FPE, supporting mental well-being, fostering a supportive culture, and ensuring availability of FPE. The influences of gender, ethnicity, and role require further exploration., Conclusions: FPE adherence may be improved by addressing modifiable factors and developing population-specific strategies., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Genomics has received significant attention in recent years. Nurses can uniquely contribute to the field of genomics and improve genomic healthcare. However, they lack the necessary knowledge to accomplish this, impacting their confidence, willingness, and ability to implement genomics healthcare negatively. Given Oman's unique healthcare context, its prospective genomics application, and the global trend toward genomic competency, it is essential to gauge nurses' genomic knowledge as basis for equipping them., Aim: This study assessed the genomic knowledge among nurses in the Sultanate of Oman. It also explored the predictors and outcomes of their genomic knowledge., Design: This study used a quantitative, descriptive, cross-sectional design., Settings: Nurses from four public hospitals in Muscat Governorate, Sultanate of Oman were recruited to participate in the study., Methods: A total of 661 out of 700 nurses responded to the pen and paper self-report questionnaire (94 % response rate). Univariate, bivariate, and regression analyses were used for data analysis., Results: Consistent with international studies, nurses in Oman had low to moderate genomic knowledge. Years of experience in genetics healthcare and working in either the surgical and maternity units were positively associated with higher genomic knowledge. Working in the bone marrow transplant unit and having a family history of consanguinity were associated with poorer genomic knowledge. Higher genomic knowledge was associated with an increased willingness to care for patients with genetic issues, higher confidence in providing genomic healthcare, and a lower intention to pursue continuing education on genomics., Conclusion: Strategies targeting variables, particularly those that are amenable to interventions, should be developed and implemented to foster genomic knowledge in nurses., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: Delirium is a common post-cardiac surgery complication that presents as acute changes in mental abilities with confused thinking and a lack of awareness of the surroundings. Delirium symptoms present in hyperactive- and hypoactive forms. Hypoactive delirium is often overlooked. Although nursing interventions are important in preventing and treating hypoactive delirium, studies focusing on nurses' experiences of hypoactive delirium are scarce. This study describes registered nurses' experiences of caring for patients with hypoactive delirium after cardiac surgery., Research Methodology/design: This was a qualitative descriptive study with an inductive approach. Data was collected through focus group interviews with 12 registered nurses with experience in caring for cardiac surgery patients with hypoactive delirium. The study complied with the Consolidated Criteria for Reporting Qualitative Research., Setting: A cardiac surgery department at a Swedish University Hospital., Findings: The analysis resulted in one main category; "Navigating the complexities of care when caring for patients with hypoactive delirium" and three sub-categories: "Challenges, "Nursing interventions" and "Promoting a team approach"., Conclusion: Delirium assessment and nursing interventions are perceived as essential yet demanding. when caring for patients with hypoactive delirium. Nursing interventions like maintaining the circadian rhythm and offering emotional support need to be prioritised by the nurses, in line with the autonomy of the registered nurse's profession. Moreover, the team around the patient is crucial for detecting and treating hypoactive delirium, and it is important to involve other professionals as well as the patient's relatives. Future research is needed to develop assessment instruments that more accurately capture hypoactive delirium in the postoperative setting., Implications for Clinical Practice: Despite the use of screening tools, nurses still experience challenges in detecting the symptoms of hypoactive delirium, indicating a need for more clinically effective screening tools for hypoactive delirium. Nursing interventions are emphasised in the care of patients with hypoactive delirium., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Memorializing nurses' experiences during the COVID-19 pandemic had the potential to allow scientists and policymakers to learn about the impact on the nursing profession and health care systems. Yet, nurses are considered a difficult population to recruit for research., Objective: To describe an innovative qualitative data collection method for capturing current practice experiences among nurses working during the COVID-19 pandemic., Methods: Guerilla theory served as the theoretical framework. Utilizing a qualitative descriptive design, a telephone voicemail messaging system was developed to capture nurses' experiences., Results: Nurses were recruited with convenience and snowball sampling via social media and state listservs. The telephone voicemail messaging system, Twilio, was used. After listening to the recording of the consent form, the participants shared their experiences by leaving a voice message where they answered the prompt, "Tell us about your experiences working during the COVID-19 pandemic." Seventy voicemails were included, and the voicemails were transcribed. After a nurse shared their experience via an email sent to the research team, emails were added to the data collection; 16 emails were received. Transcripts and emails were uploaded to the qualitative data analysis software program, Dedoose, and coded by 2 researchers using content analysis. Main themes were derived and discussed among the research team., Conclusion: Allowing participants multiple modes of expressing their experiences promote inclusivity in data collection. Further development and standardization of this method is needed for future research., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Workplace experiences may place Black nurses at higher risk for poor sleep and adverse health outcomes. This study aimed to identify poor sleep prevalence and associations of workplace discrimination and workplace social capital with sleep., Methodology: Descriptive statistics and multiple linear regression with exploratory analyses were conducted of cross sectional survey data from US Black nurses., Results: On average, 63 respondents reported sleeping 6.15 h, 45 min less daily than 6.9 h reported nationally for nurses. Ninety-percent of respondents reported poor sleep quality. While no direct significance was found, respondents reporting sleep quality changes had lower workplace social capital and higher workplace discrimination., Conclusion: Black nurses may have higher prevalence of poor sleep than the larger nursing workforce. A potential relationship between decreased sleep quality and negative perceptions of the work environment may exist. Organizations should examine sleep and potential occupational health inequities among Black nurses when considering worker health., (© 2023. W. Montague Cobb-NMA Health Institute.)

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

To explore the mediating role of resilience in the relationship between general self-efficacy and professional identity of nurses during the COVID-19 pandemic. A cross-sectional design was employed. A total of 982 nurses from four Grade III, class A hospitals in Shandong Province were investigated using general information questionnaire, nurses' professional identity rating scale, general self-efficacy scale (GSES), and Connor-Davidson flexibility scale (CD-RISC). SPSS22.0 and Amos21.0 were used for data analysis and structural equation modeling.      p   % counseling The nurses had a score of （27.038±5.933） for general self-efficacy score, 38.290±6.234 for psychological resilience, and （114.99±16.209） for professional identity. A positive correlation between general self-efficacy, professional identity, and psychological resilience (<0.01) was found. The SEM analysis shows that psychological resilience plays a mediating role between general self-efficacy and professional identity. The ratio of the effect is 75.155. During the COVID-19 pandemic, the levels of general self-efficacy and professional identity of nurses was medium, while psychological resilience was high. Nurses' general self-efficacy can affect their professional identity through psychological resilience. During the pandemic, the psychological status of nurses should not be ignored. Nursing managers should fully utilize of group and cognitive therapy based on mindfulness to improve nurses' psychological resilience and general self-efficacy, and to promote nurses' professional identity, so as to ensure the lower turnover rate.

Background: Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP., Aims: The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs., Methods: The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis., Results: Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal., Linking Evidence to Action: Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes., (© 2024 The Author(s). Worldviews on Evidence‐based Nursing published by Wiley Periodicals LLC on behalf of Sigma Theta Tau International.)

The study aimed to evaluate the ethical dilemmas faced by nurses who provide care to patients with hematologic cancer and determine their coping mechanisms using a phenomenological approach. This qualitative study was conducted with 35 nurses employed in clinics specializing in hematologic cancer patient care, living in diverse regions of Turkey, using semistructured, in-depth interviews through the WhatsApp mobile application. The snowball sampling technique was utilized to identify participants, and interviews continued until data saturation was achieved. All interviews were recorded and subsequently transcribed. Data analysis was conducted using Colaizzi's phenomenological analysis method, with the study adhering to the COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist for reporting. In the analysis of the data, 2 categories (ethical dilemma situations and coping experiences) and 6 subthemes (treatment, care, professional values and beliefs, emotions, struggling with emotional burdens, and psychosocial approach) emerged. According to the results, nurses responsible for hematologic cancer patients struggle with ethical dilemmas in healthcare delivery and face challenges in effectively addressing them, which could potentially impact the quality of healthcare provided by nurses., Competing Interests: The author has no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

Background: Pain is a distressing problem which commonly occurs among critically ill patients. Nurses' knowledge of, attitudes, and perceived barriers to pain assessment and management can influence the effectiveness of nursing care., Objective: To explore the current knowledge of, attitudes, and perceived barriers to pain assessment and management among Thai critical care unit nurses., Methods: A cross-sectional survey conducted between November 2022 and January 2023 among 158 Thai nurses working in one of eight adult critical care units in a tertiary hospital, evaluated their knowledge of, attitudes, and perceived barriers to pain assessment and management., Results: Nurses possessed inadequate knowledge and negative attitudes regarding pain assessment and management. The most important barrier to pain assessment and management was "patients are unable to communicate their pain". The results showed a significantly weak positive correlation between nurses' attitudes toward pain assessment and management age (r = 0.26, p = 0.001), year of ICU experience (r = 0.29, p < 0.001), and obtaining a certificate in intensive care nursing (r = 0.37, P < 0.001)., Conclusions: Thai critical care unit nurses possessed inadequate knowledge and negative attitudes. Further training and education regarding pain assessment and management could include case studies or simulation and immersive virtual reality to improve critical care unit nurses' knowledge and attitudes as well as identifying potential barriers to pain assessment and management in the critical care settings., Implications for Clinical Practice: The implications for clinical practice recommend that continued quality assurance procedures should be implemented and maintained to evaluate the effectiveness of current pain assessment practices. Additionally, the perceived barriers to effective pain assessment and management should be considered and managed not only through continued education and training but could include using nursing case review, morbidity and mortality data identifying those patients that experience chronic pain post-ICU discharge., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: ADHD and autism are common and increasing neurodevelopmental disorders in the world and also occur among nurses. However, almost nothing is known about nurses with these diagnoses. To promote high-quality care provision and well-being in the nursing workforce, it is important to discover more about these nurses. Therefore, in the present study, we aimed to describe how nurses with ADHD and/or autism experience their working life., Methods: The study was descriptive in design. Nurses were invited via Swedish Facebook groups targeting nurses. Semi-structured individual interviews were conducted with 17 nurses with ADHD and/or autism, online or by telephone. Data were analyzed using qualitative content analysis., Results: One overarching theme and seven subthemes emerged from the analysis. The theme "feeling like an untapped resource" reflected the subthemes: 1) Being passionate about one's job, 2) having strengths and talents to use in working life, 3) a stressful and disturbing work environment inhibits personal strengths, 4) managers show goodwill but lack knowledge and resources, 5) feeling appreciated but socially different among colleagues, 6) using a variety of strategies to facilitate working life and 7) toward an uncertain future., Conclusion: Nurses with ADHD and/or autism experience having abilities and talents that are useful in the nursing profession. However, they feel that the physical and organizational working conditions and lack of managerial support entail challenges that prevent them from making optimal use of their strengths., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Importance: Supporting healthy aging is a US public health priority, and gratitude is a potentially modifiable psychological factor that may enhance health and well-being in older adults. However, the association between gratitude and mortality has not been studied., Objective: To examine the association of gratitude with all-cause and cause-specific mortality in later life., Design, Setting, and Participants: This population-based prospective cohort study used data from self-reported questionnaires and medical records of 49 275 US older female registered nurses who participated in the Nurses' Health Study (2016 questionnaire wave to December 2019). Cox proportional hazards regression models estimated the hazard ratio (HR) of deaths by self-reported levels of gratitude at baseline. These models adjusted for baseline sociodemographic characteristics, social participation, physical health, lifestyle factors, cognitive function, and mental health. Data analysis was conducted from December 2022 to April 2024., Exposure: Gratitude was assessed with the 6-item Gratitude Questionnaire, a validated and widely used measure of one's tendency to experience grateful affect., Main Outcomes and Measures: Deaths were identified from the National Death Index, state statistics records, reports by next of kin, and the postal system. Causes of death were ascertained by physicians through reviewing death certificates and medical records., Results: Among the 49 275 participants (all female; mean [SD] age at baseline, 79 [6.16] years), 4608 incident deaths were identified over 151 496 person-years of follow-up. Greater gratitude at baseline was associated with a lower hazard of mortality in a monotonic fashion. For instance, the highest tertile of gratitude, compared with the lowest tertile, was associated with a lower hazard of all-cause deaths (HR, 0.91; 95% CI, 0.84-0.99) after adjusting for baseline sociodemographic characteristics, social participation, religious involvement, physical health, lifestyle factors, cognitive function, and mental health. When considering cause-specific deaths, death from cardiovascular disease was inversely associated with gratitude (HR, 0.85; 95% CI, 0.73-0.995)., Conclusions and Relevance: This study provides the first empirical evidence suggesting that experiencing grateful affect is associated with increased longevity among older adults. The findings will need to be replicated in future studies with more representative samples.

Public health crises can significantly impact the emotional well-being of healthcare workers. Network analysis is a novel approach to exploring interactions between mental disorders at the symptom level. This study aimed to elucidate the characteristics of post-traumatic stress disorder (PTSD), anxiety, depression, and insomnia symptoms network among frontline nurses under sudden public health crisis. A cross-sectional survey was conducted online among 556 frontline nurses through convenience sampling in Hubei Province, China, from 21 February 2020, to 10 March 2020. Symptoms of PTSD, anxiety, depression, and insomnia were assessed by the Post-Traumatic Stress Disorder Checklist (PCL-5), Generalized Anxiety Disorder scale (GAD-7), Patient Health Questionnaire (PHQ-9) and Insomnia Severity Index, respectively. Central symptoms (the most important symptoms, activation has the strongest influence the other nodes) and bridge symptoms (nodes where deactivation can prevent activation from spreading from one disorder to another) were identified via centrality and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. We found that the correlation between PHQ-9 item 9 'suicidal thoughts' and PCL-5 item 16 'reckless or self-destructive behaviour' was the strongest. Moreover, 'reckless or self-destructive behaviour' was the strongest central symptom, and PHQ-9 item 3 'sleep problems' was the most important bridge symptom. Other major symptoms included GAD-7 item 6 'uncontrollable anxiety' and PHQ-9 item 2 'depressed or sad mood'. Timely, systemic targeting interventions on central symptoms and bridge symptoms may effectively alleviate co-occurring experiences of psychopathological symptoms among frontline nurses., (© 2024 John Wiley & Sons Ltd.)

Proper nurse placement is crucial for enhancing the performance and quality of health services. This study aims to explore in-depth the relationship between nurse placement and performance in order to promote nursing excellence. A quantitative analysis was conducted using a descriptive correlational methodology. The population in this study consisted of 214 executive nurses at Medan Government Hospital, with a sample size of 139. The study's findings revealed that nurses performed exceptionally well in providing nursing care, scoring 94.2%, with those well-placed scoring 90.6%. The results from the Spearman rho correlation test showed that nursing qualifications, experience, work environments, and team dynamics have significant relationships with nurse performance. Meanwhile, the nurse's rho factor towards patients and the policy or regulation component showed low significance and relationship. The novelty of this study lies in its indication that nursing performance can be enhanced by aligning the placement of nurses with their abilities and experience, and fostering a work environment and positive team dynamics that encourage collaboration and efficiency. These findings provide vital insights for nursing staff management in order to enhance nursing care quality and patient health outcomes. This study highlights the need for suitable placement and professional development for nurses in order to attain maximum performance.

Nurses are at the frontline, dealing with people's most immense healthcare needs in stressful and demanding work environments. Consequently, it is essential to thoroughly examine how various coping mechanisms might affect the relationship between stress and quality of life (QOL). This study aimed to examine the mediation effect of both problem-focused coping (PFC) and emotion-focused coping (EFC) mechanisms on mitigating the effect of stress on the QOL among Jordanian nurses. A multisite cross-sectional descriptive correlational design was used in this study. An online survey was completed by 203 nurses using a convenience sampling technique between October 2023 and January 2024. The study included nurses working in different Jordanian healthcare sectors including governmental, private, and university-affiliated hospitals. Several measures were used to collect data, including questionnaires on sociodemographics, QOL, coping, and stress. Two models were hypothesized for this study. The two models were analyzed using Andrew Hayes Process Macro Model 4 for testing the mediation effects. Additionally, descriptive and correlational analyses were run prior to the main analysis. The results showed that coping significantly mediated the relationship between stress and QOL with variations between PFC and EFC. In conclusion, psychological distress symptoms were common among Jordanian nurses; psychological distress, coping, and QOL are correlating variables. Nurses' stress levels and coping modalities can predict QOL with a superior effect of PFC compared with EFC. Strategies should be put in place to improve effective coping to improve nurses' QOL. The results of this study have important implications for nursing education, practice, future research, and policy., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wafa'a Ta'an et al.)

This study assessed anxiety, depression, and stress levels among midwives and maternity nurses in Oman using the DASS-21 questionnaire in a cross-sectional survey of 200 participants from three public hospitals. Results indicated that 27.0% experienced mild to moderate depression, while 33.5% and 32% reported mild to moderate anxiety and stress, respectively. No severe cases were observed, but the findings highlight significant predictors such as sleep quality, job satisfaction, caseload per shift, age, and working area. These factors were significantly associated with the mental health outcomes measured. The study underscores the importance of addressing the psychological and emotional well-being of midwives and maternity nurses through targeted support and interventions, given the substantial percentage experiencing mild to moderate symptoms. Continuous efforts are essential to mitigate these issues and promote a healthier work environment for these healthcare professionals., Competing Interests: The Authors declared no conflict of interest, (African Journal of Reproductive Health © 2024.)

Background: Nurses face high levels of stress and emotional exhaustion due to heavy workloads and demanding work environments. Prolonged exposure to these stressors predisposes nurses to burnout, which can adversely affect patient care. Addressing burnout among nurses requires a multifaceted approach, involving both personal and organizational strategies. While organizational strategies target systemic workplace issues, personal interventions are often favored for their ease of implementation, immediate benefits, and empowerment of health care workers through stress management and resilience-building. Prioritizing evidence-based interventions to mitigate burnout among nurses is crucial for managing occupational stress and promoting well-being. Person-directed psychoeducation is an effective personal intervention strategy used to equip nurses with the appropriate knowledge and skills to handle stressors, thereby safeguarding their mental health and ensuring high-quality patient care., Objective: This protocol proposes a systematic review that aims to identify and assess the effectiveness of person-directed psychoeducational interventions for nurses. The review aims to pinpoint effective interventions that can be implemented to manage burnout and support the mental health of nurses., Methods: This systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. In total of 5 electronic databases (PubMed-MEDLINE, EBSCOhost, Ovid MEDLINE, Scopus, and ScienceDirect) will be searched for studies published between January 1, 2014, and December 31, 2023. The search will encompass 3 main keywords: "nurses," "burnout intervention," and "burnout." Predefined eligibility criteria will guide the screening process. Data will be extracted to address the objectives of the review. The risk of bias for each study will be assessed using Joanna Briggs Institute Critical Appraisal Tools., Results: Preliminary searches have been initiated since February 2024, with the review expected to be completed by June 2024. The expected results will include a comprehensive list of psychoeducational interventions and their effectiveness in reducing burnout among nurses. The review will highlight interventions that demonstrate significant impact in published studies from various countries., Conclusions: Given the rising prevalence of burnout among nurses and its detrimental effects on individuals and health care organizations, the findings from this systematic review are expected to inform health care policy and practice. By evaluating different interventions, it will provide insights into the most effective strategies, contributing to evidence-based practices that support nurses' mental health and well-being. The findings can support stakeholders in developing and implementing targeted strategies to combat nurse burnout, ultimately enhancing the quality of patient care and health care delivery. In addition, the findings will also offer valuable information for researchers, guiding future practice and research in this area., Trial Registration: PROSPERO CRD42024505762; https://tinyurl.com/4p84dk3d., International Registered Report Identifier (irrid): DERR1-10.2196/58692., (©Ili Abdullah Sharin, Norehan Jinah, Pangie Bakit, Izzuan Khirman Adnan, Nor Haniza Zakaria, Shazwani Mohmad, Siti Zubaidah Ahmad Subki, Nursyahda Zakaria, Kun Yun Lee. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 30.09.2024.)

Critical care nurses have high workloads due to the severity of the disease and the complexity of the treatment and care. Understanding the factors that influence subjective workload as well as the association between subjective and objective workload could lead to new insights to reduce critical care nurses' workload. (1) To describe critical care nurses' subjective and objective workload per shift in a university-affiliated interdisciplinary adult intensive care unit in Switzerland and (2) to explore the association between objective and subjective workload. The study used a prospective longitudinal cohort design. Critical care nurses completed the adapted Questionnaire on the Experience and Evaluation of Work 2.0 (QEEW2.0) to assess the subjective workload after every shift for four weeks (0 = never loaded, 100 = always loaded). The objective workload was assessed with the Therapeutic Intervention Scoring System-28 (TISS-28), Nine Equivalents of Nursing Manpower Use Score (NEMS), Swiss Society for Intensive Care Medicine (SGI)-patients' categories and Patient-to-Nurse Ratio (PNR). Data was analysed using multilevel mixed models. The workload of 60 critical care nurses with a total of 765 shifts were analysed. The critical care nurses experienced a subjective high mental load (66 ± 26), moderate pace and amount of work (30 ± 25) and physical load (33 ± 25), and low emotional-moral load (26 ± 22). The one-time baseline subjective workload values were higher than the day-to-day values. The mean objective shift load using the TISS-28 was 43 ± 16 points, the NEMS 36 ± 14 points, the SGI-category 1.1 ± 0.5 nurses needed per patient and the PNR 1.2 ± 0.4. We found positive associations between day-to-day objective variables with subjective pace and amount of work, with physical and mental load but not with emotional-moral load and performance. Measured objective workload is associated with only certain subjective workload domains. To promote and retain critical care nurses in the profession, nursing management should give a high priority to understanding subjective workload and strategies for reducing it., (© 2024. The Author(s).)

The aim of this study was to investigate and compare justice sensitivity between self-perceived beneficiaries, victims, and observers in a sample of 90 healthcare workers (nurses and physiotherapists) at the Varaždinske Toplice Special Medical Rehabilitation Hospital, Croatia. For this purpose we used a questionnaire consisting of demographic data and the Croatian version of the justice sensitivity inventory developed by Schmitt. Regardless of its limitations, our study clearly shows that healthcare professionals at Varaždinske Toplice are most sensitive to injustice from the beneficiary's perspective, that is, as persons who personally benefitted from injustice, although they may not have been instrumental to this effect. They are less sensitive to injustice perceived on the outside (observer's perspective) or to injustice suffered by themselves (victim's perspective). Another important finding is that participants of female gender, rural residence, and nurses (who are all women) are significantly more sensitive to injustice, whereas age and marital status do not seem to contribute to justice sensitivity. Future research should investigate the perception of injustice over a longer timeframe and involve all healthcare workers. It could also address different approaches to management, especially in terms of worker rewards and career advancement. Qualitative research among healthcare workers could provide a broader and clearer idea of social injustice at their workplace., (© 2024 Irena Canjuga et al., published by Sciendo.)

Background: The increasing use of telemedicine (TM) represents a major shift for health workers and patients alike. Thus, there is a need for more knowledge on how these interventions work and are implemented. We conducted a qualitative process-evaluation alongside a larger randomized controlled trial designed to evaluate a telemedicine follow-up intervention for patients with a leg- or foot-ulcer, who either have or do not have diabetes. Accordingly, the aim of this study was to explore how both health care professionals and patients experienced the implementation of TM follow-up in primary care., Methods: The intervention comprised an interactive TM platform facilitating guidance and counselling regarding wound care between nurses in primary care and nurses in specialist health care in Norway. Nurses and patients from seven clusters in the intervention arm were included in the study. We conducted 26 individual interviews (14 patients and 12 nurses) in primary care between December 2021 and March 2022. Thematic analyses were conducted., Results: The analyses revealed the following themes: (1) enhancing professional self-efficacy for wound care, (2) a need to redesign the approach to implementing TM technology and (3) challenging to facilitate behavioral changes in relation to preventive care. As to patients' experiences with taking part in the intervention, we found the following three themes: (1) experience with TM promotes a feeling of security over time, (2) patients' preferences and individual needs on user participation in TM are not met, and (3) experiencing limited focus on prevention of re-ulceration., Conclusions: TM presents both opportunities and challenges. Future implementation should focus on providing nurses with improved technological equipment and work on how to facilitate the use of TM in regular practice in order to fully capitalize on this new technology. Future TM interventions need to tailor the level of information and integrate a more systematic approach for working with preventive strategies., Clinical Trial Registration: NCT01710774. Registration Date 2012-10-17., (© 2024. The Author(s).)

Background: A voluntary and free initial health assessment is offered to all asylum seekers upon arrival in Finland. The central aim of this initial health assessment is early identification of service needs. There is, however, limited information on how effective the initial assessment is in fulfilling its aims. This study explores the viewpoints of asylum seekers, reception centre nurses, and health authorities regarding the objectives of the initial health assessment. It serves as a starting point for effectiveness research, where effectiveness is defined as the achievement of intended aims., Methods: This qualitative descriptive study is based on 31 semi-structured individual interviews (13 asylum seekers, 14 nurses, and four asylum health authorities) conducted in January and February 2019. Reflective thematic analysis was employed for data analysis, involving initial separate analyses for each group, followed by an assessment of differences and similarities between the groups., Results: The importance of a comprehensive initial health assessment and preventing infections was emphasized by all groups. The main differences were views on service needs assessment in relation to persons in vulnerable situation and information provision. All groups described both individual and public health perspectives., Conclusions: This study provides valuable insights for developing a more effective assessment. Asylum seekers require comprehensive health assessment and details about their rights. To address these needs, it is crucial to update reception centre nurses' practices. Additionally, authorities responsible for planning and guiding services should refine their instructions concerning the information provided to asylum seekers and persons in vulnerable situations. The findings of this study can be used to enhance information provision and develop targeted training programs for nurses, as well as to evaluate the achievement of established aims., (© 2024. The Author(s).)

Background: The incidence of non-suicidal self-injury (NSSI) is high and often occurs repeatedly. Psychiatric nurses play a vital role in the care and treatment of NSSI patients, as they have the most frequent contact with patients. The experiences and attitudes of nurses has a direct affect on the quality of care they provide to patients. Negative care experiences and attitudes of patient aversion on behalf of nurses may delay the observation and treatment of changes in the patient's condition, leading to irreversible risks. Although cross-sectional studies have investigated the attitudes of medical staff toward NSSI patients, quantitative research results cannot comprehensively reflect the emotional experiences and complex psychological changes of the study subjects. A few studies have focused on the psychiatric nurses' care experiences and attitudes toward patients with repeated NSSI., Objective: This study aimed to explore psychiatric nurses' care experiences and attitudes toward patients during repeated NSSI., Methods: A thematic analysis qualitative study was used. Using purposive sampling, 18 psychiatric nurses were recruited from a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using six-phase thematic analysis., Results: Four themes emerged from the analysis: psychiatric nurses' care experiences, perceptions, care attitudes and coping style toward repeated NSSI patients. Psychiatric nurses have experienced negative care experiences and severe career burnout during the patient's repeated NSSI. Nurses' attitudes toward NSSI patients changed during repeated NSSI, from understanding to indifference to anger and resentment. At the same time, it was found that nurses' coping style with NSSI patients could be divided into three stages, namely, active coping, neglect and perfunctory, and criticism and punishment., Conclusions: The findings have implications for health care systems regarding interventions to improve nurses' care experiences and attitudes toward repeated NSSI patients. These findings suggest that enhancing nurses' understanding of NSSI, establishing standardized emergency response and intervention programs, guiding positive professional values and responsibility, and improving nurses' caring attitudes can promote the early detection and timely intervention of NSSI., (© 2024. The Author(s).)

Background: Home care provides an excellent opportunity for personalizing treatment as nurses see patients in their natural environment. Along with its many advantages, the home care environment carries unique risks, as nurses are usually alone, without the protection and security provided by primary care clinics. There are no accurate data in Israel on the scope and characteristics of client violence against nurses during home visits. We conducted a qualitative study to investigate the nature of client violence faced by Israeli nurses during home visits, to gain insights into their perceptions and experiences, and to contribute to the development of effective policies and strategies to combat client violence in the healthcare sector., Methods: Twenty-seven female nurses from primary care clinics, who were exposed to client violence during a home visit, were interviewed using a semi-structured interview guide. The interviews were transcribed and analyzed, and categories and themes were extracted., Results: Most nurses interviewed experienced at least three incidents of client violence, the most common of which was verbal abuse. The nurses perceived that the location of the encounter between the nurse and the patient in the patient's natural surroundings, rather than within the controlled boundaries of a clinic, contributes to the risk of violence. Violence affected the nurses' professional decisions. The nurses reported that their organization had no established guidelines or instructions for safely conducting home visits, they were not provided with protective or security measures for emergencies, nor did they perceive that they had sufficient training to deal with client violence in clients' homes., Conclusions: Nurses encounter a range of challenges that make it difficult for them to deal with client violence during home visits, affecting their personal safety and professional decisions. Their ability to manage such situations is shaped by a complex interplay of personal and organizational factors and requires a range of strategies and resources to effectively address them., (© 2024. The Author(s).)

Introduction: Pressure injuries are a common and significant concern in clinical practice, often serving as a vital quality indicator. While (clinical) practice guidelines have been established to offer recommendations for mitigating hospital-acquired pressure injuries, adherence among stakeholders remains inconsistent. The subjective perceptions of stakeholders, such as patients and nurses, may impede adherence to pressure ulcer prevention guidelines, potentially reducing the effectiveness of these interventions. However, there is currently insufficient evidence to comprehensively understand this influence. Therefore, this review aims to offer a broader understanding of how the perspectives of patients and nurses engaged in pressure injury prevention affect the effectiveness of specific interventions for pressure ulcer management., Methods and Analysis: We will conduct a convergent, segregated mixed-methods systematic review and perform a narrative synthesis with a focus on evidence of the effectiveness of pressure injury prevention strategies and patient and nurse perceptions. Our search will encompass several databases, including the 'Centre for Reviews and Dissemination' (CRD) Database, Medline (via Ovid), CINAHL (via Ebsco) and Scopus (via Elsevier). Additionally, we will cross-check reference lists from all included systematic reviews. Two independent reviewers will screen titles, abstracts, and full texts and extract data from the included studies. The quality of methodology of systematic reviews will be assessed using 'A Measurement Tool to Assess Systematic Reviews-2' (AMSTAR 2) and the risk of bias using 'Risk of Bias in Systematic Reviews' (ROBIS). Qualitative studies will undergo critical appraisal using appropriate Joanna Briggs checklists. If it is feasible to pool data from included studies, we will synthesise them accordingly, using meta-analysis for quantitative reviews and meta-aggregation for qualitative studies. The results from both qualitative and quantitative analyses will be compared with derive new recommendations for healthcare practice aimed at enhancing the quality of care., Ethics and Dissemination: Ethical approval is not required due to the nature of this intended review. The results of this review will be disseminated through publications, reports and conference presentations., Prospero Registration Number: CRD42023438792., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background:  Professional nurses typically promote and advocate self-care practices to their patients to achieve better health outcomes, but rarely engage in these practices themselves., Methods:  A qualitative, descriptive phenomenological approach was used in this study. Ten professional nurses employed in different primary health care facilities were purposively sampled. Semi-structured interviews were conducted to collect data, which were analysed using Colaizzi's data analysis strategy, and data saturation was reached., Results:  Two themes were identified. Theme 1: the participants expressed that internal and external factors compromised self-care practices, such as subconscious self-neglect, insufficient resources, and a depressed economy, which encouraged them to work extended hours. Theme 2: participants' holistic well-being was compromised, as they neglected their mental well-being., Conclusion:  Self-care practices among professional nurses seem unachievable. The extent of this population's self-care neglect was evident during the coronavirus disease 2019 (COVID-19) pandemic when professional nurses globally gave of themselves relentlessly.Contribution: This is the first study conducted on the topic in the City of Ekurhuleni, and the findings will provide relevant stakeholders with a directive on what strategies, policies, and guidelines to develop and implement to make self-care practices attainable for professional nurses.

Purpose: Psychological violence and harassment have been reported to be associated with mental health problems and turnover intention among nurses. Cyberbullying, a hidden form of harassment using information and communication technology, is attracting attention as a factor that threatens the mental health of nurses. This study aimed to add coping characteristics, social support, and workplace social capital to psychological violence, harassment, and cyberbullying in female nurses and determine their association with depression and turnover intention., Participants and Methods: An anonymous, self-administered questionnaire survey was conducted, targeting 2,158 female nurses working in four domestic hospitals, excluding those in management positions. The analysis included 1,151 nurses who responded (valid response rate: 53.3%). Multiple regression analysis was performed with depression and turnover intention as dependent variables and psychological violence and harassment, cyberbullying, the brief scales for coping profile (BSCP) and social support scale scores, and social capital (SC) as independent variables., Results: Depression was positively correlated with psychological violence and harassment, cyberbullying, and the BSCP subscale "avoidance and suppression" and negatively correlated with the BSCP subscale "changing the point of view" and social support subscales "support from supervisors" and "support from co-workers." Turnover intention was positively correlated with psychological violence and harassment and the BSCP subscale "avoidance and suppression" and negatively correlated with the BSCP subscale "changing the point of view," social support subscale "support from supervisors," and vertical SC., Discussion and Conclusion: The results suggest that work environments should prevent psychological violence and harassment in nurses to promote a sense of security and eliminate mental health problems. Cyberbullying was inferred as a factor that could lead to mental health problems among nurses. Therefore, each nurse should raise their awareness of information literacy, besides attending more to their words and attitudes.

Background: A favorable clinical environment and nurse motivation are both essential for achieving high-quality patient outcomes and organizational performance in healthcare systems, which can be highly distressing for nurses. The purpose of this study was thus to determine the associations among and influences of psychological distress, work environment quality, and motivation on one another., Methods: This was a cross-sectional, descriptive-correlational study conducted with a total sample of 204 nurses in two public tertiary hospitals. We used an online survey to collect nurses' responses, which comprised the Kessler Psychological Distress Scale-6, Brief Nurses' Practice Environment Scale, and Multidimensional Work Motivation Scale. We ran the necessary statistical analyses in SPSS version 28., Results: We found that nurses' psychological distress, work environment quality, and motivation were moderate. A significant, positive, and moderate relationship existed between psychological distress and work environment quality, while nurses' educational level was statistically different with their motivation level. In the regression, only the nationality, current position, and work environment variables significantly influenced psychological distress. The hospital type also significantly influenced work environment quality. No variable was found to influence nurses' motivation level, though., Conclusions: We concluded that nurses' work environment quality and motivation are interconnected with the psychological stress they experience at work. Monitoring nurses' work environment quality, motivation levels, and psychological distress is thus vital to ensure better patient care., Competing Interests: The authors declare there are no competing interests., (©2024 Alharbi et al.)

Objective: Work engagement significantly influences both the quality of nursing care and nurses' job performance. In this study, we aimed to explore the mediating effects of negative emotions on the relationship between self-compassion and work engagement among Chinese nurses., Method: A cross-sectional study was performed on nurses in a tertiary A hospital located in Henan province from September, 2023 to December, 2023. Custom-designed digital surveys were disseminated to gather pertinent data. Structural Equation Modelling (SEM) were utilised to analyse the data and determine relationships among self-compassion, negative emotions and work engagement., Results: A total of 1,201 nurses were included. According to the statistical model, self-compassion (β = 0.116, CI: -0.036 to -0.008, p  < 0.001) and negative emotions (β = -0.372, CI: -0.053 to -0.033, p  < 0.001) were correlated with work engagement. Furthermore, our analysis revealed that negative emotions partially mediated the relationship between self-compassion and work engagement (β = 0.174, CI: -0.066 to -0.020, p  < 0.01)., Conclusion: These findings indicate that incorporating self-compassion and negative emotion regulation in interventions targeting work engagement may enhance the overall level of work engagement among nurses, thereby improving job satisfaction and the quality of patient care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Yang, Chang, Guo, Gao, Wang and Ma.)

Objective: to interpret young nursing professionals' perceptions about the relationship between working, employment and health conditions., Method: a qualitative study with an interpretive approach regarding the work-related experiences of 15 young nurses, who took part in the research through voluntary snowball sampling. The data from the interviews and the focus group were analyzed to reach an approximation to the realities inherent to the nurses' work life., Results: the relevant study findings pointed out that work precariousness is a characteristic feature in the population group, mainly related to hiring modalities and to wages. According to the participants, the psychosocial working conditions (which were intensified during the COVID-19 pandemic) were the ones that caused the most effects on their mental and physical health., Conclusion: from the young nurses' perspective, this study reports how the macro- and micro-structural working conditions and their relationship with health are perceived, pointing out the key elements to devise interventions focused on life paths that foster decent and healthy work postulates in their work environments, as well as actions to prevent injuries or harms to nurses' health.

Objective: To explore the effect of training program based on service-oriented leadership theory on alleviating the degree of job burnout of clinical nurses, and provide reference for improving the situation of job burnout of nurses. Methods: From January to December 2023, 10 head nurses of a Grade A general hospital were selected by random number table method for training, and 5 nurses were selected from the department of each head nurse by random number table method, a total of 50 nurses were selected as research objects. Through the training program based on the service-oriented leadership theory, the selected head nurses were trained on the service-oriented leadership theory, job burnout and burnout mitigation methods and passed the examination. The training period was 2 months. The general data of 50 nurses were collected, and the job burnout of nurses was investigated by using the Maslach Burnout Inventory before and 6 months after the training of head nurses, and the changes of scores of each dimension were compared by paired t -test. Results: The nurses were (30.4±5.5) years old and their working life was (8.1±6.1) years. The total detection rate of job burnout before training was 100% (50/50), the detection rate of moderate to severe emotional exhaustion was 60% (30/50), and the detection rate after training was 36% (18/50). The detection rate of moderate to severe depersonalization was 72% (36/50) and 40% (20/50) after training. The detection rate of moderate to severe lack of job accomplishment was 86% (43/50) and 54% (27/50) after training. After 6 months of head nurses training, the scores of emotional exhaustion and depersonalization of nurses were significantly lower than those before training, while the scores of personal achievement were significantly higher than those before training, with statistical significances ( P <0.05) . Conclusion: The training program based on service-oriented leadership theory can scientifically prevent and alleviate nurses' job burnout after receiving training of administrators, which is helpful to improve the current situation of nurses' job burnout and reduce the degree of nurses' job burnout, and can play a positive role in promoting nurses' physical and mental health.

Background: In Jordan, nurses consider a primary providers of direct patient care, and play a multifaceted role in ensuring healthcare quality. The study aimed to examines the moderating effect of job satisfaction in the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality., Methods: A cross-sectional research approach was adopted among 311 from Registered Nurses (RN) across Jordanian hospitals. Job satisfaction, workload scale and job burnout scale were shared between March and April 2023., Results: The overall findings indicate that workload, job burnout, and turnover intention are negatively and significantly related to healthcare quality, and that job satisfaction moderates the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. These findings have broad implications for healthcare organizations, emphasizing the pivotal role of job satisfaction in mitigating the negative effects of workload, burnout, and turnover intentions among nurses., Consulsion: Strategies to enhance job satisfaction, such as reducing work-related stress and fostering supportive work environments, should be prioritized by healthcare policymakers and institutions to ensure the delivery of high-quality patient care., (© 2024. The Author(s).)

Aims and Background: The COVID-19 pandemic has had adverse effects on nurses, impacting them physically, mentally and psychosocially. These effects stem from heightened workloads, fears of contracting a life-threatening illness due to inadequate protective equipment and concerns about transmitting the disease to their families. This study assessed the impact of COVID-19 on the quality of life of nurses working on the frontlines, aiming to provide insights for future crisis responses., Methods: A descriptive-analytic study included 288 nurses from hospitals affiliated with Çukurova University, Southern Turkey using a stratified sampling method. Data on quality of life and demographics were collected using the WHO Quality of Life-BREF scale and a questionnaire. Data analysis was conducted using SPSS V.25, employing descriptive and analytic measures at a significance level of p<0.05., Results: Overall perceived quality of life was moderate (mean score: 3.31; SD: 0.56), with the highest scores in social relationships, psychological well-being and environmental factors. Positive correlations were found with gender, education, salary, vaccination status and living alone. Negative correlations were observed with alcohol consumption and longer working hours., Conclusions: To strengthen future crisis responses, health authorities should prioritise workload reduction, gender diversity promotion, support for nurses residing with family, better income opportunities, alcohol abstinence encouragement and ensuring vaccination for frontline nurses., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The use of mobile tools in nursing care is indispensable. Given the importance of nurses' acceptance of these tools in delivering effective care, this issue requires greater attention., Objective: This study aims to design the Mobile Health Tool Acceptance Scale for Nurses based on the Expectation-Confirmation Theory and to evaluate it psychometrically., Methods: Using a Waltz-based approach grounded in existing tools and the constructs of the Expectation-Confirmation Theory, the initial version of the scale was designed and evaluated for face and content validity. Construct validity was examined through exploratory factor analysis, concurrent validity, and known-group comparison. Reliability was assessed using measures of internal consistency and stability., Results: The initial version of the scale consisted of 33 items. During the qualitative and quantitative content validity stage, 1 item was added and 1 item was removed. Exploratory factor analysis, retaining 33 items, identified 5 factors that explained 70.53% of the variance. A significant positive correlation was found between the scores of the designed tool and nurses' attitudes toward using mobile-based apps in nursing care (r=0.655, P<.001). The intraclass correlation coefficient, Cronbach α, and ω coefficient were 0.938, 0.953, and 0.907, respectively., Conclusions: The 33-item scale developed is a valid and reliable instrument for measuring nurses' acceptance of mobile health tools., (©Narjes Mirabootalebi, Zahra Meidani, Hossein Akbari, Fatemeh Rangraz Jeddi, Zahra Tagharrobi, Walter Swoboda, Felix Holl. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 17.09.2024.)

Objectives: This paper utilizes an ontological approach to conduct a qualitative literature review in order to investigate the emotional impact of the Covid-19 pandemic on nurses internationally. After identifying common themes in the literature review, primary research is conducted to investigate the emotional impact of the Covid-19 pandemic on nurses working in Bermuda´s only acute healthcare facility., Methods: The literature review used the FRAMEWORK approach (Richie and Spencer, 1994, as cited in Hackett et al. (2018) to select a total of 16 papers for review, each of them qualitative primary research, aside from one paper reviewing international literature. Within the second part of this paper, investigating the experience of nurses in Bermuda, a grounded theory approach was utilised to collect primary data. Convenience sampling was used to recruit subjects to participate in one-on-one semi-structured interviews. Data saturation was achieved after 9 interviews. The FRAMEWORK method was utilised to analyse the interview transcripts, and identify, organise and collate themes., Results: The literature review highlights that nurses have strong emotional responses to caring for patients during the Covid-19 pandemic. Specific responses include: higher stress levels at work due to higher, more challenging workload, and a reliance on clinical leaders to assuage this stress. Stigma experienced outside of work lead to feelings of anxiety and isolation. Despite this, there was a common theme that nurses felt a satisfaction within their role to ´play their part´ in the pandemic. The primary research conducted in Bermuda demonstrates that there was an initial fear of Covid-19, receding as the pandemic developed. Much anxiety was due to a perceived lack of knowledge about the disease, lack of a coherent strategy, and inadequate equipment to protect staff, and properly care for patients. An increased level of cooperation amongst staff, and mutual support amongst nurses was noted, as was social stigma leading to feelings of isolation and anxiety. Social interactions and holistic activities were identified as primary resources to alleviate stress and uncertainty., Conclusions: Nurses in Bermuda elicited many of the same emotional responses as their international colleagues, as a result of caring for patients during the pandemic. These manifested as a result of higher, more challenging workload, and uncertainty about preparedness plan and quickly changing situations within the working environment. The results from this study can help formulate changes in policy to ensure smoother transitions to pandemic preparedness in the future., Competing Interests: The authors have declared that no competing interests exists., (Copyright: © 2024 Moore, Leena. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aim: To explore the views of general practitioners (GPs) and nurses on type 2 diabetes (T2D) management, including the use of recently funded T2D medications in New Zealand (NZ) and their perceived barriers to providing optimal care., Background: T2D is a significant health concern in NZ, particularly among Māori and Pacific adults. Characterised by prolonged hyperglycaemia, T2D is generally a progressive condition requiring long-term care., Methods: Semi-structured interviews were conducted between July and December 2022 with 21 primary care clinicians (10 GPs and 11 nurses/nurse prescribers) from nine different general practice clinics across the Auckland and Waikato regions of NZ. Framework analysis was conducted to identify common themes in clinicians' perceptions and experiences with T2D management., Findings: Three themes were identified: health-system factors, new medications, and solution-based approaches. Lack of clinician time, healthcare funding, staff shortages, and burn-out were identified as barriers to T2D management under health-system factors. The two newly funded medications, empagliflozin and dulaglutide, were deemed to be a positive change for T2D care in that they improved patient satisfaction and clinical outcomes, but several clinicians were hesitant to prescribe these medications. Participants suggested that additional education and specialist diabetes support would be helpful to inform optimal medication prescribing and that better use of a multi-disciplinary team (clinical and support staff) could support T2D care by reducing workload, addressing cultural gaps in healthcare delivery, and reducing burnout. An improved primary care work environment, including appropriate professional development to support prescribing of new medications and the value of collaboration with a non-regulated workforce, may be required to facilitate optimal T2D management in primary care. Future research should focus on interventions to increase support for both clinical teams and patients while adopting a culturally appropriate approach to increase patient satisfaction and improve health outcomes.

Introduction: There is a growing need for alternative forms of care to address citizen demands and ensure a competent healthcare workforce across municipalities and regions. One of these forms of care is the use of mobile care units. The aim of the current study was to describe physicians and nurses experiences of providing care to patients within a mobile care unit in Sweden., Method: Data were collected between March 2022 and January 2023 through qualitative interviews with 14 physicians and nurses employed in various mobile care units in different regions in Sweden. These interviews were transcribed verbatim and subjected to content analysis, with the study adhering to the Standards for Reporting Qualitative Research (SRQR)., Results: The analysis resulted in two main categories: "Unlocking the potential of mobile care", and "The challenges of moving hospitals to patients' homes"; and seven subcategories. The respondents viewed mobile care at home as highly advantageous, positively impacting both patients and caregivers. They believed their contributions enhanced patients' well-being, fostering a welcoming atmosphere. They also noted receiving more quality time for each patient, enabling thorough assessments, and promoting a person-centered approach, which resulted in more gratifying mutual relationships. However, they experienced that mobile care also had challenges such as geographical limitations, limited opening hours and logistical complexity, which can lead to less equitable and efficient care., Conclusions: Physicians and nurses in mobile care units emphasized positive outcomes, contributing to patient well-being through a person-centered approach. They highlighted increased quality time, comprehensive assessments, and overall satisfaction, praising the mobile care unit's unique continuity for enhancing safety and fostering meaningful relationships in the patient's home environment. In order for mobile care to develop and become a natural part of healthcare, challenges such as geographical limitations and logistics need to be addressed., (© 2024. The Author(s).)

Even during the third wave of the COVID-19 pandemic health professionals were facing mental health challenges. The aim of this study was to examine the mental health of doctors, nurses and other professional groups in Europe and to identify differences between the professional groups. We conducted a cross-sectional online survey in 8 European countries. We asked for demographic data, whether the participants were exposed to COVID-19 at work, for main information sources about the pandemic, the Depression Anxiety Stress Scales (DASS-21), and major stressors. A MANCOVA was carried out to find predictors of mental health among health care professionals. The sample (N = 1398) consisted of 237 physicians, 459 nurses, and 351 other healthcare professionals and 351 non-medical professionals with no direct involvement in patient care. The mean mental health of all groups was affected to a mild degree. Major predictors for depression and anxiety were the profession group with higher scores especially in the group of the nurses and working directly with COVID-patients. In the third wave of the COVID-19 pandemic, the psychological burden on health professionals has remained high, with being nurse and working directly with COVID19 patients being particular risk factors for mental distress. We found as a main result that nurses scored significantly higher on depression and anxiety than practitioners., (© 2024. The Author(s).)

Objective: Despite the prevalence of emergency medical service assignments related to chest discomfort, limited research delves into nurses' experiences of caring for such patients. This study aimed to illuminate prehospital emergency nurses' (PENs') experiences of caring for patients with suspected acute myocardial infarction (AMI)., Design: A qualitative interview study., Setting: Two Swedish emergency medical service organisations in two different regions., Participants: Consecutive inclusion of 12 PENs., Data Analysis: An inductive content analysis according to Elo and Kyngäs., Results: The results underline the active role of PENs in providing care for patients with AMI in the emergency medical service. They emphasise the ability to identify classic symptoms and the need for an open-minded approach to diffuse presentations. Ensuring patient security, projecting knowledge and composure are decisive for instilling a sense of safety. Healthcare providers feel profound responsibility and a fear of errors, especially in critical situations with potential patient deterioration. Prioritisation in time-sensitive cases leans towards medical interventions and immediate transportation. Continuing education is essential to enhance patient management and safety. Effective communication and trust are vital for urgent patient care, and prompt activation of the ST-elevation myocardial infarction pathway is recognised as imperative. Malfunctions result in frustration, underlining the importance of pathway functionality., Conclusions: PENs have immense responsibility for the swift and knowledgeable management of patients with suspected AMI. Balancing patient involvement and urgent medical measures is challenging, emphasising the critical role of mental preparedness and comprehensive education. The study underlines the significance of effective communication and trust between healthcare providers, particularly in time-sensitive scenarios. Establishing feedback mechanisms for prehospital staff is important for advancing prehospital emergency care in this patient category., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

This study assessed the resilience of nurses in Saudi Arabia during the corona virus 2019 (COVID-19) pandemic and examined its influence on their quality of life (QOL). A sample of 356 nurses was surveyed in this quantitative, cross-sectional study using the Resilience Scale for Nurses and the World Health Organization Quality of Life (WHOQOL-BREF) from October 2020 to March 2021. The nurses reported the highest resilience score on "situational pattern", while the lowest score was on "relational pattern." The nurses had good perceptions on their overall QOL and health and rated their "social relationship" as having the highest quality, while their "environmental" domain as having the least quality. Gender, marital status, provision of direct nursing care to COVID-19 patients, "philosophical pattern", "situational pattern" and "dispositional pattern" had multivariate impacts on the QOL dimensions. The study concluded that being resilient can positively impact the nurses' QOL during stressful situations, such as the COVID-19 pandemic., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Abdualrahman Saeed Alshehry. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: Both physical and psychosocial risk factors contributing to musculoskeletal disorders occur in the professional nursing group, and previous literature suggested that their interaction may increase the risk of musculoskeletal pain among nurses. The aim of the study was to examine perceived workload and stress as well as physical findings and musculoskeletal complaints in nurses., Material and Methods: The participants consisted of 42 female nurses, age range 23-60 years. They marked on a pain drawing the site/sites that was/were painful at the moment of testing, its duration and intensity. Thereafter they were examined using the movement and respiration domains from the Global Physiotherapy Examination (GPE). Furthermore, a subjective workload measure was made using the paper version of the National Aeronautics and Space Administration Task Load Index and stress was assessed using the Perceived Stress Questionnaire ., Results: Almost the entire study group declared that pain experienced in at least 1 location was chronic, i.e., had lasted ≥1 year (97%). The most frequent locations of pain were low back (22.4%) and cervical/head (21.6%) regions. In the GPE, most scores indicated restricted and reduced movement, with the subdomain flexibility having the highest deviation from the predefined standard. Furthermore, the results indicated hampered respiration, especially visible in standing position. Out of all workload scores, the highest was obtained for temporal demand. Perceived stress level was found to be moderate and significantly associated to chronic chest/ thoracic pain. Interestingly, the compression of thorax test positively correlated with mental (r = 0.42, p < 0.05) and physical demand (r = 0.35, p < 0.05), whereas the elbow drop test and temporal demand correlated negatively (r = -0.37, p < 0.05)., Conclusions: To sum up, the majority of nurses participating in this study had long-lasting pain and limited flexibility of the body and hampered respiration, which both may enhance intensity of experienced musculoskeletal pain. Int J Occup Med Environ Health. 2024;37(3):257-70., (This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.)

Objective: It is of critical importance to determine the factors that contribute to nurses' disaster preparedness. This study aimed to examine nurses' perceptions of disaster preparedness and the factors affecting it., Methods: This descriptive study was conducted with 464 nurses working in the East Marmara region of Türkiye. The data were collected online using the "Personal Information Form," "The Scale of Perception of Disaster Preparedness on Nurses," and the "Adult Motivation Scale." Linear regression analysis was used to analyze the influencing factors., Results: It was found that nurses possessed a high level of perceived disaster preparedness, influenced by individual disaster preparedness, status of receiving disaster-related training, willingness to respond in the case of a disaster, disaster plan awareness, experience with caring for disaster victims, extrinsic motivation, and general motivation., Conclusions: The results of the study offer evidence that can be implemented by managers and educators to better prepare nurses for disasters. Hospital administrators and policy makers should consider the factors affecting nurses' perception of disaster preparedness to develop solutions for such disasters.

Objective: This study aimed to assess nurses' perceptions of patient safety culture (PSC) and its relationship with adverse events in Hail City, Saudi Arabia., Design: A cross-sectional study was conducted between 1 August 2023 and the end of November 2023 at 4 governmental hospitals and 28 primary healthcare centres., Setting: Hail City, Saudi Arabia., Participants: Data were collected from 336 nurses using 3 instruments: demographic and work-related questions, PSC and adverse events., Results: Nurses had positive responses in the dimensions of 'teamwork within units' (76.86%) and 'frequency of events reported' (77.87%) but negative responses in the dimensions of 'handoffs and transitions' (18.75%), 'staffing' (20.90%), 'non-punitive response to errors' (31.83%), 'teamwork across units' (34.15%), 'supervisor/manager expectations' (43.22%) and 'overall perception of patient safety' (43.23%). Significant associations were found between nationality, experience, current position and total safety culture, with p values of 0.015, 0.046 and 0.027, respectively. Nurses with high-ranking perceptions of PSC in 'handoffs and transitions,' 'staffing' and 'teamwork across hospital units' reported a lower incidence of adverse events than those with low-ranking perceptions, particularly in reporting pressure ulcers (OR 0.86, 95% CI 0.78 to 0.94, OR 0.82, 95% CI 0.71 to 0.94 and OR 0.83, 95% CI 0.70 to 0.99, respectively) (p<0.05). Nurses with high-ranking perceptions of PSC in UK 'handoffs and transitions' reported a lower incidence of patient falls. Similarly, those with high-ranking perceptions in both 'handoffs and transitions' and 'overall perception of patient safety reported a lower incidence of adverse events compared with those with low-ranking perceptions, especially in reporting adverse drug events (OR 0.83, 95% CI 0.76 to 0.91 and OR 0.75, 95% CI 0.61 to 0.92, respectively) (p<0.05)., Conclusion: From a nursing perspective, hospital PSCs have both strengths and weaknesses. Examples include low trust in leadership, staffing, error-reporting and handoffs. Therefore, to improve staffing, communication, handoffs, teamwork, and leadership, interventions should focus on weak areas of low confidence and high rates of adverse events., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Imposter phenomenon is described as persistently doubting one's accomplishments, leading to an internalised fear of being exposed as a 'fraud'. This article identifies the nature and prevalence of imposter phenomenon among nursing students, newly registered nurses and senior nurses. It also explores the effects of this phenomenon for nurses and healthcare organisations, including its potential association with burnout, suboptimal performance and a lack of career development. Evidence suggests that addressing imposter phenomenon is not something individuals can accomplish by themselves, but that it requires system-level interventions from healthcare organisations and higher education institutions. This could raise awareness, promote recognition and improve resources and training to mitigate the detrimental effects of this phenomenon on healthcare provision., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Background: Although several digital health interventions (DHIs) have shown promise in the care of skin diseases their uptake in Germany has been limited. To fully understand the reasons for the low uptake, an in-depth analysis of patients' and health care providers' barriers and facilitators in dermatology is needed., Objective: The objective of this study was to explore and compare attitudes, acceptability, barriers, and facilitators of patients, dermatologists, and nurses toward DHIs in dermatology., Methods: We conducted 6 web-based focus groups each with patients (n=34), dermatologists (n=30), and nurses (n=30) using a semistructured interview guide with short descriptions of DHIs described in the literature. A content analysis was performed using deductive constructs, following the unified theory of acceptance and use of technology framework, and inductive categories., Results: Patients identified many positive performance expectancies, such as reduced travel times and improvement in follow-up appointments. Dermatologists also stated positive effects (eg, promotion of standardized care), but also negative implications of health care digitalization (eg, increased workload). All stakeholders reported that a DHI should bring additional value to all stakeholders. A lack of digital competence among patients was identified as the major barrier to adoption by all 3 groups. Nurses and dermatologists want apps that are easy to use and easy to implement into their daily routines. Trust in selected institutions, colleagues, and physicians was identified as a facilitator. Patients reported their dependence on the dermatologists' acceptance. All groups expressed concerns about data privacy risks and dermatologists stated insecurities toward data privacy laws., Conclusions: To ensure successful digitalization in dermatology, apps should be user-friendly, adapted to users' skill levels, and beneficial for all stakeholders. The incorporation of dermatologists' perspectives is especially important as their acceptance may impact use among patients and nurses. DHIs should ensure and be transparent about data privacy. The found barriers and facilitators can be used for implementation strategies., (©Patrick Reinders, Matthias Augustin, Anastasia Fleyder, Marina Otten. Originally published in JMIR Dermatology (http://derma.jmir.org), 03.09.2024.)

Background: Moral injury is prevalent among health care professionals, especially nurses. It can have negative personal consequences for clinicians, and indirectly impact the quality of patient care. Although nurses around the world experienced moral injury during the pandemic, it will continue to be a professional challenge. Thus, this study aimed to determine the psychometric properties of a scale measuring moral injury translated into Spanish., Methods: A methodological study with a cross-sectional approach was conducted. After translating the Moral Injury Symptom Scale for Healthcare Professionals (MISS-HP) into Peruvian Spanish (MISS-HP-S) using International Test Commission methods, data were collected using online survey methods from a sample of 720 Peruvian nurses. Analytical methods included exploratory and confirmatory factor analysis, and invariance by age were examined. The corrected homogeneity index, ordinal alpha, and McDonald's omega allowed the evaluation of internal reliability., Results: Findings from this sample of nurses who were mostly female (92%), from coastal Peru (57%), and averaged 39 (± 11) years of age, provided support for the validity and reliability of the MISS-HP-S. Structural validity was endorsed by findings indicating consistent factorial structure and adequate invariance among different age groups. In this study, three factors were observed: guilt/shame, condemnation, and spiritual strength. Internal consistency values included an ordinal alpha of 0.795 and McDonald's omega of 0.835., Conclusion: These findings differ from those reported from previous studies in other cultural contexts, suggesting the influence of cultural and sample-specific factors in the perception of moral injury among Peruvian nurses. Because this evidence supports the validity of the MISS-HP-S, it can be used in professional practice and in future research to identify and address situations that contribute to nurse moral injury., (© 2024. The Author(s).)

Background: Penicillin allergy delabelling (PAD), the process of evaluating penicillin allergy labels, is a key target in antibiotic stewardship, but uptake of the procedure outside clinical studies is limited. We aimed to explore factors that need to be addressed to sustainably implement a clinical pathway for PAD., Methods: We conducted a qualitative study based on semi-structured interviews with focus groups consisting of a purposive sample of twenty-five nurses and physicians working in four different hospitals in Western Norway. Systematic text condensation was applied for analysis., Results: Psychological safety was reported as crucial for clinicians to perform PAD. A narrative of uncertainty and anticipated negative outcomes were negatively associated with PAD performance. Education, guidelines, and colleague- and leadership support could together create psychological safety and empower health personnel to perform PAD. Key factors for sustainable implementation of PAD were facilitating the informant's profound motivation for providing optimal health care and for reducing antimicrobial resistance. Informants were motivated by the prospect of a simplified PAD procedure. We identified three main needs for implementation of PAD: (1) creating psychological safety; (2) utilising clinicians' inherent motivation and (3) optimal organisational structures., Conclusion: A planned implementation of PAD must acknowledge clinicians' need for psychological safety and aid reassurance through training, leadership, and guidelines. To implement PAD as an everyday practice it must be minimally disruptive and provide a contextually adaptive logistic chain. Also, the clinician's motivation for providing the best possible healthcare should be utilised to aid implementation. The results of this study will aid sustainable implementation of PAD in Norway., Ethics: The study was approved by the Western Norway Regional Committee for Medical Research Ethics (Study No:199210)., (© 2024. The Author(s).)