Journal of Nursing Management最新文献

Background: Ensuring safe practices remains a top priority for healthcare policymakers. However, limited evidence has examined the link between individual, work-related factors, and patient safety within critical care units in Oman.

Aim: To assess the relationship between staffing levels, job-related emotional exhaustion, and adverse patient events among nurses working in critical care units.

Design: A cross-sectional study was conducted to collect data from critical care nurses in Oman. Nurses were recruited using a stratified proportional sampling method.

Results: A total of 694 critical care nurses participated in the study. More than half (64.1%) of the critical care nurses experienced higher levels of emotional exhaustion. Significant predictors of adverse patient events included nurse staffing level (r = 0.09, p < 0.001), emotional exhaustion (β = 0.25, p < 0.001), hospital type (being affiliated with nonteaching hospitals) (p = 0.021), and nationality (β = −0.15, p < 0.001).

Conclusion: The occurrence of nurse-reported adverse events was associated with several key variables, including nurse staffing levels, emotional exhaustion, hospital type, and nationality.

Implications for Nursing Management: To improve patient safety, healthcare policymakers should prioritize optimizing nurse staffing levels and implement strategies to reduce emotional exhaustion, particularly in nonteaching hospitals and among specific nurse demographics.

Aim: To profile the work–family balance (WFB) among clinical nurses and identify their influencing factors.

Background: WFBs take on various patterns in nurses. Nurses with different characteristics exhibit various patterns of WFB.

Methods: A cross-sectional study was performed, involving 1292 nurses from public hospitals in Jiangsu Province from February to April 2024. Latent profile analysis (LPA) was employed to categorize the data, and multinominal logistic regression analysis to determine factors influencing WFB.

Results: A total of 1718 questionnaires were distributed, yielding 1292 valid responses (a response rate of 75.2%). The total score of WFB was 44.35 ± 8.693 points. The LPA revealed three profiles of WFB: the family priority group (28.1%), the balanced adaptation group (46.8%), and the challenge coping group (25.1%). The entropy value was high (0.892), indicating a correct classification. Multivariate regression analyses showed that professional title, department, nonclinical work pressure, organizational identification, work meaning, and self-efficacy as factors influencing WFB profiles.

Conclusion: The WFB among nurses was at a moderate level with significant heterogeneity and could be divided into three profiles. The challenge coping group presented lower professional titles and higher self-efficacy, and working at surgical, pediatric, and other specialized departments. Managers can tailor intervention strategies based on the characteristics and influencing factors of each profile.

Implications for Nursing Management: Nursing managers must consider the characteristics of high-risk groups and factors that affect WFB and take targeted measures to mitigate work–family conflicts (WFC) among nurses and stabilize the nursing workforce.

Background: Compassionate care and resilience play crucial roles in enhancing care quality. Understanding compassionate care patterns in the nursing population and their relationship with resilience can improve knowledge of these concepts.

Objective: To investigate compassionate care patterns among Iranian nurses and their associations with resilience at individual and contextual levels.

Method: This cross-sectional study used Persian versions of the 28-item Compassionate Care Questionnaire (CCQ) and Connor–Davidson Resilience Scale (CD-RISC). 478 Iranian nurses from 19 wards across 16 hospitals in northern Iran participated between February and September 2023. Latent profile analysis (LPA) was performed on compassionate care dimensions. Multilevel logistic regression modeling explored associations between resilience dimensions and compassionate care profiles, adjusting for control variables at individual and contextual levels.

Results: LPA revealed two distinct compassionate care profiles: “Low Compassionate Care” (16.3%) and “High Compassionate Care” (83.7%). After adjusting for control variables, personal competence (OR = 1.09, 95% CI: 1.02–1.15), positive acceptance (OR = 1.23, 95% CI: 1.06–1.44), and spirituality (OR = 1.17, 95% CI: 1.01–1.38) were associated with higher odds of inclusion in the “High Compassionate Care” profile. The empty model showed that 6.5% of compassionate care patterns were explained at the ward level. After adding predictors at individual and ward levels, explained variances were reduced to 1.5% and < 0.01%, respectively.

Conclusions and Implication: This study offers insights into compassionate care among nurses, showing that few exhibited “Low Compassionate Care.” Higher resilience was positively linked to elevated compassionate care levels. Policymakers, managers, and educators can leverage these findings to enhance nursing management and support systems by prioritizing resilience-building strategies, ultimately improving patient care quality.

Aim: To investigate the relationship between mindful self-care and compassion fatigue and the chain mediating effects of resilience and professional identity.

Background: Compassion is a critical quality for nurses, but they often face the risk of compassion fatigue.

Methods: From October 2023 to May 2024, a cross-sectional survey was conducted in six tertiary hospitals in Guangdong, Henan, and Jiangsu provinces by convenience sampling. A total of 1315 clinical nurses in the hospital were surveyed using the Social–demographic Characteristics Questionnaire, the Chinese Version of the Brief Mindful Self-Care Scale, the Chinese Version of the Connor–Davidson Resilience Scale, the Professional Identity Scale for Nurses, and the Chinese Version of the Compassion Fatigue Short Scale. The mediation model was analyzed using a bias-corrected bootstrapping method with PROCESS 4.1 implemented in SPSS 26.0.

Results: Pearson correlation analysis showed that there was a positive correlation between nurses’ mindful self-care, resilience, and professional identity. Mindful self-care, resilience, and professional identity were negatively correlated with compassion fatigue. Resilience played a partial mediating role between mindful self-care and compassion fatigue. Professional identity also played a partial mediating role between mindful self-care and compassion fatigue; mindful self-care affected compassion fatigue through resilience and professional identity.

Conclusion: Nurses’ mindful self-care can affect compassion fatigue through the mediating role of resilience and professional identity. In the future, attention should be paid to cultivating nurses’ mindful self-care ability and resilience and improving nurses’ professional identity, which may help to reduce nurses’ compassion fatigue.

Background: With increasing burnout and turnover rates among nurses, health leadership can effectively improve the health and well-being of both leaders and staff. However, in the nursing field, the definition and mechanisms of health leadership remain unclear and require further research.

Aim: The main objective of this study was to define the concept of health leadership in nursing, construct a nursing model program, and promote the formation of normative nursing health leadership theories and strategies.

Evaluation: We searched the PubMed, CINAHL, Embase, Web of Science, PsycINFO, and Scopus databases. The following themes were extracted from the included articles: the concept, assessment tools for health leadership, influencing factors, intervention measures, and health effects.

Key Issues: A systematic search of the relevant databases yielded 3161 initial search results. Thirty-two studies were eligible for inclusion. Research shows that the concepts and measurement tools of health leadership are rarely applied in the field of nursing. Health leadership is influenced by personal factors (e.g., leadership qualities such as care, support, courage, patience, tolerance for uncertainty, persuasion skills, work ethic, pressure, experience, effort–reward imbalance, etc.; specific knowledge; self-awareness; psychological capital; leadership style; motivation; consideration; and a commitment to health issues) and organizational factors (e.g., work environment, attention to subordinates, job expectations, and relationship transparency). Several studies have demonstrated that interventions, such as personal development planning, leadership training, face-to-face communication, self-directed learning, and reflection, are effective in promoting healthy leadership styles and improving the well-being of leaders and employees.

Conclusions: We constructed a health leadership model as a reference for the development of relevant measurement tools and intervention strategies for the nursing field.

Implications for Nursing Management: Nursing leaders should focus on their health and that of their subordinates, develop and implement health leadership, and aim for improvement in employees’ well-being and nursing quality.

Aims and Objectives: To investigate the connection between organizational climate and clinical competency among intensive care unit (ICU) nurses in government hospitals in Saudi Arabia.

Background: Across the Middle Eastern healthcare settings, studies that explored the link between organizational climate and clinical competency among ICU nurses remain underreported.

Methods: This cross-sectional study involved 206 ICU nurses from seven government hospitals in the Ha’il Region, Saudi Arabia. Two validated self-report scales were utilized to gather data from August to September 2023. Descriptive and inferential statistics were used to analyze the data.

Results: Most ICU nurses were female, aged 31–35 years, married, with a Bachelor of Science in Nursing degree, and had 4–6 years of ICU experience. The organizational climate was perceived positively by 98.10% of nurses, with the highest mean score for independent practice and support. The clinical competency mean score was at a middle level, with the highest mean score for clinical care. Significant differences were noted between organizational climate and age, marital status, educational attainment, years of experience, and hospital assigned. Also, significant differences were demonstrated between clinical competency and gender, marital status, and daily patient workload. Finally, there was a positive correlation between organizational climate and clinical competency.

Conclusion: The study revealed a positive perception of organizational climate among ICU nurses, with a moderate level of clinical competency. The hospital administrators and policymakers can focus on the enhancement of the organizational climate to further support and develop ICU nurses’ competencies.

Implications for Nursing Management: Nurse managers and healthcare administrators should cultivate a positive organizational climate and enhance clinical competency to ensure nursing care quality and improved client outcomes among ICU nurses, thereby promoting commitment, retention, and professional relationships of the workforce.

Background: Turnover intentions among nurses pose a significant challenge for healthcare systems globally. While numerous studies have explored the association between nurses’ well-being and turnover intention, the underlying mechanisms remain insufficiently understood. Addressing the interactions among psychological capital, work engagement, well-being and turnover intention is therefore essential.

Aim: This study examined the chain-mediating effects of psychological capital and work engagement on the relationship between well-being and turnover intention. It aimed to identify the mechanisms influencing turnover intention tendencies among nursing staff and to propose strategies for stabilising nursing teams.

Methods: A multistage random sampling approach was adopted across 21 hospitals in three provinces: Zhejiang (Eastern China), Heilongjiang (Central China) and Chongqing (Western China). Data were collected using the 5-item World Health Organization Well-Being Index, the Psychological Capital Questionnaire, the Utrecht Work Engagement Scale and the Turnover Intention Scale. Harman’s single-factor test was employed to detect common method bias, and chain mediation analysis was conducted using the SPSS PROCESS macro.

Results: Significant correlations were found between well-being, psychological capital, work engagement and turnover intention (p < 0.001). Well-being directly influenced turnover intention (effect = −0.1227, 95% CI = −0.1421, −0.1033). Work engagement partially mediated the relationship between well-being and turnover intention (effect = −0.0813, 95% CI = −0.0944, −0.0687). In addition, psychological capital and work engagement jointly mediated the relationship (effect = −0.0817, 95% CI = −0.0940, −0.0701).

Conclusion: Nurses’ well-being influences turnover intention via the serial mediation of psychological capital and work engagement. Hospital managers and governments should implement multifaceted interventions to mitigate turnover intentions and enhance the stability of nursing teams.

Implications for Nursing Management: The findings highlight a potential pathway linking nurses’ well-being to turnover intention. Nursing managers can adopt targeted interventions addressing this pathway to reduce turnover intention rates and ensure team stability.

Background: Understanding why new nurses quit is vital for hospitals to retain talent. New nurses of Gen Z in China, who have grown up in an era of rapid development, may face unique challenges that lead to their departure, differing from their predecessors. However, research on the turnover causes of new nurses of Gen Z in the context of China’s new era is limited.

Aim: The aim of this study was to explore the reasons why new nurses of Gen Z in China leave from hospitals.

Design: A descriptive phenomenological study.

Methods: From October 2023 to October 2024, semistructured interviews were conducted with 16 new nurses of Gen Z in China. All participants voluntarily resigned from their hospitals in less than a year of employment. The data were analyzed using the Nvivo 11.0 software, employing the Colaizzi method to extract themes.

Results: Four themes were identified: unalleviated physical and mental stress (conflict between high expectations and slow adaptation, heavy workload, lack of team support, sense of disparity and role transition, and blow from negative events/nursing errors), development planning and personal pursuit (temporary choice for hospital employment, low professional identity, and “for myself”), the power of social support (influence of parents and the role of peer), and new opportunities.

Conclusion: The turnover of China’s new nurses of Gen Z is the result of a combination of multiple factors, which collectively prompts them to leave their hospitals and even the nursing profession. Among these factors, the fundamental reason for their resignation is the lack of fulfillment of their needs.

Implications for Nursing Management: It is crucial to create a positive work environment conducive to the growth of new nurses, while paying attention to their needs and formulating retention strategies tailored to the characteristics of Gen Z.

Background: The stance of nurse leaders toward moral courage and encouragement received from them hold significant sway in determining whether nurses can courageously uphold the correct values in their duties and actions.

Aim: The objective of this study is to gain insights into nurse leaders’ perceptions of moral courage in the workplace, with the aim of addressing barriers to the development of moral courage among nurses.

Research Design: This study used descriptive qualitative methods in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ).

Participants and Research Context: This study was conducted in 2024. Participants were selected by purposive sampling. The sample size was determined by data saturation, which was reached with 10 participants. The interviews were conducted through semistructured telephone interviews. Data were analyzed using a deductive method of content analysis.

Ethical Considerations: The ethics committee of Fujian Medical University (No. 196, 2024) provided approval for this study. Verbal consent was obtained before the interview with the participants. All data were processed anonymously and confidentially.

Results: The analysis resulted in 14 subcategories, which were subsequently grouped into 4 categories.

Conclusions: This study emphasizes the essential role of nurse leaders in promoting moral courage within healthcare teams. By fostering an ethical environment and providing support, nurse leaders enable nurses to make ethically sound decisions. Future research could further explore the longitudinal development of moral courage in nursing practice to understand the impact of moral courage on healthcare outcomes.

Background: A culturally diverse research workforce benefits patients, the community and the population as patients see health and care professionals who are like them and can build trusting relationships. From our experience, ethnic minority group nurses are less likely to attend research-related workshops and have significantly less awareness about clinical research funding and career pathways. This pilot project aimed to create awareness of clinical research terminology, methods and funding streams among ethnic minorities cardiothoracic nurses and allied health professionals (NAHPs) across specific geographical locations in England.

Methods: Participants were invited using social media platforms to attend a research masterclass at various locations across England and 211 were registered but 92 attended. They were also invited to complete a pre- and postworkshop questionnaire to determine their understanding of the topics being taught during the masterclass. Data were collected and then compared before and after the masterclass.

Results: A total of 63 out of 92 participants completed the workshop evaluation. There were 88% female and 11% male participants, aged 18 to 60+ years with different educational backgrounds. The participant’s pre- and postresearch theory and skills knowledge demonstrated some significant changes after attending the Masterclass on understanding research terminologies (p < 0.001), how study aims, and objectives determine the study methodology (p < 0.001) and the difference between qualitative and quantitative research (p = 0.012). We also asked about the overall experience (98% said 10 out of 10), structure of the workshop (98% said 9 out of 10), venue, food and drinks (95% said 8 out of 10), communication/organisation (98% said 10 out of 10) and relevance of the workshops (100% said 10 out 10).

Conclusions: Our study findings suggest that raising awareness about research careers, local/national funding opportunities and research masterclasses can improve NAHPs awareness of opportunities to gain skills and confidence in leading their own research to answer pertinent clinical and care questions related to their practice and ultimately improve patient care. In addition, this study identifies the gap in clinical research and funding among clinical staff, which is crucial for advancing evidence-based practice. Encouraging clinical healthcare staff to engage in clinical research will help foster an evidence-based culture.