Journal of Nursing Management最新文献

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.

Despite the extensive literature examining the relationship between organisational justice and intention to leave, few attempts have been made to elucidate the dynamics of this relationship, especially in relation to the significant role that pay satisfaction can play within the context of Arab culture. Therefore, the aim of this study is to investigate the relationship between perceived organisational justice dimensions (procedural, distributive and interactional) and intention to leave among healthcare workers in Jordan, with a focus on the mediating role of pay satisfaction. The study population includes all physicians and nurses in Jordan’s public and private health services, with a total of 74,351 individuals, as per the Jordanian Physicians’ and Nurses’ Syndicates website. The study employed a quantitative cross-sectional research design with a snowball sampling technique, where potential respondents were personally contacted and asked to send the survey to their colleagues through WhatsApp. We received a total of 679 questionnaires, of which only 545 were valid for analysis. We analysed the data with SmartPLS 4.0 using partial least squares structural equation modelling (PLS-SEM). Our results revealed that interactional justice directly influences intention to leave, while distributive and procedural justices do not. Pay satisfaction is significantly influenced by all three dimensions of organisational justice, acting as a full mediator between distributive and procedural justice and intention to leave, but not interactional justice. The study highlights the importance of fair interpersonal relationships and equitable pay practices in reducing intention to leave within Jordanian healthcare organisations. It also emphasises the need for culturally tailored management strategies to improve organisational stability and employee retention. Our research offers novel insights into how cultural context shapes organisational behaviour in the healthcare sector. Accordingly, Arab cultural environments differ from other cultural contexts in how they perceive justice and, consequently, how it relates to intention to leave and pay satisfaction. The findings confirmed that distributive and procedural justices are the same concept within this culture (labelled structural justice), whereas interactional justice, which includes interpersonal and informational justice (as operationally defined in the literature), is a distinct concept (labelled relational justice). Thus, this study contributes to the debate in the current literature on the extent to which the dimensions of organisational justice are related and whether they are distinct from each other (Colquitt et al. 2001).

Introduction: Recent decades have seen a significant increase in focus on person-centred care. However, its implementation is complex. Person-centred care is paradoxically simultaneously described as fundamental and as extra to the nursing practice. Although the significance of leadership for the delivery of person-centred care is recognised, less is known about what this entails.

Objective: Mapping leadership in a context of person-centred care.

Methods: The search strategy focuses on the two main concepts: leader(ship) and person-centred care, with results limited to studies published between 2010 and 2023. A convergent data synthesis was performed, enabling an analysis of study characteristics and a thematic inductive analysis of qualitative, quantitative and theoretical studies in one.

Results: A total of 27 studies were included. In these studies, the leadership subjects are almost all related to a formal (leadership) position. The included studies reference several leadership components. These include person-centred vision and culture, skills, being a role model, commitment/support, client engagement and facilitating forums and conditions for person-centred care. All components regard interactions or relationships. These can be found on different levels, ranging from interactions with the self, colleagues, patients, within the team and in the organisation.

Conclusions: This review shows leadership as a concept connected to formal positions and roles and as a set of qualities, characteristics and/or skills of an individual. However, it also shows the importance of person-centred vision and person-centred culture in leadership. This includes an implicit focus on values of good care and on interactions or relationships. We propose explicating the latter two elements in a notion of person-centred leadership as a starting point for improving nursing practice and training.

Background: With the increasing frequency and severity of disasters, retaining skilled nurses is essential for sustaining healthcare systems in times of crisis. Given that behavior is largely influenced by intention, a predictive model for nurses’ intent to stay (ITS) is needed.

Aim: This study aimed to develop and validate a comprehensive structural model explaining clinical nurses’ ITS during disasters. This model addresses the critical need to understand and enhance nurse retention during crises.

Methods: In this cross-sectional study, 549 nurses who worked during the COVID-19 pandemic participated. The data were collected through a web-based self-report survey from March 5 to 15, 2024. Factor analysis, model fit confirmation, and path significance were analyzed using SPSS/WIN 23.0 and AMOS 28.0. A two-step approach was employed to validate the hypothetical model.

Results: Group cohesion significantly impacted organizational commitment, empowerment, and job satisfaction. Adequate staffing and resources were crucial in influencing moral distress and organizational commitment. Both job satisfaction and organizational commitment directly affected the ITS, with group cohesion exerting an indirect effect. Path analysis demonstrated that adequate staffing and resources notably influenced organizational commitment, while adaptive leadership, adequate staffing, and disaster nursing competency significantly impacted job satisfaction. The model explained 71.4% of the variance in nurses’ intention to stay during disasters.

Conclusion: The study highlights that organizational commitment is the strongest predictor of clinical nurses’ intent to remain during disasters.

Implications for Nursing and/or Health Policy: To ensure a stable and skilled nursing workforce in disaster situations, it is essential to foster organizational commitment. Strategies should focus on enhancing group cohesion, providing adequate staffing and resources, and supporting organizational commitment among clinical nurses.

Background: Registered nurses (RNs) play an important role in providing primary healthcare (PHC) services. Longitudinal evidence on how the RN scope of practice in these settings has evolved over the years is currently missing and is critical in understanding how Australian government health policies have shaped the reality of nursing practice.

Aim: To explore the scope of practice of RNs in Australian PHC workplace in both metropolitan and rural areas and among those with and without postgraduate qualifications during 2015–2019.

Methods: Longitudinal survey data were retrospectively retrieved, collated and analysed using variate and bivariate analyses in SPSS Version 27.0. Composite items were used to combine survey items into seven key areas of nursing practice.

Results: Majority of the 3882 participants were female (n = 3782, n = 97.4%), worked in general practice (n = 2916, 75.1%) and in metropolitan areas (n = 2145, 55.3%) and had completed a short course (n = 2470, 63.6%). A total of 904 participants (23.3%) completed at least one postgraduate degree. There was no significant and substantial difference in the frequency, and preference for frequency, of seven PHC practice areas by participants in different workplace localities, with or without a formal postgraduate degree as well as throughout the 5-year survey period.

Conclusion: The findings on the scope of practice by the RN participants might be explained by the interplay of interprofessional, organisational and institutional factors (more than individual factors).

Implications for Nursing Management: Multilayer strategies targeting interprofessional, organisational, institutional and individual factors should be in place to enable RNs to work to their full capacity and advanced level of education. RNs also need to be included in major policy- and decision-making that affects them to ensure their job satisfaction, retention in practice and contribution to patient health outcomes in PHC are sustained.