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A Concept Analysis of Change Fatigue Among Nurses Based on Walker and Avant’s Method 基于 Walker 和 Avant 方法的护士变革疲劳概念分析
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-22 DOI: 10.1155/jonm/8413242
Songmei Cao, Jingxi Lin, Yiqing Liang, Yuan Qin

Background: Change is prevalent in nursing environments and often leads to change fatigue among nurses while aiming to improve service quality and efficiency. Change fatigue is a significant stressor affecting nurses’ work and psychology, and it is a crucial factor influencing organizational change. However, the concept of change fatigue among nurses has not yet been clearly defined or analyzed.

Aim: This analysis aims to differentiate, clarify, and clearly identify the specific concept of change fatigue among nurses, which will provide nursing administrators and researchers with a comprehensive understanding of the concept of change fatigue among nurses, ultimately facilitating relevant measurements and interventions.

Methods: This study employed Walker and Avant’s concept analysis method.

Results: A total of 29 papers were included in the study. The four defining attributes of change fatigue among nurses were identified as nurses’ exposure to constant change, exhaustion, decreased agency, and passive acceptance of change. Antecedents were categorized into nurses’ personal factors and those related to the organizational environment. The consequences of change fatigue were distinguished between individual-level and organizational-level impacts.

Conclusions: This study provides a clearer understanding of the concept of change fatigue among nurses by outlining its antecedents, attributes, and consequences. An operational definition and conceptual understanding of change fatigue will aid future research in developing effective prevention strategies.

背景:变革在护理环境中普遍存在,在以提高服务质量和效率为目标的同时,变革往往会导致护士产生变革疲劳。变革疲劳是影响护士工作和心理的重要压力源,也是影响组织变革的关键因素。然而,护士变革疲劳的概念尚未得到明确定义或分析。 目的:本分析旨在区分、澄清和明确护士变革疲劳的具体概念,使护理管理者和研究者全面了解护士变革疲劳的概念,最终促进相关测量和干预措施的实施。 研究方法本研究采用 Walker 和 Avant 的概念分析方法。 结果:共收录了 29 篇论文:本研究共收录了 29 篇论文。确定了护士变革疲劳的四个定义属性,即护士面临持续变革、疲惫、代理能力下降和被动接受变革。前因分为护士个人因素和组织环境因素。变革疲劳的后果分为个人层面的影响和组织层面的影响。 研究结论本研究通过概述变革疲劳的前因、属性和后果,使人们对护士变革疲劳的概念有了更清晰的认识。对变革疲劳的操作定义和概念理解将有助于未来研究制定有效的预防策略。
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引用次数: 0
The Effect of Digital Competence on Nurses’ Career Sustainability: A Cross-Sectional Study 数字化能力对护士职业可持续性的影响:横断面研究
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-21 DOI: 10.1155/jonm/8813704
Zeyu Zhang, Shuang Zhao, Yujiao Shao, Xiaocui Duan, Ping Sun, Lingling Chen, Fei Wang, Changjiang Yuan, Xiumu Yang

Aim: This study aimed to elucidate the relationship between digital competence (DC), nurses’ career sustainability (CS), and the moderating role of family-supportive supervisory behavior.

Background: Nurses’ CS is crucial in promoting medical digital transformation in China. Thus, clarifying the influencing factors of nurses’ CS has become a priority.

Methods: This cross-sectional investigation was carried out in Anhui Province, China. Eight hundred and fifty-four nurses received self-administered questionnaires, which included the Digital Competence Questionnaire, Career Self-Efficacy Scale, Career Sustainability Scale, and Family-Supportive Supervisory Behavior Scale. A hierarchical regression analysis was used to test a hypothesized model.

Results: Nurses’ CS is significantly predicted by DC (r = 0.52, p < 0.01), and career self-efficacy (CSE) mediates this association (β = 0.682, p < 0.01). In addition, family-supportive supervisor behavior (FSSB) moderates the relationship between DC and CSE (β = 0.146, p < 0.01).

Conclusions: Our study investigates the positive impact of DC on nurses’ CS at both the individual and organizational levels, identifies potential boundary conditions, and advances theoretical research on nurses’ CS while providing a solid foundation for developing effective strategies to improve nurses’ CS.

Implications for Nursing Management: Hospital managers and leaders should focus on organizational support for nurses and their families, formulate intervention measures to increase nurses’ DC and CSE, and improve their CS.

目的:本研究旨在阐明数字化能力(DC)、护士职业可持续性(CS)和家庭支持性督导行为的调节作用之间的关系。 研究背景:护士的职业可持续发展能力(CS)对促进中国医疗数字化转型至关重要。因此,明确护士CS的影响因素已成为当务之急。 研究方法本横断面调查在中国安徽省进行。854名护士接受了自制问卷,包括数字化能力问卷、职业自我效能感量表、职业可持续性量表和家庭支持性督导行为量表。采用分层回归分析来检验假设模型。 结果显示护士的 CS 受 DC 的显著预测(r = 0.52,p <0.01),而职业自我效能感(CSE)在这一关联中起中介作用(β = 0.682,p <0.01)。此外,家庭支持性上司行为(FSSB)调节了 DC 与 CSE 之间的关系(β = 0.146,p <0.01)。 结论:我们的研究从个人和组织两个层面探讨了DC对护士CS的积极影响,确定了潜在的边界条件,推进了护士CS的理论研究,同时为制定改善护士CS的有效策略奠定了坚实的基础。 对护理管理的启示:医院管理者和领导者应重视对护士及其家属的组织支持,制定干预措施以提高护士的DC和CSE,改善护士的CS。
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引用次数: 0
Nurse-Led Telephone Program for Nonadherent to Treatment Type 2 Diabetics With Comorbid Depression: A Cost-Consequence and Budget Impact Analysis 针对不坚持治疗并伴有抑郁症的 2 型糖尿病患者的护士电话计划:成本后果和预算影响分析
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-19 DOI: 10.1155/2024/9989080
Manuel Gómez-Barrera, María Luisa Lozano-Del Hoyo, Juan Francisco Roy, María Teresa Fernández-Rodrigo, Piedad Gómez-Torres, Isabel Blázquez-Ornat, Sofía Pérez-Calahorra, Maria Esther Samaniego Diaz de Corcuera, Emilia Ferrer-López, Enrique Ramón-Arbués

Objective: To estimate the efficiency of a nurse-led telephone program for nonadherent to treatment Type 2 diabetics with comorbid depression (TELE-DD program).

Design: Secondary analysis of cost-consequence and budget impact, utilizing data from a randomized clinical trial conducted in the primary healthcare setting. The target population consisted of Type 2 diabetic patients with comorbid depression who were nonadherent to their pharmacological treatment.

Method: The average cost per controlled patient (glycated hemoglobin < 7%) and the incremental cost-effectiveness ratio were calculated. Similarly, the budgetary impact over 1 year of implementing this program in the region of reference of the randomized clinical trial was assessed.

Results: The number of controlled patients is higher in the TELE-DD group at 6, 12, and 18 months. The average cost per controlled patient was higher in the TELE-DD group than in the control group at 6 months (€160.31 vs. €49.79), but lower at 12 (€150.09 vs. €179.59) and 18 months (€209.22 vs. €376.88). The incremental cost-effectiveness ratio at 6, 12, and 18 months was €254.47, €143.65, and €177.46, respectively. The budget impact analysis revealed that implementing the TELE-DD program would result in a reduction of €721,940.68 in expenditure for the funder in the first year of application.

Conclusions: A nurse-led telephone program for nonadherent Type 2 diabetics with comorbid depression is an efficient option in the management of healthcare resources. These results highlight the role of nursing in chronic patient management and the efficient use of healthcare resources.

Trial Registration: ClinicalTrials.gov Identifier: NCT04097483.

目的评估针对不坚持治疗且合并有抑郁症的 2 型糖尿病患者的护士主导型电话项目(TELE-DD 项目)的效率。 设计:利用在基层医疗机构开展的随机临床试验数据,对成本后果和预算影响进行二次分析。目标人群包括合并抑郁症且不坚持药物治疗的 2 型糖尿病患者。 研究方法计算每位受控患者的平均成本(糖化血红蛋白< 7%)和增量成本效益比。同样,还评估了在随机临床试验参考地区实施该计划一年的预算影响。 结果显示在 6 个月、12 个月和 18 个月时,TELE-DD 组的受控患者人数更多。在 6 个月时,TELE-DD 组每位受控患者的平均成本高于对照组(160.31 欧元对 49.79 欧元),但在 12 个月(150.09 欧元对 179.59 欧元)和 18 个月时则低于对照组(209.22 欧元对 376.88 欧元)。6 个月、12 个月和 18 个月的增量成本效益比分别为 254.47 欧元、143.65 欧元和 177.46 欧元。预算影响分析显示,实施 TELE-DD 计划后,资助方第一年的支出将减少 721,940.68 欧元。 结论:以护士为主导的电话项目可有效管理医疗资源,适用于不坚持治疗且合并抑郁症的 2 型糖尿病患者。这些结果凸显了护理在慢性病患者管理和有效利用医疗资源方面的作用。 试验注册:ClinicalTrials.gov Identifier:NCT04097483。
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引用次数: 0
Effects of Hierarchical Unit Culture and Power Distance Orientation on Nurses’ Silence Behavior: The Roles of Perceived Futility and Hospital Management Support for Patient Safety 等级单位文化和权力距离导向对护士沉默行为的影响:感知的无用性和医院管理层对患者安全的支持的作用
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-19 DOI: 10.1155/jonm/6564570
Seung Eun Lee, Jeong Won Lee

Background: Patient safety is paramount in healthcare, and effective communication is a cornerstone of preventing adverse patient events. Despite nurses’ crucial role in improving patient safety, they often keep silent about their concerns. This study investigated links among hierarchical unit culture, nurses’ power distance orientation, perception of futility, and silence behavior in healthcare environments. Moreover, we aimed to determine whether nurse-perceived hospital management support for patient safety moderated the association between nurses’ perceived futility and silence behavior.

Methods: This cross-sectional, correlational study utilized survey data from 730 direct-care nurses working in 88 medical, surgical, or medical–surgical units across 34 hospitals in South Korea. Validated psychometric scales measured the study variables, and data were analyzed using a 2-1-1 type of multilevel structural equation model.

Results: Hierarchical unit culture and power distance orientation showed significant positive associations with nurses’ perception of futility (b = 0.62, p < 0.001, and b = 0.37, p < 0.001, respectively) and subsequently with their silence behavior (b = 0.22, p < 0.01, and b = 0.31, p < 0.001, respectively). Futility was found to mediate the relationship of both hierarchical unit culture (indirect effect = 0.222, 95% confidence interval (CI) [0.006, 0.438]) and power distance orientation (indirect effect = 0.132, 95% CI [0.003, 0.261]) to silence behavior. Hospital management support for patient safety significantly moderated the relationship between futility and silence behavior (b = 0.04, p < 0.05); nurses were less likely to remain silent when they perceived high management support as opposed to low support, regardless of their futility level.

Conclusion: Our findings highlight the crucial influence of organizational culture on nurses’ silence behavior. The findings also underscore the importance of hospital management support with respect to patient safety. Management support may be necessary to combat nurses’ perceived futility and to promote open communication.

背景:患者安全在医疗保健领域至关重要,而有效的沟通是预防患者不良事件的基石。尽管护士在改善患者安全方面发挥着至关重要的作用,但她们往往对自己的担忧保持沉默。本研究调查了医疗环境中科室等级文化、护士的权力距离取向、无用感和沉默行为之间的联系。此外,我们还旨在确定护士感知到的医院管理层对患者安全的支持是否调节了护士感知到的无用性与沉默行为之间的关联。 研究方法这项横断面相关研究利用了在韩国 34 家医院的 88 个内科、外科或内外科病房工作的 730 名直接护理护士的调查数据。经过验证的心理测量量表测量了研究变量,并使用 2-1-1 型多层次结构方程模型对数据进行了分析。 研究结果等级单位文化和权力距离取向与护士的无用感(b=0.62,p <0.001;b=0.37,p <0.001)呈显著正相关,随后与护士的沉默行为(b=0.22,p <0.01;b=0.31,p <0.001)呈显著正相关。研究发现,"无用论 "是等级单位文化(间接效应 = 0.222,95% 置信区间 (CI) [0.006,0.438])和权力距离导向(间接效应 = 0.132,95% CI [0.003,0.261])与沉默行为之间关系的中介。医院管理层对患者安全的支持在很大程度上调节了无效性与沉默行为之间的关系(b = 0.04,p <0.05);无论护士的无效性水平如何,当她们认为管理层的支持高而支持低时,她们保持沉默的可能性较低。 结论我们的研究结果强调了组织文化对护士沉默行为的重要影响。研究结果还强调了医院管理支持对患者安全的重要性。管理层的支持对于消除护士的无用感和促进开放式沟通可能是必要的。
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引用次数: 0
Translation and Psychometric Properties of the Persian Version of the Organizational Learning Instrument–Development Stages (OLI-DS) Instrument in Hospital Units 医院单位组织学习工具--发展阶段(OLI-DS)波斯语版工具的翻译和心理测量学特性
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-18 DOI: 10.1155/jonm/3906448
Alireza Mirzaei, Faranak Kazemi Darabadi, Sahar Havaskar, Azade Lotfi, Reza Nemati-Vakilabad

Aim: The Organizational Learning Instrument–Development Stages (OLI-DS) measure hospital units’ readiness to engage in organizational learning. This study aimed to translate and evaluate the psychometric properties of the Persian version of this instrument.

Background: Organizational learning is crucial for nurses as it enables them to continuously develop their knowledge, skills, and abilities, enhancing the quality of patient care. However, validated instruments are needed to assess organizational learning in Persian-speaking healthcare settings.

Design: The research was carried out using a cross-sectional design.

Methods: This research study involved 319 clinical nurses selected using convenience sampling. The OLI-DS tool, consisting of 35 items, underwent a forward–backward translation process to Persian before being utilized for a psychometric analysis. The face, content, and construct validity were used to evaluate the tool’s effectiveness. The quality and accuracy of the measurements were determined by calculating internal consistency and stability reliability. The data were analyzed using SPSS and AMOS software.

Results: The intended meaning and clarity of the original English version were preserved in the Persian rendition of the OLI-DS instrument. The confirmatory factor analysis (CFA) further confirmed the consistency of the Persian version with the proposed four-factor model, indicating a good fit. The overall instrument had excellent values for Cronbach’s alpha coefficient (α = 0.931), McDonald’s omega (ω = 0.921), coefficient H (H = 0.979), and mean interitem correlation (ρ = 0.278). The convergent and discriminant validity of the four latent factors was found to be good. The stability of the overall OLI-DS instrument was ICC = 0.942 (95% CI, 0.902–0.955).

Conclusion: The Persian version of the OLI-DS has been validated to evaluate hospital units’ readiness for organizational learning processes. It is a robust tool for assessing their preparedness to participate in and benefit from organizational learning initiatives.

Implications for Nursing Management: The robust psychometric validation of the Persian version of the OLI-DS instrument equips nursing administrators and leaders with a reliable tool. This tool can assess and monitor organizational learning and development in healthcare settings, empowering them to make informed decisions in critical nursing management activities.

目的:组织学习工具-发展阶段(OLI-DS)测量医院单位参与组织学习的准备程度。本研究旨在翻译和评估该工具波斯语版本的心理测量特性。 背景:组织学习对护士至关重要,因为它能使护士不断发展自己的知识、技能和能力,从而提高患者护理质量。然而,需要经过验证的工具来评估波斯语医疗环境中的组织学习。 设计:研究采用横断面设计。 方法:采用横断面设计:这项研究采用便利抽样法,共选取了 319 名临床护士。OLI-DS 工具由 35 个项目组成,在进行心理测量分析之前,先将其正向翻译成波斯语。面效度、内容效度和结构效度用于评估该工具的有效性。通过计算内部一致性和稳定性可靠性来确定测量的质量和准确性。数据使用 SPSS 和 AMOS 软件进行分析。 结果波斯语版的 OLI-DS 工具保留了英文原版的原意和清晰度。确认性因素分析(CFA)进一步证实了波斯语版本与所提出的四因素模型的一致性,表明两者契合度很高。整个工具的克朗巴赫α系数(α = 0.931)、麦当劳欧米茄系数(ω = 0.921)、H系数(H = 0.979)和项目间平均相关性(ρ = 0.278)的值都非常好。四个潜在因子的收敛效度和区分效度良好。整个 OLI-DS 工具的稳定性为 ICC = 0.942(95% CI,0.902-0.955)。 结论波斯语版本的 OLI-DS 已通过验证,可用于评估医院单位在组织学习过程中的准备情况。它是一种强有力的工具,可用于评估他们参与组织学习计划并从中受益的准备程度。 对护理管理的意义:波斯语版的 OLI-DS 工具经过了可靠的心理测量验证,为护理管理者和领导者提供了可靠的工具。该工具可以评估和监控医疗机构的组织学习和发展,使他们能够在关键的护理管理活动中做出明智的决策。
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引用次数: 0
The Impact of Perceived Emotional Intelligence on Occupational Stress Among Nurses: Empirical Evidence From a Saudi Health Cluster 感知情商对护士职业压力的影响:来自沙特医疗集团的经验证据
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-16 DOI: 10.1155/2024/8876168
Abdulaziz M. Alsufyani, Mohammed S. Almalki, Khaled A. Khader, Penelope Satnford, Samantha Freeman, Yasir M. Alsufyani

Background: Occupational stress is a significant challenge for healthcare systems worldwide. It compromises the quality of healthcare and jeopardizes patient safety. Globally, the estimated economic impact of occupational stress in the healthcare system ranges from US $221.13 million to US $187 billion. Emotional intelligence has been recognized as a behavioral buffer against occupational stress. Hence, this study investigated whether nurses’ perceptions of emotional intelligence impact their self-perceived occupational stress.

Design: A predictive correlational design was utilized.

Method: A prior power analysis using G ∗ Power 3.1 was conducted. A convenience sample of 734 nurses was recruited from Taif Health Cluster. Data were coded and analyzed using IBM® SPSS® Statistics for Windows v.25. Descriptive and inferential statistics were used. A hierarchical regression technique was used. The level of significance was established at p < 0.05. The process of data collection started at August 2022 and continued through October 2022.

Results: The results indicated that nurses’ age and working area predicted occupational stress perceptions in the first model (β = −0.28 and β = 0.21, p = 0.001, respectively). The second model showed a significant improvement (ΔF(7,727) = 162.35, p < 0.000, ΔR2 = 0.226) and indicated a negative correlation between nurses’ perceptions of emotional intelligence and occupational stress (β = −0.45, t = −12.8, p < 0.000). The nurses’ sociodemographic characteristics in the first model explained 2.4% of the variance. The second model represented 25.0% of the variance when nurses’ emotional intelligence perception was included.

Conclusion: Our study shows a novel framework that indicates a positive perceived effect of emotional intelligence on nurses’ perceptions of occupational stress in Saudi Arabia. Our findings propose that emotional intelligence is a significantly effective mechanism against occupational stress.

背景:职业压力是全球医疗保健系统面临的一项重大挑战。它损害了医疗质量,危及患者安全。在全球范围内,职业压力对医疗保健系统造成的经济影响估计在 2.2113 亿美元到 1,870 亿美元之间。情商被认为是抵御职业压力的行为缓冲器。因此,本研究调查了护士对情商的认知是否会影响其对职业压力的自我认知。 设计:采用预测相关设计。 方法:使用 G使用 G ∗ Power 3.1 进行先验功率分析。从塔伊夫卫生组招募了 734 名护士作为便利样本。使用 IBM® SPSS® Statistics for Windows v.25 对数据进行编码和分析。使用了描述性和推论性统计方法。使用了分层回归技术。显著性水平定为 p <0.05。数据收集过程从 2022 年 8 月开始,一直持续到 2022 年 10 月。 结果显示结果表明,在第一个模型中,护士的年龄和工作地区对职业压力感知有预测作用(β = -0.28 和 β = 0.21,p = 0.001)。第二个模型显示出明显的改善(ΔF(7,727) = 162.35, p < 0.000, ΔR2 = 0.226),并表明护士对情商的认知与职业压力之间存在负相关(β = -0.45, t = -12.8, p < 0.000)。第一个模型中护士的社会人口特征解释了 2.4% 的方差。第二个模型中护士的情商感知占 25.0%。 结论我们的研究提出了一个新颖的框架,表明情商对沙特阿拉伯护士的职业压力感知有积极的影响。我们的研究结果表明,情商是一种显著有效的职业压力应对机制。
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引用次数: 0
A Salutogenic Perspective on Critical Care Nurse’s Experiences of Supervising Nurses Without Training in Intensive Care to Comprehend, Manage, and Feel Meaning During a Crisis 重症监护护士督导未接受过重症监护培训的护士在危机中理解、管理和感受意义的致胜视角
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-16 DOI: 10.1155/jonm/2393128
A. Fredholm, A. Nordin, M. Andersson, Å. Engström

Introduction: Using the COVID-19 pandemic as an example of a national and international crisis, it has been possible to show how critical care nurses (CCNs) were affected by their work situation with impact on health and wellbeing. This study sought out to investigate how CCNs stress was affected and to provide some answers as to how to react and organize care in a future crisis. The specific focus was CCNs’ stressors related supervision of nurses untrained in intensive care and how these were handled in a salutogenic perspective.

Aim: The aim of this study was to analyze CCNs’ experiences of supervision of nurses without training in intensive care during the COVID-19 pandemic, and to analyze these experiences with the help of the salutogenic concept sense of coherence.

Materials and Methods: The phenomena under study were explored during the years of 2021–2022 through in-depth interviews and interpreted using deductive content analysis.

Results: By analyzing CCNs experiences of supervising nurses without training in intensive care with the lens of sense of coherence, it was possible to show in what way these concepts influenced how to cope with the demanding situation. Sense of coherence was influenced by the inevitable prioritization of patient care and nursing interventions. This prioritization caused moral distress, but was also enhanced or decreased by CCNs sense of coherence.

Conclusion: When recruiting and introducing new personnel in a future crisis to any field of healthcare, but particularly to the intensive care, we would, on the basis of these findings, suggest that well-established plans are vital for how to move personnel throughout the organization, and for how to introduce the field of intensive care. Plans for how to model care with the help of RNs without specialist training should be put in place. A communication plan for the organization is also of importance to enhance transparency.

导言:以 COVID-19 大流行病作为国内和国际危机的一个例子,可以说明重症监护护士(CCNs)是如何受到其工作环境的影响,从而对健康和福利产生影响的。本研究旨在调查重症监护护士的压力如何受到影响,并就未来危机中如何应对和组织护理提供一些答案。研究的具体重点是,CCNs 在监督未接受过重症监护培训的护士时所承受的压力,以及如何从致敬的角度处理这些压力。 目的:本研究旨在分析在 COVID-19 大流行期间,CCNs 在监督未接受过重症监护培训的护士方面的经验,并借助致救概念 "一致性感 "对这些经验进行分析。 材料与方法:在 2021 年至 2022 年期间,通过深入访谈探讨了所研究的现象,并使用演绎式内容分析法对这些现象进行了解释。 结果:通过从连贯感的角度分析社区护士指导未接受过重症监护培训的护士的经验,可以说明这些概念以何种方式影响了如何应对严峻的形势。一致性意识受到病人护理和护理干预不可避免的优先次序的影响。这种优先排序会造成精神压力,但也会因护理人员的连贯感而增强或减弱。 结论在未来的医疗危机中,尤其是在重症监护领域招聘和引进新员工时,我们建议,根据这些研究结果,制定完善的计划对于如何在整个组织内调动员工以及如何引进重症监护领域至关重要。应制定计划,说明如何在未接受过专业培训的护士的帮助下建立护理模式。组织的沟通计划对于提高透明度也很重要。
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引用次数: 0
Cluster of Speaking-Up Behavior in Clinical Nurses and Its Association With Nursing Organizational Culture, Teamwork, and Working Condition: A Cross-Sectional Study 临床护士的大声说话行为群及其与护理组织文化、团队合作和工作条件的关系:一项横断面研究
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-15 DOI: 10.1155/jonm/9109428
Eunhee Lee, Hyunjeong Kwon

Introduction: Nurses, as frontline healthcare professionals, play a crucial role in ensuring patient safety, making their ability to speak up imperative. However, there are limited studies categorizing nurses based on their speaking-up behaviors and comparing their organizational characteristics. This study aimed to identify patterns of nurses’ speaking-up behaviors and examine differences in organizational cultures, teamwork climates, and working conditions according to these patterns.

Methods: A cross-sectional survey was conducted, involving 597 nurses directly participating in nursing care in Korean hospitals. The Speaking Up about Patient Safety Questionnaire (SUPS-Q), Nursing Organizational Culture Questionnaire, and Safety Attitude Questionnaire-Korean version (SAQ-K) were employed to measure nurses’ speaking-up-related behaviors, organizational culture, teamwork climate, and working conditions. Cluster analysis was used to identify clusters of nurses based on their speaking-up-related behavior. Differences in nursing organizational culture, teamwork climate, and working conditions among clusters were analyzed using one-way analyses of variance.

Results: Three clusters of nurses were identified based on their speaking-up-related behaviors. Cluster 1 (35%) showed high perceived concerns, moderate withholding, and speaking up, while Cluster 2 (37%) had moderate concerns, low withholding, and high speaking up. Cluster 3 (28%) had moderate concerns but low withholding and speaking up. Clinical experience significantly differed among clusters, with less experienced nurses predominantly in Cluster 1. Cluster 2 had the most collaborative culture, best teamwork climate, and working conditions.

Conclusion: Ensuring patient safety requires nurses to speak up about patient safety concerns. Creating safe working environments and fostering an organizational culture that prioritizes patient safety are essential steps in promoting nurses’ willingness to speak up about patient safety.

导言:护士作为第一线的医疗保健专业人员,在确保患者安全方面发挥着至关重要的作用,因此她们必须具备畅所欲言的能力。然而,根据护士的畅所欲言行为对其进行分类并比较其组织特征的研究十分有限。本研究旨在确定护士的畅所欲言行为模式,并根据这些模式考察组织文化、团队合作氛围和工作条件的差异。 研究方法对韩国医院中直接参与护理工作的 597 名护士进行了横断面调查。采用了 "患者安全大声疾呼问卷"(SUPS-Q)、"护理组织文化问卷 "和 "安全态度问卷-韩国版"(SAQ-K)来测量护士的大声疾呼相关行为、组织文化、团队合作氛围和工作条件。采用聚类分析法根据护士的发言相关行为对其进行聚类。采用单因素方差分析法分析了不同群组之间在护理组织文化、团队合作氛围和工作条件方面的差异。 结果根据与发言相关的行为,确定了三个护士群组。群组 1(35%)表现出较高的感知担忧、中等程度的隐瞒和直言不讳,而群组 2(37%)则表现出中等程度的担忧、较低的隐瞒和较高的直言不讳。第 3 组(28%)有中等程度的担忧,但隐瞒和直言程度较低。各组之间的临床经验存在明显差异,经验较少的护士主要集中在组 1。第 2 组的协作文化、团队合作氛围和工作条件最好。 结论确保患者安全需要护士对患者安全问题畅所欲言。创造安全的工作环境和培养优先考虑患者安全的组织文化是促进护士愿意说出患者安全问题的重要步骤。
{"title":"Cluster of Speaking-Up Behavior in Clinical Nurses and Its Association With Nursing Organizational Culture, Teamwork, and Working Condition: A Cross-Sectional Study","authors":"Eunhee Lee,&nbsp;Hyunjeong Kwon","doi":"10.1155/jonm/9109428","DOIUrl":"https://doi.org/10.1155/jonm/9109428","url":null,"abstract":"<div>\u0000 <p><b>Introduction:</b> Nurses, as frontline healthcare professionals, play a crucial role in ensuring patient safety, making their ability to speak up imperative. However, there are limited studies categorizing nurses based on their speaking-up behaviors and comparing their organizational characteristics. This study aimed to identify patterns of nurses’ speaking-up behaviors and examine differences in organizational cultures, teamwork climates, and working conditions according to these patterns.</p>\u0000 <p><b>Methods:</b> A cross-sectional survey was conducted, involving 597 nurses directly participating in nursing care in Korean hospitals. The Speaking Up about Patient Safety Questionnaire (SUPS-Q), Nursing Organizational Culture Questionnaire, and Safety Attitude Questionnaire-Korean version (SAQ-K) were employed to measure nurses’ speaking-up-related behaviors, organizational culture, teamwork climate, and working conditions. Cluster analysis was used to identify clusters of nurses based on their speaking-up-related behavior. Differences in nursing organizational culture, teamwork climate, and working conditions among clusters were analyzed using one-way analyses of variance.</p>\u0000 <p><b>Results:</b> Three clusters of nurses were identified based on their speaking-up-related behaviors. Cluster 1 (35%) showed high perceived concerns, moderate withholding, and speaking up, while Cluster 2 (37%) had moderate concerns, low withholding, and high speaking up. Cluster 3 (28%) had moderate concerns but low withholding and speaking up. Clinical experience significantly differed among clusters, with less experienced nurses predominantly in Cluster 1. Cluster 2 had the most collaborative culture, best teamwork climate, and working conditions.</p>\u0000 <p><b>Conclusion:</b> Ensuring patient safety requires nurses to speak up about patient safety concerns. Creating safe working environments and fostering an organizational culture that prioritizes patient safety are essential steps in promoting nurses’ willingness to speak up about patient safety.</p>\u0000 </div>","PeriodicalId":49297,"journal":{"name":"Journal of Nursing Management","volume":"2024 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/jonm/9109428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142642228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigation of Gender Stereotypes in Nurse Clinicians’ Metaphors and Concepts of Patients 调查临床护士对患者的隐喻和概念中的性别陈规定型观念
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-15 DOI: 10.1155/2024/8861439
Selver Bezgin, Özge Odabaşı Koç

Aim: The present study aims to analyze the presence of gender stereotypes in the metaphors nurse clinicians use to describe their patients.

Methods: This study was conducted with 149 nurse clinicians working at a university hospital. Data were collected using a metaphor survey.

Results: The most common metaphors for female patients were “flower” (f: 23) and “mother/my mother” (f: 8), whereas the most common metaphors for male patients were “wood” (f: 10) and “cactus” (f: 7). These metaphors were more frequently produced by female nurses. Female patients were often described as “delicate, in need of attention and help, and fragile,” while male patients were described as “strong, authoritative, head of the family, and tough.” Female nurses likened a more delicate male patient to a “delicate woman,” and male nurses likened the strength of a male patient to a “man.” Furthermore, eight nurses, five male nurses and three female nurses, frequently used the metaphor of “patient” (f: 6) while stating that they did not view patients as female or male. Male nurses (f: 4) produced the metaphor of “patient” (f: 6) the most.

Conclusion: It is important not to overlook the factors underlying the metaphors produced by nurse clinicians. In this regard, extensive studies are needed to take into account additional factors such as cultural background, experience, or specific patient interactions that may have a major impact on how nurses perceive gender.

Implications for Nursing Management: This study evaluates nurse clinicians’ perceptions of patients in the context of gender stereotypes and highlights some important points in terms of nursing and patient care.

目的:本研究旨在分析临床护士在描述病人时使用的隐喻中是否存在性别刻板印象。 研究方法本研究的对象是在一所大学医院工作的 149 名临床护士。通过隐喻调查收集数据。 结果对女性患者最常见的隐喻是 "花"(23 个)和 "母亲/我的母亲"(8 个),而对男性患者最常见的隐喻是 "木头"(10 个)和 "仙人掌"(7 个)。女护士更常使用这些比喻。女病人通常被描述为 "娇弱、需要关注和帮助、脆弱",而男病人则被描述为 "强壮、有权威、一家之主、坚强"。女护士把比较娇弱的男病人比作 "娇弱的女人",而男护士则把强壮的男病人比作 "男人"。此外,8 名护士(5 名男护士和 3 名女护士)经常使用 "病人 "这一隐喻(f: 6),同时表示她们并不把病人视为女性或男性。男护士(4 人)使用 "病人"(6 人)的隐喻最多。 结论重要的是不要忽视临床护士产生隐喻的潜在因素。在这方面,需要进行广泛的研究,以考虑到其他因素,如文化背景、经验或特定的患者互动,这些因素可能会对护士如何看待性别问题产生重大影响。 对护理管理的意义:本研究评估了临床护士在性别刻板印象背景下对病人的看法,并强调了护理和病人护理方面的一些要点。
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引用次数: 0
Using AI to Predict Patients’ Length of Stay: PACU Staff’s Needs and Expectations for Developing and Implementing an AI System 使用人工智能预测患者的住院时间:PACU 工作人员对开发和实施人工智能系统的需求和期望
IF 3.7 2区 医学 Q2 MANAGEMENT Pub Date : 2024-11-13 DOI: 10.1155/jonm/3189531
Sara Lundsten, Maritha Jacobsson, Patrik Rydén, Lars Mattsson, Lenita Lindgren

Introduction: The need for innovative technology in healthcare is apparent due to challenges posed by the lack of resources. This study investigates the adoption of AI-based systems, specifically within the postanesthesia care unit (PACU). The aim of the study was to explore staff needs and expectations concerning the development and implementation of a digital patient flow system based on ML predictions.

Methods: A qualitative approach was employed, gathering insights through interviews with 20 healthcare professionals, including nurse managers and staff involved in planning patient flows and patient care. The interview data were analyzed using reflexive thematic analysis, following steps of data familiarization, coding, and theme generation. The resulting themes were then assessed for their alignment with the modified technology acceptance model (TAM2).

Results: The respondents discussed the benefits and drawbacks of the proposed ML system versus current manual planning. They emphasized the need for controlling PACU throughput and expected the ML system to improve the length of stay predictions and provide a comprehensive patient flow overview for staff. Prioritizing the patient was deemed important, with the ML system potentially allowing for more patient interaction time. However, concerns were raised regarding potential breaches of patient confidentiality in the new ML system. The respondents suggested new communication strategies might emerge with effective digital information use, possibly freeing up time for more human interaction. While most respondents were optimistic about adapting to the new technology, they recognized not all colleagues might be as convinced.

Conclusion: This study showed that respondents were largely favorable toward implementing the proposed ML system, highlighting the critical role of nurse managers in patient workflow and safety, and noting that digitization could offer substantial assistance. Furthermore, the findings underscore the importance of strong leadership and effective communication as key factors for the successful implementation of such systems.

导言:由于资源匮乏带来的挑战,医疗保健领域对创新技术的需求显而易见。本研究调查了人工智能系统的应用情况,特别是在麻醉后护理病房(PACU)中的应用情况。研究的目的是探讨员工对基于 ML 预测的数字化患者流程系统的开发和实施的需求和期望。 研究方法采用定性方法,通过对 20 名医疗保健专业人员(包括护士长和参与规划患者流程和患者护理的员工)进行访谈,收集他们的见解。采用反思性主题分析法对访谈数据进行分析,包括熟悉数据、编码和生成主题等步骤。然后评估所产生的主题是否与修改后的技术接受模型(TAM2)一致。 结果受访者讨论了所建议的 ML 系统与当前人工计划的优缺点。他们强调了控制 PACU 吞吐量的必要性,并期望 ML 系统能改善住院时间预测,为工作人员提供全面的患者流程概览。他们认为,确定病人的优先次序非常重要,而 ML 系统则有可能增加与病人互动的时间。不过,也有人对新的流式医疗系统可能会泄露病人机密表示担忧。受访者认为,通过有效使用数字信息,可能会出现新的沟通策略,从而腾出时间进行更多的人际互动。虽然大多数受访者对适应新技术持乐观态度,但他们也认识到,并非所有同事都会这么认为。 结论这项研究表明,受访者大多赞成实施所建议的多语言系统,强调了护士长在患者工作流程和安全方面的关键作用,并指出数字化可以提供很大的帮助。此外,研究结果还强调了强有力的领导和有效沟通的重要性,这是成功实施此类系统的关键因素。
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引用次数: 0
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Journal of Nursing Management
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