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Purpose The purpose of this study was twofold: (a) to assess predictors of the turnover intention, burnout, and perceived quality of care among nurses working in Oman, and (b) to examine the potential moderating role of job satisfaction on the relationship between work environment and nurse turnover intention. Design A cross-sectional design was used to collect data from a sample of 207 nurses working in a public hospital in Muscat, Oman. Methods An electronic survey was used to assess nurses' perceptions of work environment, burnout, job satisfaction, turnover intention, and quality of care. Findings Participation in hospital affairs, a foundation for quality of care, and staffing adequacy were predictors of burnout among nurses and perceived quality of care. Logistic regression analysis revealed that working in a favorable environment was associated with less turnover intention, but only when job satisfaction was high. Conclusions Improving nurse job satisfaction is a mechanism through which future interventions could enhance working conditions and promote better nurse retention. Clinical relevance Organizational strategies are needed to increase nurse job satisfaction by empowering nurses to take more active roles in hospital affairs as a strategy to reduce turnover intention and enhance the quality of patient care.

https://sigmapubs.onlinelibrary.wiley.com/doi/pdf/10.1111/jnu.12528

Nursing Work Environment, Turnover Intention, Job Burnout, and Quality of Care: The Moderating Role of Job Satisfaction.

Aim
To explore the relationship between spiritual climate and transformational leadership, and examine their impact on nurses perceived emotional exhaustion and intentions to quit.

Background
Transformational leadership is known to have a significant positive effect on work environment and job satisfaction. Additionally, promoting spiritual climate amongst staff can benefit workers by increasing self‐worth. The relationship between the two is unknown.

Methods
Nurse clinicians from 2 sites in the Jiangsu Province of China completed self‐report questionnaires based on spiritual climate, emotional exhaustion, clinical leadership and Turnover Intention Scales. Mediation analysis was applied to evaluate impact of spiritual climate.

Results
Perceived positive spirituality amongst nurse clinicians reinforces transformational leadership to reduce emotional exhaustion (indirect effect of −0.089, p < .01). Burnout and intention to leave showed significantly positive correlation with lower levels of perceived spirituality (r = .545, p < .01).

Conclusion
Transformational leadership in the workplace can reduce nurses' burnout, and a positive spiritual climate increases meaningfulness in their work. This may help in nurse retention.

Implications for Nursing Management
Health care leaders must look beyond transformational leadership to maintain a positive and supportive clinical climate, and this may involve acknowledgement of nurses' spiritual needs.

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Positive spiritual climate supports transformational leadership as means to reduce nursing burnout and intent to leave.

AIMS To (1) examine the level and variability of nurse work environment and job satisfaction and (2) explore how nurse job satisfaction in tertiary hospitals in Oman is influenced by the nurses' characteristics and work environment. BACKGROUND In Oman and the Middle East, a scarcity of research addressing nurse work environment and job satisfaction exists. Such evidence is necessary for policymaking to positively impact nurse job outcomes, and therefore, quality of care. METHODS We used a cross-sectional descriptive design employing a sample of 454 local and expatriate nurses who responded to a self-administered questionnaire. RESULTS The work environment was favourable, and it positively correlated with job satisfaction. Nationality, education, hospital type, staffing, resources and participation in hospital affairs were significant predictors of nurse job satisfaction. The greatest amount of variation in nurse job satisfaction was explained by the work environment. CONCLUSION The influence of work environment on nurse job satisfaction is greater than nurse characteristics and hospital and unit types. Enhancing nurse participation in hospital affairs and providing adequate staffing and resources are central means of establishing healthy work environments, which is an auspicious, cost-effective strategy for satisfying, and therefore, retaining nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY To enhance nurse work environment and job satisfaction in Oman and the Middle East, nurse and health leaders need to consider developing work and professional regulations and adopting policies to promote staffing, resources, wages, and benefits for nurses and encourage their promotion and career advancement; and foster nurse participation in hospital affairs.

Healthy work environments are critical for nurse job satisfaction: implications for Oman.

Aims Challenges in the nurse practice environment greatly affect nurse work outcomes. This study investigated the relationship between nurse practice environment and work outcomes in the Philippines. Methods This cross-sectional survey involved 549 hospital nurses in the Philippines in 2018. The nurse practice environment was measured using the Practice Environment Scale of the Nursing Work Index (PES-NWI). Four self-report scales were used to measure work outcomes: job satisfaction, job burnout, job stress and nurse-assessed quality of care. Multiple linear regression analysis was used to analyse the data. Results Significant relationships were found between nurse and organizational characteristics and nurse practice environment. Further, multivariate regression analysis revealed that the nurse practice environment had a significant and positive relationship with perceived quality of care and a significant and negative relationship with job burnout and job stress. Conclusion A favourable work environment significantly reduced job burnout and job stress and improved the quality of patient care. With considerable migration abroad, a favourable nurse practice environment may engage a better nurse workforce in the country and subsequently reduce migration. Managers must focus on developing good nurse practice environments that will improve professional work outcomes and quality patient care.

Relationship between nurse practice environment and work outcomes: A survey study in the Philippines

Background:Quality measurements are crucial to healthcare quality improvement, and patient satisfaction with nursing care is widely adopted as a key outcome indicator of the overall quality of healthcare. There is a lack of instruments to measure patient satisfaction with nursing care in an

Psychometric Properties of an Arabic Version of the Patient Satisfaction With Nursing Care Quality Questionnaire.

Objective To identify knowledge of breast cancer (BC) symptoms, time taken to consult a doctor and factors contributing to delays in medical help-seeking. Design A cross-sectional study of Omani women diagnosed with BC. Setting The two main teaching hospitals in Oman: Royal Hospital and Sultan Qaboos University Hospital. Participants Adult Omani women recently diagnosed with BC. Tools The Breast Module of the Cancer Awareness Measure and the International Cancer Benchmarking Partnership questionnaire were used to collect data. Results A total of 300 women with BC participated (response rate: 91.0%). The mean age at diagnosis was 43.0±12.50 years and 33.5% were diagnosed at stage III or IV. Although most women (74.4%) recognised breast/armpit lumps to be a symptom of BC, less than half identified other symptoms, including breast/armpit pain (44.0%), changes in the position of the nipple (36.2%), redness (31.7%), fatigue (26.3%), weight loss (23.4%) and loss of appetite (20.8%). While most (91.6%) were aware that BC could be cured if detected early, only 66.4% sought medical help within a month of developing symptoms. Initial responses to symptoms included informing husbands (40.2%) or family members (36.5%). Barriers to seeking medical help included feeling scared (68.9%) and worried about what the doctor might find (62.8%). Highly educated women were more likely to recognise the following as BC symptoms: changes in nipple position (OR: 0.16, 95% CI 0.03 to 0.81), breast pain (OR: 0.10, 95% CI 0.01 to 0.86) and unexplained weight loss (OR: 0.18, 95% CI 0.04 to 0.88) (all p Conclusions Although many Omani women with BC were aware of the importance of early diagnosis, most demonstrated inadequate knowledge of symptoms, did not prioritise seeking medical help and reported emotional barriers to help-seeking. More educational measures are needed to improve symptom recognition and address help-seeking barriers to minimise delays in diagnosis.

https://bmjopen.bmj.com/content/bmjopen/11/1/e043976.full.pdf

Knowledge of symptoms, time to presentation and barriers to medical help-seeking among Omani women diagnosed with breast cancer: a cross-sectional study.

Objective Colorectal cancer (CRC) is the fourth leading cause of mortality in Oman, with most patients diagnosed at advanced stages. Early diagnosis of CRC improves prognosis and survival rate. The aim of this study was to explore the symptom perceptions and help-seeking behaviours (HSBs) of Omani patients diagnosed with late-stage CRC. Methods Semi-structured individual interviews were conducted with 16 patients. Results Four main themes emerged, including normalisation and ignorance (patients felt healthy, perceived symptoms as not being serious and related to dietary habits, concealed them or prioritised work and family commitments), self-empowerment and self-management (patients were stubborn, employed 'wait and see' approach, used symptomatic or herbal treatments), disclosure and seeking help (patients disclosed symptoms to family members or friends, sought medical help only when symptoms worsened, visited faith healers or travelled abroad for treatment) and healthcare professionals (patients attributed treatment or diagnosis delays to lack of continuity of care, loss of trust in doctors or delays in referral). Conclusion Patients attributed delays in CRC diagnosis to several factors based on their perceptions of symptoms. Most HSBs driven by sociocultural and emotional causes. Increased awareness of CRC symptoms and modifying HSBs can encourage early diagnosis. Prompting patients to disclose CRC-related symptoms may aid referral decisions.

http://journal.waocp.org/article_89471_7c50f2a748545bcecb4b4c7ef42540ab.pdf

Huda Al-Awaisi

Papers

Healthy work environments are critical for nurse job satisfaction: implications for Oman.

Psychometric Properties of an Arabic Version of the Patient Satisfaction With Nursing Care Quality Questionnaire.

Knowledge of symptoms, time to presentation and barriers to medical help-seeking among Omani women diagnosed with breast cancer: a cross-sectional study.

Symptom Perceptions and Help-Seeking Behaviours of Omani Patients Diagnosed with Late-Stage Colorectal Cancer: A Qualitative Study.

Exploring causes of delays in help-seeking behaviours among symptomatic Omani women diagnosed with late-stage breast cancer - A qualitative study.