PURPOSE\nTo identify the cognitive processes nurses use in their decision-making in long- and short-term care settings in five countries, and the demographic variables associated with their decision-making. METHOD AND SAMPLES: The instrument used was a 56-item questionnaire that has been shown to be reliable in earlier studies. The sample consisted of five convenience samples of registered nurses working in either geriatric wards (n = 236) or acute medical-surgical wards (n = 223) in hospitals or nursing homes in Canada, Finland, Sweden, Switzerland, and the United States.\n\n\nFINDINGS\nFive models of decision-making were identified on the basis of factor analysis. They represent both analytical and intuitive cognitive processes. Analytical cognitive processes were emphasized in information collection, problem definition, and planning of care, and intuitive cognitive processes were emphasized in planning, implementing, and evaluating care. Professional education, practical experience, field of practice, and type of knowledge were significantly associated with decision-making models as well as with country of residence of the participants. The highest proportion of analytically oriented decision-makers was found among nurses in long-term care, the decision-making of nurses in short-term care was more intuitively oriented.\n\n\nCONCLUSIONS\nThe results indicate that decision-making of participants varied from country to country and in different nursing situations. Future research should be focused on reasons for these differences, the relationship between the task and the nurses' type of knowledge, and how nurses use their knowledge to make decisions in different nursing situations.

Professions and society: An exploratory study of clinical decision-making in five countries

Delirium, the most common form of acute brain dysfunction affecting up to 80% of intensive care unit (ICU) patients, has been shown to predict long-term cognitive impairment, one of the domains in "Post-ICU Syndrome" (PICS). The ICU environment affects several potentially modifiable risk factors for delirium, such as disorientation and disruption, of the sleep-wake cycle. Innovative solutions aim to transform standard concepts of ICU room design to limit potential stressors, and utilizing the patient care space as a treatment tool, exerting positive, therapeutic effects. The main areas affected by most architectural and interior design modifications are sound environment, light control, floor planning, and room arrangement. Implementation of corresponding solutions is challenging considering the significant medical and technical demands of ICUs. This article discusses innovative concepts and promising approaches in ICU design that may be used to prevent stress and to support the healing process of patients, potentially limiting the impact of delirium and PICS.

Innovative ICU Solutions to Prevent and Reduce Delirium and Post-Intensive Care Unit Syndrome.

Environmental noise has been growing in recent years, causing numerous health problems. Highly sensitive environments such as hospitals deserve special attention, since noise can aggravate patients' health issues and impair the performance of healthcare professionals. This work consists of a systematic review of scientific articles describing environmental noise measurements taken in hospitals between the years 2015 and 2020. The researchers started with a consultation of three databases, namely, Scopus, Web of Science, and ScienceDirect. The results indicate that for the most part, these studies are published in journals in the fields of medicine, engineering, environmental sciences, acoustics, and nursing and that most of their authors work in the fields of architecture, engineering, medicine, and nursing. These studies, which are concentrated in Europe, the Americas, and Asia, use as reference values sound levels recommended by the World Health Organization. Leq measured in hospital environments showed daytime values ranging from 37 to 88.6 dB (A) and nighttime values of 38.7 to 68.8 dB (A). Leq values for outdoor noise were 74.3 and 56.6 dB (A) for daytime and nighttime, respectively. The measurements were taken mainly inside hospitals, prioritizing more sensitive departments such as intensive care units. There is a potential for growth in work carried out in this area, but research should also include discussions about guidelines for improvement measures aimed at reducing noise in hospitals.

/pdf/environmental-noise-in-hospitals-a-systematic-review-2ei4ufpl1t.pdf

Environmental noise in hospitals: a systematic review

Aims and objectives To investigate the present status of anxiety among nurses fighting the spread of COVID-19 and its association with perceived stress and insomnia. Background With the outbreak of COVID-19, nurses have been caring for infected patients for a considerable length of time in Wuhan, China. Previous COVID-19 studies generally focused on patients' medical treatment, but few considered healthcare workers' psychological needs while working with a pandemic involving an unfamiliar infectious disease. Numerous nurses have experienced mental health problems, such as anxiety. Design The STROBE guidelines for a cross-sectional questionnaire were implemented. Methods An online survey of 643 frontline nurses working with COVID-19 patients was conducted from March 3 to 10, 2020. Sociodemographic data were collected, and the Generalized Anxiety Disorder Scale, the Chinese Perceived Stress Scale, and the Athens Insomnia Scale were administered. Results One-third (33.4%) of participants reported anxiety, which was associated with perceived stress and insomnia among Chinese frontline nurses in Wuhan during the COVID-19 pandemic. Significant associations were found between anxiety, perceived stress, insomnia, working four-night shifts per week, experience working during more than two epidemics, and fear of COVID-19. Conclusions This study found that a substantial proportion of frontline nurses caring for COVID-19 patients experienced anxiety. We recommend that nurse managers focus on working conditions and cultivate safe and satisfactory work environments. Meanwhile, frontline nurses should foster awareness of mental health and rely on online resources for psychological training to alleviate anxiety. Relevance to clinical practice The findings of this study could facilitate better understanding of anxiety among frontline nurses; more importantly, health care authorities and nursing managers need to pay more attention to ensuring intervention training to reduce anxiety for frontline nurses worldwide.

Anxiety and its association with perceived stress and insomnia among nurses fighting against COVID-19 in Wuhan: a cross-sectional survey.

/pdf/burnout-y-sintomatologia-depresiva-en-enfermeros-de-terapia-48zrxwsf9d.pdf

Burnout y sintomatología depresiva en enfermeros de terapia intensiva: análisis de relación

Background Intensive care units (ICUs) are noisy environments, which may have negative psychological effects on nurses. Aims and objectives To investigate the effects of the noise level of ICUs on nurses' burnout, job satisfaction, anxiety, psychological symptoms and general psychopathology level. Design A descriptive and correlational study. Methods The study was conducted with 150 intensive care nurses. A Type 2250-L Bruel & Kjaer hand-held sound level meter was used for noise measurement. A Nurse Information Form, the Maslach Burnout Inventory, Minnesora Satisfaction Questionnaire, Self-Report Inventory and Symptom Checklist-90 Revised were used for data collection. Results The highest levels of noise (71 dB(A) and above) were measured in the neonatal, neurology and cardiovascular surgery ICUs. It was observed that noise level affected extrinsic satisfaction (F = 3·704; p = 0·027) and trait anxiety (F = 3·868; p = 0·023) of nurses. Conclusions Noise levels in ICUs are well above the recommended levels, and this affects nurses' job satisfaction and anxiety levels. Relevance to clinical practice More studies on the effects of noise levels on the physical and mental states of nurses working in ICUs are needed. Increased quality of patient care can be achieved by providing healthy working conditions for nurses working in special units such as ICUs.

The effects of noise levels on nurses in intensive care units

Purpose The aim of the study was to explore the relationship between psychological capital (hope, self-efficacy, resilience, and optimism) and burnout and compassion fatigue or secondary traumatic stress among general hospital nurses, and the mediating role of compassion satisfaction in this relationship. Design Cross-sectional survey study. Participants were 697 nurses working in different nursing departments in tertiary university hospitals in a metropolitan city in Turkey. Methods The semistructured interview form, Professional Quality of Life Scale, and Psychological Capital Scale were used to gather data. Descriptive analysis, the Spearman correlation analyzer, hierarchical multiple linear regression analysis, and mediation analyzer with PROCESS and the Sobel test were used to analyze data. Findings There were moderate relationships between psychological capital total score, all subscales, and burnout, and weak negative correlations between these variables and compassion fatigue. For burnout, self-efficacy and optimism in the first model explained 26% of the variance; when compassion satisfaction was added in the second model, 45% of the total variance was explained. For compassion fatigue, self-efficacy in the first model explained 5% of the variance; adding compassion satisfaction in the second model, the variance did not change at all. Conclusions The findings of the current study may contribute to enhancing the protection of nurses' well-being in their general hospital settings by developing knowledge about the resources that are needed to prevent or decrease occupational psychological risks. Increasing psychological capital levels of nurses enhances the quality of care and the sustainability of their working conditions. Clinical relevance The findings of this study can be used to design interventions to better assist nurses in addressing their psychological health. Because psychological capital is a malleable resource, nursing managers can invest in the development and improvement of nurses' resources.

The Relationship Between Psychological Capital and the Occupational Psychologic Risks of Nurses: The Mediation Role of Compassion Satisfaction

Aim This research was carried out so as to reveal the relationships between the anxiety state of nurses, their critical thinking disposition, and decision-making strategies. Methods Survey forms and scales that were related to demographic attributes, anxiety, critical thinking and decision-making were used in this research. The sampling was formed with 326 nurses who were selected by using the random sampling method. The data were collected between November, 2014 and January, 2015 via a Descriptive Information Form, the California Critical Thinking Disposition Inventory, State-Trait Anxiety Inventory, and Decision-Making Strategies Scale. Results Of the nurses, 91.4% were discovered to have low critical thinking disposition levels. The nurses’ scores in analytics, open-mindedness, and curiosity were higher, compared to the other categories. As for decision-making, independent decision-making was the most commonly used strategy. There was a poor positive relationship between the age of the nurses and their points of independent decision-making and intuitive decision-making. It was detected that age and open-mindedness affected the total points of independent decision-making, intuitive decision-making, and rational decision-making. Conclusion The critical thinking training of nurses affects their rational decision-making levels and their age affects independent, intuitive, and rational decision-making. Systematicity affects only indecision in a negative way, whereas open-mindedness negatively affects intuitive decision-making, rational decision-making, and indecision. Anxiety negatively affects independent decision-making, whereas it affects indecision strategy positively. The working style of nurses does not affect their decision-making strategies. Indecision strategy is negatively predicted by open-mindedness, systematicity, and self-confidence and it is positively predicted by anxiety.

Decision-making styles, anxiety levels, and critical thinking levels of nurses.

/pdf/relationship-between-work-family-conflict-and-organizational-25ky984tcd.pdf

Relationship Between Work-Family Conflict and Organizational Silence and Social Support in Nurses at a University Hospital

BACKGROUND The use of empathy in problem solving and communication is a focus of nursing practice and is of great significance in raising the quality of patient care. PURPOSE The purposes of this study are to investigate the relationship between problem solving and empathy among operating room nurses and to explore the factors that relate to these two competencies. METHODS This is a cross-sectional, descriptive study. Study data were gathered using a personal information form, the Interpersonal Problem Solving Inventory, and the Basic Empathy Scale (N = 80). Descriptive and comparative statistics were employed to evaluate the study data. RESULTS Age, marital status, and career length were not found to affect the subscale scores of cognitive empathy (p > .05). A negative correlation was found between the subscale scores for "diffidence" and "cognitive empathy." Moreover, the emotional empathy scores of the graduate nurses were higher than those of the master's/doctorate degree nurses to a degree that approached significance (p = .078). Furthermore, emotional empathy levels were found to decrease as the scores for insistent/persistent approach, lack of self-confidence, and educational level increased (p < .05). The descriptive characteristics of the participating nurses were found not to affect their problem-solving skills. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Problem solving is a focus of nursing practice and of great importance for raising the quality of patient care. Constructive problem-solving skills affect cognitive empathy skills. Educational level and career length were found to relate negatively and level of self-confidence was found to relate positively with level of cognitive empathy. Finally, lower empathy scores were associated with difficult working conditions in operating rooms, intense stress, and high levels of potential stress-driven conflicts between workers in work settings.

Şehrinaz Polat

Papers

The effects of noise levels on nurses in intensive care units

The Relationship Between Psychological Capital and the Occupational Psychologic Risks of Nurses: The Mediation Role of Compassion Satisfaction

Decision-making styles, anxiety levels, and critical thinking levels of nurses.

Relationship Between Work-Family Conflict and Organizational Silence and Social Support in Nurses at a University Hospital

Relationship Between the Problem-Solving Skills and Empathy Skills of Operating Room Nurses.