Showing papers in "Journal of Nursing Scholarship in 2019"

Understanding the Relationship Between Staff and Job Satisfaction, Stress, Turnover, and Staff Outcomes in the Person-Centered Care Nursing Home Arena

Abstract: Background The provision of quality care in nursing home (NH) facilities is an ongoing challenge, and the literature indicates that the quality of care (QOC) is often suboptimal. While it is highly recommended that NH facilities adopt a culture of person-centered care (PCC) to ensure quality care, the outcomes of this shift on staff working in NH settings has not been well studied. The purpose of this article was to understand the theoretical relationship between staff and job satisfaction, stress, turnover, and staff outcomes in PCC NH settings, by utilizing Cohen-Mansfield's (1995) comprehensive occupational stress model. Methods An integrative review of the electronic databases of research published in English between 2000 and 2015 was conducted. Results A review of 11 papers suggested that job satisfaction in the nursing workforce is positively related to consistency in QOC delivery and increased quality of life among residents in NHs. Management support and PCC practices positively correlate with improved QOC, staff satisfaction, and staff retention. Conclusions This review showed that PCC intervention and training representing the key concept of workplace resources has a positive impact on NH staff job stress and satisfaction. Clinical relevance Supporting the NH workforce through PCC training is essential for promoting job satisfaction and reducing job-related stress as well as turnover, which in turn will improve QOC delivered to the residents living in NHs.

The Relationship Between Depression and Frailty in Community-Dwelling Older People: A Systematic Review and Meta-Analysis of 84,351 Older Adults.

Abstract: Objectives In this study we investigated the correlation between depression and frailty in older adults. Additionally, correlations among study designs (prospective vs. cross-sectional), regions, depression indices, frailty indices, covariance corrections, and sexes were explored to support the analysis. Methods A systematic literature review and meta-analysis were conducted. A total of 84,351 older adults, all 65 years of age or older, were analyzed. Both authors independently extracted and examined retrieved articles. Searched keywords included "depression" or "depressive"; "frailty" or "frail"; and "older people," "elderly," "geriatric," or "senior." Articles published between January 2000 and December 2016 were searched. A literature quality assessment was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic REVIEWS AND META-ANALYSES: Systematic literature searches were conducted on the Embase, PubMed, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library databases, and collected studies were analyzed using a random effects model. Results Fourteen studies on people 65 years of age or older were collected, and a correlation analysis was conducted for depression and frailty. According to the meta-analysis, the risk for frailty due to depression was nonsignificant among the subgroups for study design (p for heterogeneity = .149), region (p = .429), depression criteria (p = .934), covariate adjustment (p = .702), and frailty criteria (p = .661). Notably, the risk for frailty due to depression was significantly higher in men than in women (pooled odds ratios for men and women: 4.76 and 2.25, respectively; Qbetween χ2 = 9.93, p = .002). Conclusion Older adults with depression are more prone to frailty than are those without depression. Regardless of study design, region, depression index, frailty index, and covariance corrections, no significant differences were observed in the results of studies on depression and frailty in older adults. The only factor that had a significant influence was sex; older men with depression were at a higher risk for frailty than were older women with depression. Clinical relevance Depression and frailty are pertinent health concerns related to geriatric syndromes. Because older adults with depression have a high risk for frailty, nursing personnel should use a depression index as early as possible to screen for depression and further reduce the occurrence of frailty in older adults. Furthermore, based on the aforementioned differences between the sexes, special attention should be paid to older men with depression to reduce their risk for frailty.

The Role of the Nurse Scientist as a Knowledge Broker.

Abstract: PURPOSE This article introduces the importance and nature of the role of the nurse scientist as a knowledge broker. DESIGN A systematic literature review was completed using a modified version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) appraisal tool to trace the emergence and characteristics of the knowledge broker role across disciplines internationally and in the United States. METHODS Salient publications were identified using PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sociological Abstracts, and ProQuest Dissertations & Theses, as well as hand searches and searches of the grey literature. Authors used these resources to define the knowledge broker role and with their role-related experiences developed the Thompson Knowledge Brokering Model. FINDINGS A knowledge broker is one who connects science and society by building networks and facilitating opportunities among knowledge producers and knowledge users. The knowledge broker role includes three components: forming and sustaining partnerships; facilitating knowledge application; and creating new knowledge. There are five major strategies central to each role component: establish, engage, educate, empower, and evaluate. CONCLUSIONS The knowledge broker role has been increasingly recognized worldwide as key to translating science into practice and policy. The nurse scientist is ideally suited for this role and should be promoted worldwide. The Thompson Knowledge Brokering Model can be used as a guide for nurse scientists. CLINICAL RELEVANCE The role of the knowledge broker is to facilitate translation of useful research to practice and policy by connecting stakeholders through meaningful engagement.

Satisfaction With Work-Family Balance Mediates the Relationship Between Workplace Social Support and Depression Among Hospice Nurses.

Abstract: Purpose The purpose of this study was to investigate the relationship between social support (from personal and workplace sources) and psychological distress (depression, anxiety, and stress symptoms), as well as to examine the mediating role of satisfaction with work-family balance among hospice nurses. Design and method A cross-sectional study design was utilized with a sample of 90 hospice nurses from the southern United States. Participants completed online surveys, including (a) the Depression, Anxiety, and Stress Scale (DASS-21), (b) loosely adapted items from the Affectivity, Burnout, and Absenteeism Scales, and (c) Satisfaction with Work-Family Balance Scale. Findings Workplace social support, not personal social support, was associated with lower psychological distress, and satisfaction with work-family balance mediated the relationship between workplace social support and depression symptoms, a component of psychological distress. Conclusions Hospice nurses' social support in the workplace and their satisfaction with the balance between their work and family lives play a role in supporting their mental health. Clinical relevance Hospice nurses may benefit from programs fostering the creation of workplace-based interpersonal relationships.

Effects of Work‐Related Stressors and Mindfulness on Mental and Physical Health Among Australian Nurses and Healthcare Workers

Abstract: Purpose To examine the relative impact of work-related stressors and the personal resource of mindfulness on employees' mental and physical health. Design A cross-sectional survey design with nursing and healthcare workers in Victoria, Australia. Methods Data were collected from 702 respondents. Mean scores for work-related stressors and employee mental and physical health were compared with population norms. We used hierarchical linear regressions to examine the relative impact of demographics, work-related stressors, and mindfulness on employee mental and physical health. Findings Employees in this sample reported higher levels of work-related stress and poorer mental health compared to available norms, while their levels of physical health were within the normal range. Regression analyses showed that work-related stressors were important predictors of employee mental health, but mindfulness was the stronger predictor. There was a slightly stronger relationship between employee physical health and work-related stress compared to mindfulness. Furthermore, being younger and employed in a non-nursing role were associated with better physical health. Clinical relevance Encouraging mindfulness as a health behavior practice among nurses and other healthcare workers could improve employee well-being and potentially enable them to more effectively fulfill the requirements of their demanding roles.

A Systematic Review of Physical Activity and Exercise on Physiological and Biochemical Outcomes in Children and Adolescents With Type 1 Diabetes

Abstract: PURPOSE In this systematic review we aimed to evaluate the effects of physical activity (PA) and exercise on biochemical and physiological outcomes in children and adolescents with type 1 diabetes (T1D). DESIGN The review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHODS The search of literature was performed using PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, the Cochrane Library, Scopus, Medline, PsycINFO, the Nursing Reference Center, and Google Scholar. The search was limited to include peer-reviewed articles published in English from May 2012 to May 2018 and included adolescents <19 years of age with T1D. Twenty-seven studies met the inclusion criteria: 8 interventional and 19 observational studies. FINDINGS Both observational and interventional studies showed considerable agreement that supervised regular moderate to vigorous physical activity (MVPA) is more effective on adiposity and cardiorespiratory fitness than habitual PA. Further, it was reported that PA of different intensities improves insulin sensitivity and decreases daily insulin dosage. Results of glycemic control were equivocal. Although observational studies reported improvement in glycemic control with PA of different intensities, most of the experimental studies revealed no significant associations. A consistent agreement among the studies revealed a considerable benefit of regular habitual PA of light to moderate intensity on blood glucose regulation and lipid profile. CONCLUSIONS The reviewed studies showed that regular MVPA was associated with several health benefits in adolescents with T1D; however, additional studies are needed to fully understand the effect of PA on health outcomes. CLINICAL RELEVANCE Regular MVPA (at least 4 hr per week) with good glycemic control is a promising option for adolescents with T1D when risk management of hypoglycemia is appropriately taken.

Impact of Coping Strategies on Nurses' Well-Being and Practice.

Abstract: Objectives To examine the mechanisms of coping strategies on nurses' psychological well-being, practice environments and safety attitudes. Methods A cross-sectional study design was used. Structural equation modeling was performed to analyze the results. Five hundred clinical nurses were randomly selected from a large group of 1,500 from a medical center with 1,350 beds in Taipei, Taiwan, from July to October 2015. Self-report questionnaires were administered to measure coping strategies (Brief COPE), psychological well-being (Ryff's Psychological Well-being Scale), nurses' practice environments (Practice Environment Scale of the Nursing Work Index), and safety attitudes (Safety Attitudes Questionnaire). Results Of the 500 participants who gave written consent, 474 (94.8%) filled out the questionnaire. Results showed that using more approach-oriented coping strategies and fewer avoidant coping strategies was associated with greater psychological well-being. Psychological well-being was directly associated with quality of nurses' practice environments and safety attitudes. The impact of psychological well-being on safety attitudes was mediated significantly by the quality of the practice environment. The use of approach-oriented coping strategies was significantly predictive of positive psychological well-being, a good practice environment, and good safety attitudes. Conclusions and clinical relevance This study found a distinct pathway for the relationships between clinical nurses' psychological well-being, practice environment, and safety attitudes. Psychological well-being in clinical nurses was higher for those with more approach-oriented coping strategies. Psychological well-being directly impacted safety attitudes, which mediated nurses' practice environments. The practical implications of the results suggest that interventions designed to promote positive psychological well-being may help improve nurses' practice environments, which, in turn, may result in better safety attitudes and nursing care outcomes.

Effectiveness of a Social Media–Based, Health Literacy–Sensitive Diabetes Self-Management Intervention: A Randomized Controlled Trial

Abstract: AIMS The purpose of the study was to evaluate the effects of a social media-based, health literacy-sensitive diabetes management intervention on patient activation, self-care behaviors, and glucose control compared to telephone-based, health literacy-sensitive diabetes management intervention and usual care. Additionally, this study aimed to identify how patient health literacy influenced the effectiveness of health literacy-sensitive diabetes management interventions. DESIGN 3 (treatment condition) × 2 (health literacy level) randomized factorial trial. METHODS In total, 151 patients diagnosed with type 2 diabetes were randomly assigned to the social media-based or telephone-based, health literacy-sensitive diabetes management interventions or the usual care control. The health literacy-sensitive diabetes management intervention consisted of an initial face-to-face diabetes nurse education using easy-to-read educational materials, the teach-back method, and eight weekly action-planning sessions guided with the use of social media or phone calls for each group. FINDINGS Patients with high health literacy at the 9-week follow-up showed higher levels of patient activation than those with low health literacy in the control group, but the effect of health literacy was no longer significant when patients were provided with social media-based or telephone-based interventions. Patients who received the telephone-based, health literacy-sensitive diabetes management intervention had a significantly higher score for self-care behaviors than the usual care control group at 9 weeks' follow-up. No other effects for self-care behaviors or glycated hemoglobin were significant at follow-up. CONCLUSIONS The social media-based, health literacy-sensitive diabetes management intervention was effective at mitigating the disadvantages faced by people with low health literacy when attempting to improve self-care activation. CLINICAL RELEVANCE Social media-based self-management interventions accommodating low health literacy have the potential to help people overcome their disadvantages associated with low health literacy.

Difficult Peripheral Venous Access in Children: An International Survey and Critical Appraisal of Assessment Tools and Escalation Pathways.

Abstract: Background: Peripheral venous cannulation is considered a routine procedure, yet 50% of first attempt insertions fail, necessitating repeat insertion attempts. Identification of children with difficult intravenous access (DIVA) can help promote prompt escalation to an appropriately skilled clinician. Objective: To describe current international practice regarding the identification and management of children with DIVA, and to systematically review clinical tools and clinical pathways for children with DIVA. Methods: A cross‐sectional, international survey; followed by a systematic review and critical appraisal of clinical pathways using the Appraisal of Guidelines for Research Evaluation (AGREE) II checklist. Results: A total of 148 clinicians from eight countries completed the survey. The majority were nurses (n = 92; 62%), practicing as vascular access specialists (n = 27; 18%). Twenty‐three respondents (16%) reported using a DIVA tool, of which the DIVA Score was most common (n = 5; 22%). Five clinical pathways were identified from the survey and review. Based on the AGREE II domains, pathways generally scored well for scope and purpose, and for clarity of presentation areas. Information on the rigor of development and editorial independence was infrequently detailed. Based on AGREE II findings, one pathway was recommended for clinical practice, and four were recommended for use with modification. Conclusions: Resources for the identification and escalation of children with DIVA are not standardized or consistently used. Further work is needed to streamline processes for DIVA identification and escalation to the appropriate clinician, with technology‐assisted insertion capability. This will enhance patient experiences and reduce harm from multiple insertion attempts. Clinical Relevance: Multiple failed insertion attempts come at great cost to the child, family, and healthcare service. Early identification and management of the child with DIVA can ensure prompt escalation and management, improving the patient and family experience.

The Impact of Social Support Networks on Family Resilience in an Australian Intensive Care Unit: A Constructivist Grounded Theory.

Abstract: Purpose This article discusses the findings of a grounded theory of family resilience in an Australian intensive care unit (ICU) with a specific focus on families' experiences of their interactions with other members within their own family, and the families of other patients in the ICU. Design A constructivist grounded theory methodology was adopted. Data were collected using in-depth interviews with 25 family members of 21 critically ill patients admitted to a tertiary-level ICU in Australia. Findings The core category regaining control represents the families' journey toward resilience when in ICU. The major categories represent facilitators for, and barriers to, regaining control. One of the main facilitators is drawing strength, and it explains the manner with which families receive social support from their own and other family members to help them cope. Conclusions This study offers a framework to improve patient- and family-centered care in the ICU by facilitating families' ability to manage their situation more effectively. Social support offered by family members facilitates the families' ability to regain control. An ICU family resilience theoretical framework, situated within the context of the Australian healthcare system, adds to what is currently known about the families' experiences in the ICU. Clinical relevance The relationships that develop between families in the ICU may provide a source of social support; however, not all families welcome interactions with other ICU families, and it may cause further emotional distress. Further research is warranted to determine whether families suffer a secondary stress reaction from incidental interactions with other patients' families in the ICU. Furthermore, when family members pull together and offer social support to each other, they are better able to regain control. This process contributes to an ICU family resilience framework.

Strategies and Resources for Increasing the PhD Pipeline and Producing Independent Nurse Scientists

Abstract: Nurse scientists play an indispensable role in developing new knowledge to advance the health of patients, families, and communities. Yet PhD nurse enrollment has significantly dropped, and many later career nurse scientists are nearing retirement. The purpose of this article is to outline potential strategies to enhance the PhD nurse pipeline. Potential strategies are identified at three distinct time points along the PhD trajectory: (a) prior to a PhD program (increasing the pipeline), (b) during a PhD program (enhancing graduation rates and transitioning into research-focused careers), and (c) in the postdoctoral or early career period (establishing scholarly independence and an active program of research). Talented students should be approached early on in their education to ascertain interest in a scientific research-based career, and all students could be engaged in research opportunities while in undergraduate programs. During a PhD program, supportive mentors are a key component for student success and may provide assistance in obtaining ongoing funding and scholarship support. Throughout doctoral study and into early career, less structured opportunities can be influential, including conference support, online and face-to-face training, and ongoing funding and scholarship support for postdoctoral study or fellowships. At each career stage, there should be a focus on designing scientifically sound nursing research that will impact outcomes in measurable and sustainable ways. We must not focus our attention only on student recruitment. Public messaging efforts are needed to raise awareness of the role of nurse researchers. In addition, several stakeholders play a role in increasing the PhD pipeline and producing independent nurse scientists, and they should be acknowledged in these efforts. The strategies described may be beneficial for any nurse contemplating a research career as well as for those who may serve as mentors to these individuals. More broadly, these strategies may be employed by colleges and universities, funding bodies, professional nursing societies, and healthcare organizations in the United States and abroad. Increasing the PhD pipeline, and fostering a more robust field of independent nurse scientists, will translate into improved patient outcomes.

Psychological Work Environment and Suicidal Ideation among Nurses in Taiwan

Abstract: Purpose Nurses are exposed to a poor psychological work environment; this may cause poor mental health, which is a risk factor for suicidal ideation. We investigated the association between psychological work environment and suicidal ideation among hospital nurses in Taiwan. Design We conducted a cross-sectional survey in Taiwan female nurses using stratified sampling by region (north, central, south, and east) to select representative centers for this study. Methods A self-report questionnaire including items on demographic data, the psychological work environment, and suicidal ideation was sent to nurses working in hospitals. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of the psychological work environment on suicidal ideation. Findings A total of 2,734 eligible questionnaires (76.8%) were returned. The prevalence of suicidal ideation was 18.3%, and higher risk was found to be associated with the educational level of junior college or below, higher personal burnout, higher client-related burnout, and always feeling stressed at work. Estimation of population attributable risk showed that higher personal burnout, client-related burnout, and always feeling stressed at work were the most crucial factors among nurses, accounting for 19.4%, 8.6%, and 10.5% of suicidal ideation, respectively. Conclusions A considerable proportion of nurses developed suicidal ideation. A poor psychological work environment was a relevant factor for suicidal ideation. Clinical evidence This study provides relevant knowledge for nursing management levels in preventing the development of suicidal ideation among nurses. Not only for nurses' mental health, but for patient safety and care quality, further studies in improving nurses' psychological work environment are warranted.

Role of Career Satisfaction in Basic Psychological Needs Satisfaction and Career Commitment of Nurses in Nigeria: A Self-Determination Theory Perspective.

Abstract: PURPOSE The purpose of this study was to test how basic psychological needs satisfaction contributes to career commitment through career satisfaction among nurses. BACKGROUND There is an increasing rate of turnover among nurses and a general shortage of nurses in many countries. This has made it necessary for researchers to focus on the career satisfaction of nurses and their commitment to their careers. DESIGN AND METHODS A cross-sectional design was employed in a survey of 233 nurses in public hospitals in southeastern Nigeria. Participants responded to self-report measures of career commitment, career satisfaction, and work-related basic needs satisfaction. FINDINGS In the regression-based path analysis, basic psychological needs satisfaction was positively related to career satisfaction (p < .001) and career commitment (p < .001) of nurses. Career satisfaction was positively related to career commitment (p < .05). Career satisfaction mediated the relationship between basic psychological needs satisfaction and career commitment (95% confidence interval [.009, .068]). CONCLUSIONS The results show that basic psychological needs are relevant for employee commitment, giving support to the self-determination theory. Career satisfaction provides further explanations for the relationship between psychological needs satisfaction and career commitment, although there could be reverse causal links. CLINICAL RELEVANCE The results advance knowledge on how satisfaction of basic psychological needs can increase career satisfaction and foster more career commitment. Designing work environments that help employees to fulfil their basic psychological needs is important in the retention of nurses.

Nursing Diagnoses as Predictors of Hospital Length of Stay: A Prospective Observational Study.

Abstract: Purpose: To investigate whether the number of nursing diagnoses on hospital admission is an independent predictor of the hospital length of stay. Design: A prospective observational study was carried out. A sample of 2,190 patients consecutively admitted (from July to December 2014) in four inpatient units (two medical, two surgical) of a 1,547-bed university hospital were enrolled for the study. Methods: Data were collected from a clinical nursing information system and the hospital discharge register. Two regression analyses were performed to investigate if the number of nursing diagnoses on hospital admission was an independent predictor of length of stay and length of stay deviation after controlling for patients’ sociodemographic characteristics (age, gender), clinical variables (disease groupers, disease severity morbidity indexes), and organizational hospital variables (admitting inpatient unit, modality of admission). Findings: The number of nursing diagnoses was shown to be an independent predictor of both the length of stay (β =.15; p <.001) and the length of stay deviation (β =.19; p <.001). Conclusions: The number of nursing diagnoses is a strong independent predictor of an effective hospital length of stay and of a length of stay longer than expected. Clinical Relevance: The systematic inclusion of standard nursing care data in electronic health records can improve the predictive ability on hospital outcomes and describe the patient complexity more comprehensively, improving hospital management efficiency.

Establishing the Genomic Knowledge Matrix for Nursing Science

Abstract: PURPOSE To establish the knowledge needed to integrate the multiple branches of omics into nursing research to accelerate achieving the research recommendations of the Genomic Nursing Science Blueprint. METHODS The creation of the Genomic Knowledge Matrix occurred in three phases. In phase 1, the Omics Nursing Science and Education Network (ONSEN) Education Workgroup completed an evidence, bioinformatics, and technology review to inform the components of the Matrix. The ONSEN Advisory Panel then reviewed and integrated revisions. Phase 3 solicited targeted public comment focused on education and research experts, and applicable revisions were made. FINDINGS The Genomic Knowledge Matrix establishes the following content areas: cellular and molecular biology, system physiology, microbiology, and translational bioinformatics as the minimum required preparation for nurse scientists to understand omics and to integrate this knowledge into research. The Matrix also establishes levels of understanding needed to function based on the role of the nurse scientist. CONCLUSIONS The Genomic Knowledge Matrix addresses knowledge important for nurse scientists to integrate genomics into their research. Building on prior recommendations and existing genomic competencies, the Matrix was designed to present key knowledge elements critical to understand omics that underpin health and disease. Knowledge depth varies based on the research role. CLINICAL RELEVANCE The Genomic Knowledge Matrix provides the vital guidance for training nurse scientists in the integration of genomics. The flexibility of the Matrix also provides guidance to inform fundamental genomic content needed in core science content in undergraduate and graduate level nursing curricula.

Unit Leadership and Climates for Evidence‐Based Practice Implementation in Acute Care: A Cross‐Sectional Descriptive Study

Abstract: PURPOSE The purposes of this study were to (a) describe nurse manager (NM) leadership behaviors for evidence-based practice, NM evidence-based practice competencies, and unit climates for evidence-based practice implementation in acute care, and (b) test for differences in NMs' and staff nurses' (RNs') perceptions. DESIGN A multisite cross-sectional design was used to collect data from a sample of 24 NMs and 553 RNs from 24 adult medical-surgical units in seven U.S. community hospitals. METHODS Responses were collected using electronic questionnaires, inclusive of the Nurse Manager Evidence-Based Practice Competency Scale (NM only), Implementation Leadership Scale, and Implementation Climate Scale. E-mail reminders and gift card lottery drawings encouraged response. Descriptive statistics described total and subscale scores by role. Differences in perceptions were evaluated using independent t-tests with Bonferroni correction (α = .05). FINDINGS 23 NMs and 287 RNs responded (95.8% and 51.9% response rates, respectively). NMs reported they were "somewhat competent" in evidence-based practice (M = 1.62 [SD = 0.5]; 0-3 scale). NMs and RNs perceived leadership behaviors (NM: M = 2.73 [SD = 0.46]; RN: M = 2.88 [SD = 0.78]; 0-4 scale) and unit climates for evidence-based practice implementation (NM: M = 2.16 [SD = 0.67]; RN: M = 2.24 [SD = 0.74]; 0-4 scale) as evident to a "moderate extent." RN and NM perceptions differed significantly on the Proactive (p = .01) and Knowledgeable (p < .001) leadership subscales. CONCLUSIONS Evidence-based practice competencies and leadership behaviors of NMs, and unit climates for evidence-based practice were modest at best and interventions are needed. To close the research to practice gap, future studies should investigate the interplay between social dynamic context factors and implementation strategies to promote uptake of evidence-based practices. CLINICAL RELEVANCE Critical attention is needed to build organizational capacity for evidence-based practices through development of unit leadership and climate for evidence-based practice to accelerate routine use of evidence-based practices for improving care delivery and patient outcomes. The three instruments described herein provide a foundation for nurse leaders to assess these dynamic context factors and design interventions or programs where there is opportunity for improvement.

Plagiarism in Predatory Publications: A Comparative Study of Three Nursing Journals

Abstract: PURPOSE This study compared three known predatory nursing journals to determine the percentage of content among them that was plagiarized or duplicated. A serendipitous finding of several instances of plagiarism via duplicate publications during the random analysis of articles in a study examining the quality of articles published in predatory journals prompted this investigation. DESIGN The study utilized a descriptive, comparative design. All articles in each journal (n = 296 articles) from inception (volume 1, number 1) through May 1, 2017, were analyzed. METHODS Each article was evaluated and scored electronically for similarity using an electronic plagiarism detection tool. Articles were then individually reviewed, and exact and near exact matches (90% or greater plagiarized content) were paired. Articles with less than 70% plagiarized scores were randomly sampled, and an in-depth search for matches of partial content in other journals was conducted. Descriptive statistics were used to summarize the data. FINDINGS The extent and direction of duplication from one given journal to another was established. Changes made in subsequent publications, as a potential distraction to identify plagiarism, were also identified. There were 100 (68%) exact and near exact matches in the paired articles. The time lapse between the original and duplicate publication ranged from 0 to 63 months, with a mean of 27.2 months (SD =19.68). Authors were from 26 countries, including Africa, the United States, Turkey, and Iran. Articles with similarity scores in the range of 20% to 70% included possible similarities in content or research plagiarism, but not to the extent of the exact or near exact matches. The majority of the articles (n = 94) went from Journal A or C to Journal B, although four articles were first published in Journal B and then Journal A. CONCLUSIONS This study found a substantial level of plagiarism via duplicate publications in the three analyzed predatory journals, further diluting credible scientific literature and risking the ability to synthesize evidence accurately to inform practice. Editors should continue to use electronic plagiarism detection tools. Education about publishing misconduct for editors and authors is a high priority. CLINICAL RELEVANCE Both contributors and consumers of nursing literature rely on integrity in publication. Authors expect appropriate credit for their scholarly contributions without unethical and unauthorized duplication of their work. Readers expect current information from original authors, upon which they can make informed practice decisions.

Barriers to education of Syrian refugee girls in Jordan: gender-based threats and challenges

Abstract: Purpose The purpose of this study was to uncover and describe the barriers to education as experienced by Syrian refugee girls in the Za'atri Syrian Refugee Camp in Jordan. Design A qualitative nonexperimental design utilizing focus group discussions (FGDs), individual interviews, and participant and nonparticipant observation was used for this study. Four FGDs were facilitated in three dropout education centers (nonformal school) in the Za'atri Syrian Refugee Camp. Data were collected over a period of 5 months from December 2017 to April 2018. Methods Using an FGD format, the United Nations Human Rights ABC module in the Arabic language was used to educate, to empower with knowledge and skills, and to elicit participants' responses to perceived barriers to exercising their universal human rights, especially their right to education. Data were collected using a demographic tool, digitally recorded FGDs, an observation notebook, a flip chart, and a detailed interview schedule. Fifteen in-depth, individual, 1½-hr interviews of self-selected participants were conducted. Narrative statement and content analysis were used to analyze the data for each FGD. A constant comparative method was used to compare and verify codes, categories, and themes within and between groups. Findings The complex interplay of patriarchy, tradition, and religious practices, combined with the added vulnerabilities of protracted warfare displacement, prevent Syrian girls from being their own agents, prevent their access to education, and expose them to even greater health risks through coercion into early marriage. Several themes explained the process by which the interactive nature of patriarchy, traditional cultural, and religious practice influenced the girls' right to education and their right to make their own decisions about marriage. These are (a) gender role and the social position of girls in the family, (b) gender role and the cultural disvaluing of girls' education, (c) economic survival priorities and child labor, and (d) the intersection of environmental stressors with preservation of family honor as motivators for early marriage. Repeated exposure to threats and physical abuse seem to be the mechanisms that reinforce the girls' perceived gender-based vulnerabilities, submissiveness, and educational truancy. Conclusions Syrian refugee girls seem to consistently face conflicts and daily adverse experiences that pose serious physical and psychological risks to their health with potentially far-reaching negative health consequences. Gender-based physical and psychological threats and abuses, along with the coercive practice of early marriage, while viewed as a way of protecting them, put Syrian refugee girls at greater health risk, psychological threat, and social and economic challenge. Evidence on refugees who experienced violence shows that they are more likely to experience post-traumatic stress disorder (PTSD), dissociative disorders, depression, and anxiety, along with a host of life-threatening physical comorbidities. Clinical relevance Syrian refugee girls are at high risk for gender-based abuse and violence. Nurses can play an important role in reducing the health risks associated with gender-based abuse by assessing clients for symptoms of physical and psychological abuse, including symptoms of PTSD, depression, anxiety, and suicidal ideation. Maternal and child health assessment and health-promoting interventions should be included in the healthcare plan. Understanding the sociopolitical conditions, as well as the cultural and religious backgrounds, that shape the lived experiences of displaced girls is also essential for offering a congruent, culturally sensitive plan of care and for creating targeted and relevant educational and treatment intervention strategies and referrals.

Motivations, Beliefs, and Expectations of Spanish Nurses Planning Migration for Economic Reasons: A Cross‐Sectional, Web‐Based Survey

Abstract: Purpose Migration of nurses is not a new or recent event. During the past few decades, nursing migration flows have been a constant trend worldwide. The main objective of this study was to explore the motivations, beliefs, and expectations that Spanish nurses had when considering migration to another country in the near future. Design Cross-sectional, Internet survey of Spanish nurses planning migration for professional reasons. Methods Ad hoc, web-based questionnaire following the Nurses Early Exit Study guidelines. Findings One hundred seventy-two nurses responded. Fifty percent of the participants intended to emigrate in the following 6 months and had chosen the United Kingdom as their destination. The most important drivers of migration were unemployment or precarious employment, and professional development. Fifty-eight percent of the participants were very afraid of experiencing discrimination or rejection. Conclusions This first study conducted in Spain directly exploring determinants of nurse migration highlighted globalization-driven factors and specific acculturation fears. Clinical relevance Employment uncertainty and professional development remain key push drivers for migration of Spanish nurses. Discrimination and rejection due to migrancy were concerns for 60% of the participants.

The Impact of the Syrian Refugee Crisis on Nurses and the Healthcare System in Lebanon: A Qualitative Exploratory Study.

Abstract: Purpose To explore Lebanese nurses' perspectives on the impact of the protracted Syrian refugee (SR) crisis on nurses working in hospitals and primary healthcare centers in Lebanon. Design A qualitative research design drawing on a semistructured in-depth interview approach. Methods We recruited participants through the Order of Nurses in Lebanon. We interviewed six primary healthcare nurses and six nursing directors working in regions with high concentration of SRs. We used the thematic inductive approach to analyze the data. Findings Two themes emerged. In Theme I, nurses and nursing directors described the SR health profile as poor at baseline, and as the crisis was protracting the type of diseases shifted from acute to chronic with convoluted complications. As for determinants of health, SRs had poor health literacy and poor living conditions. In Theme II, nurses and nursing directors voiced the impact of the SR crisis on nurses, nursing practice, healthcare system, and host community. They cited fatigue, burnout, and depleted compassionate care at the individual level; rationing and stressed interpersonal relationships at the practice level; shortage in resources and poor performance at the healthcare system level; and a shift in the patient population that led the host community to seek health care elsewhere. Alternatively, more money was injected, and new services and clinical programs were introduced. Conclusions Lebanese nurses bore a profound burden as a result of the SR crisis. Should this crisis be replicated in other contexts, the important lessons learned encompass (a) increasing access to care to refugees, coupled with an emergency plan to increase human health resources; (b) improving preparedness of nurses in handling priority health conditions; (c) documenting and reporting the challenges and resilience of health workers, especially nurses facing the crisis; and (d) engaging more nurses to be at the policy table. Clinical relevance There is a need to prepare nurses for efficient response to crisis related to refugee health by increasing human resources and training them to be competent in delivering safe and high-quality care necessary to respond to the special healthcare needs of the refugees.

Challenges, Coping, and Resilience Among Immigrant Parents Caring for a Child With a Disability: An Integrative Review.

Abstract: Purpose The aim of this integrative review is to synthesize quantitative and qualitative research evidence on challenges in caring for a child with a disability among immigrant parents and to understand their coping strategies and resiliency factors associated with their coping. Methods A comprehensive literature search was conducted to identify relevant studies from the following databases: MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, PsycINFO, Social work abstract, Cochrane library, and EMBASE. Findings This review included 25 studies: 1 quantitative, 23 qualitative, and 1 narrative review. The main challenges that parents faced were language barriers, financial hardships, service utilization challenges, poor adaptation to new culture, stigma related to mental illness, discrimination, and social isolation. This review found poor communication and lack of cultural awareness among some healthcare professionals. Immigrant parents used problem-focused coping, avoidance coping, spiritual coping, and social support to manage their challenges. Parents who received social, emotional, and instrumental support were more resilient. Personality traits and faith were protective factors that enhanced resilience. Conclusions When immigration and disability are considered concurrently, the burden of care multiplies. Immigrant parents with children who have disabilities faced extra challenges related to adaptation, finance, service utilization, and stigma. Healthcare providers can play an important role in aiding these parents in service utilization and adaptation. Significance This review adds new knowledge on immigrant parents' challenges in caring for their children with disabilities. Such knowledge could help health professionals to develop supportive interventions to enhance parental coping and resilience. Clinical relevance Culturally appropriate and sensitive communication and care provided by healthcare providers can facilitate service utilization and reduce perceived stigma. Special training provided to healthcare providers regarding the challenges of these families may enhance awareness. Information support and parental support groups may help to enhance parental coping and reduce isolation. An interpreting service should be provided in all aspects of care.

Genomic Literacy of Registered Nurses and Midwives in Australia: A Cross-Sectional Survey.

Abstract: Purpose: Registered nurses and midwives require a degree of genomic literacy if they are to adequately communicate with other healthcare professionals and provide optimal care to patients, their families, and the community. Several studies have been conducted internationally to assess the genomic literacy of nurses; however, the genomic literacy of Australian registered nurses and midwives has not been investigated. The aim of this study was to measure the genomic literacy of Australian registered nurses and midwives through assessing participants’ understandings of genomic concepts most critical to nursing and midwifery practice, as well as their perceived knowledge and attitude towards genomics in nursing and midwifery practice. Design: Cross-sectional survey of Australian registered nurses and midwives using the Genomic Nursing Concept Inventory (GNCI©), a 31 multiple-choice question survey instrument. Participants were recruited via two key Australian nursing and midwifery organizations over an 8-month period in 2016. Methods: Descriptive and inferential statistical techniques were used to calculate the total GNCI© score and scores on individual subcategories, as well as relationships between demographic variables and GNCI© scores. Findings: Most respondents worked as clinicians (71.4%) in a hospital or hospital-based setting (61.8%). Most registered nurses (80.5%) and midwives (97.2%) reported that genetics was relevant to clinical practice; however, over 80% of registered nurses and midwives believed their knowledge of genetics was poor or average. Genomic knowledge was assessed using the GNCI©. Scores ranged from 3 to 29 (out of a possible 31), with a mean score of 13.3 (SD 4.559) based on 253 (N = 253) respondents, indicating that genomic literacy is low. There was a significant difference between genomic knowledge scores and education and training level (p = .036). Conclusions: The genomic literacy of registered nurses and midwives in Australia is low. More must be done to ensure Australian registered nurses and midwives have an adequate level of genomic literacy to provide optimal care to patients, their families, and the community. Clinical Relevance: Modern medicine requires a healthcare workforce that is literate in genomics. Findings from this study may serve as the catalyst to improve the genomic literacy of the Australian nursing and midwifery workforce, allowing for improved health outcomes for individual and the wider Australian public.

Nursing Research Literature Production in Terms of the Scope of Country and Health Determinants: A Bibliometric Study

Abstract: PURPOSE The aim of this paper was to present the results of the first study in which nursing research literature production was studied in the relation to country and health determinants. DESIGN Bibliometric analysis was used. METHODS The corpus of nursing publications was harvested from the Scopus indexing and abstracting database. Using research articles' metadata (funding acknowledgments, publication years, and author affiliations), we analyzed global trends in the nursing research literature production of funded and nonfunded publications. Next, we performed a regression analysis and correlation analysis relating nursing research productivity to health and country determinants. FINDINGS The search resulted in 118,870 papers, among which 22.0% were funded (24.7% for G8 countries). Nursing literature production is exhibiting a positive trend. The United States is by far the most productive country in terms of funded and nonfunded literature production, although it is ranked only ninth in per capita production, for which Sweden is the most productive country regarding funded papers. The study also revealed that gross domestic product, human development factor, and gross national income were related to nursing research literature productivity. CONCLUSIONS The positive trend in nursing research literature production (both funded and nonfunded) reveals a growth in nursing research funding. Regionally centered research literature production shows that the more developed and "rich" countries produce the majority of publications. A positive correlation is evident between country determinants and research literature production, as is a positive correlation between per capita literature research production and well-being and health determinants. CLINICAL RELEVANCE Substantial growth in terms of nursing research literature production and research funding has been identified. While a limited amount of research in this area exists, this study revealed some interesting relations between nursing literature production and country and health determinants, which might motivate nursing researchers to pursue more intensive research and funders to support further growth of nursing research funding.

How Do Family Strengths-Oriented Therapeutic Conversations (FAM-SOTC) Advance Psychiatric Nursing Practice?

Abstract: Purpose Family nursing interventions, focusing on therapeutic conversations, have been found to benefit primary caregivers dealing with chronic and acute illnesses. Less is known, however, about the benefit of these interventions for partner caregivers. The aims of this study were to develop and test the Family Strengths-Oriented Therapeutic Conversation (FAM-SOTC) intervention for partner caregivers of young individuals with eating disorders (EDs). Methods Eighteen partner caregivers of adolescents and young adults with ED participated in this quasi-experimental study. The FAM-SOTC intervention was offered over 4 months, during which time the focus was on establishing the therapeutic relationship and identification of the family relationships. The five key elements of the FAM-SOTC intervention are (a) drawing forward illness stories; (b) asking therapeutic questions; (c) identifying strength, resiliency, and resources; (d) offering evidence-based information and recommendations; and (e) strengthening helpful beliefs and challenging hindering beliefs. These elements provided the foundation for the study. Findings Significantly higher family support and illness beliefs were reported after five sessions of the FAM-SOTC intervention and again after 3 follow-up booster sessions. The FAM-SOTC intervention demonstrated a positive benefit for participants. Clinical relevance The FAM-SOTC intervention was found to benefit families, both in the short and long term, in psychiatry settings. After having participated in five sessions of the FAM-SOTC intervention and 3 booster sessions, partner caregivers of young individuals with ED experienced higher family support and reported better knowledge, more confidence, and more positive illness beliefs regarding the disorder.

A Conflict of Values: Nurses' Willingness to Work Under Threatening Conditions.

Abstract: Purpose The purpose of this study was to determine the willingness of Israeli registered nurses to work under threatening conditions, their perceived level of threat, and perceptions of peer willingness to report to work. Design This descriptive study was based on a convenience sample of registered nurses working in four hospitals throughout Israel from internal medicine, surgical, emergency, and intensive care units. Methods A questionnaire designed by the investigators was administered to registered nurses while on duty. The questionnaire consisted of three sections: personal characteristics, perceived level of personal threat from five situations (caring for a patient with a dangerous infection, terror attack, war, radiation or chemical disaster, or natural disaster), and perceived personal and peer willingness to work under these threats. Findings A convenience sample of 249 registered nurses from four hospitals responded. The highest level of perceived threat was a natural disaster (earthquake; M = 2.15, SD = 0.9). Terror (M = 0.83, SD = 0.6) and war (M = 1.01, SD = 0.6) received the lowest mean perceived threat scores. Most respondents were not willing to work during a natural disaster but were willing to care for patients with dangerous infections and during times of war. Weak positive statistically significant correlations were found between the level of perceived threat and willingness to work for all of the threats, except for terror (Spearman rank correlation = .16-.35). Conclusions Local culture, perceptions of the level of threat, and perceived peer responsiveness are associated with registered nurses' willingness to work under threat. Clinical relevance When faced with a threat to personal safety or security, many registered nurses might not be willing to work as usual. What is perceived as threatening is influenced by the local culture and environment. Therefore, managers should be aware of potential cultural and peer influences on this possible conflict of values.

Postdoctoral Nurses' Experiences With Leadership and Career Development : A Qualitative Study

Abstract: PURPOSE: The purpose of this study was to explore the experiences and perceptions of Dutch postdoctoral nurses working in research with leadership and career development. METHODS AND DESIGN: A generic explorative qualitative design with semistructured in-depth interviews was used. A criterion sample of 13 postdoctoral nurses working in research in the Netherlands was included. The data were analyzed using thematic analysis. FINDINGS: Three themes were identified: (a) developing leadership and identity as a PhD nurse, (b) becoming a valuable member in the scientific world of academe, and (c) continuous search for progression while balancing worlds and tasks. Postdoctoral nurses experienced their leadership and professional development as a serious and conscious process. Their vision of nursing, health care, and research was an important motive regarding future career choices. Although the scientific world of academe was perceived as honorable, the nurses experienced it as a complex work environment. All the postdoctoral nurses had to deal with the demands and pressures of the scientific world. Coping with the tension between enjoying work and handling high workloads and academic achievements was described as challenging. Searching for balance was important, especially because of the different part-time employment or working activities with various commitments. CONCLUSIONS: This study demonstrates that postdoctoral nurses do show considerable progression in their leadership and career development; however, they experience the scientific working environment as challenging. The findings of this study indicate the need for more academic positions, the strengthening of the infrastructure for nursing research, and the development of supportive leadership and mentoring programs for postdoctoral nurses to provide optimal evidence-based and high-quality care for patients. CLINICAL RELEVANCE: Postdoctoral nurses need to develop strong leadership competencies to strengthen research, education, and evidence-based practice in clinical care to improve patient and healthcare outcomes.

Maternal and Child Health During Forced Displacement.

Abstract: Purpose To discuss the effects of forced displacement on maternal and child health, highlight the major pitfalls in delivering humanitarian services to this vulnerable group, and underscore the need for multilayered interventions to improve health, protect rights, and reduce vulnerabilities during forced displacements. Methods A comprehensive literature search was undertaken from databases including Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, Google Scholar, Scopus, and ProQuest. No restrictions were placed on geographical region, type, and year of publication. The key words used were displacement, children, women, health, challenges, disaster response, emergency medicine, terrorism, maladjustment, morbidity, disaster response, cultural sensitivity, and interventions. Conclusions Forced displacement negatively affects maternal and child health. The key challenges during forced displacement include food insecurity, lack of shelter, unavailability of clean water and sanitation, poor infrastructure of healthcare services, unavailability of birth attendants and healthcare professionals to manage medical emergencies, inaccessibility to educational and training facilities, and lack of cultural sensitivity of humanitarian workers. The ultimate outcome of forced displacement is a sudden rise in maternal and child mortality and morbidity, maladjustment, psychological issues, altered familial roles, displaced parenting, and vulnerability to exploitation. In view of Bronfenbrenner's socio-ecological framework, multilayered interventions are proposed to improve maternal and child health during forced displacements. Clinical relevance In view of the effects of forced displacement on maternal and child health and considering the major pitfalls in the delivery of humanitarian services to this vulnerable group, the proposed multilayered interventions can improve health, protect rights, and reduce vulnerabilities surrounding maternal and child health during forced displacements.

Self-Management Behaviors in Relation to Psychological Factors and Interdialytic Weight Gain Among Patients Undergoing Hemodialysis in Indonesia.

Abstract: Purpose The purpose of this study was to understand the influence of demographic and psychological factors on self-management behaviors and interdialytic weight gain (IDWG) as a fluid adherence marker among patients undergoing hemodialysis in Indonesia. Design A quantitative correlational study. Method A convenience sample of 145 patients undergoing hemodialysis was recruited from the dialysis units in two hospitals in Jakarta from September to December 2015. Questionnaires were used to examine self-management behaviors, depression, anxiety, and stress. Data for IDWG were obtained by subtracting the individual's predialysis weight from his or her postdialysis weight from the previous session. Hierarchical multiple linear regression identified the predictors of IDWG. Results Self-advocacy was ranked the least performed self-management behavior, while medication adherence was ranked the most likely to be performed. Among the subscales of the Self-Management Behavior Indices, positive correlations were found between the communication dimension with all psychological factors (depression, anxiety, and stress), while self-advocacy had positive correlation with anxiety. Subjects gained a mean of 4.5% of their postdialysis weight, with over 50% exceeding the recommended 4% IDWG. Overall, 53.6% of the IDWG was explained by the weekly duration of hemodialysis, level of depression, communication, partnership in care, and self-advocacy. Conclusions Self-management behaviors are potential predictors that can be modified by nephrology nurses in order to enhance clinical outcomes, with the specific outcome being IDWG. Self-management behaviors contribute to the promotion of appropriate IDWG. Depressed patients are less likely to adhere to weight gain restrictions. Clinical relevance Education combined with training in self-management behaviors-particularly communication, becoming a partner in care, and advocating for care-may improve adherence to IDWG guidelines among Indonesian hemodialysis patients. Interventions targeting depressed patients are needed.

Migrants' Healthcare Experience: A Meta-Ethnography Review of the Literature.

Abstract: Purpose: Worldwide, more than 214 million people have left their country of origin. This unprecedented mass migration impacts on healthcare in host countries. This paper explores and synthesizes literature on the healthcare experiences of migrants. Design: A meta- ethnography study of qualitative studies was conducted. Methods: Eight databases (MEDLINE, CINAHL, PsychInfo, EMBASE, Web of Science, Migration Observatory, National Health Service Scotland Knowledge Network, and ASSIA) were searched for relevant full text articles in English, published between January 2006 and June 2016. Articles were screened against inclusion criteria for eligibility. Included articles were assessed for quality and analysed using Noblit and Hare's seven step meta ethnography process. Findings: Twenty-seven studies were included in the review. Five key contextualization dimensions were identified: Personal Factors, The Healthcare System, Accessing Healthcare, The Encounter and Healthcare Experiences. These five areas all underlined the uniqueness of each individual migrant emphasizing the need to treat a person rather than a population. Within a true person-centred approach, the individual's cultural background is fundamental to effective care. Conclusion: From the findings, a model has been designed using the five dimensions and grounded in a person-centred care approach. This may help healthcare providers to identify weak points, improve the organisation and healthcare professionals to provide person-centred care to migrant patients. Clinical relevance: The proposed model facilitates identification of points of weakness in the care for migrant patients. Employing a person-centred care approach may contribute to improve health outcomes for migrant patients.

Update on Research and Practices in Major Sleep Disorders: Part I. Obstructive Sleep Apnea Syndrome.

Abstract: Purpose The purpose of this first of two review articles providing an update on sleep disorders was to examine the pathophysiology, epidemiology, and treatment of obstructive sleep apnea (OSA). OSA is a common sleep disorder whose prevalence is similar to asthma. As with other sleep disorders, OSA has a broad impact on individuals, affecting their daily behaviors, cognitive abilities, and performance, and putting them at increased risk for accidents, mood disorders, cancer, cardiovascular disease, and hypertension. Thus, early recognition and management, much of which can be implemented by nurses, can reduce health and accident risks and improve daily functioning. Methods This narrative review utilized medical databases such as PubMed to identify relevant English language original and systematic review articles predominantly from peer-reviewed journals from 2012 to 2018. However, as background, findings from classic articles prior to 2012 were also included. Clinical relevance OSA is a common condition with considerable impact on daily functioning and potential for accidents and serious comorbidities such as hypertension, cardiovascular disease, diabetes, and depressed mood. The impairments and comorbidities associated with OSA can be reduced through early detection, encouraging treatment, providing education about sleep and OSA, and, importantly, promoting adherence to the predominant therapy, positive airway pressure.