International Journal of Nursing Studies Advances最新文献

{"title":"Exploring the reasons behind nurses' intentions to leave their hospital or profession: A cross-sectional survey","authors":"Marco Enea ,&nbsp;Laura Maniscalco ,&nbsp;Neeltje de Vries ,&nbsp;Anke Boone ,&nbsp;Olivia Lavreysen ,&nbsp;Kamil Baranski ,&nbsp;Silvana Miceli ,&nbsp;Alessandra Savatteri ,&nbsp;Walter Mazzucco ,&nbsp;Santo Fruscione ,&nbsp;Malgorzata Kowalska ,&nbsp;Peter de Winter ,&nbsp;Szymon Szemik ,&nbsp;Lode Godderis ,&nbsp;Domenica Matranga","doi":"10.1016/j.ijnsa.2024.100232","DOIUrl":"10.1016/j.ijnsa.2024.100232","url":null,"abstract":"<div><h3>Background</h3><p>Multiple factors can fuel nurses’ intention to leave their employing hospital or their profession. Job dissatisfaction and burnout are contributors to this decision. Sociodemographic and work context factors can also play a role in explaining nurses’ intention to leave.</p></div><div><h3>Objective</h3><p>To investigate the role of sociodemographic and work context factors, including job resources, job demands, job dissatisfaction, depersonalization, and emotional exhaustion, on nurses’ intention to leave their hospital or their profession.</p></div><div><h3>Design</h3><p>Multicentre cross-sectional study.</p></div><div><h3>Setting(s)</h3><p>Eight European hospitals, two per each country, including Belgium, the Netherlands, Italy, and Poland.</p></div><div><h3>Participants</h3><p>From May 16 to September 30, 2022, we collected 1,350 complete responses from nurses working at the selected hospitals (13 % response rate).</p></div><div><h3>Methods</h3><p>The intention to leave was assessed through two 5-Likert scale outcomes, agreeing with the intention to leave the profession and the intention to leave the hospital. Logistic regression models were used for statistical analysis.</p></div><div><h3>Results</h3><p>At the multivariable analysis, a higher intention to leave the hospital was observed for: younger age, having served on the frontline against COVID-19, lack of quipment, living in the Netherlands, emotional exhaustion, dissatisfaction with work prospects, and dissatisfaction with the use of professional abilities. There was a higher intention to leave the profession for: younger age, living in the Netherlands, having work-related health problems, depersonalization, emotional exhaustion, low possibilities of professional development, dissatisfaction with work prospects, lack of use of professional abilities, overall ob issatisfaction, and dissatisfaction with salary. Nurses living in Italy expressed the lowest intention to leave.</p></div><div><h3>Conclusion</h3><p>While confirming the role of job dissatisfaction and burnout, we found higher intention to leave for young nurses, nurses with work-related health problems, and caregivers during the COVID-19 pandemic. Dissatisfaction with work prospects, professional development, and salary also increased the intention to leave. We call for educators, managers, and policymakers to address these factors to retain at-risk nursing categories, implementing strategies to mitigate intentions to leave.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100232"},"PeriodicalIF":3.1,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000596/pdfft?md5=5786b4fcfb295a5ce60831d93399fa16&pid=1-s2.0-S2666142X24000596-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141978864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing the status quo of person-centred dementia care in different types of care units in German nursing homes: A convergent mixed methods study","authors":"Anna Louisa Hoffmann-Hoffrichter ,&nbsp;Mike Rommerskirch-Manietta ,&nbsp;Johannes Michael Bergmann ,&nbsp;Martina Roes ,&nbsp;Bernhard Holle ,&nbsp;Rebecca Palm","doi":"10.1016/j.ijnsa.2024.100233","DOIUrl":"10.1016/j.ijnsa.2024.100233","url":null,"abstract":"<div><h3>Background</h3><p>The policies and mission statements of nursing homes support the implementation of person-centred dementia care. The Dementia Policy Questionnaire assesses the content of person-centred dementia care in policies. To date, it is unknown whether these policies exist exclusively in dementia care units and whether the policies are consistent with the mission statements of nursing homes.</p></div><div><h3>Objective</h3><p>We aimed to (1) investigate nursing home care unit types regarding the existence of policies measured by the Dementia Policy Questionnaire, (2) explore whether these policies are addressed in the mission statements of the nursing homes, and (3) integrate both results.</p></div><div><h3>Design</h3><p>This is a convergent mixed methods study performed with a quantitative and qualitative dataset that was collected in the BeStaDem survey (2020).</p></div><div><h3>Setting</h3><p>The BeStaDem survey included licensed nursing homes in Germany.</p></div><div><h3>Participants</h3><p>A total of 134 nursing home administrators provided informed consent to participate in the BeStaDem survey.</p></div><div><h3>Methods</h3><p>For quantitative data, we performed Fisher's exact test to identify differences in the Dementia Policy Questionnaire item distribution of several types of care units (aim 1). To support the results of Fisher's exact test, we additionally applied logistic regression analysis. For qualitative data, we analyzed the mission statements deductively with the qualitative content analysis method (aim 2). For integration, we used a convergent triangulation approach (aim 3).</p></div><div><h3>Results</h3><p>The quantitative data collected from 134 German nursing homes show significant associations among person-centred dementia care policies, such as behavior assessment, and nursing homes with dementia care units. Regarding the qualitative data, of the 60 mission statements in total, eight mission statements of nursing homes with dementia care units exclusively address aspects such as dementia-specific interventions. The convergent triangulation approach shows that the answers given by the nursing homes in the quantitative survey are not always consistent with what they address in their mission statements.</p></div><div><h3>Conclusions</h3><p>Nursing homes with dementia care units provide more person-centred dementia care policies than other care unit types do but mostly do not address these aspects in their mission statements. The implementation of person-centredness benefits from the existence of policies and mission statements if nursing homes clearly address what is meant by person-centred dementia care in their nursing home.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100233"},"PeriodicalIF":3.1,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000602/pdfft?md5=648f449905d505b3f344a0ec63ffeee6&pid=1-s2.0-S2666142X24000602-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a brief diabetic foot risk screening scale for diabetic patients","authors":"Wenjing Luo ,&nbsp;Qiuhong Zhou ,&nbsp;Jingcan Xu ,&nbsp;Zheyu Tan ,&nbsp;Xinyi Li ,&nbsp;Ying Ye ,&nbsp;Honglin Wang ,&nbsp;Shuyi Peng","doi":"10.1016/j.ijnsa.2024.100230","DOIUrl":"10.1016/j.ijnsa.2024.100230","url":null,"abstract":"<div><h3>Objective</h3><div>To develop a concise screening tool for diabetic foot risk assessment in patients with diabetes, and rigorously evaluate its reliability and validity.</div></div><div><h3>Methods</h3><div>390 adults diagnosed with diabetes were selected for a study in Changsha, China. The study was conducted in two phases. In the first phase, initial items were developed by amalgamating existing diabetic foot risk screening tools and group discussions. Additionally, diabetic foot experts established content validity during this phase. In the second phase, the validity and reliability of the developed items were evaluated through various methods such as item analysis, exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha coefficient, retest reliability, inter-rater reliability, ROC curve and AUC.</div></div><div><h3>Results</h3><div>The Brief Diabetic Foot Risk Screening Scale consists of 6 dimensions and 19 items. An exploratory factor analysis was conducted on the scale, revealing six principal factors that accounted for 74.139 % of the total variance. The I-CVI was greater than 0.8, indicating good content validity, while the S-CVI was 0.737. Confirmatory factor analysis showed that the model fit well. The scale's Cronbach's α coefficient was 0.770, indicating good internal consistency, and its test-retest reliability was 0.958. The AUC suggests that the Brief Diabetic Foot Risk Screening Scale is an effective measure for identifying diabetic foot.</div></div><div><h3>Conclusion</h3><div>The Scale is a reliable and valid tool for assessing foot risk.</div></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100230"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of the ShareD dEciSIon making for patients with kidney failuRE to improve end-of-life care intervention: A pilot multicentre randomised controlled trial","authors":"Louise Engelbrecht Buur ,&nbsp;Hilary Louise Bekker ,&nbsp;Henning Søndergaard ,&nbsp;Michell Kannegaard ,&nbsp;Jens Kristian Madsen ,&nbsp;Dinah Sherzad Khatir ,&nbsp;Jeanette Finderup","doi":"10.1016/j.ijnsa.2024.100231","DOIUrl":"10.1016/j.ijnsa.2024.100231","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Kidney failure is associated with a high disease burden and high mortality rates. National and international guidelines recommend health professionals involve patients with kidney failure in making decisions about end-of-life care, but implementation of these conversations within kidney services varies. We developed the DESIRE (ShareD dEciSIon-making for patients with kidney failuRE to improve end-of-life care) intervention from our studies investigating multiple decision maker needs and experiences of end-of-life care in kidney services. The DESIRE intervention's three components are a training programme for health professionals, a patient decision aid, and a kidney service consultation held to facilitate shared decision-making conversations about planning end-of-life care.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;p&gt;To assess the feasibility and acceptability of integrating the DESIRE intervention within kidney services.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;A pilot study using a multicentre randomised controlled design.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;p&gt;Four Danish nephrology departments.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;p&gt;Patients with kidney failure who were 75 years of age or above, their relatives, and health professionals.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Patients were randomised to either the intervention or usual care. Feasibility data regarding delivering the intervention, the trial design, and outcome measures were collected through questionnaires and audio recordings at four points in time: before, during, post, and 3 months after the intervention. Acceptability data were collected through semi-structured interviews with patients and relatives, as well as a focus group with health professionals post the intervention.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Twenty-seven patients out of the 32 planned were randomised either to the intervention (&lt;em&gt;n&lt;/em&gt;= 14) or usual care (&lt;em&gt;n&lt;/em&gt;= 13). In addition, four relatives and 12 health professionals participated. Follow-up was completed by 81 % (&lt;em&gt;n&lt;/em&gt;= 22) of patient participants. We found that both feasibility and acceptability data suggested health professionals improved their decision support and shared decision-making skills via the training. Patient and relative participants experienced the intervention as supporting a shared decision-making process; from audio recordings, we showed health professionals were able to support proactively decision-making about end-of-life care within these consultations. All stakeholders perceived the intervention to be effective in promoting shared decision-making and relevant for supporting end-of-life care planning.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Participant feedback indicated that the DESIRE intervention can be integrated into practice to support patients, relatives, and health professionals in planning end-of-life care alongside the management of worsening kidney failure. Minimising exhaustion and enhancing engagement with the in","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100231"},"PeriodicalIF":3.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000584/pdfft?md5=298dc81b7c55b102912551e388ef2639&pid=1-s2.0-S2666142X24000584-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illness: A qualitative study","authors":"Hege Wathne ,&nbsp;Carl May ,&nbsp;Ingvild Margreta Morken ,&nbsp;Marianne Storm ,&nbsp;Anne Marie Lunde Husebø","doi":"10.1016/j.ijnsa.2024.100229","DOIUrl":"10.1016/j.ijnsa.2024.100229","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Patients living with long-term chronic illnesses often need ongoing medical attention, lifestyle adjustments, and psychosocial support beyond the initial diagnosis and treatment phases. Many experience illness deterioration and subsequently require hospitalisation, especially in the transition period after hospital discharge. A promising strategy for managing long-term conditions is promoting self-management. eHealth interventions involving remote patient monitoring have the potential to promote self-management and offer a more seamless bridge between the hospital and the patient´s home environment. However, such interventions can only significantly impact health and health care if they are effective, accepted and adopted by users, normalised into routine practice and everyday life, and able to be widely implemented. Feasibility studies are used to determine whether an intervention is suitable for the target population and effective in achieving its intended goal. They may also provide critical information about an intervention´s acceptability and usability.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;p&gt;We aimed to evaluate the acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illnesses by use of the core constructs of normalisation process theory.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;p&gt;A descriptive and explanatory qualitative approach was used, with patients observed during training and semi-structured interviews conducted with patients and nurses after study completion.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Settings&lt;/h3&gt;&lt;p&gt;Participants were recruited from two university hospitals in Norway between December 2021 and February 2023.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;p&gt;Ten patients were observed during training, and 27 patients and eight nurses were interviewed after study completion.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;Structured and overt observations were made while the patients received training to operate the remote patient monitoring service, guided by an observation guide. Semi-structured interviews were conducted with patients and nurse navigators about their experiences of remote follow-up care, guided by open ended questions. Data analysis followed a stepwise deductive inductive method.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;`Achieving acceptance and usability through digital social interaction´ emerged as a unifying theme that bridged the experiences of patients with long-term illnesses and the nurse navigators. This overarching theme was illustrated by four sub-themes, which all reflected the usability and acceptability of the nurse-assisted remote patient monitoring service in various ways.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;Acceptability and usability are critical factors to consider when evaluating remote patient monitoring interventions. In this study, the most important feature for promoting acceptability and usability was the interaction between patie","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100229"},"PeriodicalIF":3.1,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000560/pdfft?md5=51ef0fc17c6d65888894aeae87fc8e1f&pid=1-s2.0-S2666142X24000560-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health economic evaluations of programs reducing preterm birth: A scoping review","authors":"Anvitaa Chadha,&nbsp;Suzanne Moore,&nbsp;Sue Kildea,&nbsp;Yu Gao","doi":"10.1016/j.ijnsa.2024.100228","DOIUrl":"10.1016/j.ijnsa.2024.100228","url":null,"abstract":"<div><h3>Background</h3><p>Preterm birth has lifelong implications, placing a burden on individuals, families, communities and the health system. While several interventions to reduce preterm birth have been economically evaluated, no scoping review has been undertaken.</p></div><div><h3>Objective</h3><p>To conduct a scoping review of economic evaluations of interventions that have reduced preterm birth, identify gaps in the literature and inform future health care providers and researchers on the economic value of preterm birth reduction interventions.</p></div><div><h3>Methods</h3><p>Databases such as PubMed, Cumulative Index to Nursing and Allied Health Literature, EBSCO, Medline (OVID), EMBASE, NHS Health Technology Assessment, the Cost-Effectiveness Analysis Registry, and the NHS Economic Evaluation Database and grey literature were comprehensively searched for economic evaluations of interventions that reduced preterm birth conducted since 2000. Items included: preterm birth reduction, intervention, method of economic evaluation, time-horizon of analysis, study population, perspective of evaluation, effectiveness, and costs. Review processes were undertaken by two reviewers, and disagreements were resolved by the larger team.</p></div><div><h3>Results</h3><p>Fifteen publications met the inclusion criteria, including pharmacological interventions (5), telemedicine (1), diagnostic procedures (2), public and community health (2), prenatal care and nutrition (2), father's involvement (1), doula care (1) and a comprehensive maternity service redesign (1). Variations were observed in study design, time-horizon, study population and method of evaluation. Most studies (n = 13) adopted either a healthcare payer, provider, or system perspective. Shorter timehorizons for analysis were adopted in all studies, except one that conducted a lifetime economic evaluation. All included interventions, except one, were found to be costeffective, cost-beneficial or led to cost-savings.</p></div><div><h3>Conclusion</h3><p>Despite preterm birth placing a high economic burden on health systems and society, we found a dearth of long-term economic evaluations of prevention and reduction initiatives. Future research on preterm birth reduction initiatives should include economic evaluations.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100228"},"PeriodicalIF":3.1,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000559/pdfft?md5=e4ffbef59c6e7a295335188b8b3d3211&pid=1-s2.0-S2666142X24000559-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of nursing-sensitive indicators: A critical discussion","authors":"Edel Gormley ,&nbsp;Michael Connolly ,&nbsp;Mary Ryder","doi":"10.1016/j.ijnsa.2024.100227","DOIUrl":"10.1016/j.ijnsa.2024.100227","url":null,"abstract":"<div><h3>Discussion arguments</h3><p>In a science-based profession, nurses must continuously monitor and evaluate the effectiveness of their care. However, data on what constitutes nursing care in practice and the delivery process is lacking. Insufficient evidence on how nurses contribute to patient care hampers the evaluation of nursing practice.</p><p>We discuss nursing-sensitive indicators, their origins, current applications, and challenges related to their use in evaluating the quality of nursing care. We analyse nursing-sensitive indicators in the context of criticisms levelled at the profession related to the lack of evidence to support their value in the larger healthcare environment.</p></div><div><h3>Conclusions</h3><p>We have a disjointed approach to evaluating nursing care. Current systems designed to monitor nursing care, such as metrics and data sets, are not adequate or effective for comprehensively evaluating nursing care, considering the fundamentals and values of the nursing profession.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100227"},"PeriodicalIF":3.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000547/pdfft?md5=9409dc3ed38512f3efedc0419f677a73&pid=1-s2.0-S2666142X24000547-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of followership among nurses: A qualitative study","authors":"Sulaiman Alanazi ,&nbsp;Richard Wiechula ,&nbsp;David Foley","doi":"10.1016/j.ijnsa.2024.100222","DOIUrl":"10.1016/j.ijnsa.2024.100222","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Followership is defined as the role individuals play in supporting, contributing to, and realizing the vision and directives set by their leaders. Such a role is indispensable in healthcare, facilitating effective team dynamics and healthcare delivery. Within the nursing field, it encompasses nurses' active engagement and participation in healthcare delivery, ensuring safety, fostering teamwork, and enhancing patient outcomes. Despite its significance, the exploration of followership within the nursing context of Saudi Arabia remains limited.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;p&gt;This study aims to explore how followership is perceived and practiced by nurses in this unique cultural and professional setting, and its implications for healthcare delivery.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We conducted a qualitative inquiry involving seven registered nurses working in hospitals affiliated with the Saudi Arabian Ministry of Health. Semi-structured interviews were conducted, and a thematic analysis was utilized to extract key findings.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Our thematic analysis identified four main themes and several sub-themes that encapsulate the participants' perspectives on followership. The themes include: (1) Understanding of followership, where a predominant lack of clarity about the concept was observed, often conflating it with teamwork; (2) Followers' involvement in decision-making, highlighting the limited participation of nurses in decision-making processes due to hierarchical and autocratic leadership structures; (3) Barriers to followership, which encompassed issues such as poor leadership, the undervaluation of the follower role, lack of training and development opportunities, challenges in collaboration, and language barriers; and (4) Facilitators of followership, identified as effective leadership, followership training, communication skills, positive relationships, respect, collaboration, understanding of roles, commitment, and flexibility. These findings elucidate the complex landscape of followership within the nursing profession in Saudi Arabia, revealing both the challenges and pathways to fostering effective followership in healthcare settings.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion and Implications&lt;/h3&gt;&lt;p&gt;This study reveals a widespread lack of awareness about followership among nurses in Saudi Arabia, highlighting significant challenges related to hierarchy and the undervaluation of the follower role in nursing practice and education. It underscores the need for educational and training interventions that redefine and elevate the role of followership in clinical settings to enhance collaboration, assertiveness, and decision-making skills. Moreover, the study advocates for the re-evaluation of leadership practices to better acknowledge and value followership, promoting a more flattened hierarchy that encourages active participation in patient care and organizational development. Implementing these chang","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100222"},"PeriodicalIF":3.1,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000493/pdfft?md5=1d6c077f908ae8879883781eaefde420&pid=1-s2.0-S2666142X24000493-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenges Experienced by ICU Nurses in Kuwait during the COVID-19 Pandemic","authors":"Ali Al Haddad ,&nbsp;Anne Arber ,&nbsp;Anna Cox ,&nbsp;Ann Gallagher","doi":"10.1016/j.ijnsa.2024.100226","DOIUrl":"10.1016/j.ijnsa.2024.100226","url":null,"abstract":"<div><h3>Background</h3><p>The coronavirus (COVID-19) pandemic presented unprecedented challenges to healthcare systems worldwide, with intensive care unit (ICU) nurses at the forefront of patient care. To date, there is limited evidence into ICU nurses'experiences of the pandemic in Kuwait.</p></div><div><h3>Research question/aims/objectives</h3><p>To elucidate the challenges faced by ICU nurses in Kuwait during the pandemic, by considering two research questions: “What contributed to intensified pressure for the ICU nurses?” and “How were the nurses affected?”.</p></div><div><h3>Research design</h3><p>This was a qualitative study which utilised semi-structured interviews. Interviews were conducted between January 2021 and June 2022 with ICU nurses who worked during the COVID-19 pandemic. The data were analysed using Charmaz's grounded theory methodology.</p></div><div><h3>Participants and research context</h3><p>25 nurses from three ICUs in Kuwait.</p></div><div><h3>Ethical considerations</h3><p>The study was approved by the University Ethics Committee and by the Ministry of Health in Kuwait.</p></div><div><h3>Findings/Results</h3><p>The analysis identified two themes (the factors contributing to intensified pressure in the ICU, and the impact on the nurses) and seven sub-themes. The pressure in the ICU intensified due to the rise in the number of patients, staff shortages, and the requirement to adhere to unrealistic new procedures for infection control. Restricted and cancelled leave, as well as impaired autonomy at work, impeded the nurses’ ability to recover from stress. The heightened stress also contributed to a worsening in interpersonal relationships between the nurses and their colleagues. The nurses’ care was compromised by these challenges, leading to moral distress and a range of mental health symptoms (e.g., stress, anxiety, emotional exhaustion).</p></div><div><h3>Conclusions</h3><p>The study accords with other research conducted during the pandemic in revealing a significant mental health toll among healthcare workers during the pandemic. The stressors were similar to those which have been reported in other studies, although there were also context-specific effects relating to the environment of the ICU and the Kuwaiti context.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100226"},"PeriodicalIF":3.1,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000535/pdfft?md5=fd1940e7a3a9a2eb30caa61fab766b9f&pid=1-s2.0-S2666142X24000535-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Under pressure - Nursing staff's perspectives on working hours and recovery during the COVID-19 pandemic: A qualitative study","authors":"Isabelle Hernandez ,&nbsp;Marie Söderström ,&nbsp;Ann Rudman ,&nbsp;Anna Dahlgren","doi":"10.1016/j.ijnsa.2024.100225","DOIUrl":"10.1016/j.ijnsa.2024.100225","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic contributed to increased pressure on healthcare systems. During periods when the demands exceed the capacity of healthcare organizations, adaptive strategies are used to meet these demands. During the COVID-19 pandemic, working hours for nursing staff were reorganized and extended. This has posed challenges for recovery, which may be a key factor for maintaining health and safety under such conditions.</p></div><div><h3>Objectives</h3><p>The aim of the study was to bring insights into how nursing staff perceived their working hours and recovery during the COVID-19 pandemic, and if they experienced any changes in their sleep and well-being.</p></div><div><h3>Design</h3><p>A qualitative descriptive design was chosen, as it is suitable for gaining insight into perceptions and experiences.</p></div><div><h3>Methods</h3><p>Qualitative semi-structured interviews were conducted using an interview guide. The interviews were analyzed using thematic analysis. Sixteen registered nurses and six certified nursing assistants from four Swedish hospitals participated in the study.</p></div><div><h3>Results</h3><p>The organization of working hours during the COVID-19 pandemic was considered suboptimal and resulted in more demanding working hours and poor recovery. Nursing staff experienced loss of control as they lost influence over working hours, working hours became more unpredictable and the boundaries between work and leisure became blurred. Nursing staff also experienced a decline in their health and well-being, including extreme fatigue, impaired sleep and physical/mental changes.</p></div><div><h3>Conclusion</h3><p>The strategies used by healthcare organizations to meet increasing demands during the COVID-19 pandemic contributed to impaired recovery and well-being of nursing staff, which could generate negative feedback loops contributing to depletion of resources at the organizational level.</p></div>","PeriodicalId":34476,"journal":{"name":"International Journal of Nursing Studies Advances","volume":"7 ","pages":"Article 100225"},"PeriodicalIF":3.1,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666142X24000523/pdfft?md5=38f2269f592a7545ecbacdc44412d364&pid=1-s2.0-S2666142X24000523-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}