Journal of Nursing Management

Aim. The study is aimed at exploring the relationship between newly graduated nurses’ transition shock, negative coping, job satisfaction, and intent to stay during the time of COVID-19. Background. The shortage of nurses is a global dilemma aggravated by the COVID-19 pandemic. It has been a hot topic in recent years to help newly graduated nurses transition smoothly. Transition shock is one of the essential indicators to describe the transition state of newly graduated nurses, which has a far-reaching impact on the intention of newly graduated nurses to stay in their posts. However, few studies have studied the mechanism behind this relationship, which may affect the effectiveness of retention strategies. Methods. A descriptive cross-sectional study was conducted from July to August 2021 in 31 tertiary hospitals in Shanghai, China. Participants comprised a convenience sample of 759 newly graduated nurses for surveys. Structural equation models were used to examine the study’s hypothetical model. Results. The results showed that transition shock had a significant direct effect on job satisfaction (b = −0.412, ) and intent to stay (b = −0.145, ). Job satisfaction had a significant direct effect on intent to stay (b = 0.702, ). The indirect effect of transition shock on intent to stay through job satisfaction was statistically significant (b = −0.289), the 95% C.I. was (−0.493, −0.357), and the proportion of mediating effect to total effect was 66.59%. Moreover, the moderated mediation analysis showed that the interaction effect of transition shock and negative coping style on job satisfaction was significant (b = −0.082, ). Conclusion. This study revealed the impact of transition shock on intent to stay of newly graduated nurses during the time of COVID-19, and found that job satisfaction played a mediating role and negative coping played a moderating role. These findings are of great significance for nursing managers to take measures to improve the intention of newly graduated nurses to stay. Implication for Nursing Management. The level of transition shock is an important indicator reflecting the transition state of newly graduated nurses, and can further predict the job satisfaction and intention of newly graduated nurses to stay. Therefore, nursing managers should pay attention to taking corresponding measures to reduce the level of transition shock of newly graduated nurses.

Aims. To estimate the prevalence and bother of lower urinary tract symptoms (LUTS) and the work-related and individual factors associated with LUTS among a representative sample of female nurses. Background. A healthy nursing workforce is essential to advance global health goals, especially during times of extraordinary demand for nursing care. LUTS frequently occur and persist in women and are correlated with multiple negative health outcomes and diminished work engagement and productivity. However, the study of LUTS among female nurses failed to receive sufficient attention from researchers. Methods. We used baseline data for 13,191 female nurses in China collected for the prospective cohort study, the Nurse Urinary Related Health Study (NURS). We assessed nurses’ self-reported LUTS and symptom-related bother using the International Consultation on Incontinence Questionnaire-Female LUTS. We used descriptive statistics to summarize LUTS prevalence and its related bother and a mixed-effects logistic regression model to test the effects of work-related and individual factors on LUTS. Results. Most of the participants in this study were younger than 40 years old (82.9%), were married (74.8%), and had given birth once or never (73.7%). Few participants had chronic diseases (3.4%), consumed alcohol (7.3%), smoked (0.4%), or had overweight/obesity (27.7%). The prevalence of any LUTS was 51.1%, and over 50% of the nurses with LUTS in this study had experienced moderate or severe bother, except for urinary frequency. Working longer than five years, more than 40 hours per week, and in Level A, major tertiary hospitals were found to be risk factors of LUTS, and a nurse-to-bed ratio higher than 0.40 was found to be a protective factor. Increased fluid intake also was found to be a protective factor of LUTS in nurses, and having chronic constipation was found to be a risk factor. Conclusions. LUTS are highly prevalent and severely bothersome among female nurses in China, despite the fact that the female nurses in this study were relatively young, healthy, had few childbirths, and were living healthy lifestyles. This finding warrants remedial action that is related to both behavioral and environmental factors to ensure a healthy nursing workforce. Nurses cannot reasonably be expected to contribute to global health when one of their basic needs as humans, i.e., the normal function of urinary elimination, is ignored. Implications for Nursing Management. Nurse managers should be aware that nurses’ basic needs regarding urination are negatively affected by LUTS and related bother. Nurse managers should address LUTS-related problems on multiple levels, including overseeing and reporting LUTS in nurses, exploring innovative care models to mitigate the negative effects of excessive workloads on nurses, and remodeling the nursing culture and encouraging positive coping behaviors for the self-health of nurses.

Aim. To investigate the current status of NBDs’ core competencies through latent profile analysis, identify potential subgroups and their population characteristics, and analyze the influencing factors of different categories. Background. NBDs are essential in the treatment and rehabilitation of burn patients. However, the core competencies of Chinese NBDs are seldom reported. Methods. Our analyses were based on a cross-sectional and multicenter study of 267 Chinese NBDs. Latent profile analysis was employed to identify NBDs’ core competence profiles using the NBD Core Competencies Self-rating Scale (NBD-CCSS). We then explored the characteristics among different profiles and determined socio-demographic variables associated with profile membership by conducting ANOVA, Chi-square test, and multinominal logistic regression analyses. Results. A 3-profile model provided the best fit. The three profiles were titled “skillful competencies” (Class 1, n = 77, 28.8%), “moderate competencies” (Class 2, n = 140, 52.4%), and “poor competencies” (Class 3, n = 50, 18.7%). Regression analysis suggested that professional title, years of employment, and BICU experience were influencing factors of NBDs’ profile membership of core competencies. NBDs who were supervisor nurses or above (OR = 0.802, 95% CI: 0.009, 0.759), with more than 7 years of employment (OR = 0.091, 95% CI: 0.009, 0.906) and BICU experience (OR = 3.564, 95% CI: 1.423, 8.925) were more likely to fall into Class 1. Conclusions. Our findings could provide evidence for nursing administrators to develop training programs to enhance NBDs’ core competencies. In particular, variables associated with profile membership determined in the study may facilitate more tailored training strategies.

Aim. To develop a valid, reliable assessment tool to measure risk factors associated to low back pain (LBP) in intensive care unit (ICU) nurses. Background. LBP is defined as the pain extending from the 12th rib to the iliac crest and often coexists with buttock pain. Nursing has been identified among the top professions at risk of LBP. A mean of 70% prevalence per year in ICU nurses was reported, exceeding those employed in heavy industry. Environmental factors in workplace were also most important risks related to LBP in this population except factors including individual, physical, psychosocial, and lifestyle. However, there is lack of tools to assess environmental risk related to LBP for nurse managers currently. Methods. Focus group interviews, field research, and panel discussion were used to develop item pool. Two-round expert reviews and preinvestigation were carried out to form initial scale named Environmental Risk Assessing Instrument-Occupational Low Back Pain in Nurses (ERAI-N). A cross-sectional survey with 188 ICU participants in Hunan Province in China was implemented to collect data. Cronbach’s alpha, split-half reliability, and test-retest reliability were used to test ERAI-N’s reliability. Expert review was performed to test ERAI-N’s content validity, and confirmatory factor analysis (CFA) was performed to assess its construct validity, being carried out in IBM SPSS Amos 26 Graphics. Results. Final version of ERAI-N scale had five dimensions with 18 items that were space, equipment, belief, guideline, and safe culture. ERAI-N scale’s score of Cronbach’s alpha, Guttman split-half, and intraclass correlation coefficient (ICC) was 0.958, 0.927, and 0.994, respectively. Item-level content validity scores ranged from 0.89 to 1.0, and scale-level content validity was 0.983. Standardized factor loadings ranged from 0.567 to 0.974. Model adjusted fit statistics were as follows: the chi-square statistic and degrees of freedom (χ²/df) = 3.943, root mean square error of approximation (RMSEA) = 0.071, incremental fit index (IFI) = 0.905, comparative fit index (CFI) = 0.904, parsimony normed fit index (PNFI) = 0.641, and parsimonious comparative fit index (PCFI) = 0.661. Conclusions. ERAI-N scale had moderate reliability, content validity, and construct validity. Implications for Nursing Management. Designers may use ERAI-N scale to plan the interior layout when design a new ICU. Nurse managers might utilize this instrument as a managing tool to assess whether there is environmental risk factors related to LBP in ICU.

Aim. To explore and describe the factors that influence the job satisfaction of nurses working in the intensive care unit (ICU). Background. High turnover and dropout rates of nurses currently put pressure on the accessibility and quality of ICU care. Job satisfaction is an important predictor for turnover. However, there is little knowledge about the factors that enhance or frustrate the job satisfaction of ICU nurses. Methods. A qualitative descriptive study was conducted from March to July 2022. Semistructured interviews were held with 23 registered nurses who were purposively sampled from the ICU in four hospitals in the Netherlands. Interview transcripts were analyzed by using a thematic content analysis approach. Results. Six themes emerged: (1) being part of a solid team; (2) professional autonomy; (3) competence development; (4) appreciation of work by others; (5) work content; and (6) human resource management. Interviewees described the importance of being part of a team, having professional autonomy and opportunities to develop and remain challenged as a professional. In practice, these needs are often not met. Interviewees expressed their own role in meeting these needs by taking charge in situations, being eager to learn, and actively looking for ways to keep work attractive. Recognition and appreciation for their work are important catalysts for staying motivated. Monotonous work, poor leadership, and bureaucracy reduced their job satisfaction. Conclusion. Our findings provide deeper insight into a range of factors that influence the job satisfaction of ICU nurses and may also apply to nurses in other settings. Practical recommendations are given for keeping the nursing profession attractive for the current and future generation. Implications for Nursing Management. Findings emphasize the importance of optimizing nurses’ work conditions by investing in their social embeddedness, professional autonomy, opportunities for competence development, and appreciation of work.

Aims. The aim of this study was to adapt the Safety Climate Survey and examine its validity and reliability for use in the Turkish healthcare context. Background. Maintaining patient safety is a challenge for healthcare systems world-wide, and healthcare professionals need valid and reliable tools to measure improvements in safety. Methods. The Safety Climate Survey is unidimensional and contains 19 items, which are all five-point Likert-type scales as follows: 1 (totally disagree), 2 (disagree), 3 (neither agree nor disagree), 4 (agree), and 5 (totally agree). Language adaptation of the Safety Climate Survey conducted in accordance with the International Society for Pharma economics and Outcome Research (ISPOR) and expert assessments to calculate the content validity indices was undertaken in the first phase of the study. In phase two, a survey of 434 nurses employed in three hospitals in İzmir (Turkey) was conducted to test the construct validity with confirmatory factor analysis and internal consistency with Cronbach’s alpha, split-half reliability, and item-total correlation. The intraclass correlation coefficient was also checked via test-retest reliability for stability. Results. The content validity index score was 0.97 for the scale and above 0.90 for the items, confirming excellent validity. The confirmatory factor analysis showed an adequate fit, and all the factor loadings were positive and greater than 0.30. Cronbach’s alpha was 0.90, and Spearman̶–Brown coefficient 0.83, indicating good internal consistency. The item-total correlation coefficients were between 0.33 and 0.70, exceeding the acceptable level. The intraclass correlation coefficient value obtained was 0.84, reflecting a good level for time stability. Conclusion. The Turkish version of the Safety Climate Survey is a valid, reliable, and practical tool which can provide essential data on safety issues for healthcare professionals and administrators. Implications for Nursing Management. The instrument can be used in hospital settings to measure the safety climate among nurses, and the results obtained can be used to inform the development of safety improvement strategies.