Nursing Forum

Aim. To examine death anxiety and its related factors among candidates to become advanced nurse practitioners. Background. Nurses are required to care for dying patients and frequently face death-related issues in clinical practice. Yet, as human beings, it is natural for nurses to feel anxious about their own mortality, which can be incited by witnessing the death of another person. It is evident that a nurse’s death anxiety level may influence how they care for their patients. However, studies to date focus primarily on the death anxiety of patients. Little is known about such experiences among registered nurses, especially those training to be advanced nurse practitioners. Design. This is a quantitative cross-sectional study. Methods. Participants were postgraduate students pursuing their advanced nurse practitioner degree at Nam Dinh University of Nursing, Vietnam. The enrolment criteria included full-time student status and a willingness to participate in the study. Data were collected from 297 participants who completed a self-administered questionnaire during February or March 2022. Death anxiety was measured using Templer’s Death Anxiety Scale. Results. Most advanced nurse practitioner candidates demonstrated a moderate level of death anxiety (109/297; 39.1%). Nearly three in ten (74/297; 26.5%) reported a high level of death anxiety. No statistically significant associations between nurses’ life satisfaction, age, and death anxiety were found. Death anxiety levels did not differ by gender, work position, workplace, or frequency of caring for dying patients (). Conclusions. There is an identified need to support nurses, especially future nurse clinical leaders, to manage their death anxiety. Professional training programs should offer nurses the opportunity to develop skills necessary to cope with their negative attitude toward death. Further research is recommended to confirm the apparent associations between death anxiety and demographic and psychosocial factors. Those relationships should be examined with appropriate consideration of the contextual and cultural environment in which the study is performed.

Aim. To review the current literature on the developing role of nursing innovation, specifically, those nurses who have progressed their innovative practice into product development. Design. A scoping review was conducted utilising the Population, Concept, Context framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Data Sources. An initial search was performed in February 2023 with a repeat search and revision to the review completed in September 2023. Electronic searches of the British Nursing Index, Current Index of Nursing Allied Health Literature, Emerald Insight, National Health Service Knowledge and Library Hub, and Google Scholar™ were undertaken using the terms Nursing AND (new product development) AND (device innovation). Two authors (LS and MS) also undertook hand searching of relevant reference lists. Review Methods. Two authors were involved in the screening process of available and relevant literature (LS and MS) with the third author (FH) available for decision-making in the event of any generated disagreements. Results. We undertook a review of seventeen papers from 274 results. The impetus of nursing innovation, defining the nurse inventor, facilitators to the nurse inventor concept, and barriers to the nurse inventor concept were all identified as themes to be explored. Conclusion. The nurse inventor concept requires further challenge and clarity. Nurses should aim for a consensus of definition, typology, scope of practice, and job planning. Healthcare institutions should acknowledge and explore this novel role in detail, with consideration afforded to how the role is to be specified and integrated into today’s nursing practice roles. Reporting Method. Adherence to EQUATOR guidance was achieved through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

Introduction. Value creation can begin through a joint development process. Value creation not only relies on interactions between group members but also requires studying other attributes. This study aimed to explain the experiences of nursing managers regarding value creation in nursing. Methods. A descriptive content analysis approach was used in this study. Sampling was done purposefully from April to December 2022 among the nursing managers working in Birjand educational hospitals who were willing to participate in the study. Data were collected through unstructured interviews. Graneheim and Lundman’s (2020) qualitative content analysis method was used to analyze the data, and four Lincoln and Guba criteria were used for the data rigor process. All interviews were recorded, typed in a Word file, and entered into MAXQDA (2020). Twenty-two interviews were conducted with nineteen participants. Results. In this study, eleven participants were female, and eight were male. They were employed at three different management levels, including head nurses, supervisors, and matrons. The data analysis has resulted in the identification of ten distinguished subcategories, which have been grouped into four categories based on their similarities. These four categories are concerned with value-seeking, purposeful identification of values, determining strategies to grow values, and perpetuation of values. Conclusion. By prioritizing value creation and emphasizing its importance, nursing managers can effectively improve patient outcomes and enhance the overall quality of care provided in healthcare organizations. Additionally, nursing managers play a crucial role in facilitating and maintaining values in the organization by contextualizing opportunities for the flourishing of value and directing them towards valuable benefits. Therefore, it is essential that nursing managers have a correct understanding of nursing values and value creation in nursing practice.

Purpose. The purpose of this paper is to analyze the concept of scope of practice for occupational health nurses. Background. Occupational health nurses (OHNs) practice in different industries alone or with other nurses, providing care to employees. The demand on occupational health nurses to respond to increasing organizational healthcare needs of employees and other healthcare demands raises the question, do occupational health nurses understand their scope of practice? Occupational health nurses inadvertently practicing outside their scope may jeopardize their nursing licenses, and the safety and quality of care of employees. Method. A literature review was conducted to identify defining attributes, antecedents, and consequences for the concept of scope of practice for OHNs. Walker and Avant’s eight-step framework for concept analysis was applied. Results. The defining attributes of the scope of practice for OHN include but are not limited to standards and guidelines: competency, public safety; practicing certificates; using sound judgement; regulatory restrictions, limitations of practice in occupational health settings, and type of educational qualifications. The antecedents include education, training, competency, regulation, and experience. The consequences include improved quality care when education, training, and competencies are met within the practice guidelines. Possible disciplinary actions against the nurse and employer violation of workplace safety standards may occur. Conclusion. OHNs must understand and practice within their scope of practice even when placed in situations by their employers that could defy the limits of their practice. Defining the scope of practice for OHNs will lay the framework for research studies.

Introduction. Hospital and emergency department closures are emblematic of America’s changing healthcare delivery system, which often places rural vulnerable communities at further risk for poor health outcomes. Employing the Vulnerable Populations Conceptual Model (VPCM), we aimed to synthesize the existing research addressing care quality in these facilities and the impacts of their closures on affected communities and health status. Materials and Methods. We conducted a modified integrative literature review (outlined by Whittemore and Knafl), comparing and contrasting articles via an organizational matrix. We identified articles through three databases and ancestral searches. We included English-written, peer-reviewed articles published from 2010 forward. We excluded international and nonresearch articles that focused on the closure of specific departments (other than emergency departments). Our final sample included 26 primary research studies (24 quantitative and two qualitative). We scored the articles according to their scientific rigor and data relevance, then deductively coded them according to the VPCM constructs. Results. We identified two overarching themes from the literature: (1) association of rural hospital care and patient health outcomes and (2) access to hospital care-effects of closures and openings on rural vulnerable populations. Subthemes reflected access to care and other resources, relative risks associated with time-sensitive health events, and health outcomes. Discussion and Conclusion. We found that rural hospitals provide access to essential health services and emergency care in these vulnerable, underserved communities. Their loss may increase adverse outcomes in affected communities and the overall health system. However, our review was limited by the retrospective, nonexperimental nature of most included articles, and more data quantifying these effects and the impact of confounding factors are needed. Multidisciplinary stakeholders must jointly address declining access to hospital and emergency care by sustainably addressing social determinants of health, quality assurance, innovative healthcare delivery systems, and rural hospital funding.

Background. Parents’ health literacy has a great impact on child’s care and health. Knowing parent’s health literacy levels is crucial to avoid the consequences of limited literacy and for the creation of better health policies and educational interventions. To assess those levels, we must have tools tailored to this population. However, there is a lack of specific instruments to evaluate this capacity in Portuguese parents of children aged less than 12 months. Aim. To perform the cultural adaptation and psychometric validation of the Parental Health Literacy Assessment Test-8 for use in Portugal. Methods. Methodological study is divided into two phases: cultural adaptation and psychometric validation. The first phase followed the Beaton guidelines. The second, carried out with 176 parents, took place at a public hospital in Portugal, between October 2020 and June 2021. Data were analyzed for internal reliability using the Kuder–Richardson reliability coefficient (KR-20). Confirmatory factor analysis was used to estimate factor validity, applying polychoric correlation measures using the “lavaan package” for the R statistical package. Results. In the cultural adaptation, the expert committee adjusted the translated version, validating the content for Portuguese parents. At validation, the calculated value of KR-20 was approximately 0.50. The empirical indices of the goodness-of-fit of the factor model showed a good overall fit, although two of the items had low weights (0.24 and 0.32). The results of the factors show an acceptable value for the factor (FC = 0.756) and a lower value for the average variance extracted. Conclusion. The version of the instrument adapted for Portugal presented adequate semantic and content equivalence. The psychometrics suggested that the PHLAT-8-PT is a reliable and valid instrument that can be used systematically by the health team to measure the health literacy levels and improve health education.