Professional identity and nursing: contemporary theoretical developments and future research challenges

The nurses' clinical environment belongingness and professional identity: The mediating role of professional values

BackgroundBelonging to the clinical environment and the professional values of the performers play a role in forming a professional identity. Therefore, it is necessary to understand the degree of connection among these concepts.AimThis study aimed to examine the mediating effects of professional values on the relationship between nurses' clinical environment belongingness and professional identity.DesignIn the present study, a descriptive cross-sectional multicenter design was used.Participants and research contextA convenient sample of 635 nurses recruited from three hospitals in Fars Province, Southern Iran, from September 2023 to January 2024. Nurses Professional Values Scale-Revised, Clinical Environment Belongingness Scale, and Professional Identity Scale were used to collect the data. The mediation model was analyzed using SPSS v27 and the Process Macro 4.0.Ethical considerationsThe protocol of this study was approved by the Research Ethics Committee of Fasa University of Medical Sciences, and informed consent was obtained from all nurses. The study conforms to the principles outlined in the Declaration of Helsinki.ResultsBased on the results of regression analysis, clinical environment belongingness had a positive and significant impact on professional identity (β = 0.366, p < 0.001) and professional value (β = 0.676, p < 0.001). Professional value significantly predicted professional identity (β = 0.170, p < 0.001). The indirect effect of clinical environment belongingness on professional identity via professional values was statistically significant (β = 0.115, SE = 0.024, 95% CI = [0.068, 0.162]), and this effect was directly (β = 0.336, SE = 0.034, 95% CI = [0.297, 0.434]) significant.ConclusionsThe new theoretical framework for nurses developed in this study can contribute to professional development. It is further recommended that the promotion of professional value and clinical environment belongingness may be effective in enhancing the professional identity of the nursing staff, as indicated by the results.

Mental health practitioners' perceptions and adoption intentions of AI-enabled technologies: an international mixed-methods study

BACKGROUND

As mental health disorders continue to surge, exceeding the capacity of available therapeutic resources, the emergence of technologies enabled by artificial intelligence (AI) offers promising solutions for supporting and delivering patient care. However, there is limited research on mental health practitioners' understanding, familiarity, and adoption intentions regarding these AI technologies. We, therefore, examined to what extent practitioners' characteristics are associated with their learning and use intentions of AI technologies in four application domains (diagnostics, treatment, feedback, and practice management). These characteristics include medical AI readiness with its subdimensions, AI anxiety with its subdimensions, technology self-efficacy, affinity for technology interaction, and professional identification.

METHODS

Mixed-methods data from N = 392 German and US practitioners, encompassing psychotherapists (in training), psychiatrists, and clinical psychologists, was analyzed. A deductive thematic approach was employed to evaluate mental health practitioners' understanding and familiarity with AI technologies. Additionally, structural equation modeling (SEM) was used to examine the relationship between practitioners' characteristics and their adoption intentions for different technologies.

RESULTS

Qualitative analysis unveiled a substantial gap in familiarity with AI applications in mental healthcare among practitioners. While some practitioner characteristics were only associated with specific AI application areas (e.g., cognitive readiness with learning intentions for feedback tools), we found that learning intention, ethical knowledge, and affinity for technology interaction were relevant across all four application areas, underscoring their relevance in the adoption of AI technologies in mental healthcare.

CONCLUSION

In conclusion, this pre-registered study underscores the importance of recognizing the interplay between diverse factors for training opportunities and consequently, a streamlined implementation of AI-enabled technologies in mental healthcare.

Psychological entitlement and willingness to work in rural areas: the moderating role of organizational identification and professional identification

BACKGROUND

In many rural areas, medical talent shortages in healthcare present significant challenges. While developing countries and organizations invest in enhancing the education and training of medical students, they often struggle to retain them in rural areas. Traditional efforts to address this issue, such as scholarships, loan repayment programs, and increased funding, have yet to see much success in sustainably attracting professionals to rural areas. Few studies have explored the internal psychological factors influencing medical students' willingness to work in rural areas. This study aims to address this gap by examining how psychological entitlement impacts the willingness to work in rural areas and the moderating roles of organizational and professional identification.

METHODS

This study investigated 406 participants using the stratified cluster sampling method at the universities undertaking oriented medical students (OMS) programs. The data collection instruments were the willingness to work in rural areas, psychological entitlement, organizational identification, and professional identification questionnaires. We conducted descriptive analyses, hierarchical regression analyses, and simple slope analysis using SPSS 26.0.

RESULTS

The findings revealed that psychological entitlement was negatively related to the willingness to work in rural areas (β < 0.00, p < .01). Organizational identification positively moderated the relationship between psychological entitlement and willingness to work in rural areas (β > 0.00, p < .01), such that this negative relationship was buffered when organizational identification was higher than lower. Whether professional identification was high or low, when organizational identification was high, the negative impact of psychological entitlement on willingness to work in rural areas was significantly buffered.

DISCUSSION

The study offers valuable insights indicating that psychological entitlement negatively predicted OMS' willingness to work in rural areas. Importantly, it identifies that organization identification rather than professional identification was the critical factor that mitigates this negative impact. These findings highlight that considering psychological entitlement and organization identification could inspire solving talent shortage problems in rural areas for organizations and policymakers.

CLINICAL TRIAL NUMBER

Not applicable.

Becoming a Nurse: Professional Identity in Prelicensure Nursing Students

BACKGROUND

A correlation exists between professional identity (PI), hope, and job satisfaction that warrants interventional measures to reverse nurse turnover. Developing, nurturing, and improving nurses' PI can positively address nurse turnover.

PURPOSE

The purpose of this study was to examine the intersections between career motivation, PI formation, and belongingness in prelicensure nursing students.

METHODS

As part of a larger mixed-methods study, a quantitative survey was disseminated to students.

RESULTS

Findings suggest significant connections between the depth of perceived PI, motivation to enter the field, and future orientation(s) that are mediated through classroom instruction. PI was shaped by student relationships, confidence, and autonomy.

CONCLUSIONS

Findings underscore the importance of academic intentionality in incorporating PI early in nursing education. Prioritizing quality bedside experiences to develop meaningful relationships while simultaneously increasing confidence and autonomy to assist the nursing student in connecting with their PI is key.

Do media stories about medical workers' arduousness scare medical students? Insights from a cross-sectional study

BACKGROUND

Under the combined influence of the aftermath of the epidemic and aging, the shortage of health workforce has become increasingly serious across the globe, posing constraints to the achievement of Universal Health Coverage. Improving the professional identity of medical students can ensure a steady supply of potential medical workers, which can mitigate the shortage of medical workers. This study focuses on sad news about medical workers' arduousness, a dominant news type in public crises, and examines how it affects medical students' professional identity, which is regarded to be important in the development of medical education and public health.

METHODS

This study employed a paper-and-pencil survey and recruited 1441 medical students in a Chinese university. Structural equation modeling (SEM) analysis with SmartPLS 3.0 was used to analyze the data.

RESULTS

The results reveal that media stories have multi-layered impacts on medical students' professional identity. Their exposure of sad news about medical workers' arduousness not only has direct impacts on professional identity, but also exerts indirect impacts via the provision of online emotional support.

CONCLUSION

This study has both theoretical and practical implications. In theory, the findings highlight the importance of media stories in the construction of professional identity and propose a theoretical framework for explaining the impacts of sad news exposure. In practice, this study contributes to the improvement of medical education, hospital management and public health governance in the digital age.

Nursing postgraduates' innovative behaviour, influencing factors and educational requirements: a national cross-sectional study

BACKGROUND

Innovative behaviours are important for nursing postgraduates who are a significant reserve for future nursing career, thinking critically, utilizing technologies and solving complex problems. In nursing undergraduates' education, innovative behaviour is closely linked with the development of professional identity. However, there are limited studies exploring innovative behaviours, influencing factors and educational requirements of nursing postgraduates.

AIM

To investigate nursing postgraduates' innovative behaviour, influencing factors, and the correlation between innovative behaviour and professional identity. Moreover, exploring nursing postgraduates' requirements for innovational education.

METHODS

A national descriptive cross-sectional study was conducted among postgraduate students in Chinese nursing schools between October and November 2022. A general information questionnaire, The Nurses' Innovative Behaviour Scale, the Professional Identity Questionnaire for Nurse Student, and a multiple-choice question about students' innovation education requirements were collected. The independent-sample t-test, one-way analysis of variance (ANOVA), multiple linear regression, and Pearson's correlation analyses were conducted.

RESULTS

This study recruited 426 nursing postgraduates from 44 nursing schools across China. The mean score of innovative behaviour of nursing postgraduates was 38.96 ± 4.90 (min-max 10-50). Nursing postgraduates' professional identity was positively correlated with innovative behaviour (r = 0.436, P < 0.01). Participants who read scientific literature frequently, had a high level of professional identity, and grew up in urban areas had high levels of innovative behaviour (adjusted R2 = 0.244, P < 0.001).

CONCLUSIONS

It was determined that the level of innovative behaviour is associated with their professional identity and the frequence of reading scientific literature in nursing postgraduates. It is imperative for educators to foster an environment that encourages postgraduate nursing students to engage with a wider array of scholarly literature and elevates postgraduate nursing students' professional identity. Furthermore, the dissemination of advanced knowledge and the adoption of diverse pedagogical approaches are likely to meet the innovative demands of nursing postgraduates.

[Strong Professional identity construction as a change lever]

Professional identity is the way in which professionals define themselves in relation to their professional role, encompassing both their sense of identity and the expected behaviors associated with that role. The formation of this identity is a complex process that begins at the undergraduate level and continues throughout a pharmacist's professional career. Several different professional identities have been identified in the world of pharmacy, which may indicate a degree of ambiguity in the role expected of this professional and a lack of clear direction and characterization of what makes the pharmacist "unique", although it may also suggest a flexible and broad view of the pharmacist's role. For the clinical role promoted by the various professional organizations at the international level to become a reality, and for the profession to be re-professionalized, students need to build a solid identity, and this work must begin at the undergraduate level. With the publication of the recent Delegated Directive (EU) 2024/782, a window of opportunity has opened for both the university and the profession to discuss where the profession should go and, more specifically, what the professional role of the pharmacist should be.

A qualitative analysis of opportunities to strengthen pharmacy technician career pathways across practice settings

PURPOSE

To identify pharmacy technician career pathways across pharmacy practice settings and opportunities to strengthen and expand these pathways.

METHODS

Interviews were conducted with 17 participants from national pharmacy organizations, community pharmacies, health systems, and academia from March to May 2023. Interview questions were designed to elicit participants' perceptions of factors influencing entry into, recruitment and retention of, and advancement of the pharmacy technician workforce. Interview notes were analyzed using a rapid thematic analysis approach.

RESULTS

Seven themes were identified, including 3 themes related to entry: (1) healthcare interest and prior exposure facilitate pharmacy technician career discovery; (2) variation in and quantity of entry-level requirements can impede entry into pharmacy technician careers; and (3) proactive promotion of pharmacy technician careers needed. Two themes were related to recruitment and retention: (4) pharmacy technician compensation not aligned with job demands and (5) career ladders or lattices create advancement opportunities. Two themes were related to professional advancement: (6) pharmacy technician advancement limited by weak professional identity and (7) scope-of-practice policies can facilitate pharmacy technician advancement.

CONCLUSION

This study highlights the challenges pharmacy technicians face in their careers. Key findings stress cultivating a professional identity for pharmacy technicians, establishing career ladders or lattices, and advocating for policies that facilitate pharmacy technician professional advancement. These efforts are vital for sustaining the pharmacy technician workforce and ensuring quality patient care amidst the changing landscape of the pharmacy profession.

The mediating effect of coping on perceived stress and professional identity among nursing interns: a cross-sectional study conducted in a medical university in China

BACKGROUND

Developing a strong professional identity is crucial to helping nursing students pursing nursing career. Stress and coping are two factors that may influence professional identity. The relationship between nursing interns' professional identity, coping, and perceived stress, however, has not received much attention in the literature. This study aimed to examine the role of coping as a mediator in the relationship between perceived stress and professional identity among nursing interns.

METHODS

In September 2020, a cross-sectional study was done at a Chinese medical university. Data were collected online from 213 nursing interns via convenience sampling using the personal characteristics questionnaire, the professional identity scale for nursing students, the stress rating scale for nursing students in practice and the simplified coping style questionnaire. Multiple regression analysis, and a bootstrap approach with SPSS Process macro were adopted to examine the mediating role of coping on perceived stress and professional identity.

RESULTS

The overall mean score for nursing interns' professional identity was 3.30 ± 0.51. Perceived stress was negatively correlated with professional identity (r = -0.217, p < 0.01), and positively correlated with positive coping style (r = 0.168, p < 0.05). Positive coping style was positively correlated with professional identity (r = 0.177, p < 0.01). Positive coping style acted as a mediator between perceived stress and professional identity among nursing interns.

CONCLUSION

This study showed that nursing interns had a medium level of professional identity and the negative influence of stress perceived by nursing interns on their professional identity might be buffered by the increased use of positive coping style. Therefore, coping training programs should be developed to help mitigate the negative impact of stress on the professional identity of nursing interns in clinical practicum.

Relationship between the sense of nursing professional pride and adversity quotient, grit levels among nurses in blood purification centers: a multicenter cross-sectional study

Objective

This study aims to examine nursing professional pride levels in blood purification center nurses, explore its relationship with adversity quotient and grit, and identify influencing factors.

Methods

Using convenience sampling, this study selected 231 nurses from blood purification centers at 11 tertiary hospitals in China during July to August 2023 as research subjects. A general data survey questionnaire, nurse professional pride scale, nurse adversity quotient self-assessment scale, and the Oviedo resilience scale were employed for the investigation. The results were statistically analyzed using descriptive analysis, t-tests, one-way ANOVA, Pearson correlation analysis, and multiple stepwise linear regression analysis.

Results

In the blood purification center, the average scores were as follows: nursing professional pride (69.53 ± 15.21), adversity quotient (132.90 ± 41.10), and grit (30.95 ± 10.54). There was a significant positive correlation between nursing professional pride, adversity quotient, and grit (P < 0.001). Multiple linear regression analysis (n = 231) revealed that education background, professional title, average monthly income, adversity quotient, and grit significantly influenced nursing professional pride (P < 0.001). The R 2 value indicates that this study accounted for 76.2% of the total variance in nursing professional pride.

Conclusion

The findings of this study indicate that blood purification center nurses have a moderate level of nursing professional pride. The level of nursing professional pride can be enhanced by focusing on factors such as adversity quotient and grit.

Registration

This study was approved by the Ethics Committee of Pidu District People's Hospital, Chengdu, China (2021 No. 231). All participants were informed of the relevant information and research purposes before their participation. Participants were also required to independently and anonymously complete the questionnaires.

Experiences of undergraduate nursing students and new graduate nurses in paid employment models and health-related work influencing the transition to practice: a qualitative systematic review protocol

OBJECTIVE

This review aims to synthesize qualitative literature exploring the experiences of undergraduate nursing students and newly graduated nurses who are employed for less than 1 year in clinical settings after graduation. It will focus on those who had paid employment and health-related work experience during their undergraduate studies, examining the influence of these experiences on the transition to practice.

INTRODUCTION

Nursing professionals undergo a transformative journey, starting from envisioning themselves as nurses to developing professional identity and competence. However, the initial transition to nursing practice often poses challenges for undergraduates and newly graduated nurses. To ease this transition, gaining additional clinical experience through paid employment or health-related work during undergraduate studies can be beneficial.

INCLUSION CRITERIA

This review will include qualitative studies on the experiences of undergraduate nursing students and newly graduated nurses in paid employment models and health-related work. No restrictions on the publication date or country will be applied; however, only English-language publications will be included.

METHODS

The JBI methodology for qualitative systematic reviews will be employed. Searches will be conducted in MEDLINE, Embase, Emcare (Ovid); CINAHL Complete (EBSCOhost); and ERIC (ProQuest), along with gray literature in ProQuest Dissertations and Theses and Google Scholar. Study selection, quality assessment, and data extraction will be conducted as per the JBI methodology. Findings will be synthesized using meta-aggregation, and a ConQual Summary of Findings will be created.

REVIEW REGISTRATION

PROSPERO CRD42024520724.

Person-environment fit, turnover intention and satisfaction with life. The role of seniority

BACKGROUND

Based on the person-environment fit model, we examined how occupational stress and job satisfaction are correlated with an intention to leave the current workplace or profession and life satisfaction in two groups of midwives with low and high experience.

PARTICIPANTS AND PROCEDURE

Data were collected between March and December 2022 using a set of psychological questionnaires. Low-experienced midwives (n = 152) and high-experienced midwives (n = 174) participated in the study. Multigroup path analysis was used to analyze the data.

RESULTS

Research has shown that midwives of varying levels of seniority experience similar levels of general occupational stress, job satisfaction, intentions to leave their current workplace or profession, and life satisfaction. The study found a negative correlation between occupational stress and job satisfaction and life satisfaction in both groups. The correlation between job satisfaction and the intention to leave the current workplace or profession was significantly negative only among low-experienced midwives. In high-experienced midwives, the relationship between stress and the intention to leave the current workplace or profession was direct. In the group of low-experienced midwives, links between occupational stress and all outcome variables were completely mediated by job satisfaction.

CONCLUSIONS

Our study demonstrates that degree of person-environment fit accurately predicts the positive and negative consequences of working conditions for behavior both at work and outside of work. The correlations between stress at work, thoughts of leaving work, and the assessment of well-being differ between low- and high-experienced employees.

Impact of Concurrent Media Exposure on Professional Identity: Cross-Sectional Study of 1087 Medical Students During Long COVID

BACKGROUND

Long COVID has widened the health gap across society and highlighted the vulnerabilities and risks faced by health care systems. For instance, the global trend of medical workers resigning has become a prominent topic on social media. In response to this severe social problem in global public health within the digital society, it is urgent to investigate how the professional identity of medical students, who are digital natives and the future workforce of medical practitioners, is affected by the media environment.

OBJECTIVE

This study aims to examine how media exposure relates to medical students' perceptions of informational and emotional support, and how these perceptions further influence the development of their professional identity.

METHODS

Building on the Stimulus-Organism-Response (SOR) framework, this study develops a theoretical model to illustrate how media exposure affects medical students' professional identity through the mediation of social support. Specifically, media exposure was assessed through online news media and social media exposure; social support was evaluated in terms of informational and emotional support; and professional identity was measured through medical students' sense of belonging and professional commitment. A survey was conducted at a medical school in China, yielding 1087 valid responses that were analyzed using SmartPLS 4.0.

RESULTS

Consistent with our expectations, online news media exposure was positively associated with both informational support (β=.163; P<.001) and emotional support (β=.084; P=.007). Similarly, social media exposure showed positive associations with informational support (β=.122; P<.001) and emotional support (β=.235; P<.001). Thereafter, informational support (β=.228; P<.001) and emotional support (β=.344; P<.001) were positively associated with students' sense of belonging. Meanwhile, both informational support (β=.245; P<.001) and emotional support (β=.412; P<.001) positively impacted medical students' professional commitment. In addition, a mediation test was conducted. The results confirmed that informational support and emotional support partially mediated the effect of online news media, while fully mediating the effect of social media on medical students' sense of belonging and professional commitment.

CONCLUSIONS

This study finds that exposure to online news media and social media can enhance medical students' sense of belonging and professional commitment through the formation of informational and emotional support. It expands the discussion on the role of media in providing social support and facilitating the development of medical students' professional identity. This is a valuable contribution to addressing complex public health crises through effective media governance in the network era.

Fostering Professional Identity Formation and Motivation for Joining Nursing and Midwifery Programmes among Undergraduate Nursing/Midwifery Students and Recent Graduates in Uganda

Introduction: The development of a strong professional identity is influenced by the motivation behind enrolling in a nursing or midwifery programme. Professional identity is a driving force that sustains the commitment of nurses and midwives to nursing/midwifery and their dedication to the well‑being of those they serve. This study evaluated Ugandan students' reasons for enrolling in nursing and midwifery programmes. Furthermore, we investigated the nurse/midwifery practices that support professional identity creation in recent graduates and undergraduate nursing/midwifery students. Methods: A mixed‑method research approach was employed amongst nursing/midwifery students of Makerere University and Mbarara University of Science and Technology and recent nursing/midwifery graduates from Mulago National and Mbarara Regional referral hospitals. We collected quantitative data from 173 participants, and for qualitative data, we conducted six focus group discussions among recent graduates and students of nursing/midwifery. We used descriptive statistics and thematic analysis to analyse the quantitative and qualitative data. Results: Nearly all - 95.4% (165/173) - of the participants were motivated to undertake nursing/midwifery as their programme of study, and 94.2% (163/173) participants identified as nurses/midwives, all with an average score above 3. They also strongly agreed that they took up the programmes because they wanted to learn new things [111/173 (64.2%)] and considered nurses' groups important [68.8% (119/173)]. Participants proposed measures to promote the formation of professional identity among students and graduates, including the improvement of clinical education, the phasing out of certain levels of practice, the empowerment and embedding of ethical principles, recognition and motivation, mentorship, leadership, career guidance and the inclusion of men and challenging of gender stereotypes. Conclusion: Participants were motivated to work in nursing. The ways to promote professional identity included the improvement of clinical education, the phasing out of certain levels of practice, the empowerment and instillation of ethical principles, recognition and motivation, mentorship, leadership, career guidance and male inclusiveness and the challenging of gender stereotypes. Nursing and midwifery leadership needs to provide guidance, mentorship and empowerment; challenge gender stereotypes in nursing/midwifery practice; and give support while advocating for ethical practice.

Nursing Professional Identity: A Critical Review of the Concept Amidst COVID-19

Heroism is an immutable and quintessential part of what gives rise to the phenomenon that is nurse. This altruistic discourse comes with profound consequences for the nursing profession, particularly in relation to nursing's professional identity. This critical review explores nursing's professional identity against the backdrop of gendered and heroic discourses. Two concept analyses of nursing's professional identity are critically reviewed and juxtaposed with literature on the topic amidst COVID-19. Using poststructural feminism and critical discourse analysis, the review provides valuable insights into the evolutionary significance of the concept and raises key questions around knowledge-power structures and discursive constructions of nurse.

Who you are and who you want to be: a pilot study of dental hygiene students' professional identity formation

BACKGROUND

Dental hygienists play a crucial role in providing successful community-based healthcare for patients. They should perform expected roles to address various tasks, in response to changing social contexts and needs. The value created by the role of a dental hygienist closely relates to job satisfaction, which is formed through daily clinical experiences, and in the process of professional identity formation, learners must internalise a value system. This study examined how dental hygiene students developed their professional identities during their undergraduate education.

METHODS

This study adopted a case study approach based on an interpretivist paradigm. Ten dental hygiene students in their final year were selected, and semi-structured interviews were conducted regarding changes in their views on dental hygienists and their identities as health professionals. The data were analysed using a thematic analysis approach to identify the components of their professional identities and the factors influencing identity formation.

RESULTS

Students pre-professional identities were transformed into inter-professional collaborators with a more patient-centric and generalist perspective. The following three aspects of professional identity were identified: their own roles in promoting oral and general health, broadening the perspectives on professional competencies of dental hygienists, and the context of inter-professional collaborative practice. Additionally, this study identified some key factors influencing their identity formation, namely role models, clinical experiences, health care system, and social relationships with others. Among these factors, role models and clinical experiences were the most influential.

CONCLUSIONS

This study suggests that recognition of professional roles during preclinical education, and collaborative opportunities in clinical education are necessary to promote professional identity formation. Such learning opportunities enable students to reflect on the kind of dental hygienist they want to become. Moreover, for the students to continuously pursue their profession with a sense of fulfilment, educators need to gain a deeper understanding of the challenges the students would encounter as they transition from their undergraduate degrees to employment. This understanding is essential for developing and supporting communities where dental hygienists connect, help, and learn from each other.

Investigating academic dishonesty and its relationship with moral competence and professional identity of nursing students: a cross-sectional study

BACKGROUND

Academic dishonesty as a fundamental challenge in adherence of ethical principles in providing care to patients has caused concern to the scientific community of nurses. In addition, positive professional identity and high moral competence are important for nurses to perform multiple care roles in high quality care of patients. The purpose of the present study is of investigating academic dishonesty and its relationship with moral competence and professional identity of master's and PhD nursing students.

METHODS

This descriptive-analytical study was conducted by census method on 65 master's and PhD nursing students in Shiraz University of Medical Sciences, Iran in 2023. Data collection tools included 4 questionnaires (Demographic information, Academic Dishonesty Scale (DAS), Nurses' moral competence and Professional Identity Scale for Nursing Students (PISNS)). Data collection was done within 2 months. Descriptive and inferential analyzes including independent t-test, Pearson correlation coefficient and linear regression were used to analyze the data. The collected data were analyzed by SPSS.V.22 software. P-value less than 0.05 was considered significant.

RESULTS

The average age of 65 participants was 31.5 ± 5.61 years. The majority of the participants in this study were women 48 (73.8%). There is a significant and negative correlation between academic dishonesty and moral competence (r=-0.260, P-value = 0.036). There is no significant correlation between academic dishonesty and professional identity (r = 0.154, P-value = 0.22). Also, a significant positive correlation was found between moral competence and professional identity (r = 0.294, P-value = 0.018).

CONCLUSION

Therefore, considering that the fact that students have a great impact on patient care, Researchers suggest that educational institutions should prevent the increase of academic dishonesty among students by establishing new rules and regulations.

The association between proactive personality and interprofessional learning readiness in nursing students: The chain medication effects of perceived social support and professional identity

BACKGROUND

Interprofessional education (IPE) has been advocated for all healthcare students, and readiness for interprofessional learning significantly influences its effectiveness. It is essential to explore the antecedent factors of readiness for interprofessional learning among nursing students to promote IPE. While a proactive personality might impact readiness for interprofessional learning, its specific role has remained unspecified.

OBJECTIVE

To examine the mediation effects of perceived social support and professional identity on the association between proactive personality and readiness for interprofessional learning among nursing students.

DESIGN

The study utilised a cross-sectional design.

SETTINGS

Research was conducted at two universities and two vocational schools in Hainan Province, China.

PARTICIPANTS

On-campus nursing students were invited to participate between March and May 2023.

METHODS

A flyer was distributed to the participants with a QR code to scan to voluntarily complete the online survey, including the Readiness for Interprofessional Learning Scale (RIPLS), Proactive Personality Scale, Perceived Social Support Scale and Professional Identity Status Questionnaire Scale 5d. Descriptive analysis, Pearson associations and mediation analysis were conducted using SPSS software version 26.0 and PROCESS version 4.2 for SPSS.

RESULTS

The participants' average RIPLS score was 66.93 ± 9.28. Proactive personality (r = 0.633, p < 0.01), perceived social support (r = 0.605, p < 0.01) and professional identity (r = 0.549, p < 0.01) were all positively related to readiness for interprofessional learning. Meanwhile, the relationship between proactive personality and readiness for interprofessional learning was partly mediated by perceived social support (25.15 %), professional identity (13.35 %) and the chain effects (9.48 %) of perceived social support and professional identity.

CONCLUSIONS

The nursing students in Hainan, China demonstrated a medium level of readiness for interprofessional learning. Compound strategies that foster proactive personality, provide social support and boost positive professional identity are warranted to improve nursing students' readiness for interprofessional learning.

The influence factors of tour guides' professional identity and professional decision before and after the COVID-19 pandemic

The COVID-19 pandemic has significantly impacted the tourism sector, particularly tour guides (TGs), affecting their professional identity (TGPI) and intentions to return to work. As China strives to revive its tourism industry, it is crucial to understand the current state of TGPI, its evolution, influencing factors, and its impact on TGs' return intentions. This study employed a quantitative approach, using comparative analysis and binary logistic regression, to investigate these issues among frontline TGs in China, pre- and post-pandemic. Cross-sectional surveys were conducted with 422 participants in 2019 and 398 in 2022, yielding 370 and 342 valid responses, respectively. The questionnaire utilized a five-point Likert scale. Findings reveal that (1) The overall TGPI level in 2022 post-pandemic is medium (3.93), showing a significant decrease from the pre-pandemic level in 2019 (4.15). (2) Influencing factors of TGPI are predominantly material, reflected in social insurance and income changes pre- and post-pandemic. (3) This study presents a novel definition and scale of TGPI, encompassing tour guides' professional value identity (TGPVI), emotion identity (TGPEI), relationship identity (TGPRI), and behavior tendency (TGPBT). (4) The two dimensions of the TGPI, TGPVI and TGPRI, income and education level, significantly influence TGs' return intentions. The study provides valuable academic and practical insights into TGPI and offers significant implications for enhancing TGs' return intentions and policymaking for post-pandemic tourism industry development.

The potential influences of professional identity for undergraduate nursing students during the COVID-19 pandemic: A cross-sectional study

AIM

We aimed to investigate the level of undergraduate nursing students' professional identity (PI) during the COVID-19 pandemic and its potential influences.

METHODS

This cross-sectional study included 742 undergraduate nursing students from Chengdu Medical College. Basic demographics, personal characteristics and PI score were collected. Chi-squared test, one-way analysis of variance, and multivariable logistic regression analysis were used to analyze the data.

RESULTS

In the classes of 2019, 2020, and 2021, the PI score was 96.85 ± 18.26, 105.37 ± 17.46, 106.67 ± 22.08 (P < .001). PI score was the independent predictive factor for both "want to be a nurse" and "willingness to serve during COVID-19 or other pandemics".

CONCLUSIONS

PI contributes greatly to nursing students' willingness to be a nurse and overcome pandemics. The challenge of culturing PI during COVID-19 pandemic revealed the necessity of developing individual management strategies for nursing education.

The mediating effect of self-directed learning ability between professional identity and burnout among nursing students

Objectives

Burnout influences students' academic performance and mental health. This study analyzed the relationship between professional identity, self-directed learning ability, and burnout, and examined the mediating effect of self-directed learning ability between professional identity and burnout among nursing students.

Methods

884 nursing students were recruited at two medical universities in China. Demographic information, Academic Burnout Scale, Professional Identity Questionnaire for Nursing Students, and Self-directed Learning Instrument were distributed to collect data.

Results

Both professional identity (β = -0.17) and self-directed learning ability (β = -0.43) showed negative associations with students' burnout. Meanwhile, there was a partial mediating effect of self-directed learning ability between professional identity and burnout (-0.24, 95% CI = -0.30, -0.20).

Conclusions

Nursing educators should emphasize on developing effective strategies to improve nursing students' professional identity and self-directed learning ability to prevent or reduce their burnout.

Barriers and facilitators to the formation of professional identity among nursing students: A four-year longitudinal qualitative study

BACKGROUND

Nursing professional identity (NPI) is essential for nurses to develop their nursing profession. It reflects the competencies consistent with the professional practices of nurses and contributes to them providing better healthcare and public health. The formation process of NPI started with undergraduate nursing education and continued throughout the nursing career.

OBJECTIVE

To explore nursing students' perceptions of facilitators and barriers to the formation of NPI during their study.

METHODS

A 4-year longitudinal, qualitative research design with yearly semi-structured interviews undertaken from 2019 to 2022. The reflexive thematic analysis methodology was applied for the data analysis.

RESULTS

Ninety-three nursing students were recruited, joining a group or individual interview. The four-year nursing baccalaureate program revealed a dynamic formation process of NPI: "Outsider of nursing", "Entering the nursing courses", "Building nursing competence", and "Thinking and acting like a nurse". A total of 12 themes were identified to present the barriers and facilitators to the NPI formation at different stages. Specifically, the six barriers include conflict between their ideals and reality, sociocultural stereotypes about nursing, the negative impact of COVID-19, the pre-internship concerns, struggling to meet expectations, and potential danger and discrimination in the healthcare settings. The enablers were: self-motivation and inner belief towards the nursing profession, the power of role models, the improvement of nursing capacity, well integration into the healthcare professional teams, understanding of the clinical environment, and recognition and encouragement from others.

CONCLUSIONS

The formation of nursing students' NPI is an ever-changing process, with various intrinsic and extrinsic influences during their four-year study. Nursing educators are suggested to prepare and develop students' professional comportment in their theoretical and clinical practice to develop their professional identity as a nurse.

Identifying the impact of audit and feedback on the professional role of the nurse and psychological well-being: An integrative systematic review

This systematic review aimed to critically synthesis evidence to identify the impact that audit and feedback processes have on the professional role of the nurse and psychological well-being. Little is known about the extent to which audit and feedback processes can positively or negatively impact the professional role of the nurse and psychological well-being. An integrative systematic review was conducted. Covidence systematic review software was used to manage the screening process. Data extraction and methodological quality appraisal were conducted in parallel, and a narrative synthesis was conducted. Nurse participation and responsiveness to audit and feedback processes depended on self-perceived motivation, content, and delivery; and nurses viewed it as an opportunity for professional development. However, audit was reported to negatively impact nurses' psychological well-being, with impacts on burnout, stress, and demotivation in the workplace. Targeting framing, delivery, and content of audit and feedback is critical to nurses' satisfaction and successful quality improvement.

Graduate entry nursing students' development of professional nursing self: A scoping review

BACKGROUND

Accelerated graduate entry nursing programmes require students to rapidly socialise to the profession. Professional identity is an important element of becoming a nurse.

OBJECTIVE

This scoping review aimed to synthesise published literature reporting the development of professional identity, belongingness and self-concept as a nurse in students enrolled in a pre-registration graduate entry nursing programme.

DESIGN

Scoping review.

SETTING

Graduate entry nursing programmes.

PARTICIPANTS

Graduate entry nursing students.

METHOD

Following a pre-registered protocol, we searched electronic databases for publications investigating graduate entry nursing students' development of professional identity, belongingness and self-concept. Screening, data extraction and analysis were initially in duplicate and independent, and then by consensus.

RESULTS

Of the 871 records identified, twenty met the inclusion criteria. Publications were from the USA, Australia, New Zealand, Canada, and the UK. We identified one overarching theme of 'professional nursing self', with four sub-themes: 1) professional socialisation, 2) professional self-concept, 3) developing nursing agency, and 4) identity formation. Socialisation into nursing and belongingness to the profession occurred concurrently as students moved through their programme of learning. Due to the accelerated nature of the programmes, rapid professional socialisation was required, supported by positive relationships in the clinical setting. Strategies that enhanced belongingness and wellbeing enabled students to feel connected to the profession.

CONCLUSIONS

The development of professional identity in graduate entry nursing students is impacted by their rapid professional transition through an accelerated programme. Students' growing sense of nursing agency is embodied in their experiences of thinking and acting as a nurse. Their previous professional identity is then reconstituted in their new graduate selves; educational programmes support this transition.

TWEETABLE ABSTRACT

Scoping review finds professional identity development in graduate entry nursing students is rapid in accelerated preregistration degrees #belonging #connection.

Core competence of midwives in township hospitals and its influencing factors-A cross-sectional study

Objective

This study aimed to assess the core competence of midwives in township hospitals through a self-assessment questionnaire. The relationship between professional identity and core competence and the factors influencing midwives' core competence was also investigated.

Method

Convenience sampling was conducted in 77 township hospitals in Ganzhou, Jiangxi Province, China, with 150 participants. The questionnaires were distributed online in November 2021. We conducted a descriptive data analysis, a correlation analysis of the two variables of professional identity and core competencies, and multivariate linear regression to analyse the influencing factors, including the sociodemographic information, the Midwife Core Competence Scale, and the Nurses' Professional Identity Scale scores.

Results

The mean score for the core competence was 206.43 (±37.45) out of 270. The highest score was for pregnancy care (3.97 ± 0.70) and the lowest was for newborn care (3.72 ± 0.78). The independent sample t-test results and one-way analysis of variance showed that qualifications, midwifery training situation, and midwifery working years had differential effects on midwives' core competencies (P < 0.05). Multiple linear regression showed that qualifications, midwifery working years, and level of professional identity were influencing factors (P < 0.05).

Conclusions

The core competencies of midwives in township hospitals were lower than those reported in other studies. Advancements in education, midwifery working years, and professional identity may increase midwives' core competencies.

Influence of perceived parental child-rearing attitudes and ego identity on college adjustment among Korean nursing students

BACKGROUND

This study aimed to examine the relationship between nursing students' perceived parental child-rearing attitude, ego identity, and college adjustment in Korea and explore factors that influence college adjustment.

METHODS

This study surveyed 224 nursing students enrolled in universities located in two regions within South Korea. Data were collected from October 14 to November 31, 2019. Perceived parental child-rearing attitude (paternal emotional warmth, paternal rejection, paternal overprotection, maternal emotional warmth, maternal rejection, and maternal overprotection) and ego identity of nursing students were used as independent variables on college adjustment. Collected data were subjected to correlation analysis using SPSS version 26.0 for Windows. Further, regression analysis was performed on the influence of parental child-rearing attitude and ego identity on college adjustment.

RESULTS

Among the parental child-rearing attitudes, paternal emotional warmth (r = .30, p < .001), maternal emotional warmth (r = .38, p < .001), and ego identity (r = .71, p < .001) were positively correlated with nursing students' college adjustment, whereas maternal rejection was negatively correlated with ego identity (r = - .28, p < .001) and college adjustment (r = - .15, p = .025). Regression analysis of the effects of nursing students' perceived parental child-rearing attitude and ego identity on college adjustment, with grade as a control variable, revealed that ego identity (p < .001) had a significant effect on college adjustment, and the higher the ego identity (β = 0.712), the higher the college adjustment. Further, the explanatory power of explaining college adjustment was high at 49.9%.

CONCLUSIONS

The nursing students' perceived paternal emotional warmth, maternal emotional warmth, and ego identity were positively correlated with college adjustment. Additionally, ego identity was found as the influencing factor in Korean nursing students' college adjustment. Therefore, programs to strengthen ego identity should be developed and implemented for college adjustment among nursing students.

Educational interventions to improve student nurses' knowledge, attitudes, or willingness to work with older people: a systematic review of quantitative findings

The purpose of this systematic literature review of quantitative findings was to examine the effectiveness of educational interventions to improve gerontological knowledge, attitudes, and willingness to work with older people in baccalaureate nursing students. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic literature search was conducted in five databases. Quality assessment was conducted using the Mixed-Methods Appraisal Tool. Based on inclusion and exclusion criteria, 41 papers were included in the review. The overall quality of studies included was moderate. The interventions were classified as education content, simulation or immersion experiences, clinical placement, or a combination of these pedagogical approaches. Majority of studies demonstrated improvement in knowledge and attitudes but there was a limited change in willingness to work with older people. There is insufficient evidence to make recommendations for the most effective educational intervention for enhancing bachelor of nursing students' willingness to engage in gerontological care.

Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections: An Evidence-Based Literature Review

Background

Surgical site infections (SSIs) are a frequent postoperative complication that nurses commonly need to provide asepsis-specific meticulous care for. The application of a closed-incisional negative pressure wound therapy (iNPWT) device is regarded as a novel technique that aims to lower the risk of external wound contamination.

Aim

The purpose of this review was to evaluate the effectiveness of iNPWT on high-risk closed laparotomy incisions with the aim to inform nursing practitioners and physicians engaged in multieffort wound care practices. Nursing professionals play a crucial role in mitigating the incidence of SSIs, from the time of application, through ongoing assessment tissue condition, and ensuring asepsis, thereby enhancing patient care and safety.

The Research Question

Is prophylactic negative pressure wound therapy effective in reducing the incidence of (closed) surgical site wound infections postlaparotomy?

PICO Elements

The population studied included patients undergoing laparotomy surgery. The intervention under review included the application of iNPWT, compared to the use of standard gauze dressing. The expected outcome was SSI reduction.

Methods and Results

A systematized literature search was conducted using various databases to identify published studies that address the PICO question. The PRISMA checklist and Critical Appraisal Skills Programme tools allowed to exclude irrelevant articles and to critically appraise the evidence, respectively. Eleven key articles were retrieved including four RCTs and seven systematic reviews and meta-analysis. The results indicated an overall positive association between iNPWT and a reduction in SSI in laparotomy surgeries when compared to standard dressings.

Linking Evidence to Action

Data across most studies reviewed support the benefits with the use of iNPWT as a preventive strategy to lower the rates of SSI, with some claiming no difference. Although heterogeneity in the studies precludes a definite conclusion, nurses may make a more informed decision when navigating the demands of SSI prevention targeted nursing care.

Mediating effects of transition shock and professional identity on the perception of a caring climate in hospitals and patient safety attitudes of nursing interns: A cross-sectional study

AIM

To determine the association between the perception of a caring climate in hospitals and patient safety attitudes of nursing interns, and the multiple mediating effects of professional identity and transition shock on this relationship.

BACKGROUND

Limited research has been conducted on the involvement of nursing interns in patient safety management and the direct relationship between the perception of a caring climate in hospitals and patient safety attitudes of nursing interns. Furthermore, it remains unclear whether professional identity and transition shock play significant roles as mediating factors in this relationship.

DESIGN

A cross-sectional study.

METHODS

This study employed a convenience sampling to recruit 356 nursing interns from 30 nursing schools in a comprehensive hospital in Hunan Province, China, between December 2022 and April 2023. Data on general information, the perception of a caring climate in hospitals, professional identity, transition shock, and patient safety attitudes was collected from nursing interns using a general information questionnaire and reliable scales. This study utilized a structural equation model with AMOS 24.0 to examine the relationship between variables.

RESULTS

The perception of a caring climate in hospitals directly impacted patient safety attitudes of nursing interns (Effect = 0.253, 95% confidence interval: 0.218-0.542). Meanwhile, the perception of a caring climate in hospitals indirectly influenced patient safety attitudes of nursing interns through multiple mediating factors, including professional identity and transition shock (Effect = 0.037, 95% confidence interval: 0.017-0.073).

CONCLUSION

To ensure patient safety, it is crucial to enhance patient safety attitudes of nursing interns. Our findings suggest that nursing educators and managers can enhance patient safety attitudes of nursing interns by establishing a caring climate. Professional identity and transition shock are important mediators of the patient safety attitudes. Additionally, nursing educators can implement measures to foster a positive work environment, including providing care and support to nursing interns and reducing their workload, to increase professional identity, alleviate transition shock, and ultimately enhance patient safety attitudes of nursing interns.

TWEETABLE ABSTRACT

The relationship between the perception of caring climate in hospitals and patient safety attitudes of nursing interns. Professional identity and transition shock play multiple mediating roles in the relationship. #PatientSafetyAttitudes #NursingInterns #CaringClimate.

Impact of Teaching Social Determinants of Health on PIF in the Health Professions

OBJECTIVE

To address the lack of methods for assessing learning on social determinants of health, particularly from a health systems perspective. Using a conceptual framework of professional identity formation applied across 3 professions (athletic training, occupational therapy, and pharmacy), the study aimed to describe students' level of professional identity when applying knowledge of structural factors' impact on health.

METHODS

This study was a deductive content analysis of students' written reflections. Identified themes explored how students explained sociopolitical influences on health as well as their assessed level of professional identity.

RESULTS

Students were inclined to author narratives focused on the ways in which structural factors influence individual outcomes and aspects within the health care system. Most students were assessed to be at the initial levels of professional identity formation, but those with a comparatively higher level of professional identity expressed a commitment to professional behaviors that address social determinants of health.

CONCLUSION

This analysis created a foundation for future pedagogical work in health care system-related structural learning outcomes within and between different health professions. Findings suggest that across professions, most first-year students demonstrated the ability to reconcile different perspectives and were in the early stages of aligning personal values with professional values. The use of reflection has the potential to assess professional identity formation among a range of health professional students.

New registered nurse and registered psychiatric nurse graduates' transition-to-practice amid the pandemic: An art-based grounded theory study

BACKGROUND

According to the Transition Shock theory, new Registered Nurses face formidable obstacles within their first year of practice. However, little is known about the experience of new Registered Psychiatric Nurses entering the workforce.

OBJECTIVES

The aim was to explore how new graduates from nursing and psychiatric nursing experience their transition into the workplace that included identifying mediating factors that assist or challenge these entry-level professionals within their transition.

DESIGN

Constructivist grounded theory methodology developed by Charmaz was utilized to explore the first-year transition period using art-based methods.

PARTICIPANTS AND SETTING

A total of 13 new graduates practicing as Registered Nurses and Registered Psychiatric Nurse in a western Canadian province were recruited to participate in the study. Three art-based workshops occurred at four, eight, and 12-months starting in the fall of 2020 through the Spring of 2021 during the novel coronavirus pandemic with subsequent member checks in the Spring of 2022.

METHODS

A total of 38 interview and focus group data were collected. Art-based activities included sand tray and figurine object exercises, collaging, reflective and thematic writing, as well as group concept mapping. Through co-creation of knowledge using Charmaz's methodology, participants selected the major themes throughout their first year of transition with guided researcher facilitation. Data were analyzed using the constant comparative method of analysis for each workshop drawing on the art creations, discussion, and narrative reflective writing pieces generated by participants.

RESULTS

Participants were in a basic psychosocial process of growing personal and professional self. Through co-construction of knowledge with the participants, three substantive interconnected categories were identified: (1) Being thrown into the fire; (2) Adjusting and adapting to the team environment; and (3) Nurturing self and others.

CONCLUSIONS

The findings revealed many recommendations for employers hiring new graduates and nursing education programs preparing graduates for the practice arena.

Interprofessional Collaboration Between Nurses and Physicians in the Perioperative Period

PURPOSE

To explore nurses' and physicians' experiences of the six dimensions of interprofessional (IP) collaboration when using Goal-Directed Therapy (GDT), and to examine how existing protocols on GDT facilitate the six dimensions of IP collaboration.

DESIGN

A qualitative design using individual semi-structured interviews and participant observations.

METHODS

A secondary analysis of data from participant observation and semi-structured interviews with nurses (n= 23) and physicians (n=12) in three departments of anesthesiology. Observations and interviews were carried out from December 2016 to June 2017. A deductive, qualitative content analysis using the Inter-Professional Activity Classification as a categorization matrix was used to explore interprofessional collaboration as a barrier to implementation. This analysis was supplemented by a text analysis of two protocols.

FINDINGS

Four dimensions were identified to influence IP collaboration: commitment, roles and responsibilities, interdependence, and integration of work practices. Negative factors included hierarchical boundaries, traditional nurse-physician relationship, unclear responsibility, and lack of shared knowledge. Positive factors included physician involvement of nurses in decisions and bedside education. The text-analysis showed a lack of clear directions of specific action and responsibility.

CONCLUSIONS

Commitment and roles and responsibilities were dominant aspects of interprofessional collaboration in this context, causing problems for enhanced collaboration. Lack of clear guidance in the protocols might detract nurses' feelings of responsibility.

'I've got no idea': an ethnography of Critical Care Nurses' nuanced and ambiguous professional identities in regional Australia

Historical sociological perspectives posit professional identity to emerge from socialisation and attainment of 'traits' considered unique to and distinguishing of a profession. Such essentialist understandings, however, cannot account for group heterogeneity, nurses' lived experiences, nor the fluidity of professional and personal identity. This article conceptualises professional identity as being both individual and collective, influenced by context, involving subjective meaning-making, and membership to a specific professional group. Drawing on ethnographic data gathered through participant observation and semi-structured interviews with Critical Care Nurses in an Intensive Care Unit in regional Australia, we identify four themes that reveal different aspects of professional identity: conceptualising professional identity; professional identity as a title and legislative requirement; professional identity as qualifications and training; and professional identity as a social performance. The findings demonstrate that Critical Care Nurses hold multifaceted perceptions of professional identity. While they collectively distinguish their nursing training, knowledge, and practice from other nurses, they struggle to articulate what professional identity is, while creating boundaries between different forms of nursing education and qualifications to construct their professional identity. These uncertain and diverse meanings of professional identity contribute to nurse identity ambiguity, while also reflecting the necessity of flexible individual and collective nursing identities.

Exploring nursing students' perceptions from nursing role function (SP-NRF) during the COVID-19 pandemic in Ardabil Province: a cross sectional study from Iran

BACKGROUND

Perception of nursing roles among nursing students significantly influences their active engagement in nursing processes and care delivery. However, there is evidence to suggest that students' interest in and perceptions from the nursing profession at the undergraduate level are often insufficient.

OBJECTIVE

This study aimed to assess nursing students' perceptions of nursing role function and identify areas that require improvement.

METHODS

A cross-sectional study was conducted in 2021 among nursing students in the third- and fourth-years from three faculties in the Ardabil Province. The participants were selected through census sampling. The data were collected through interviews with the Standardized Professional Nursing Role Function (SP-NRF) questionnaire. Statistical analysis was performed using the SPSS-18 software at a significance level of less than 0.05.

RESULTS

A total of 320 nursing students participated in this study. The mean score for nursing role perception was 223.1 ± 20.3 out of 255. The results indicated significant gender differences in the mean scores of perception of the nursing role function, particularly in the supportive, professional-moral care, and professional-educational dimensions. Women scored significantly higher than men did (P < .05). Additionally, students who obtained a mean score of 19 to 20 (A) had significantly higher total scores in perception of the nursing role function than other students. Furthermore, a positive correlation was observed between students' interest in nursing and their perceived ability with nursing role perception (r = .282, P < .01) and all its dimensions.

CONCLUSION

Overall, nursing students demonstrated a favorable perception of nursing role function. However, their perception of mental and spiritual care was relatively weak. These findings highlight the need to review nursing education programs and incorporate the spiritual care dimension to enhance students' understanding of and preparation for their role as nurses.

Self-esteem and professional identity among male nurses and male nursing students: mediating roles of perceived prejudice and psychological distress

Introduction

There are not enough nurses around the world, and there are even fewer male nurses. It has not been easy for men to become nurses because of stereotypes about the roles of men and women in the workplace, which lead to prejudice and discrimination. This study explored how the self-esteem of male nurses and male nursing students affects their professional identity in an environment where stereotypes and social prejudice exist. This study also examined the differences of relevant variables in different sociodemographic characteristics of the research subjects in a Chinese social context.

Methods

By purposive and snowball sampling, 464 male nurses and male nursing students were surveyed through questionnaires from November 2021 to January 2022. Data analysis was performed using SPSS 25.0 and PROCESS Macro 3.3.

Results

Self-esteem could indirectly affect professional identity through perceived prejudice and psychological distress. Nonetheless, self-esteem still had a significant direct effect on professional identity. The total mediating effect accounted for 32.816% of the total effect, and the direct effect accounted for 67.184% of the total effect. Also of note was that 81.7% of participants reported experiencing psychological distress.

Discussion

To improve the professional identity of male nurses and male nursing students, nursing educators and administrators should do the following: protect and improve their self-esteem; take steps to reduce social prejudice against them; value their mental health and alleviate their psychological distress.

Moral courage of master's students of nursing during COVID-19

BACKGROUND

Moral courage is a recognized virtue. In the context of the COVID-19 pandemic, the master's students of nursing (MSNs) in China have shown tenacious moral courage.

OBJECTIVE

This study elaborates on the moral courage of Chinese MSNs through their experiences of volunteering during the pandemic.

RESEARCH DESIGN

Descriptive qualitative, interview-based.

PARTICIPANTS AND RESEARCH CONTEXT

Participants were nursing postgraduate students who participated in the prevention and control of the COVID-19 pandemic selected by purposeful sampling. The sample size was determined by data saturation, which was reached with 10 participants. Data were analyzed using a deductive method of content analysis. Because of the isolation policy, telephone interviews were adopted.

ETHICAL CONSIDERATIONS

After obtaining the approval of the ethical institution of the author's school (No. 138, 30 August 2021), verbal consent was obtained before the interview with the participants. All data were processed anonymously and confidentially. In addition, we recruited participants through MSNs' counselors, and obtained their phone numbers with their permission.

RESULTS

Data analysis resulted in 15 subcategories that were subsequently grouped into 3 major categories including proceed without hesitation, the outcome of practicing moral courage, and develop and maintain moral courage.

CONCLUSION

This qualitative study is based on the special background of the COVID-19 pandemic, and the MSNs in China have shown tenacious moral courage in the work of epidemic prevention and control. Five factors led them to take action without hesitation, and six possible outcomes followed. Lastly, this study provides some suggestions for nurses and nursing students to enhance their moral courage. To better develop and support moral courage in the future, it is necessary to use different methods and multidisciplinary approaches to study moral courage.

The Influence of Gender Equity in Nursing Education Programs on Nurse Job Satisfaction

(1) Background: One of the strategies to overcome the shortage of nurses is to minimize gender inequity in nursing culture, starting from the undergraduate education program. Although the number of men entering the nursing profession has increased over the years, the portion of male nurses remains low, particularly in Asian countries. Only a few studies have been conducted to identify gender inequity in nursing, and most of these studies used qualitative study design. Therefore, it is necessary to quantitatively identify gender equity in nursing education and the influence it has on nurse job satisfaction. (2) Methods: A total of 165 male nurses participated in this study. Validated questionnaires were used to assess gender equity in nursing education programs, nurse job satisfaction, nurse job esteem, and nursing professional pride. (3) Results: The mean score of gender equity in nursing programs was 62.6, showing a positive correlation with nurse job satisfaction, nurse job esteem, and nursing professional pride. Gender equity positively predicted nurse job esteem. (4) Conclusions: The gender equity in nursing education programs has positive predictive effects on the factors that influence male nurse job satisfaction. In order to increase nurse job retention, educators should incorporate strategies to minimize gender inequity.

Understanding the identity of lived experience researchers and providers: a conceptual framework and systematic narrative review

BACKGROUND

Identity is how we understand ourselves and others through the roles or social groups we occupy. This review focuses on lived experience researchers and providers and the impact of these roles on identity. Lived experience researchers and providers use their lived experience of mental or physical disability either as experts by experience, researchers, peer workers, or mental health professionals with lived experience. They must navigate both professional and personal aspects to their roles which can be complex. Performing roles simultaneously embodying professional and lived experiences contribute towards a lack of clarity to identity. This is not adequately explained by the theoretical evidence base for identity.

MAIN BODY

This systematic review and narrative synthesis aimed to provide a conceptual framework to understand how identity of lived experience researchers and providers is conceptualised. A search strategy was entered into EBSCO to access Academic search complete, CINAHL, MEDLINE, PsycINFO, Psych Articles, and Connected papers. Out of the 2049 yielded papers, thirteen qualitative papers were eligible and synthesised, resulting in a conceptual framework. Five themes explained identity positions: Professional, Service user, Integrated, Unintegrated and Liminal. The EMERGES framework, an original conception of this review, found themes of: Enablers and Empowerment, Motivation, Empathy of the self and others, Recovery model and medical model, Growth and transformation, Exclusion and Survivor roots contributed to lived experience researcher and provider identities.

CONCLUSIONS

The EMERGES framework offers a novel way to understand the identities of lived experience researchers and providers, helping support effective team working in mental health, education, and research settings.

Shifting Professional Identity Among Indonesian Medical Practitioners During the COVID-19 Pandemic

The COVID-19 pandemic has had a significant impact on medical practitioners' professional identities due to its novelty and intensity. Using constructivist grounded theory, we investigated how the COVID-19 pandemic shifted individuals' identities as medical practitioners in Indonesia, where the pandemic caused high death rates among healthcare workers, particularly medical practitioners. By interviewing 24 medical practitioners and analyzing relevant documents and reports, we developed a grounded theory of professional identity shifts. We found two patterns: (1) identity growth, in which the medical practitioners thrive and claimed stronger professional identities, and (2) psychological and moral distress leading to attrition, facilitated adaptation, or professional identity collapse. We also found several primary protective factors including religious beliefs, good leadership, team cohesion, healthy work boundaries, connection to significant others, and public acknowledgment. Without adequate protective factors, medical practitioners experienced difficulties redefining their professional identities. To cope with the situation, they focused on different identities, took some time off, or sought mental health support, resulting in facilitated adaptation. Others resorted to attrition or experienced professional identity collapse. Our findings suggest that medical practitioners' experience of professional identity shifts can be improved by providing medical practitioners with opportunities for knowledge updates, better organizational leadership and work boundaries, strategies to enhance team cohesion, and other improvements to medical systems.

Perceived social support and professional identity in nursing students during the COVID-19 pandemic era: the mediating effects of self-efficacy and the moderating role of anxiety

BACKGROUND

Health professionals, including nurses, experienced heavy workloads and significant physical and mental health challenges during the coronavirus disease (COVID) 19 pandemic, which may affect career choices for those considering nursing and for nursing students. The COVID-19 pandemic is not only a period of risk, but also an occasion to redeploy the professional identity (PI) of nursing students. However, the relationship between perceived social support (PSS), self-efficacy (SE), PI and anxiety remains unclear under the background of COVID-19. This study aims to explore whether PSS has an indirect effect on PI through mediation of SE and whether the anxiety can moderate the relationship between PSS and SE in nursing students during their internship period.

METHODS

An observational, national cross-sectional study was conducted following the STROBE guidelines. An online questionnaire was completed by 2,457 nursing students from 24 provinces in China during their internship during September to October 2021. Measures included Chinese translations of the Professional Identity Questionnaire for Nursing Students, the Perceived Social Support Scale, the General Self-Efficacy Scale, the 7-item Generalized Anxiety disorder scale.

RESULTS

Both PSS (r = 0.46, p < 0.001) and SE (r = 0.51, p < 0.001) were positively correlated with PI. The indirect effect of PSS on PI through SE was positive (β = 0.348, p < 0.001), with an effect of 72.7%. The results of the moderating effect analysis showed that anxiety attenuated the effect of PSS on SE. Moderation models indicated that anxiety has a weak negative moderating effect on the effect of PSS on SE (β =-0.0308, p < 0.05).

CONCLUSIONS

A better PSS and higher scores in SE were associated with PI in nursing students, and a better PSS had an indirect effect on the PI of nursing students through SE. Anxiety played a negative moderating role in the relationship between PSS and SE.

Nursing students doing gender: Implications for higher education and the nursing profession

The average age of women nursing students in Australia is rising. With this comes the likelihood that more now begin university with family responsibilities, and with their lives structured by the roles of mother and partner. Women with more traditionally gendered ideas of these roles, such as nurturing others and self-sacrifice, are known to be attracted to nursing as a profession; once at university, however, these students can be vulnerable to gender role stress from the competing demands of study. A qualitative research design, guided by Gadamer's hermeneutic philosophy, explored the gendered behaviours and experiences of 22 women nursing students, all of whom had children and began university in a heterosexual intimate relationship. The findings reveal traditional ideas of gender were almost universal among participants, and these ideas had a significant influence on the nursing degree experience. Participants commonly prioritised family over the university and practiced maternal gatekeeping (prevention of male partner involvement in domestic work). These traditionally gendered behaviours, coupled with experiences of gender role stress, had a detrimental impact on participants' capacity to study and their personal wellbeing. The importance of these findings to the burgeoning nursing workforce shortage nursing is considered in terms of student retention and the supply of graduates into the profession. The implications to the nursing profession are also explored against the evidence that nursing students with traditional gender beliefs are less likely to develop as autonomous, critical thinking nurses compared to their gender-egalitarian peers. The introduction of gender theory via critical pedagogy in the undergraduate nursing degree curriculum is recommended to enlighten and empower women nursing students and promote the competence, agility, and sustainability of the nursing profession.

Moral distress, moral courage, and career identity among nurses: A cross-sectional study

Background

The concept of career identity is integral to nursing practices and forms the basis of the nursing professions. Positive career identity is essential for providing high-quality care, optimizing patient outcomes, and enhancing the retention of health professionals. Therefore, there is a need to explore potential influencing variables, thereby developing effective interventions to improve career identity.

Objectives

To investigate the relationship between moral distress, moral courage, and career identity, and explore the mediating role of moral courage between moral distress and career identity among nurses.

Design

A quantitative, cross-sectional study.

Methods

A convenient sample of 800 nurses was recruited from two tertiary care hospitals between February and March 2022. Participants were assessed using the Moral Distress Scale-revised, Nurses’ Moral Courage Scale, and Nursing Career Identity Scale. This study was described in accordance with the STROBE statement.

Ethical consideration

Research ethics approval was obtained from the researcher’s university and hospital where this study was conducted prior to data collection.

Findings

Moral distress is negatively associated while moral courage is positively associated with career identity among nurses. Moral courage partially mediates the relationship between moral distress and career identity ( β = −0.230 to −0.163, p < 0.01).

Discussion

The findings reveal a relationship between moral distress, moral courage, and career identity among nurses.

Conclusion

By paying attention to nurses’ moral distress and courage, healthcare providers can contribute to the development of effective interventions to improve career identity, and subsequently performance, among nurses.

Has the COVID-19 pandemic affected nursing students' career self-efficacy and professional calling? The mediating impact of professional identity

BACKGROUND

Professional calling (PC) is crucial for ascertaining their professional goals and fulfilling career choices in nursing students. Thus, understanding its antecedents and helping schools improve PC among nursing students is critical. This study aims to explore whether professional identity (PI), as a crucial antecedent of PC, acts as an intermediary between career self-efficacy (CSE) and professional calling during the COVID-19 pandemic.

METHODS

A sample of 565 nursing students were selected by a web-based survey through convenience sampling. The study was conducted from October to November 2020. Measures of CSE, PI, and PC were assessed during the COVID-19 pandemic. We analyzed demographic data and the correlation of the research variables. The significance of the mediation effect was assessed using a bootstrap method with SPSS.

RESULTS

CSE during the COVID-19 pandemic outbreak (r = 0. 359, p < 0. 01) and PI (r = 0. 670, p < 0. 01) were both relevant to PC among nursing students. In addition, CSE had a positive indirect effect on PC through PI (β = 0. 288, p < 0. 05).

CONCLUSIONS

Higher scores in CSE and a better PI were associated with PC in nursing students. Furthermore, a better CSE had an indirect effect on the PC of students through PI. The favorable evidence in our study confirms that nursing educators can adopt PI interventions to improve the sense of PC among nursing students.

Relationship between nursing students' attitudes toward nursing profession and online learning satisfaction during COVID-19 lockdown

Formal education is crucial for the development of nurses’ professional identity and can play a decisive role in attracting students to the nursing profession. This is even more important during a public health emergency such as the COVID-19 pandemic. This study aimed to investigate nursing students’ attitudes and feelings toward their future profession and academic studies during the first COVID-19 lockdown. A cross-sectional, descriptive study was conducted on 361 nursing students. The data were collected through the Students’ attitudes toward the nursing profession during the COVID-19 outbreak scale, and the Satisfaction with online learning scale. Nursing students expressed higher levels of commitment and dedication to their profession compared to perceived job security. They were generally satisfied with their distance learning experience in terms of accessibility of study materials, adaptation of lectures and quality of communication with academic staff. However, students perceived the ICT-supported distance learning as moderately effective. Students’ satisfaction with online learning was positively related to their perceived professional commitment. In times of health crisis, faculties should consider students’ perceived quality of nursing education and attitudes toward future profession to promote appropriate professional identity.

Perceived professional identity and related factors in Iranian nursing students: a cross-sectional study

BACKGROUND

Professional identity, an important process in the development and expansion of the nursing profession, is built over time and includes gaining insight into professional performances and fostering ideals and values for the profession. Several factors influence the formation of professional identity. This study investigates the level of professional identity in nursing students and its predictors using a localized tool.

METHODS

This cross-sectional study recruited 195 nursing students at Semnan University of Medical Sciences, Semnan, Iran, who were selected by census sampling in 2020. Data were collected using a researcher-made professional identity questionnaire and were then analyzed in SPSS-18 using descriptive and inferential (logistic regression) statistics.

RESULTS

The mean total score of the students' perceived professional identity was 316.72, indicating a strong professional identity. The students' professional identity had a significant relationship with variables including GPA above 16 (OR = 2.65, P = 0.002), choosing the field out of interest (OR = 2.15, P = 0.015), and having work experience while studying (OR = 3.10, P = 0.006).

CONCLUSION

The findings showed that selecting the field of nursing out of interest, having a GPA above 16 and work experience while studying are associated with a higher perception of professional identity among nursing students. The professional identity of nursing students can be enhanced through reinforcing the mentioned factors and further attention to their role in the promotion and consolidation of professional identity. The researchers recommend that educational directors, nursing professors, and clinical nursing educators make greater efforts to develop and promote the professional identity of nursing students.

The evolution of advanced nursing practice: Gender, identity, power and patriarchy

To address longstanding workforce shortages, increase efficiency and control the costs associated with the modern health-care provision, there has been a worldwide policy to promote increased flexibility within the health-care workforce. This is being done primarily by extending the 'scope of practice' of existing occupational roles into what is referred to as 'advanced' practice. The development of the advanced practice nurse (APN) has occurred within the context of a shortage of medical staff, and the need to control cost. However, the means by which substantially repurposed occupational groups such as these, are incorporated into complex, hierarchical organisations such as the UK national health service (NHS) remains poorly understood. Using modern sociological theory, the development of the APN role has been examined in terms of power, control, professional identity and gender relations. Each of the theoretical approaches used adds to the quality of the discussion, although none provide a comprehensive picture. However, when synthesised, they do provide an enhanced insight into the evolution of the role. It is argued here that by critically examining the development of the APN role, this will enable both a better understanding of, and the means to influence, its future direction of travel.

Undergraduate nursing students' experiences of becoming a professional nurse: a longitudinal study

Background

During education it is essential for nursing students to develop professionalism in nursing. Nurses are placed in situations based on trust, and it is crucial that their patients have confidence in them to provide professional and safe care. A key period in nursing students’ development of a professionalism occurs during training when students gain knowledge and skills that separate nurses as professional healthcare workers from laypeople. The purpose of this study was to investigate nursing students’ experiences of professional competence development during education.

Methods

A longitudinal study was carried out using qualitative content analysis with a manifest inductive approach. Thirty-four students enrolled in a Swedish three-year nursing program, from August 2015 to January 2017 were interviewed on four occasions.

Results

The results revealed that students’ professional role developed gradually. The students’ started their education with dreams and a naive understanding of the profession, but their understanding of the complexity of the nursing profession gradually evolved. Students became theoretically equipped at the university and developed clinical skills through practice. Students’ focus went from mastering medical technology to a more holistic approach. Before graduating, students felt ready but not fully trained.

Conclusions

Our findings indicate a discrepancy between the content of the theoretical education and the clinical settings since students identified a lack of evidence-based practice. A solid theoretical education before entering clinical training offered students possibilities for reflecting on evidence-based practice and the clinical settings. The realization that there is always potential for professional improvement can be interpreted as an emerging awareness, and development of professionalism. It is clear that students could benefit from increased collaborative work between clinical supervisors and faculty staff at the university.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01002-0.

Exploring professional identity in rehabilitation professions: a scoping review

Professional identity is believed to foster self-confidence and resilience in health care professionals. While literature exists describing professional identity in medicine, the relevance of this evidence to rehabilitation professionals (occupational therapy (OT), physical therapy (PT) and speech-language pathology (S-LP)) is limited due to differences between professions in decision-making authority (patient care), professional autonomy and understanding of their scope of practice. The objective was to determine the extent, range and nature of the literature on professional identity/professional identity formation in rehabilitation professionals. Findings from the scoping review based on Arksey and O'Malley's methodological framework are presented. A search was conducted on MEDLINE (Ovid), Embase (Ovid), AMED, CINAHL, and ProQuest Dissertations and Theses from 1996 to October 2020 for empirical and conceptual studies on OT, PT, and S-LP clinicians or students. Of 4983 retrieved records, 53 papers were selected for data extraction. Data were organised into themes for professional identity/professional identity formation: conceptual descriptors (dynamic state, multiple identities); influences (person, professional education/environments, profession-at-large). Findings are consistent with the professional identity literature in medicine. However, they point to gaps for further empirical inquiry in the role of symbols and rituals in the professional identity/professional identity formation of rehabilitation professionals, profession-specific differences between OT, PT and S-LP, and influences related to the profession-at-large on the professional identity/professional identity formation of rehabilitation professionals. These findings may help to inform professional education programs and health care and professional systems in developing resources to support professional identity formation of rehabilitation professionals.

Professional competence development through interprofessional simulation-based learning assists perioperative nurses in postgraduation acute clinical practice situations: A qualitative study

AIMS AND OBJECTIVES

To explore recently graduated perioperative nurses' experiences of interprofessional simulation-based learning during postgraduate education and investigate whether and how this learning approach contributed to the development of their professional competence in meeting acute clinical situations.

BACKGROUND

Perioperative nursing requires specialised education that offers professional development to ensure high-quality nursing care and patient safety in acute situations. Interprofessional simulation-based learning exposes students to acute situations in a safe environment without the risk of harming the patient, and it prepares postgraduate nursing students for clinical practice. Despite extensive research regarding simulation-based learning, there is a lack of knowledge on what impact such training has on perioperative nursing students after graduation.

DESIGN

An explorative qualitative design was used, and this study is reported in accordance with the COREQ guidelines.

METHOD

Between March 2019-November 2020, 16 perioperative nurses participated in semi-structured individual interviews three to five months after their graduation from five different educational institutions. During their postgraduate education, they had participated in interprofessional simulation-based learning that included acute clinical situations. A phenomenological hermeneutical analysis was applied to the data involving three steps: naïve reading, structural analysis and comprehensive understanding.

RESULTS

During the naïve reading, three themes emerged: competence in handling acute situations, competence in interprofessional teamwork and professional identity development.

CONCLUSION

Interprofessional simulation-based learning in perioperative nursing education developed relevant and important competence, including professional identity development, among perioperative nursing students. As recent graduates, their professional competence was transferred to clinical practice and developed further.

RELEVANCE TO CLINICAL PRACTICE

Findings indicate that interprofessional simulation-based learning is an important educational approach in perioperative nursing education. It is essential to use effective learning approaches to develop competencies that are transferable to clinical practice and improve perioperative nurses' performance as recent graduates. Therefore, interprofessional simulation-based learning should be implemented into perioperative nursing education.