The role of gender, profession and informational role self-efficacy in physician-nurse knowledge sharing and decision-making

The effect of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit

BACKGROUND

Shared decision-making is essential for improving infant prognoses. Medical staff should consider the effect of illness uncertainty and self-efficacy on parents' perceptions of shared decision-making.

AIMS

This study examined the impact of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit.

STUDY DESIGN

A descriptive-analytical cross-sectional study design was used. Data were collected from April to June 2023. A total of 103 parents of infants admitted to the neonatal intensive care unit participated in this study. The participants used a self-report questionnaire that included general characteristics of their infants, uncertainty of illness, self-efficacy and perception of shared decision-making. Data were analysed using descriptive statistics, independent t-test, analysis of variance, Scheffe's test, Pearson's correlation coefficient and multiple linear regression.

RESULTS

Illness uncertainty (r = -.659, p < .001, 95% confidence interval = [-1.209, -0.765]) was negatively correlated with self-efficacy, and self-efficacy (r = .255, p = .009, 95% confidence interval = [0.082, 0.569]) was positively correlated with the perception of shared decision-making. Using multiple linear regression, the number of visits to the intensive care unit (β = -1.939, p = .015, 95% confidence interval = [-3.490, -0.389]) and parents' self-efficacy (β = .271, p = .028, 95% confidence interval = [0.030, 0.512]) had a statistically significant effect on the perception of shared decision-making, accounting for 11.9% of the total explanatory power.

CONCLUSIONS

The results support that higher self-efficacy is associated with a higher degree of perception of shared decision-making among parents of infants in the intensive care unit. Therefore, clinicians might support parents in taking a more active role in shared decision-making by discussing available options with clinicians and reaching treatment plans together.

RELEVANCE TO CLINICAL PRACTICE

The study suggests creating scales to assess nurses' participation in shared decision-making and recommends educational programmes to boost parents' self-efficacy with infants, significantly affecting perceptions of shared decision-making.

Development and Psychometric Testing of the Cultural Bias Scale for Health Professionals: A Methodological Study

INTRODUCTION

Cultural bias can negatively affect processes such as making the correct diagnosis, creating appropriate treatment plans, and ensuring patient satisfaction when providing health care services to individuals. This study aims to develop and conduct the psychometric evaluation of a reliable tool to measure the bias levels of health care professionals.

METHOD

The scale was developed with a pilot study conducted on 50 nurses in Erzurum, Turkey. The scale initially consisted of 53 items, and data collection was performed on 720 participants.

RESULTS

The scale Kaiser-Meyer-Olkin (KMO) value was found to be 0.861. The anti-image value for items was ≥0.5. Bartlett's sphericity tests indicated suitability for factor analysis (χ2 = 2,850.732, df = 210, p < .01). The variance explained by each subscale of the scale was 18.582%, 16.342%, and 14.507%, respectively.

DISCUSSION

Because health care professionals should take a holistic approach to patient care, the scale might be a useful a important instrument for evaluating the cultural biases of health care professionals.

The influence of psychosocial work environment, personal perceived health and job crafting on nurses' well-being: a cross-sectional survey study

BACKGROUND

The World Health Organization urged governments to prioritize the health and work well-being of nursing staff by promoting a positive working environment. A safe and healthy physical and psychosocial work environment is a basic human right for nurses. Job crafting is a necessary skill when facing challenging working conditions.

OBJECTIVES

This cross-sectional correlational research based on the Job Demands-Resources Model aimed to explore the correlation between psychosocial work environment and work well-being among nurses working in the intensive care unit (ICU) and determine whether personal perceived health could mediate the relationship and whether job crafting can moderate the mediating effect. The study hypothesized that: 1. The psychosocial work environment would impact nurses' work well-being; 2. Personal perceived health would play a role as a mediator in the relationship between psychosocial work environment and work well-being; 3. Job crafting would moderate the relationship between personal perceived health and work well-being.

METHODS

A total of 655 registered nurses (RNs) from 7 ICUs in a teaching hospital in Beijing participated in this study. The RNs completed a battery questionnaire measuring their health, psychosocial work environment, well-being, and job crafting. PROCESS macros analysis was used to test mediating and moderating effects.

RESULTS

Personal perceived health mediated the relationship between psychosocial work environment and work well-being (b = 0.012, 95% CI [0.008, 0.016]). The moderated mediated analysis revealed that job crafting moderated perceived health's impact on work well-being (b = -0.007, 95% CI [- 0.010, - 0.003]).

CONCLUSION

A better psychosocial work environment with well-designed work organization and job content through job crafting could positively impact nurses' health and work well-being.

Navigating tensions when life-sustaining treatment is withdrawn: A thematic synthesis of nurses' and physicians' experiences

AIM

To synthesise nurses' and physicians' experiences with withdrawing life-sustaining treatment in an intensive care unit.

DESIGN

The chosen methodology is thematic synthesis. The Preferred Reporting Items for Systematic Review and Meta-Analyses and Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement.

METHODS AND DATA SOURCES

A systematic search is conducted in APA PsycINFO, CINAHL Plus, EMBASE, PubMed and Web of Science following the inclusion and exclusion criteria in April 2023. Two reviewers independently screened and extracted the qualitative data. Subsequently, data analysis was conducted using thematic analysis of qualitative research. This study was not registered with any review registry due to the irrelevance of the data to health-related outcomes.

RESULTS

From the 16 articles, 267 quotes were extracted and analysed. The findings of the study revealed five analytical themes: (1) tensions between interdependent collaboration and hierarchical roles; (2) tensions between dignified dying or therapeutic perspectives; (3) family members' reflections of patient's wishes; (4) tensions in family members' positions; and (5) double-sidedness of distress.

CONCLUSION

This study contributes to nursing knowledge by providing a more nuanced understanding of this complex phenomenon of withdrawing life-sustaining treatment. The findings of this study have revealed significant variations globally in the practices surrounding the withdrawal of life-sustaining treatment in intensive care units, emphasising the need for further research to inform clinical practices that cater to diverse contexts.

REPORTING METHOD

Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement (ENTREQ statement).

PATIENT OR PUBLIC CONTRIBUTION

Since this study reported a potential collision between the patient's dignified dying and the family member's perceptions and interests, the family member's wishes should be carefully distinguished from the patient's quality of end of life in practice.

Interprofessional clinical decision-making process in health: A scoping review

AIMS

To describe the key elements of the interprofessional decision-making process in health, based on published scientific studies. To describe the authors, reviews and subject matter of those publications.

DESIGN

Scoping review of the literature.

DATA SOURCES

MEDLINE, APA Psycinfo OpenGrey, Lissa and Cochrane databases were searched in December 2019 and January 2023.

REVIEW METHODS

References were considered eligible if they (i) were written in French or English, (ii) concerned health, (iii) studied a clinical decision-making process, (iv) were performed in an interprofessional context. 'PRISMA-scoping review' guidelines were respected. The eligible studies were analysed and classified by an inductive approach RESULTS: We identified 1429 sources of information, 145 of which were retained for the analysis. Based on these studies, we identified five key elements of interprofessional decision-making in health. The process was found to be influenced by group dynamics, the available information and consideration of the unique characteristics of the patient. An organizational framework and specific training favoured improvements in the process.

CONCLUSION

Decision-making can be based on a willingness of the healthcare organization to promote models based on more shared leadership and to work on professional roles and values. It also requires healthcare professionals trained in the entire continuum of collaborative practices, to meet the unique needs of each patient. Finally, it appears essential to favour the sharing of multiple sources of accessible and structured information. Tools for knowledge formalization should help to optimize interprofessional decision-making in health.

IMPACT

The quality of a team decision-making is critical to the quality of care. Interprofessional decision-making can be structured and improved through different levels of action. These improvements could benefit to patients and healthcare professionals in every settings of care involving care collaboration.

IMPACT STATEMENT

Interprofessional decision-making in health is an essential lever of quality of care, especially for the most complex patients which are a contemporary challenge. This scoping review article offers a synthesis of a large corpus of data published to date about the interprofessional clinical decision-making process in healthcare. It has the potential to provide a global vision, practical data and a list of references to facilitate the work of healthcare teams, organizations and teachers ready to initiate a change.

Gender Inequity in the Clinical Setting

Women in surgery continue to face inequitable treatment from surgical leadership, their peers, hospital staff, and even from their patients. Despite this, women surgeons continue to produce equal, or improved, clinical outcomes for their patients, with their work being given less remuneration than that of their male peers. The cultural stereotypes and biases that drive these inequities are implicit and subtle; however, they have dramatic effects on the lives and careers of women surgeons.

Perceived Barriers to Providing Spiritual Care in Palliative Care among Professionals: A Portuguese Cross-Sectional Study

Spiritual care is an important dimension of palliative care (PC) and a facet of holistic care that helps ill people find meaning in their suffering and lives. This study aims to: (a) develop and test the psychometric properties of a new instrument, Perceived Barriers to Spiritual Care (PBSC); (b) explore participants' perceptions of how prevalent those (pre-identified) barriers are; and (c) examine the association of their personal and professional characteristics with those perceptions. A descriptive cross-sectional study was carried out using a self-reporting online survey. In total, 251 professionals registered with the Portuguese Association of Palliative Care (APCP) completed the study. The majority of respondents were female (83.3%), nurses (45.4%), had more than 11 years of professional experience (66.1%), did not work in PC (61.8%), and had a religious affiliation (81.7%). The psychometric assessment using PBSC provided sound evidence for its validity and reliability. The three most common perceived barriers were late referral for palliative care (78.1%), work overload (75.3%), and uncontrolled physical symptoms (72.5%). The least commonly perceived barriers were different spiritual beliefs among professionals (10.8%), differences between the beliefs of professionals and patients (14.4%), and the shame of approaching spirituality in a professional context (26.7%). The findings show there is some relationship between sex, age, years of professional experience, working in PC, having a religious affiliation, the importance of spiritual/religious beliefs, and responses to the PBSC tool. The results highlight the importance of advanced training in spirituality and intervention strategies. Further research is needed to properly study the impacts of spiritual care and establish outcome assessments that accurately reflect the effects of the various spiritual care activities.

Barriers and Facilitators for Female Healthcare Professionals to Be Leaders in Pakistan: A Qualitative Exploratory Study

Purpose

Despite being in high numbers in medical colleges, only a small proportion of women join the workforce and even fewer reach leadership positions in Pakistan. Organizations like United Nations and Women Global Health are working towards closing the gender gap. The study aims to explore the enablers and barriers for women in healthcare leadership and to explore the strategies to promote women in leadership positions in Pakistan's specific societal culture.

Methods

In this qualitative exploratory study, semi-structured interviews of 16 women holding leadership positions in the health-care profession, ie, medical and dental (basic or clinical sciences) were included. The data were collected until saturation was achieved. The data were analyzed in MS Excel. Deductive and Inductive thematic analysis was done.

Results

Thirty-eight codes were generated that were combined in the form of categories. The major themes that emerged from the data were: elevating factors, the shackles holding them back, let us bring them up and implicit bias. Elevating factors were intrinsic motivation and exceptional qualifications, while the shackles were related to gender bias, male insecurities, and lack of political background. It was noteworthy that differences in gender roles were highly defined by culture and religion.

Conclusion

There is a need to change the perception of South Asian society and redefine gender roles through media and individual attempts. Women must take charge of their choices and believe in themselves. The institutional policies to help promote gender equality would be mentorship programs for new faculty, gender-responsive training for everyone, equal opportunities for all, and maintaining gender diversity on all committees.

Impact of digitalization on employee's autonomy: evidence from French firms

Purpose

This paper aims to clarify the relationship between digitalization and the employees’ autonomy. It proposes a positive relationship between digitalization and employees. It explains why strategic human resource management (HRM) is essential in this relationship. The study aims to solve the control autonomy paradox related to the use of technology in organizations.

Design/methodology/approach

The paper opted for the explanatory study using a cross-sectional design. Responses were received from the alumni of a French business school using the survey strategy. Structural equation modelling has been used to validate the measure and to test the hypotheses.

Findings

The paper provides empirical evidence for the positive relationship between digitalization and employees’ autonomy. It suggests that an enabling control-based HRM system mediates the positive relationship between digitalization and autonomy.

Originality/value

The study enriches the literature in information technology by solving the control autonomy paradox associated with information technology. Moreover, the study also highlights the importance of an enabling control-based HRM system by underlining its role in developing the empowering organizational context.