Nurses' Perceptions of Self as Role Models of Health

Intensive Care Unit Nurses' Experience of Watson's Theory of Human Caring Caritas Process III: Developing Spiritual Self to Provide Spiritual Nursing Care

The purpose of this study was to explore intensive care unit (ICU) nurses' experience of developing spiritual self to meet the significant spiritual and existential needs of patients and their families. A qualitative descriptive method with directed content analysis guided by Watson's Theory of Human Caring was utilized. From a sample of 10 ICU nurses, 3 main themes were described. The themes articulate ICU nurses' experience of personal spiritual growth as influenced by their work environment and the need for continued development of spiritual self to support their clinical role.

Nurses' role model duties for health and COVID-19 pandemic precautions

Role modelling communicates a standard of behavior to another person. Silent role modelling occurs when this standard can be communicated without articulating reasons for the action; articulate role modelling occurs when it is necessary to articulate reasons in order to effectively role model the standard of behavior, and to avoid misinterpretation. Nurses are role models in virtue of the respect and admiration given to the nursing profession. As such, nurses have role model obligations. This paper examines nurses' role model obligations for healthy behaviors and pandemic precautions. Research often identifies nurses as role models for healthy behavior, despite the fact that nurses are typically no healthier than the general population. This paper argues that nurses do not have a duty to role model healthy behaviors. The ability to adopt healthy behaviors is affected by numerous personal and individual factors. For a nurse to share their struggles to adopt healthy behaviors as articulate 'imperfect' role models violates their right to privacy. By contrast, nurses do have a moral duty to role model pandemic precautions during the COVID-19 pandemic, such as correctly wearing appropriate masks, maintaining social distancing, avoiding gatherings of multiple households when pandemic precautions are not being taken, and staying up to date on vaccination. Nurses' duty to role model pandemic precautions does not involve sharing any personal information. Nurses have a duty to be silent role models when the risk of misinterpretation is low, and a duty to be articulate role models, who explicitly communicate reasons for the role modelled behavior, when necessary to ensure they are not misinterpreted. When articulate role modelling goes beyond the minimal role modelling duty, and imposes a comparative cost to the nurse, articulate role modelling is not obligatory, but supererogatory.

Psychosocial Factors Associated With Alcohol Use Among Nurses: An Integrative Review

Background

Understanding alcohol use among nurses may inform interventions related to the coping mechanisms nurses use for workplace stress and trauma. Alcohol use can be caused by a variety of factors and has serious implications on a nurse's personal health and professional practice. Understanding psychosocial factors and preventive measures may assist in the development of interventions to improve coping mechanisms and reduce the incidence of alcohol misuse.

Purpose

To review the psychosocial factors and preventive measures associated with alcohol use among nurses.

Methods

For this integrative review, systematic searches were conducted in CINAHL, PubMed, PsychNet, and ProQuest Central. Included studies were peer-reviewed and addressed alcohol use among nurses in the United States. Articles were appraised using methods-specific tools indicated by the Whittemore and Knafl framework. Data were extracted and themes identified using constant comparison.

Results

Of 6,214 nonduplicate articles screened, 78 were selected for full-text review and 13 were included after application of inclusion criteria. Synthesis resulted in four themes: (1) occupational stress and trauma, (2) workplace characteristics, (3) mental health implications, and (4) protective factors. The data show that workplace stress and trauma contribute to alcohol use among nurses. Night shifts, rotating shifts, and shift length are factors related to alcohol use, as are mental health problems such as anxiety, depression, trauma, and suicide. Protective factors that reduce alcohol use among nurses include faith, resilience, and perceived organizational support.

Conclusion

Alcohol use among nurses presents challenges for the nursing profession and regulatory bodies with specific and interrelated phenomena related to the role and identity of nurses. A better understanding of these factors through research will facilitate a healthier nursing workforce that is better prepared to take on the rewards and challenges of a nursing career.

Self-care neglect through the voices of nurses working in primary healthcare clinics in Gauteng, South Africa

BACKGROUND

Self-care is essential, but while professional nurses often pay attention to the health of their patients, they give little heed to their own well-being. With the current pandemic continuing to negatively affect the world, the need for health professionals to make time for self-care is imperative. The concept "self-care" is not a new phenomenon; however, this study strives to show the importance of self-care practices in the world of nurses and its benefit for the nursing profession. The reality for nurses taking care of themselves will assist them in providing consistent quality care for their patients.

METHOD

A qualitative approach with a descriptive, phenomenological, contextual method was used in this study. Ten professional nurses employed within different primary healthcare clinics were selected through purposeful sampling. Through in-depth, individual interviews, the professional nurses shared their lived experiences with self-care practices while being employed within a primary healthcare clinic. The recorded interviews were transcribed verbatim and then analyzed using Colaizzi's method.

RESULTS

The findings revealed: Theme 1: Participants experienced internal and external factors that compromised self-care practices Theme 2: Holistic well-being and the quality of patient care are compromised by self-care neglect Theme 3: Participants experienced the need to take responsibility and accountability to promote self-care practices.

RECOMMENDATIONS

Specific recommendations were formulated to facilitate professional nurses' empowerment to practise self-care as a lifestyle. These specific recommendations focused on reducing the burden of caring for others to the extent that professional nurses working in primary healthcare settings have nothing left for themselves.

Physical activity in university health science students: Motivations influencing behaviors

Objective: To understand how competence, self-efficacy, enjoyment and motivation relates to physical activity behavior during transition from school to university. Participants: Health science students (n = 558) studying first year biology at an Australian university. Methods: Cross-sectional correlational survey design using five self-report questionnaires to establish relationships between a physical activity index and motivational variables. Results: Self-reported physical activity index scores of satisfactory or above were achieved by 80% of students with scores significantly higher for males than females. Enjoyment, self-efficacy and competence were predictive of physical activity index scores across genders. Conclusions: The physical activity index is a useful measure of activity dimensions across a variety of physical activities. Health science students need to underpin health messages with personal practice in modeling a healthy lifestyle. Universities have a special responsibility for building and supporting physical activity for all students, but especially for future health professionals.

Relationship between clinical performance and professional self-concept in critical care nurses

Objective

To determine the relationship between clinical performance and professional self-concept in critical care nurses.

Methods

This study was conducted on 308 critical care nurses. Data gathering instruments were nurses’ clinical performance questionnaire (NCPQ) and nursing professional self-concept measure (NPSCM). Independent sample t-test, one-way analysis of variance (ANOVA), and Pearson correlation coefficient were used for data analyses.

Results

The average age of the nurses was 33.74 ± 7.01 years. The clinical performance score of female nurses was significantly higher than male nurses. In the domain of clinical performance, clinical judgment and clinical inquiry had the highest and lowest scores, respectively. In the nurses’ professional self-concept, the highest and lowest scores were awarded to the subscales of self-confidence and staff relations, respectively. In addition, there was a significant positive correlation between self-concept and clinical performance of nurses.

Conclusions

Increasing professional self-concept improves the clinical performance of critical care nurses. Professional self-concept enhancement measures are recommended to improve the clinical performance of nurses in critical care units.

Workplace Health Promotion and COVID-19 Support Measures in Outpatient Care Services in Germany: A Quantitative Study

Working conditions in the care sector, especially under the increased strain during COVID-19, make it difficult for outpatient caregivers to adhere to health-promoting behaviours. Research on workplace health promotion (WHP) and COVID-19 support measures in outpatient care services is limited. The aim of this pilot study was to characterise the current situation of WHP and COVID-19 support measures in outpatient care services and to explore how to offer WHP support measures targeted for a specific group. A web-based cross-sectional survey was conducted with outpatient caregivers (N = 171) in northern Germany. The results showed that 60.2% of the study participants were offered WHP support measures, with significantly higher work engagement when WHP support measures were available (Z = 4279.50, p < 0.01) and that 77.2% received specific support from their employer during the COVID-19 pandemic. Although spending a break in a break room was significantly associated with longer breaks as compared with being in a car (Z = 39.10, padj. = 0.01), a break room was neither available in all outpatient care services, nor did it appear to be feasible. Overall, WHP in outpatient care services is insufficiently covered. In order to be able to offer WHP support measures that are targeted to outpatient caregivers, cooperation among local care services, feasibility, and digital measures should be examined.

The Health Behaviour of German Outpatient Caregivers in Relation to Their Working Conditions: A Qualitative Study

Ongoing demographic change is leading to an increasingly older society and a rising proportion of people in need of care in the German population. Therefore, the professional group of outpatient caregivers is highly relevant. Their work is characterised not only by interacting with patients in a mobile setting but also by working in shifts. Health behaviour under these specific working conditions is crucial for ensuring long-term work ability and performance. Little is known about the health behaviour of German outpatient caregivers and its potential impact on their work. The aims of the study were (1) to examine health behavioural patterns (nutrition, exercise, smoking, regeneration) of outpatient caregivers, (2) to illuminate their personal health-promoting behaviours, and (3) to identify potential work-related factors influencing their health behaviour. Fifteen problem-centred interviews were conducted with outpatient caregivers working in Northern Germany in the period January–April 2020. Interviews were analysed by using qualitative content analysis. Outpatient caregivers reported improvable nutrition and hydration, with simultaneous high coffee consumption, low physical activity, poor regeneration (breaks and sleep quality), and good personal health-promoting behaviour (e.g., back-friendly habits), although the majority were smokers. Barriers to the implementation of health-promoting behaviours were a high perception of stress due to increased workload and time pressure, while aids to better health-promoting behaviour were described as being social support and personal resources. The respondents perceived their working conditions as potentially influencing their health behaviour. On the basis of their descriptions, various practice-relevant strategies were derived. The data explore a potential need for outpatient care services to develop interventions on behavioural and structural levels that can help create healthier working conditions for their employees so these caregivers can adopt better health behaviours.

Theory of Planned Behavior and Perceived Role Model as Predictors of Nutrition and Physical Activity Behaviors Among College Students in Health-Related Disciplines

Physical activity (PA) and nutrition behaviors among college students in health-related disciplines are understudied. We used theory of planned behavior (TPB) and role model beliefs (RMB) to predict PA and eating behaviors of college students in health-related programs (nurses, physical education, exercise science, and athletic training). A 26-item survey was administered among the participants. Independent variables included TPB constructs and RMB measured on a 5-point scale. PA was measured by multiplicative scores of students' number of days by the amount of time spent exercising per week. Nutrition behavior was measured using fruits (2½ c-eq/day), vegetables (2½ c-eq/day), dairy (2 c-eq/day), grains (6 oz-eq/day), and proteins (5½ oz-eq/day). Multiple regression analyses were used to predict PA and nutrition behaviors. A total of 271 college health majors (mean age 22.5 ± 4.6 years) participated in the study. The majority (56.8%) of students did not meet the weekly PA guidelines and 43.2% did not meet the recommended dietary guidelines for daily servings of food groups combined. Regression analyses showed that outcome evaluation, behavioral belief, and RMB, were significantly related with student's PA behavior and they accounted for 34%, 8%, and 1% of the variance, respectively (total R² = 44.7). Outcome evaluation and behavioral beliefs were significantly related with nutritional behavior and they accounted for 13.3%, and 5.3% of the variance respectively (total R² = 18.6). TPB (outcome evaluation, behavioral belief) and RMB could be used to guide programs in promoting PA and nutrition behavior among college health majors.

Nurses' physical activity exploratory study: Caring for you so you can care for others

BACKGROUND

Nurses report the greatest stress of all health care workers. Although physical activity (PA) is associated with health benefits among other populations, nurses have stressors that other occupations do not typically encounter. It is important for nurses to identify techniques for stress management since stressors negatively impact their health and patient care.

OBJECTIVE

We aimed to examine the relationship between PA levels and physical, mental, and occupational health among nurses.

METHODS

Nurses (N = 62) completed measures of anthropometrics, demographics, and domains of physical, mental, and occupational health. Pearson correlations determined the relationship between PA and measures health along with the relationship between PA and health among active versus inactive nurses.

RESULTS

Fatigue was significantly correlated with moderate-to-vigorous PA (r = -0.27, p < 0.05). Relationships were found between mental health and light and moderate intensity PA (r = 0.40, p < 0.001; r = 0.30, p < 0.05).

CONCLUSIONS

Stress is prevalent among nurses and negatively impacts a nurse's health along with patient care. Findings suggest health benefits associated with PA among nurses. PA interventions among nurses may be needed to fully see the effects of PA on physical, mental, and occupational health, and ultimately patient health and safety.

Strategies to promote nurses' health: A qualitative study with student nurses

Developing strategies to support student nurses' health is a global priority for healthcare organisations and governments. This is because emerging international evidence indicates that improvements in student nurses' health are required to increase the longevity of careers and reduce the loss of time, skill and financial cost of sickness absence and workforce exit. However, we do not know what intervention strategies student nurses think would support their health. The study aim was to explore student nurses' views on factors that influence health-related behaviours and strategies that could improve health. Data were collected through participatory activities during focus groups with student nurses in Scotland. Analysis was theoretically informed and involved mapping to the Behaviour Change Wheel framework. Students identified several factors that influenced health-related behaviours. Four were ranked most important: knowledge, culture, time constraints, and stress. Strategies student nurses thought should be prioritised to improve nurses' health-related behaviours were: stimulating a health-promoting environment by reviewing shift work, improving workplace support, increasing staffing levels, subsidising and role-modelling of healthy food and exercise; and creating applied health-promoting curricula by integrating time and stress management training and lifestyle advice into nursing education. Educational and environmental interventions are needed to support student nurses' health.

The effect of regulatory focus and time preference on the dual process of physical activity: A cross-sectional study among nurses

AIMS

To examine the dual process of physical activity adoption among nurses and its relationships with two personal orientations-regulatory focus-the tendency to focus on promotion (vs. prevention) goals and time preference as measured by delay discounting: the tendency to overvalue immediate rewards over long-term ones.

BACKGROUND

The dual process theory suggests that both conscious and non-conscious processes influence the adoption of physical activity. However, the role of regulatory focus and time preference in this process was not yet examined.

DESIGN

A cross-sectional online survey among 143 nurses during August-November 2017.

METHODS

Validated measures were used to estimate physical activity habit strength (a non-conscious process) and intention, planning and behaviour control (conscious processes), physical activity level, regulatory focus and time preference. Multivariable ordered logit and logistic models were specified to examine determinants of both processes.

RESULTS

Promotion focus was positively associated with having a strong habit of physical activity among nurses with moderate-to-low activity levels, but it was negatively associated with habit for active nurses. As for time preference, higher delay discounting was negatively associated with nurses' conscious intention to adopt physical activity and with their action planning.

CONCLUSION

Promotion focus and time preference are associated with both conscious and non-conscious processes of physical activity adoption among nurses and should be considered in future health promotion interventions targeted to this population.

IMPACT

Promotion focus and time preference have a significant role in this dual process. Enhancing physical activity of health providers by adjusting the intervention to personal orientations may improve public health.

Self-Care Posters Serve as a Low-Cost Option for Physical Activity Promotion of Hospital Nurses

Hospital nurses play an important role in the nation's short- and long-term patient care. At the same time, nurses often experience high levels of occupational stress and participate in low levels of physical activity (PA). The purpose of this study was to examine the impact of self-monitoring and a poster campaign on the PA behaviors of hospital nurses. Motivational and instructional exercise posters were hung in break rooms of experimental units and replaced biweekly for 8 weeks. A total of 26 nurses (control: n = 13; experimental: n = 13) wore accelerometers for 3 workdays pre-, mid-, and postintervention. Participants were provided a step counter at baseline and a PA report at each stage. Moderate to vigorous PA (MVPA) and step count (SC) increased pre- to midintervention for control (MVPA: 14.8 ± 7.6%; SC: 19.1 ± 7.8%) and experimental (MVPA: 26.7 ± 18.5%, SC: 17.6 ± 8.3%) participants. Physical activity levels returned to baseline postintervention for control ( p > .05) and increased mid- to postintervention for experimental (MVPA: 16.2 ± 5.2%, SC: 10.7 ± 4.7%, p < .05) participants. In conclusion, a low-cost, self-care poster campaign may increase PA levels of hospital nurses when combined with personalized PA feedback.