1
|
Huang ZE, Qiu X, Yan J, Liao DD, Huang H, Fu YQ, Liu BR, Zhu SC, Yi QF. Structural equation modeling for associated factors with patient safety behaviors among nursing interns: A cross-sectional study based on the capability opportunity motivation-behavior model. NURSE EDUCATION TODAY 2024; 132:105992. [PMID: 37890194 DOI: 10.1016/j.nedt.2023.105992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/22/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Nursing interns are one of the most crucial providers of nursing services. Their safety behaviors are closely associated with adverse events. Therefore, it is vital to explore the factors influencing nursing intern safety behavior to improve patient safety. OBJECTIVE To evaluate patient safety behavior among nursing interns and explore latent influencing mechanisms based on the capability opportunity motivation-behavior (COMB) model. DESIGN A cross-sectional study SETTINGS AND PARTICIPANTS: The participants were 422 nursing interns recruited through convenience sampling from a comprehensive teaching hospital. METHODS Data on general information, nursing interns' patient safety behavior, metacognitive ability, clinical internship environment, and moral sensitivity were collected. Nursing interns' patient safety behavior was described with means and standard deviations. The independent sample t-test, ANOVA, Pearson's correlation, and SEM were used to determine contributing factors to nursing interns' patient safety behavior. RESULTS The mean total score for patient safety behavior was 53.08 ± 6.22. The results indicated that metacognitive ability not only directly affects the patient safety behavior of nursing interns (β = 0.554, P < 0.001, 95 % CI = [0.446, 0.637]) but indirectly affects interns' safety behavior through professional identity (β = 0.009, P = 0.031, 95 % CI = [0.001, 0.019]). The clinical internship environment also has both direct (β = 0.258, P = 0.001, 95 % CI = [0.166, 0.349]) and indirect (β = 0.007, P = 0.029, 95 % CI = [0.001, 0.015]) effects on the patient safety behavior of nursing interns. CONCLUSION There are some specific areas where nursing interns' safety behaviors need to be improved. This study reveals that strong metacognitive ability and a clinical internship environment with rich opportunities might be essential for the development of patient safety behaviors. To promote nursing interns' patient safety behaviors, clinical teachers could use reflective teaching methods and provide a supportive clinical environment to nurture nursing interns' professional identities and patient safety behaviors.
Collapse
Affiliation(s)
- Zhuo-Er Huang
- Department of Nursing Teaching and Research, the Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China
| | - Xing Qiu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Jin Yan
- Xiangya Nursing School, Central South University, Changsha, China; Department of Nursing, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Dan-Dan Liao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hui Huang
- Department of Nursing Teaching and Research, the Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China
| | - Ya-Qian Fu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Bi-Rong Liu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Su-Cui Zhu
- Department of Pulmonary and Critical Care Medicine, the Third Xiangya Hospital, Central South University, Changsha, China.
| | - Qi-Feng Yi
- Department of Nursing Teaching and Research, the Third Xiangya Hospital, Central South University, Changsha, China; Xiangya Nursing School, Central South University, Changsha, China.
| |
Collapse
|
2
|
DÜZENCİ S, MALAK B. Environmental Ethics and Mental Health during COVID-19. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1076940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
As the cause of the COVID-19 pandemic, climate change, population density, ecological changes, etc. natural phenomena are shown. The physical, chemical, biological, socioeconomic, cultural and psychological effects of COVID-19 have been felt all over the world. COVID-19 negatively affects the environment with an unbalanced increase in medical waste and disposable products, while quarantine and pandemic measures have given an opportunity for nature to renew itself. The causes and consequences of COVID-19 have brought the concepts of environmental health and therefore environmental ethics to the agenda of healthcare professionals. As the environmental ethics attitudes and behaviors of health professionals develop, health professionals will be able to take initiatives to create these attitudes and behaviors in society. Environmental ethics has been evaluated in the context of public health, mostly in the physical health. However, environmental ethics is also very important in terms of community mental health. Living in an unhealthy environment threatens mental health. Because people want to live in a safe environment, every factor that threatens this trust poses a risk for mental health. There is actually literally no way to talk about happiness in an environment where there is no environmental order and nature is deteriorated and polluted. Therefore, we aimed to explain the concepts of environmental health, environmental ethics and mental health during the COVID-19 process. Thus, an important strategy development in the pandemic process can be achieved by enabling the assessment and management of the causes of the COVID-19 pandemic from a broader perspective.
Collapse
|
3
|
Goktas S, Aktug C, Gezginci E. Evaluation of moral sensitivity and moral courage in intensive care nurses in Turkey during the COVID-19 pandemic. Nurs Crit Care 2023; 28:261-271. [PMID: 35821613 PMCID: PMC9350110 DOI: 10.1111/nicc.12820] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, intensive care nurses may experience ethical issues related to fear of transmission, limited resources, and increased workload. Nurses' moral sensitivity and courage may have a role in dealing with these problems. AIM The purpose of this study was to assess intensive care nurses' moral sensitivity and moral courage during the COVID-19 pandemic. DESIGN Descriptive cross-sectional survey. METHODS A total of 362 nurses working in the intensive care units of pandemic hospitals in Turkey participated in the study between January and March 2021. Data were obtained using a personal information form, the Moral Sensitivity Questionnaire, and the Nurses' Moral Courage Scale. A link to the online data collection tools was sent to the management of participating institutions, who forwarded it to nurses. Reporting followed the CHERRIES guidelines. RESULTS In this study, the response rate of nurses was 89%. The nurses' total mean moral sensitivity score was 90.70 ± 28.89 and their mean moral courage score was 82.08 ± 13.51. A weak inverse correlation was found between the nurses' moral sensitivity and moral courage scores (r = -.176, p = .001). Total moral sensitivity score differed significantly according to years of Intensive care unit (ICU) experience (p = .007). Total moral courage scores increased significantly with education level (p = .012), years of nursing experience (p = .016), and willingness to work in the ICU (p < .001). CONCLUSION The study suggests that nurses working in the intensive care unit during the pandemic had moderate moral sensitivity and high levels of moral courage. Nurses' sociodemographic characteristics and ICU work conditions may affect their moral sensitivity and moral courage. RELEVANCE TO CLINICAL PRACTICE The results of this study can help guide efforts to improve moral courage and sensitivity and address ethical issues among ICU nurses.
Collapse
Affiliation(s)
- Sonay Goktas
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
| | - Cemile Aktug
- Faculty of Health Sciences, Department of Nursing, Gümüşhane University, Gumushane, Turkey
| | - Elif Gezginci
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Istanbul, Turkey
| |
Collapse
|
4
|
Legal Regulations and the Anticipation of Moral Distress of Prospective Nurses: A Comparison of Selected Undergraduate Nursing Education Programmes. Healthcare (Basel) 2022; 10:healthcare10102074. [PMID: 36292521 PMCID: PMC9602732 DOI: 10.3390/healthcare10102074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/12/2022] [Accepted: 10/15/2022] [Indexed: 11/18/2022] Open
Abstract
Moral distress is commonly experienced by nurses in all settings. This bears the risk of a reduced quality of care, burnout and withdrawal from the profession. One approach to the prevention and management of moral distress is ethical competence development in undergraduate nursing education. Profession-specific legal regulations function as a foundation for the decision on the educational content within these programmes. This theoretical article presents the extent to which legal regulations may open framework conditions that allow for the comprehensive preparation of prospective nurses to manage moral distress. The legal frameworks and the immediate responsibilities regarding their realisation in the context of undergraduate nursing education vary slightly for the three chosen examples of Switzerland, Austria and Germany. While an increased awareness of ethics’ education is represented within the nursing laws, no definite presumption can be made regarding whether undergraduate nursing students will be taught the ethical competencies required to manage moral distress. It remains up to the curriculum design, the schools of nursing and instructors to create an environment that allows for the realisation of corresponding learning content. For the future, the establishment of professional nursing associations may help to emphasise acutely relevant topics, including moral distress, in undergraduate nursing education.
Collapse
|
5
|
Han P, Duan X, Zhao S, Zhu X, Jiang J. Nurse's Psychological Experiences of Caring for Severe COVID-19 Patients in Intensive Care Units: A Qualitative Meta-Synthesis. Front Public Health 2022; 10:841770. [PMID: 35387188 PMCID: PMC8978605 DOI: 10.3389/fpubh.2022.841770] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background COVID-19 has been listed as an international public health emergency. During the pandemic, the nurses were affected physically and mentally when in contact with and caring for patients infected with COVID-19, especially those in intensive care units (ICUs). Objective To summarize and evaluate the actual psychological experience of nurses caring for patients with severe pneumonia in the ICUs during the COVID-19 pandemic. Methods Relevant publications were identified by systematic searches across 11 databases in December 2021. All qualitative and mixed-method studies in English and Chinese from 2019 that explored the experiences of nurses who cared for severe COVID-19 patients in ICUs were included. The qualitative meta-synthesis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Two independent reviewers selected the studies and assessed the quality of each study. Meta-synthesis was performed to integrate the results. Results A total of 12 studies revealed 9 sub-themes and 3 descriptive themes: physical reactions and psychological changes, the need for support from multiple sources, and increased adaptation and resilience. Conclusion Nurses who treated severe COVID-19 patients have experienced severe work trials and emotional reactions during the pandemic. They have also developed personally in this process. Managers should develop strategies that address the nurse's needs for external support, reasonably respond to public health emergencies, and improve nursing care outcomes.
Collapse
Affiliation(s)
- Peng Han
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xia Duan
- Nursing Department, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Sijia Zhao
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoping Zhu
- Nurisng Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinxia Jiang
- Emergency Department, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| |
Collapse
|
6
|
Abstract
BACKGROUND Ethical sensitivity is a prerequisite for ethical nursing practices. Efforts to improve nurses' ethical sensitivity are required to correctly recognise ethical conflicts and for sound decision-making. Because an emerging infectious disease response involves complex ethical issues, it is important to understand the factors that influence public health nurses' ethical sensitivity while caring for patients with COVID-19, an emerging infectious disease. OBJECTIVES This study aims to identify the relationship between nursing professionalism, the organisation's ethical climate, and the ethical sensitivity of nurses who care for emerging infectious disease patients in Korean public health centres. Further, it sought to identify factors influencing ethical sensitivity and the mediating effect of the organisational ethical climate to inform guidelines and improve ethical sensitivity. RESEARCH DESIGN This was a cross-sectional descriptive study. PARTICIPANTS AND RESEARCH CONTEXT Data were collected from February 3 to 8 March 2021. Participants included 167 nurses caring for patients with COVID-19 in public health centres in South Korea. ETHICAL CONSIDERATION This study was approved by the Institutional Review Board of the Chung-Ang University and followed the principles of research ethics. RESULTS The factors influencing ethical sensitivity were working at a COVID-19 disease direct response department, nursing professionalism, and organisation's ethical climate. The organisation's ethical climate showed a partial mediating effect on the influence of nursing professionalism on ethical sensitivity. CONCLUSION Our findings show that nurses' ethical sensitivity can be improved by refining the organisation's ethical climate and nursing professionalism.
Collapse
Affiliation(s)
- Hyeji Seo
- Seoul Nurses Association, Seoul, Korea
| | | |
Collapse
|
7
|
Xu H, Stjernswärd S, Glasdam S. Psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic - A qualitative systematic review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021; 3:100037. [PMID: 34308373 PMCID: PMC8285218 DOI: 10.1016/j.ijnsa.2021.100037] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Frontline nurses have been directly exposed to the SARS-CoV-2 virus and come in close contact with patients during the COVID-19 pandemic. Nurses execute tasks related to disease control and face multiple psychosocial challenges in their frontline work, potentially affecting their mental well-being and ability to satisfyingly perform their tasks. OBJECTIVES To explore the psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic. DESIGN The qualitative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Registered in PROSPERO (CRD42021259111). DATA SOURCES Literature searches were performed through PubMed, CINAHL, and the WHO COVID-19 database. Inclusion criteria were: All types of nurses having direct contact with or taking care of patients; Primary, secondary, and tertiary health-care services admitting and treating COVID-19 patients; Experiences, perceptions, feelings, views in psychosocial aspects from the identified population group; Qualitative studies; Mixed methods studies; Language in English; Published date 2019-2021. Exclusion criteria were: Commentaries; Reviews; Discussion papers; Quantitative studies; Language other than English; Published in 2018 or earlier; Studies without an ethical approval and ethical statement. REVIEW METHODS The studies were screened and selected based on the inclusion and exclusion criteria. Quality appraisal was conducted according to the Critical Appraisal Skills Program qualitative study checklist. Data was extracted from included studies and a thematic synthesis was made. RESULTS A total of 28 studies were included in the review. The experiences of 1141 nurses from 12 countries were synthesised. Three themes were constructed: 'Nurses' emotional, mental and physical reactions to COVID-19', 'Internally and externally supported coping strategies', and 'A call for future help and support'. CONCLUSION Nurses working frontline during the COVID-19 pandemic have experienced psychological, social, and emotional distress in coping with work demands, social relationships, and their personal life. The results pointed to a need for increased psychological and social support for frontline nurses to cope with stress and maintain mental well-being, which may subsequently affect nursing care outcomes.
Collapse
Affiliation(s)
- Hongxuan Xu
- Department of Health Sciences, Lund University, Sweden
| | - Sigrid Stjernswärd
- Health-promoting Complex Interventions, Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1 B, Lund S- 222 41, Sweden
| | - Stinne Glasdam
- Integrative Health Research, Department of Health Sciences, Faculty of Medicine, Lund University, Margaretavägen 1 B, Lund S- 222 41, Sweden
| |
Collapse
|