Professional Identity During the COVID-19 Pandemic: A Cross-Sectional Survey of Nurses in China

Relationship between competency inventory, perceived career benefits, and professional identity among pediatric nurses

OBJECTIVE

To investigate the relationship between competency inventory, perceived career benefits, and professional identity among pediatric nurses.

METHODS

A convenience sampling method was used to select 444 pediatric nurses from 10 tertiary hospitals in Hebei Province between June 2023 and August 2023 as the research subjects. The survey was conducted on September 15, 2023, during the morning meetings (nurses who were not on duty that day were surveyed when they returned to work). The China Competency Inventory for Registered Nurses (CIRN), Nurses' Perceived Career Benefits Questionnaire (NPCBQ), and the Professional Identity Scale for Nurses (PISN) were used to assess the competency inventory, perceived career benefits, and professional identity of pediatric nurses, respectively. Bivariate Pearson correlation analysis was used to analyze the relationship between these variables. Additionally, mediation effect analysis and structural equation modeling were used to test the mediating effect of professional identity between competency inventory and perceived career benefits of pediatric nurses.

RESULTS

The scores of CIRN, NPCBQ, and PISN of 444 pediatric nurses were at a moderate level. The correlation results showed that the competency inventory of pediatric nurses was positively correlated with perceived career benefits and their professional identity. Perceived career benefits were positively correlated with professional identity (r = 0.236, 0.326, 0.444, P < 0.001). The mediation effect analysis indicated that professional identity accounted for 29.08% of the total effect in the relationship between competency inventory and perceived career benefits (the contribution rate of the mediating effect to the total effect: ab/c × 100% = 29.08%). Linear regression analysis showed that competency inventory and perceived career benefit are important factors influencing professional identity.

CONCLUSION

Professional identity plays a mediating role between pediatric nurses' competency inventory and perceived career benefit. In clinical practice, enhancing nurses' perceived career benefit may improve their professional identity and competency inventory.

Insights from the top-cited papers in the critical care nursing literature: A bibliometric and visualized analysis

BACKGROUND

Highly cited papers in critical care nursing can offer valuable insights for all stakeholders engaged in the research process by highlighting key research trends, guiding resource allocation and shaping future research priorities.

AIM

To gain insights from the top-cited papers in the top critical care nursing journals.

STUDY DESIGN

This was a bibliometric analysis of the top-cited papers in the top critical care nursing journals as reported by the Journal Citation Report 2023-released in June 2024. Data were tabulated and visualized using Microsoft Excel and the VOSviewer software.

RESULTS

Forty papers from the top four critical care nursing journals (Intensive and Critical Care Nursing [ICCN], Nursing in Critical Care [NICC], Australian Critical Care [ACC] and American Journal of Critical Care [AJCC]) were analysed. Half of the analysed papers were related to the COVID-19 pandemic, and mental health was the most addressed theme (n = 11 papers). Papers from the ICCN featured contributions from 17 countries, the highest among the journals analysed, followed by NICC, with contributions from 11 countries. Articles received more citations than reviews (median [interquartile range]: 18 [9-23] vs. 8 [8-11.5]), and open-access papers were cited about twice those published under a subscription model (19 [16-31] vs. 9 [8-15]). In ICCN, 9 of the 10 analysed papers were published open access compared with 3 in NICC and ACC and 2 in AJCC.

CONCLUSIONS

The identified themes in this paper underscore the dynamic nature of the field of critical care nursing and the ongoing efforts to address key challenges in critical care nursing practice and health care delivery. Publishing open-access articles on trending topics and collaborating internationally seem to be effective approaches for gaining more citations.

RELEVANCE TO RESEARCH

Understanding these prevalent themes has significant implications for guiding research priorities, informing clinical practice, shaping policy and improving patient outcomes. Academic journals need to encourage increasing the representation of researchers from the Global South in both journals' editorial boards and submissions to the journals.

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.

Incidence of effort-reward imbalance among nurses: a systematic review and meta-analysis

Introduction

To systematically evaluate the incidence of effort-reward imbalance among nurses.

Method

PubMed, Web of Science, Embase, CNKI, WanFang Data, and VIP databases were searched to collect studies on the incidence of effort-reward imbalance among nurses. The search timeframe was from database construction to December 2023. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. The meta-analysis was performed using Stata 17.1 software.

Results

A total of 60 studies, including 79,644 participants, were included. The prevalence of effort-reward imbalance among nurses was 52.3% (95% CI: 44.9-59.7%). In terms of time, the incidence of effort-reward imbalance among nurses before 2010 (26.6, 95%CI: 6.8-46.4%) and in 2010-2015 (42.4, 95%CI: 32.1-52.8%), 2016-2020 (60.2, 95%CI: 49.6-70.7%), and 2021-2023 (65.0, 95%CI: 51.5-78.4%) continued to increase. Geographically, Asia (57.4, 95%CI: 51.8-63.1%) nurses had a relatively higher prevalence of effort-reward imbalance. In terms of department, the incidence of effort-reward imbalance among nurses was relatively higher in operating rooms (71.8, 95%CI: 64.5-79.0%), ICU (64.6, 95%CI: 27.7-100.0%), emergency (68.7, 95%CI: 62.9-74.5%), and pediatrics (65.8, 95%CI: 32.2-99.3%).

Discussion

The prevalence of nurse effort-reward imbalance is high, and there are differences in its prevalence across time, geography, department. Hospital administrators should actively take measures to effectively prevent and reduce the effort-reward imbalance for nurses, especially for nurses in Asia, operating rooms, emergency pediatrics and ICU departments.

Systematic review registration

PROSPERO (CRD42023452428).

Are we heroes or couriers? A phenomenological study on reappropriation of professional subjectivity and agency among health professionals during COVID-19 contact tracing in Türkiye

During the COVID-19 pandemic, Türkiye implemented a distinctive contact tracing approach involving in-person home visits by medical professionals to individuals who tested positive for the virus. This study examines the experiences of health professionals involved in contact tracing, exploring how they reappropriated their professional subjectivity and agency during their deployment in this role. It is an interpretive phenomenological qualitative study. We conducted 21 semi-structured in-depth interviews, subsequently carried out two separate focus group interviews with an additional 31 participants from various districts in Istanbul. Participants were selected from different medical professions (i.e. doctors, nurses, midwives), career stages, gender and age groups, and hierarchical levels (i.e. officers and directors). Data analysis was conducted collaboratively by the research team from sociology and public health disciplines. Our main finding is that for the majority of health professionals, contact tracing was a novel experience with challenges and ambivalances. Yet, regardless of their perceptions (positive, negative, or mixed), the experience promoted a reaffirmation of professional identity and reappropriation of professional subjectivity and agency, which discloses that professional subjectivity is not firm but dynamic, carrying stability as well as flexibility and adjustment. Four main themes are identified in their reappropriation of professional subjectivity and agency: uncovering professional fulfillment, feeling restrained in professional dissatisfaction, assessing the job, and engaging in professional and bureaucratic negotiations.The profound exploration into the dynamics of contact tracing amidst the pandemic illuminates a multidimensional narrative that transcends the conventional discourse on physical and psychological stress experienced by medical professionals. Contact tracing experience had a transformative impact on meaning and purpose of professional identity. Our findings highlight a need for a balanced approach between centralized decision-making, mobilization of professionals, quantitative evaluation, and professional autonomy and discretion, qualitative assessments, and meaningful engagement.

Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study

Background

The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover.

Objective

This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism.

Methods

In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between.

Results

Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect).

Conclusion

Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.

The role of professional identity and job satisfaction in paediatric nurses' intention to remain employed amidst the COVID-19 pandemic

The COVID-19 pandemic has significantly affected nursing, as nurses are crucial in providing healthcare services. Understanding the factors influencing nurse retention is essential for maintaining a strong and long-lasting workforce because nurse retention is becoming increasingly complex. This study aimed to investigate the influence of professional identity and job satisfaction on the intention to remain employed while also evaluating the levels of professional identity, job satisfaction, and intention to stay among paediatric nurses amidst the COVID-19 pandemic. This correlational and descriptive study included a stratified sample of 257 paediatric nurses and was guided by the STROBE checklist. Data were collected through valid and reliable questionnaires, which included a nurses' professional identity scale, job satisfaction survey, intention to stay scale, and a demographic questionnaire. Data collection was conducted from January to April 2022. The study was approved by the ethical research committee at the Nursing Faculty - Mansoura University, ensuring adherence to the Helsinki Declaration. The paediatric nurses reported elevated professional identity, moderate job satisfaction, and moderate intention to stay employed with mean scores of 80.35 ± 13.22, 113.70 ± 19.58, and 8.40 ± 3.55, respectively. Multiple regression explained 13.0% of the variation in paediatric nurses' intention to remain employed (F = 18.50, p < 0.001). Professional identity positively correlated with the intention to stay (β = 2.69, p = 0.008). Job satisfaction also had a positive relationship with the intention to stay (β = 3.49, p < 0.001). Healthcare managers should focus on professional identity strategies such as supportive work environments, growth opportunities, and valuing paediatric nurses' contributions. Implementing interventions such as fair compensation, support, and rewards can enhance paediatric nurses' retention and quality of patient care.

Explaining the Impact of the COVID-19 Pandemic on Massage Therapists in Australia and Canada: A Mixed Methods Study

Background: The COVID-19 pandemic was a time of rapid change and uncertainty, with individual jurisdictions within countries implementing a variety of preventative measures. At the onset of the pandemic, as little was known about how COVID-19 was transmitted, restrictions, such as lockdowns, were implemented to prevent further spread of this virus. In many jurisdictions, massage therapists were deemed as nonessential for a period. This disruption to their livelihood, as a professional group and without autonomy to decide, was unprecedented. This prompted the question as to whether this experience had impacted massage therapists' professional identity. Methods: A sequential explanatory mixed methods design was used and massage therapists in Australia and Canada were recruited to participate. Results from a quantitative questionnaire completed by 649 respondents and from 31 semistructured interviews from a subset of the questionnaire participants were used in the mixed analysis. Results: Massage therapists, impacted by the pandemic, experienced a discord between what it means to be a massage therapist, providing patient-centered care and the public health initiatives implemented during the pandemic. This discord occurred in multiple situations and the type of discord was influenced by a number of factors, including how therapists identified themselves within the workforce (i.e., as a health care provider or a service provider). Conclusion: This study sought to understand how the COVID-19 pandemic impacted massage therapists' professional identity. Massage therapists reported that the pandemic impacted their professional identity through a lack of congruence and discord between their identity-constituting beliefs and what it means to be a massage therapist. The sequela to this discord was therapists experiencing different types of moral distress and or moral injury. Future research is needed to determine the longer-term impacts of COVID-19 on massage therapists.

Factors Influencing Professional Identity of Psychiatric Nurses as Second Victims: A Cross-Sectional Study

The current study aimed to explore the status and influencing factors of professional identity among psychiatric nurses as second victims in China by using a cross-sectional design. We investigated 291 psychiatric nurses from two psychiatric hospitals. Participants were asked to complete a demographic questionnaire, Second Victim Experience and Support Scale, Multidimensional Health Locus of Control Scale, and Professional Identity Scale for Nurses. Scores of professional identity of psychiatric nurses as second victims were moderate. Regression analysis showed that the second victim experience and support and internal control were significant predictors, explaining 34.2% of the variance in professional identity. Identifying risk factors related to the professional identity of psychiatric nurses as second victims will help managers take timely preventive measures to improve the awareness of the self-health responsibility of psychiatric nurses and reduce the adverse effects of patient safety incidents to enhance their professional identity. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 47-54.].

Career optimism and job-related well-being of Australian nurses during COVID-19: A cross-sectional study

BACKGROUND

Australia has been confronted with a severe nursing deficit, making it difficult to maintain a strong healthcare workforce capable of meeting the mounting demands of healthcare organizations.

AIMS

This study aimed to understand how personal and organizational resources influence career optimism and job-related affective well-being of Australian nurses during a pandemic using the Conservation of Resource Theory.

METHODS

A cross-sectional online survey was emailed to 123 Australian nurses from January to February 2021. The survey consisted of self-reported measures, including mindfulness, career optimism, job-related affective well-being, personal and job resources measures, and the Dirty Dozen scale. Correlations, independent sample t-test, and a series of hierarchical regressions were conducted on the cross-sectional data with SPSS Version 27. The STROBE checklist was used to report the results.

RESULTS

Findings suggested that mindfulness, perceived supervisor support, and job autonomy were significant predictors of job-related well-being, whereas mindfulness, perceived supervisor support, and opportunities for professional growth contributed more to career optimism of nurses during a health crisis. Male nurses in this study reported significantly higher mindfulness, career optimism, and job-related well-being levels than female nurses.

LINKING EVIDENCE TO ACTION

Developing mindfulness among nurses, allocating organizational resources to facilitate more supervisor support, and providing job autonomy may enhance career optimism and job-related well-being of nursing staff who work in disruptive and high-demand work environments such as those experienced during the COVID-19 health crisis. Supervisors should also facilitate and encourage nurses to reflect and be mindful of their behaviors with their peers and patients which can help to reduce exploitative or arrogant behaviors in the workplace.

The Social and Professional Image of the Nurse: Results of an Online Snowball Sampling Survey among the General Population in the Post-Pandemic Period

Background. The COVID-19 pandemic has transformed people's lifestyles by imposing social, economic, and labor changes. Health professionals have been in the spotlight, occasionally even elevated to the status of "heroes", as they have been at the forefront of the health emergency. Media exposure has undoubtedly played a pivotal role in the evolution and perception of the public's image of nurses, especially within the Italian context. Currently, there is only one study conducted in Italy during the pandemic period. For this reason, we have opted to delve further into this subject during the post-pandemic period, with the ultimate goal of identifying this perceptual evolution. Methods. An online snowball sampling survey was conducted among the Italian population using social networks between August 2022 and January 2023. The survey utilized the Nursing Attitude Questionnaire (NAQ) to collect data. Results. The sample consisted of 564 individuals. Among the respondents, 63.8% (n = 360) were familiar with the nursing pathway, and the level of agreement regarding the training of nurses was 81.5% (n = 260). In terms of recognizing the professional role of nurses, variations emerged in certain domains of the NAQ. Specifically, professional values of nurses were more pronounced in northern and central Italy (M = 26.27). Moreover, stereotypes were more prevalent in the north (23.73 ± 3.538) and the center (23.13 ± 4.104) (p = 0.001). Conclusions. The sample acknowledged a unique competence inherent to nurses that cannot be replaced by other professionals. The study population perceives the nursing profession as pivotal within the IHS (Integrated Health System). However, the attractiveness of the profession remains exceedingly low. This study was not registered on a publicly available registry.

The paradox of the impact of the COVID-19 pandemic on massage therapists in Australia and Canada: The reporting of a qualitative strand of a mixed methods study

INTRODUCTION

In both Australia and Canada, healthcare providers considered essential were allowed to operate during the COVID-19 pandemic. The impact of the global pandemic on professional identity included opportunities for role expansion, a focus on ethical principles and social accountability, and professional pride. These results were found only for those considered to be essential and do not likely resonate with those classified as non-essential, such as massage therapists, leaving a gap in understanding.

MATERIALS AND METHODS

This qualitative strand of a sequential explanatory mixed methods study used qualitative description. Individuals who expressed interest were purposefully selected, based on age, gender, type of practice, and experience with the four key phenomena of interest. Data collected through semi-structured interviews was analyzed using qualitative content analysis. Member checking enhanced the trustworthiness of the results.

RESULTS

Thirty-one (16 Australian and 15 Canadian) participants were interviewed. The main theme described was the pandemic paradox. At some point during the pandemic, most participants were labelled by government agencies as a non-essential service. However, participants reported feeling both essential and non-essential. Two subthemes were also described: factors contributing to creating the paradox and consequences of the paradox.

CONCLUSION

A number of pre-existing factors around professional identity, such as patient relationships combined with the conditions instituted to manage the COVID-19 pandemic included designating health care services as essential or non-essential, created the paradox experienced by respondents and the subsequent experience of moral distress. Further research into moral distress experienced by massage therapists is needed.

Reconfigured professional purpose in times of crisis: Experiences of frontline healthcare professionals during the COVID-19 pandemic

How is professional purpose impacted in the context of a crisis? Building on discussions about professional purpose and identity, the paper explores how the understanding that professionals have about the framing, scope of functioning and aims of their profession is impacted during a time of crisis. The paper draws on interviews with 41 kinesiologists working at an accidents & emergencies (A&E) hospital in Chile during the COVID-19 pandemic. The paper shows professional purpose as a fluid, situated notion that gets re-shaped in light of contextual features. In the face of new and changing demands during times of crisis, professionals reconfigure their professional purpose to take advantage of the opportunities available. This reconfiguration takes place in response to the external context of the profession (its positioning in the public domain) and the internal relational context of the profession (its positioning with other professionals). The paper suggests a research agenda to develop a processual, situated approach to the interrogation of professional purpose to embed contextual features in scholarship in this area.

Impact of the COVID-19 Pandemic on Nurses Working in Intensive Care Units: A Scoping Review

BACKGROUND

The COVID-19 pandemic resulted in significant system strain, requiring rapid redeployment of nurses to intensive care units. Little is known about the impact of the COVID-19 pandemic and surge models on nurses.

OBJECTIVE

To identify the impact of the COVID-19 pandemic on nurses working in intensive care units.

METHODS

A scoping review was performed. Articles were excluded if they concerned nurses who were not caring for critically ill adult patients with COVID-19, did not describe impact on nurses, or solely examined workload or expansion of pediatric intensive care units.

RESULTS

This search identified 417 unique records, of which 55 met inclusion criteria (37 peer-reviewed and 18 grey literature sources). Within the peer-reviewed literature, 42.7% of participants were identified as intensive care unit nurses, 0.65% as redeployed nurses, and 72.4% as women. The predominant finding was the prevalence of negative psychological impacts on nurses, including stress, distress, anxiety, depression, fear, posttraumatic stress disorder, and burnout. Women and members of ethnic minority groups were at higher risk of experiencing negative consequences. Common qualitative themes included the presence of novel changes, negative impacts, and mitigators of harm during the pandemic.

CONCLUSIONS

Nurses working in intensive care units during the COVID-19 pandemic experienced adverse psychological outcomes, with unique stressors and challenges observed among both permanent intensive care unit and redeployed nurses. Further research is required to understand the impact of these outcomes over the full duration of the pandemic, among at-risk groups, and within the context of redeployment roles.

Professional identity, job satisfaction, and intention to stay among clinical nurses during the prolonged COVID-19 pandemic: A mediation analysis

AIM

This study aims to examine the relationship between professional identity and job satisfaction and their impact on intention to stay among clinical nurses in China during the prolonged COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted from April 30 to May 25, 2021, in China. Data were collected using professional identity, job satisfaction, and intention to stay questionnaires from 1425 clinical nurses. A single mediation analysis was utilized to test the interrelationship among the variables, and the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist as a reporting guide.

RESULTS

Nurses indicated a medium level of professional identity, job satisfaction, and intention to stay, with mean scores of 3.85, 3.25, and 3.47, respectively. The professional identity displayed positive indirect effect on nurses' intention to stay through job satisfaction (indirect effect = 0.498, 95% CI [0.439, 0.558]).

CONCLUSION

Cultivating professional identity among nurses can increase their job satisfaction and ultimately enhance the intention to stay in the nursing profession. However, this study also suggests paying more attention to job satisfaction to keep nursing retention. These may be helpful to retain the nursing workforce.

Experience of clinical nurses engaged in caring for patients with COVID-19: A qualitative systematic review and meta-synthesis

AIMS AND OBJECTIVE

This qualitative review summarises and synthesises the available evidence on subjective experiences of clinical nurses who cared for patients with COVID-19.

BACKGROUND

Nurses are first responders and play a vital role in emerging infectious disease epidemics such as the COVID-19 pandemic. In this context, they also face many difficulties and challenges related, for example to the imbalance between extensive demands and low control over work tasks.

DESIGN AND METHOD

A systematic review of qualitative studies and meta-synthesis focused on the experiences of clinical nurses caring for patients with COVID-19 during the pandemic was carried out.

RESULTS

A total of 279 findings were extracted, aggregated into 21 categories and combined into seven synthesised findings, namely (1) professional nursing practice during the pandemic, (2) support systems, (3) somatic sensations and psychological experiences, (4) difficulties and challenges, (5) coping strategies and behaviour, (6) impact on life, profession and values, and (7) needs and expectations for the future.

CONCLUSION

Nurses encountered considerable difficulties and challenges in caring for patients with COVID-19. Nurses caring for patients with COVID-19 need more support from organisations, families and society. It is essential to explore positive coping strategies suitable for working in different cultural backgrounds. Policymakers and decision-makers should pay attention to the experiences and voices of nurses.

RELEVANCE TO CLINICAL PRACTICE

It is critical for nurse managers to consider how to enhance the support system and help nurses develop adaptive coping strategies in response to COVID-19. Nurses' experiences and voices are valuable in improving health emergency response systems.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.

Workplace violence against nursing interns and patient safety: The multiple mediation effect of professional identity and professional burnout

BACKGROUND

Most nursing interns have suffered some form of workplace violence in clinical settings, which has been linked to the jeopardizing of patient safety. Although previous research studies have examined the effect of workplace violence on patient safety, few studies have examined whether workplace violence is associated with patient safety through professional identity and professional burnout among nursing interns.

AIMS

To test whether professional identity and professional burnout play mediating roles in the relationship of workplace violence and patient safety among nursing interns.

DESIGN

Cross-sectional study.

METHODS

The study included 466 nursing interns from three tertiary grade A hospitals. The Workplace Violence Scale, the Professional Identity Scale, the Maslach Burnout Inventory-General Survey, and the Patient Safety Behaviour Scale were used to gather data. Associations among workplace violence, professional identity, professional burnout, and patient safety were assessed by correlation and the serial-multiple mediation analysis.

RESULTS

Workplace violence, professional identity, professional burnout and patient safety were significantly correlated. Workplace violence can have a direct positive impact on patient safety of nursing interns, but also an indirect impact on patient safety through three paths: the independent mediating role of professional identity, the independent mediating role of professional burnout, and the chain mediating role of professional identity and professional burnout.

CONCLUSIONS

Our findings suggest that workplace violence can affect patient safety through decreasing professional identity and increasing professional burnout among nursing interns. Interventions aimed at decreasing workplace violence among nursing interns would be beneficial for professional attitude and patient safety.

The impact of caring for COVID-19 patients on nurse professional identity: A cross-sectional study using propensity score analysis

Objective

To examine the impact of caring for COVID-19 patients on the professional identity of nurses.

Methods

An online survey was conducted between 19 May and 7 August 2020 in 11 Chinese cities, including Dongguan, Foshan, Guangzhou, Hong Kong, Huizhou, Jiangmen, Macao, Shenzhen, Zhaoqing, Zhongshan, and Zhuhai. Propensity score matching was used to adjust for confounding variables between nurses with and without experience caring for COVID-19 patients. To analyze the impact of caring for COVID-19 patients on nurses' professional identity, a nominal logistic regression model was used rather than an ordinal regression model because the parallel regression assumption was violated.

Results

After propensity score matching, the final sample contained 1,268 participants, including 634 nurses who cared for COVID-19 patients. During the COVID-19 outbreak, 88.6% of nurses had high levels of professional identity. Nurses who cared for COVID-19 patients had the lowest percentage of high score level on the professional identity subscale for "sense of organizational influence," as did nurses who did not care for COVID-19 patients. The findings indicated that nurses who cared for COVID-19 patients were 17.95 times more likely to have a high professional identity than a low professional identity (95% CI 2.38-135.39, p = 0.005), after completely controlling for the other factors. There were significant differences between nurses who cared for COVID-19 patients and those who did not in scores on the subscales of professional identity, except for the subscales "sense of self-decision-making" (χ² = 4.85, p = 0.089) and "sense of organizational influence" (χ² = 4.71, p = 0.095).

Conclusion

Nurses' professional identity is positively impacted by their experience caring for COVID-19 patients. Caring for COVID-19 patients should be highlighted as an opportunity to enhance nurses' professional identity. To further enhance the professional identity of nurses, we call for visible nursing leadership during the COVID-19 pandemic and improve their working environment.

Factors influencing caring behaviour among registered nurses during the COVID-19 pandemic in China: A qualitative study using the COM-B framework

AIM

The aim of this work is to explore the influencing factors of nurses' caring behaviour during the COVID-19 pandemic based on the Capability, Opportunity, Motivation as determinants of Behaviour (COM-B) theoretical framework.

BACKGROUND

Nurse caring behaviour is vital to reduce and speed up the healing process of COVID-19 patients. It is important to understand the factors that influence caring behaviour among nurses during the COVID-19 pandemic. Research suggests that when it comes to understanding behaviour, using a theoretical framework is likely to be most effective, and the COM-B framework is a recommended approach.

METHODS

Semistructured interviews with 42 nurses working in 11 Chinese cities were conducted, and their verbatim statements were transcribed and analysed using thematic analysis. The results were mapped to COM-B framework.

RESULTS

Ten key themes emerged: Capability (professional knowledge and skills, emotional intelligence, cross-cultural care competence); opportunity (resources, organizational culture, social culture); motivation (past experience, character, role, beliefs).

CONCLUSIONS

Ten factors were found to influence nurses' caring behaviour. This study added two new influencing factors, social culture and past experiences, that further contributed to the understanding of nurses' care behaviours.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurses' caring behaviour is influenced not only by themselves but also by institutions and society, so interventions aiming to improve their caring behaviour should consider these elements. The negative impact of the pandemic on capability factors that influence nurses' caring behaviour should be counteracted as soon as possible.

Individual factors in dignified care: a cross-sectional study of critical care nurses

AIM

To determine the level of dignified care provided by critical care nurses and to explore the associated individual factors.

BACKGROUND

Dignity is a fundamental right of human beings. Critically ill patients are dependent on nurses. Their need for respect and dignity is liable to be neglected in intensive care unit settings. Both critically ill survivors and dying patients suffer mental anguish due to loss of dignity.

METHOD

This was a cross-sectional study of 526 critical care nurses working at intensive care units for adults in Zhejiang Province, China. Data were collected from February 2021 to May 2021 using the Intensive Care Unit Dignified Care Questionnaire, Wong and Law Emotional Intelligence Scale, Jefferson Scale of Empathy-Health Professional, Nurses Professional Values Scale-Revised.

RESULTS

The total score of dignified care was 67.37 (8.83), with the standard score as 74.07 (12.99). Participants who performed poorly in absolute and relative dignity accounted for 8.4% and 31.2% of the total sample, respectively. Emotional intelligence (β = 0.379, p < .001), empathy (β = 0.319, p < .001), professional values (β = 0.147, p < .001), age (β = 0.075, p = .003), and training in dignified care (β = 0.074, p = .010) were associated with dignified care, explaining 67.6% of the variance.

CONCLUSION

The average level of participants' behaviors of maintaining patient dignity was medium. Critical care nurses need to improve their ability to maintain relative dignity of patients. Emotional intelligence, empathy, professional values, age level, and training in dignified care were predictors of dignified care.

IMPLICATIONS FOR NURSING MANAGEMENT

Improving emotional intelligence, empathy, and professional values of critical care nurses and training them (especially less experienced nurses) will enhance their ability in dignified care. This study provides a novel perspective to help nursing managers develop interventions to promote humanized care in the intensive care unit.

Impact of the COVID-19 Pandemic on the Professional Identity of Massage Therapists: The Reporting of a Quantitative Strand of a Mixed-Methods Study

Introduction: In late 2019, a pathogen outbreak occurred that rapidly spread, resulting in the coronavirus disease 2019 (COVID-19) global pandemic. Governments responded to the pandemic with a range of strategies, including forced quarantines and nationwide lockdowns. Research on professional identity during the pandemic has predominately focused on health care providers declared as "essential" rather than "nonessential." In this study, the authors examine the impacts on the professional identity of massage therapists (MTs) who were predominately deemed as nonessential health care providers during the COVID-19 pandemic. Materials and methods: An online, questionnaire-based study sought to answer "In what ways has the professional identity of MTs in Canada and Australia been impacted by the COVID-19 global pandemic?" MTs in Canada and Australia were recruited using convenience sampling through e-mail and social media. A questionnaire was developed and pilot tested before implementation. Results: Six hundred and forty-nine MTs participated (329 from Canada and 316 from Australia). Known constructs of professional identity that were affected during the pandemic included not feeling respected as a health care practitioner, feeling less professional than other health care providers, and experiencing burnout. New constructs that may have developed out of the pandemic and the measures established to manage them included being classified as nonessential and feeling a sense of camaraderie and belonging. Conclusions: This study is the first of its kind to report the impact of the COVID-19 pandemic on the professional identity of MTs. The emerging constructs reported will be used to create interview questions for the subsequent qualitative strand of this explanatory mixed-methods study. In the qualitative study, respondents will be invited to share their experiences with their own voice to further the understanding of the impact of the COVID-19 pandemic on MTs' professional identity.

Professional Self-Concept and Self-Confidence for Nurses Dealing with COVID-19 Patients

PURPOSE

To identify the impact of dealing with COVID-19 patients in clinical areas on nurses' professional self-concept and self-confidence.

BACKGROUND

Professional self-concept is considered a critical factor in the recruitment/retention process in nursing, nursing shortage, career satisfaction, and academic achievements. Professional self-confidence is also a crucial determinant in staff satisfaction, reducing turnover, and increasing work engagement.

DESIGN

Descriptive, comparative study.

METHODS

The study was conducted between February to May 2021 by utilizing a convenience sampling technique. A total of 170 nurses from two facilities were recruited from two COVID-19- and non-COVID-19-designated facilities. The level of professional self-concept and self-confidence was assessed by utilizing the Nurses' Self-Concept Instrument and Self-Confidence Scale.

RESULTS

The professional self-concept level among the group exposed to COVID-19 patients was lower than the comparison group, while the professional self-confidence level among the exposed group to COVID-19 patients was similar to the comparison group. On the other hand, the satisfied staff and those who received professional training in dealing with COVID-19 patients reported a higher level of professional self-concept.

CONCLUSIONS

Dealing with COVID-19 patients has an impact on professional self-concept; the exposure group was lower than those who did not deal with COVID-19 patients, while the professional self-confidence level among the exposed group was similar to the comparison group. Getting professional training in dealing with COVID-19 patients and being satisfied at work were significant factors in improving professional self-concept. Policymakers should create strategies that target the improvement of professional training in dealing with COVID-19 patients.

Registered Nurse’s Perception on Nursing Brand Image during the COVID-19 Pandemic Era in Indonesia

BACKGROUND: Coronavirus disease 2019 (COVID-19) has changed the image of nursing globally. However, the nursing brand image remains limited to explore among registered nurses during the COVID-19 pandemic era in Indonesia. AIM: This study aims to explore registered nurse’s perception of nursing brand image in Indonesia during the COVID-19 pandemic era. METHODS: The descriptive qualitative study was conducted using purposive sampling technique. This study enrolled 15 registered nurses who cared for COVID-19 patients. The semi-structured interview was conducted face-to-face within 45–60 min through WhatsApp video calls. Colaizzi’s methods and NVivo 12TM Plus were used for data analysis. RESULTS: The data analysis revealed five themes, namely, (1) Caring as a nursing brand image; (2) Interprofessional collaboration culture; (3) Providing 24-h holistic care; (4) Being more respected; (5) Becoming a long-life learner. CONCLUSION: During COVID-19 pandemic era, nurses perceived that nursing brand image becomes more positive in Indonesia.