Relationship between job demands, work engagement, emotional workload and job performance among nurses: A moderated mediation model.

AIM: To explore the mediating effect of work engagement and the moderated mediating effect of emotional workload on the relationship between job demands and job performance among nurses. BACKGROUND: Nurses work in a high-demand situation that could affect their job performance. However, previous studies have reported an inconsistent relationship between job demands and job performance. The underlying mechanism of how job demands influence job performance remains unclear. METHODS: An online cross-sectional survey was conducted with a convenience sample of 893 nurses from 14 cities in Sichuan Province between November and December 2021. Data were collected using the Job Demands Scale, Job Performance Scale, Utrecht Work Engagement Scale, and emotional workload subscale of the Questionnaire on the Experience and Evaluation of Work. Bootstrap and simple slope methods were used to test a moderated mediation model using Hayes' PROCESS macro. The STROBE reporting guidelines were utilized. RESULTS: Job demands had a positive effect on job performance, and this effect was mediated by work engagement. Emotional workload moderated the indirect relationship between job demands and job performance. Specifically, the positive effect of job demands on job performance via work engagement was attenuated in nurses with a high emotional workload. CONCLUSION: This study sheds light on the complex relationship between job demands and job performance. Work engagement and emotional workload deserve more attention to improve nurses' performance. IMPLICATIONS FOR NURSING AND NURSING POLICY: Policymakers and nurse managers should make efforts to develop and implement strategies to foster nurses' work engagement, reduce their emotional workload, and further help nurses efficiently deal with job demands.

Factors influencing early mobilisation for patients undergoing pancreatic surgery from multiple perspectives: a qualitative descriptive study.

OBJECTIVES: Despite early mobilisation as a key component of enhanced recovery after surgery pathways for pancreatic surgery, the implementation of early mobilisation remains unsatisfactory. What factors influence the implementation of early mobilisation from the lens of all stakeholders is unclear. The aim of this study was to identify the influencing factors of early mobilisation in pancreatic surgery from the perspective of patients, family members and health professionals. DESIGN: A qualitative descriptive design using individual interviews and focus groups. SETTING AND PARTICIPANTS: Twenty-two patients undergoing pancreatic surgery, 10 family members and 10 healthcare professionals from a large university teaching hospital in China. METHODS: We collected data on participants' views on factors influencing early mobilisation after pancreatic surgery. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis. RESULTS: Three main categories that influenced the implementation of early mobilisation in pancreatic surgery were identified: (1) attitude towards early postoperative mobilisation (eg, perceived advantages or disadvantages of early mobilisation), (2) subjective norm (eg, impact from health professionals, family members and fellow patients) and (3) perceived behavioural control (eg, knowledge, abilities, resources and environment). CONCLUSION: Factors influencing early mobilisation are diverse and multidimensional. The successful implementation of early mobilisation requires the dedication of both patients and healthcare professionals.

Development and Psychometric Evaluation of the Career Growth Scale for Nurses.

PURPOSE: The purpose of this study was to develop the career growth scale for nurses (CGSN) and evaluate its psychometric properties. METHODS: This study was conducted in four phases: (1) creating a pool of potential items through a qualitative design; (2) developing a preliminary scale using a modified two-round Delphi process; (3) refining the preliminary scale to finalize the scale using a cross-sectional survey; and (4) evaluating the psychometric properties of the final scale using another cross-sectional survey. A sample of 858 registered nurses from 12 general hospitals was recruited for this study. RESULTS: The final scale consisted of 17 items categorized into three factors: career goal progress, professional ability and attribute improvement, and career promotion and prestige increase. The three factors accounted for 75.4% of the observed variance in career growth. The overall Cronbach's α was .96, and the intraclass correlation coefficient was .92. The content validity index was .97. Confirmatory factor analysis showed acceptable model fitness. CONCLUSIONS: These results showed that the CGSN has good psychometric properties and can be used to evaluate specific career growth among nurses. This new instrument can further help nurse managers and clinical nurses themselves assess career growth and identify unsatisfactory aspects of growth, thereby designing tailored training programs and evaluating the effectiveness of such interventions.

Adherence, belief, and knowledge about oral anticoagulants in patients with bioprosthetic heart valve replacement: a cross-sectional study.

Aims: To investigate adherence to oral anticoagulants among patients after mechanical heart valve (BHV) replacement and further examine the mediating role of medication belief in the relationship between knowledge and medication adherence. Background: The number of patients who undergo BHV replacement has increased in recent years. Short-term anticoagulant therapy is recommended for patients after BHV replacement. However, little is known about adherence to oral anticoagulant therapy and the underlying mechanisms among patients with BHV replacement. Methods: A cross-sectional study was conducted between September 2022 and November 2022. A convenience sample of 323 patients who underwent BHV replacement was recruited from a tertiary public hospital in Southwest China. Data were collected by using the 8-item Morisky Medication Adherence Scale, Beliefs about Medicines Questionnaire-specific, and the Knowledge of Anticoagulation Questionnaire. The mediation model was tested by Hayes's PROCESS macro. The STROBE checklist was used. Results: Approximately 17.3% of participants had low adherence, 47.1% had medium adherence, and only 35.6% reported high adherence to oral anticoagulants. Knowledge and necessity beliefs were positively related to medication adherence, while concern beliefs were negatively correlated with medication adherence. Medication belief mediated the relationship between knowledge and adherence to oral anticoagulants. Conclusion: Patients with BHV replacement demonstrated relatively low adherence to oral anticoagulant therapy. Efforts to enhance medication adherence should consider improving patients' knowledge and medication beliefs.

The relationship between work practice environment and work engagement among nurses: The multiple mediation of basic psychological needs and organizational commitment a cross-sectional survey.

Background: Previous researchers have demonstrated that the work practice environment influences nurses' engagement; however, few studies have explored the mechanisms that explain the links between them. Objectives: To examine whether basic psychological needs and organizational commitment mediate the relationship between the work practice environment and work engagement. Methods: A cross-sectional survey was conducted with a sample of 893 nurses from 14 cities in Sichuan Province of China between November 2021 and December 2021. Data were collected online using the Chinese version of the Practice Environment Scale of the Nursing Work Index, Basic Needs Satisfaction in General Scale, Organizational Commitment Scale, and Utrecht Work Engagement Scale. The Pearson correlation analysis and multiple mediation model were used to analyze the data. Results: The Pearson correlation analysis showed that work practice environment, basic psychological needs, and organizational commitment were positively associated with work engagement. The positive relationship between work practice environment and work engagement was mediated by basic psychological needs and organizational commitment [B = 0.505, SE = 0.032, 95% CI (0.442, 0.566)]. Conclusions: The study substantially contributes to the existing knowledge by revealing the mechanisms of fostering work engagement among nurses and explaining why the work practice environment influences work engagement.

The mediating role of psychological needs on the relationship between perceived organizational support and work engagement.

AIM: To examine the mediating effect of basic psychological needs on the relationship between perceived organizational support and work engagement among nurses. BACKGROUND: The satisfaction of basic psychological needs is crucial for breeding and sustaining individuals' intrinsic motivation. Little is known about the underlying motivational mechanisms that explain the relationship among perceived organizational support, basic psychological needs, and work engagement in a nursing context. METHODS: This was a cross-sectional online survey. A sample of 858 nurses from 12 hospitals was surveyed on their perceived organizational support, basic psychological needs, and work engagement. Structural equation models and bootstrapping methods were used to examine the hypotheses. STROBE reporting guidelines were utilized. RESULTS: Perceived organizational support was positively associated with basic psychological needs and work engagement. Basic psychological needs were positively associated with work engagement. Basic psychological needs mediated the relationship between perceived organizational and work engagement. CONCLUSION: Perceived organizational support may enhance work engagement by fulfilling the basic psychological needs of nurses. IMPLICATIONS FOR NURSING AND NURSING POLICY: Basic psychological needs deserve more attention in nursing organizations. Managers should seek optimal strategies to fulfill nurses' needs for autonomy, competence, and relatedness to stimulate their intrinsic motivation to enhance work engagement.

Nurses' perceptions of career growth: A qualitative descriptive study.

AIMS: To explore nurses' experiences and perceptions of career growth and its influencing factors, as career growth is more closely associated with individual attitudes and behaviours in the new career era. DESIGN: A qualitative descriptive design was used. METHODS: Thirty-one nurses from 10 secondary and 8 tertiary hospitals in Sichuan Province of China were purposively selected to participate in this study. The data were collected using individual semi-structured face-to-face interviews. Two researchers independently reviewed the transcripts and emergent coding. The data were analysed using qualitative content analysis. FINDINGS: The nurses' perceptions of career growth fully described the nurses' experience and occurred in five dimensions: career promotion, career goal progress, professional ability and quality improvement, professional identity development and increase in personal prestige. The factors influencing career growth were identified at the organizational, individual and social levels. Career growth in nursing was complex, changed over time and showed several specific characteristics compared with other careers. The nurse-specific symbol of career growth was professional identity development, which reflected career progression characteristics. CONCLUSIONS: Career growth is a multi-dimensional concept with varying influencing factors. The meaning of career growth for nurses is distinct from that for employees in other careers. IMPACT: Nursing managers should guide nurses to comprehensively assess their career growth from multiple perspectives, and professional identity development deserves more attention. Both organizations and individuals should take responsibility for career management to pursue career growth.

Effects of mindfulness-based intervention on glycemic control and psychological outcomes in people with diabetes: A systematic review and meta-analysis.

AIMS/INTRODUCTION: Psychological therapies have showed benefits for both glycemic control and psychological outcomes in people with diabetes. However, the effects of mindfulness-based intervention (MBI) on glycemic control and psychological outcomes are inconsistent across studies, and the evidence for MBI has not been summarized. We aimed to identify the effects of MBI on glycemic control and psychological outcomes in people with diabetes by carrying out a systematic review and meta-analysis. MATERIALS AND METHODS: Six databases (Pubmed, Embase, CINAHL, Cochrane, Web of science and PsycINFO) were searched from inception to October 2019. Randomized controlled trials of MBI for people with type 1 and type 2 diabetes were included. Two authors independently extracted relevant data and assessed the risk of bias, with a third reviewer as arbitrator. Subgroup analyses and sensitivity analyses were also carried out. RESULTS: Eight studies with 841 participants met the eligibility criteria. Meta-analysis showed that MBI can slightly improve glycosylated hemoglobin (HbA1c; -0.25%, 95% confidence interval [CI] -0.43 to -0.07) and diabetes-related distress (-5.81, 95% CI -10.10 to -1.52) contribute to a moderate effect size in reducing depression (standardized mean difference -0.56, 95% CI -0.82 to -0.30) and stress (standardized mean difference -0.53, CI -0.75 to -0.31). Subgroup analyses showed greater HbA1c reductions in subgroups with baseline HbA1c levels <8% and follow-up duration >6 months. Mixed effects were observed for anxiety. CONCLUSIONS: MBI appears to have benefits on HbA1c, depression, stress and diabetes-related distress in people with diabetes. More rigorous studies with longer follow-up duration are warranted to establish the full potential of MBI.

[Effects of Nurse-Led Team Management on Type 2 Diabetes Patients in the Community].

BACKGROUND: Managing increasing numbers of diabetic patients is placing increasing pressure on healthcare providers, especially general practitioners, who usually serve in multiple roles. This situation has caused generally poor results in terms of diabetes management. However, community nurses in some countries have successfully and effectively controlled chronic diseases among their patients. Therefore, the effects of nurse-led management is worth further exploration in order to better understand and promote this mode of care. PURPOSE: To explore the effects of community-nurse-led team management on diabetes patients. METHODS: An experimental research design was adopted. Patients with type 2 diabetes were recruited from two community health centers (the first for the intervention group, the second for the control group) in Wuhou District, Chengdu City, China. The intervention group received nurse-led team management care for 2 years, while the control group received standard care. The evaluations were conducted before the intervention and at 6, 12, and 24 months into the intervention. Outcomes included glycosylated hemoglobin (HbA1c) level, body mass index, waist circumference, visual acuity, ankle brachial index, kidney function index, urinary protein level, and electrocardiogram. RESULTS: The 179 participants included 88 in the intervention group and 91 in the control group. After the intervention, HbA1c level, ankle brachial index, and waist circumference were all significantly better in the intervention group than in the control group (F = 28.894, p < .01; F = 4.065, p < .01; F = 5.540, p < .01). The other outcome variables remained statistically similar between both groups throughout the study period. CONCLUSIONS: Community nurse-led team management is an effective mode of care in terms of controlling blood glucose control and preventing diabetes-related complications.