Posttraumatic growth and its associations with perceived stress and core beliefs in women after traumatic childbirth during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic added new challenges and stressors to the childbirth period, potentially increasing the risk of traumatic childbirth experiences. There is little known about posttraumatic growth (PTG) in a childbearing population. This study describes PTG in women after traumatic childbirth during the COVID-19 pandemic and its association with sociodemographic, birth-related characteristics, traumatic childbirth events, perceived stress, and core beliefs, as well as explores what factors predict PTG. METHODS: A cross-sectional study was conducted with 202 women who self-identified as having experienced traumatic childbirth. Measures included sociodemographic and birth-related characteristics, traumatic childbirth events, self-reported stress during childbirth, the PTG Inventory, and the Core Beliefs Inventory (CBI). RESULTS: Perceived stress at the time of birth was very high in 70% of the respondents. CBI showed moderate disruption of core beliefs. 41.6% of mothers indicated substantial PTG. Education and type of birth were related to perceived stress levels; higher disruption of core beliefs was observed in individuals who experienced perineal trauma and lack of partners' presence during childbirth, and higher disruption of core beliefs was positively associated with PTG. Predictive models showed that perceived stress had a minimal effect, while the disruption of core beliefs showed a significant positive association with PTG. CONCLUSION: Traumatic childbirth experiences during the COVID-19 pandemic were positively related to PTG. Health professionals should create an environment where women can explore their feelings and emotions. Changes in current practices are also necessary as cesareans have been shown to be highly associated with high levels of perceived stress.

Translation and Validation of the City Birth Trauma Scale With Lithuanian Postpartum Women: Findings and Initial Results.

The childbirth experience and birth-related trauma are influenced by various factors, including country, healthcare system, a woman's history of traumatic experiences, and the study's design and instruments. This study aimed to validate the City Birth Trauma scale for Lithuanian women post-childbirth. Using a descriptive, cross-sectional survey with a nonprobability sample of 794 women who gave birth from 2020-2021, the study found good validity, reliability, and presented the prevalence of birth-related stress symptoms. A bifactor model, consisting of a general birth trauma factor and two specific factors for birth-related symptoms and general symptoms of PTSD, showed the best model fit. The Lithuanian version of the City Birth Trauma scale can be effectively used in research and clinical practice to identify birth-related trauma symptoms in women after giving birth.

Key dimensions of women's and their partners' experiences of childbirth: A systematic review of reviews of qualitative studies.

BACKGROUND: The World Health Organization 2018 intrapartum guideline for a positive birth experience emphasized the importance of maternal emotional and psychological well-being during pregnancy and the need for safe childbirth. Today, in many countries birth is safe, yet many women report negative and traumatic birth experiences, with adverse effects on their and their families' well-being. Many reviews have attempted to understand the complexity of women's and their partners' birth experience; however, it remains unclear what the key dimensions of the birth experience are. OBJECTIVE: To synthesize the information from reviews of qualitative studies on the experience of childbirth in order to identify key dimensions of women's and their partners' childbirth experience. METHODS: Systematic database searches yielded 40 reviews, focusing either on general samples or on specific modes of birth or populations, altogether covering primary studies from over 35,000 women (and >1000 partners) in 81 countries. We appraised the reviews' quality, extracted data and analysed it using thematic analysis. FINDINGS: Four key dimensions of women's and partners' birth experience (covering ten subthemes), were identified: 1) Perceptions, including attitudes and beliefs; 2) Physical aspects, including birth environment and pain; 3) Emotional challenges; and 4) Relationships, with birth companions and interactions with healthcare professionals. In contrast with the comprehensive picture that arises from our synthesis, most reviews attended to only one or two of these dimensions. CONCLUSIONS: The identified key dimensions bring to light the complexity and multidimensionality of the birth experience. Within each dimension, pathways leading towards negative and traumatic birth experiences as well as pathways leading to positive experiences become tangible. Identifying key dimensions of the birth experience may help inform education and research in the field of birth experiences and gives guidance to practitioners and policy makers on how to promote positive birth experiences for women and their partners.

Posttraumatic growth in women after a childbirth experience: The influence of individual characteristics and intrusive and deliberate rumination.

OBJECTIVE: This study targets women who had a self-defined traumatic childbirth experience to (a) explore the differences between sociodemographic-, obstetric-, and trauma-related variables in relation to the rumination style; (b) determine differences between intrusive and deliberate rumination in relation to posttraumatic growth (PTG) dimensions, and (c) test whether intrusive rumination is associated with deliberate rumination, which in turn is associated with PTG dimensions. METHOD: A cross-sectional study design was employed using a web-based survey method for data collection. In total, 202 women who identified their childbirth experience as traumatic participated in this study. RESULTS: Intrusive rumination and deliberate rumination were positively associated with all dimensions of PTG in women following the traumatic childbirth event. Deliberate rumination fully explained the relationship between intrusive rumination and PTG aspects of relating to others, new opportunities, and personal strength, and partially explained the relationship between intrusive rumination and PTG aspects of spiritual changes and appreciation of life. CONCLUSIONS: The results suggest that deliberate rumination can contribute to explain the occurrence of PTG. These findings could help develop psychosocial interventions to maximize opportunities for deliberate rumination for women with traumatic childbirth experiences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Spiritual Well-Being and Related Factors in Children With Cancer.

Introduction: There are specific gaps that call for empirical research in the experiences of spiritual well-being among children 12 years old and younger with cancer. Understanding these relationships can help to develop holistic and family centered care in pediatric oncology wards. This study assessed the spiritual well-being of children with cancer in association with their general well-being, happiness, quality of life, pain intensity, and personal characteristics. Method: The data were collected in Lithuania between June 2020 and November 2021. Children with cancer (N = 81) who were hospitalized at pediatric oncology-hematology centers participated in the study. Inclusion criteria were age (from 5 to 12 years old), diagnosis of oncologic disease for the first time, and absence of other chronic diseases. The instruments used were: Feeling Good, Living Life; Oxford Happiness Questionnaire, Short Form; Well-Being Index; PedsQL™3.0 Cancer Module, and a Wong-Baker FACES® Pain Rating Scale. Results: Communal and personal domains of spiritual well-being had the highest scores among pediatric oncology patients while both dimensions of the transcendental domain scored lowest. Age, level of education, and family composition revealed differences in children's spiritual health, happiness, and well-being, and church attendance was significant for overall spiritual well-being and its transcendental domain on lived experience dimension. Happiness had the strongest effect on all four domains of spiritual well-being. Discussion: Children emphasized the importance of spiritual aspects to feel better to a greater extent than they experienced in their lives. Despite their young age, children were familiar with family traditions, that is, religious practice and church attendance, and followed them in a particular sociocultural context.

Mentors' cultural competence at mentoring culturally and linguistically diverse nursing students in clinical practice: An international cross-sectional study.

AIMS: This study aimed to identify mentors' cultural competence profiles at mentoring culturally and linguistically diverse nursing students in clinical practice and explore associating factors. BACKGROUND: Globalization has had a significant impact on healthcare, increasing the diversity of healthcare workforces and the number of culturally and linguistically diverse nursing students in clinical practice. The cultural competence of mentors is important to secure students' safe and successful learning. The mentor role in clinical practice contributes toward enabling and ensuring students' high-quality and goal-oriented development of competence. DESIGN: This study implemented a cross-sectional design with a final sample of 270 clinical practice mentors from Finland, Lithuania, Spain and Slovenia. METHODS: The data were collected using an online survey including the Mentors' Cultural Competence Instrument, Mentors' Competence Instrument and background questions during 2020-2021. The data were analyzed using a K-mean cluster algorithm to identify mentors' competency profiles. RESULTS: Three significantly differing mentor competency profiles (Profile A 42%, Profile B 41%, Profile C 17%) were identified in this study. The cultural competence of the mentors in clinical practice varied between intermediate and high levels. Mentors rated their cultural competence as best in the area of cultural sensitivity and awareness, whereas the lowest scored area was cultural interaction and safety. CONCLUSIONS: This study showed that the cultural competence of mentors in clinical practice varied and was influenced by mentors' work experience, age, job title and frequency of mentoring. This study provides new knowledge that could help to develop cultural competence operating models and education to enhance the cultural competence of healthcare professionals.

Spiritual lives of children with cancer: A qualitative descriptive study in Lithuania.

PURPOSE: To explore the experience and perception of spiritual lives of children with cancer. DESIGN AND METHODS: A qualitative descriptive study included the collection of narratives on spiritual lives of children drawn from two university hospitals in Lithuania in the form of a semi-structured face-to-face interviews. Purposive sample of twenty-seven hospitalized children (5-12 y.) with non-terminal stage of cancer participated in the study. RESULTS: The final four themes emerged from across all the questions as: being normal, community, comfort and connections with God. CONCLUSIONS: Children with cancer needed to maintain as normal a life as posssible, despite being ill and undergoing treatment. Connections with family and friends were echoed in all the themes that emerged in the study. Children seemed to own their views about needing to pray or not; their needs revolved around asking for health and remission of their illness. Children diagnosed with cancer have a unique understanding of spirituality that is linked to their age, gender, and family composition. These ideas change as children develop and mature. PRACTICAL IMPLICATIONS: The need to explore the spiritual lives of children with life threatening illnesses from an early age is evident. Health professionals need to recognize that a child is the product of their family, their community, their culture and their spirituality. Conversations with children about what God means to them and how prayer supports them, is essential. The opinion that spirituality topic might be hardly understood or too sensitive to children is rejected by the researchers.

Individualized care for older adults with diabetes and its relationship with communication, psychosocial self-efficacy, resources and support for self-management and socio-demographics.

AIM: To examine the relationship between patient-provider communication, psychosocial patient self-efficacy, resources and support for self-management and socio-demographics within individualized care of older adults with diabetes. DESIGN: A quantitative study with a cross-sectional survey design. METHODS: Data were collected from September 2019 to January 2021 using: Individualized Care Scale, The Communication Assessment Tool, The Diabetes Empowerment Scale and The Resources and Support for Self-Management Scale. Patients with either Type 1 or Type 2 diabetes mellitus that were 65 years old and over (N = 145) participated in the study. RESULTS: The most positive aspects of patient-provider communication were respect and creating a comfortable environment for the patient. A significant relationship was observed between patients' perceptions and support of individualized care and diabetes-related measures. Effective communication was the main factor associated with support for individualizing care, and together with education level, empowerment and access to resources, explained 23% of the variance.

Dignity at the end of life: from philosophy to health care practice - Lithuanian case.

Regulation and clinical practices regarding end of human life care differ among the nations and countries. These differences reflect the history of the development of state health systems, different societal values, and different understandings of dignity and what it means to protect or respect dignity. The result is variation in the ethical, legal, and practical approaches to end-of-life issues. The article analyzes the diversity of strategies to strengthen dignity at the end of life of terminally ill patients and to highlight the legal preconditions and limitations for implementing these strategies in independent Lithuania, as a former state of the Soviet Union. It is based on the critical analysis of philosophical literature, legal national and international documents and scientific evidence related to the issue. The author argues that the legal system in Lithuania is not sufficient to ensure the patient's dignity at the end of life and remains far behind other Western European countries. Legal regulations in Lithuania do not guarantee the right of the patient to express his or her will regarding the future treatment, including the refusal of resuscitation, do not regulate the termination of burdensome, non-viable and meaningless treatment that is undesired by the patient, and limit the accessibility of palliative care with its necessary quality and comfort.

Mentoring of nursing students-A comparative study of Japan and five European countries.

AIMS: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan. METHODS: The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis. RESULTS: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring. CONCLUSION: Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses.

Mentors' competence in mentoring nursing students in clinical practice: Detecting profiles to enhance mentoring practices.

AIMS: To describe the mentoring competence of clinical practice nurse mentors and identify different mentor profiles. DESIGN: Cross-sectional research design, secondary analysis. METHODS: An international, cross-sectional study design was performed in five European countries. A total of 1 604 mentors from 33 healthcare organizations participated in the study between 2016-2019. The Mentors' Competence Instrument (MCI), which includes seven sub-dimensions and 44 items, was used to collect data. K-means cluster and binary regression analyses were performed to detect mentor profiles and determine how various factors affect competence, respectively. RESULTS: The K-means cluster analysis identified three distinct profiles: A (n = 926); B (n = 566); and C (n = 85). The profiles showed significantly different values (p < .001) across all seven areas of mentoring competence. In comparison with the other profiles, nurses in profile A were older, had more work experience and were more probably to have completed mentoring-specific training.

Predictors of missed infection control care: A tri-partite international study.

AIM: This study aimed to quantify types and frequencies of missed infection control care and to develop a theoretical model for estimating nurses' consensus scores about this form of missed care. DESIGN: A non-experimental research design using self-audit data was selected to collect information about the types and frequencies of missed infection control care from nurses employed in hospitals located in three different countries. Data collection commenced mid-year 2018. METHODS: A multivariate approach was used to apply the consensus scores of 1.911 internationally based nurses in the missed opportunities for maintaining infection control. RESULTS/FINDINGS: Thirteen variables exert direct effects on the nurses' total scores underpinning missed infection control care. These include the methods used to prevent hospital-acquired infections, surveillance and hand hygiene practices. Significant nurses' demographic factors also included their countries of origin, employment status, employer type, job retention intentions, work intensity, length of clinical experience and staff development attendance. CONCLUSION: In magnitude of importance and having the largest effect on missed infection control care is missed care related to reducing hospital-acquired infections followed closely by surveillance. Missed infection control care can be quantified, and variances in its practices can be accounted by exploring the nurses' differing demographic factors, including the nurses' country of origin. IMPACT: Variations in missed infection control care can be accounted for across three countries. While ward hygiene is underestimated by staff as a mechanism to minimize nosocomial infections, infection control surveillance remains the key to reducing hospital-acquired infections. The study's outcomes invite the use of an ongoing, whole-of-organization approach to infection control with scrutiny being needed for improved staff adherence particularly with hand hygiene.

Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers.

BACKGROUND: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient's clinical situation, personal life situation, and decisional control. METHODS: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. RESULTS: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals' perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients' ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals' and patients' samples, related to the personal life situation sub-scale. CONCLUSIONS: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients' understanding and experience of individuality in care.

Spiritual Wellbeing of Cancer Patients: What Health-Related Factors Matter?

This study aimed to determine the predictors of spiritual wellbeing of non-terminal stage cancer patients hospitalized in oncology units in Lithuania. An exploratory cross-sectional study design was employed. During structured face-to-face interviews, 226 cancer patients hospitalized in oncology units responded about their spiritual wellbeing, perception of happiness, satisfaction with life, pain intensity, levels of education and physical functioning, and length of inpatient stay. A set of standardized tools were used: spiritual wellbeing scale SHALOM, brief multidimensional life satisfaction scale, Oxford Happiness Questionnaire, Barthel Index questionnaire, and verbal pain intensity scale. Additionally, social- and health-related factors were included in data analyses. Structural equation modeling was adapted for a comprehensive assessment of the mediating effect of spiritual wellbeing on the relationship between different health- and value-related factors. The overall fit of the structural model was generally good: [Formula: see text] = 66.94 (χ2/df = 2.31), CFI = 0.94, RMSEA = 0.08, and SRMR = 0.06. Data were analyzed using the Statistical Package for Social Sciences (IBM SPSS Statistics) version 24.0 and Mplus version 8.2. Level of happiness, life satisfaction, and spiritual wellbeing scored in the moderate upper range. The communal domain of spiritual wellbeing rated with the highest mean score and transcendental domain with the lowest score. Education (b = 0.208, p = 0.004), physical functioning (b = 0.171, p = 0.025), and hospital duration (b = - 0.240, p = 0.001) were significant predictors of spiritual wellbeing. Happiness and life satisfaction were negatively influenced by pain intensity, which ranged from mild to moderate. Levels of education, physical functioning, and length of hospital stay predict spiritual wellbeing of non-terminally ill cancer patients. Happiness, as well as life satisfaction, was negatively predicted by pain intensity but had no direct influence on spiritual wellbeing of cancer patients. Spiritual wellbeing positively influences emotional wellbeing (happiness and life satisfaction), and its influence is stronger than the negative influence of physical pain has on emotional wellbeing.

A SCOPING REVIEW: The role of the nurse manager as represented in the missed care literature.

AIM: To examine how the nurse manager role is represented in the literature on missed nursing care and what is known about the impact of the nurse manager on missed care levels. BACKGROUND: The literature to date on missed nursing care is focused primarily on structural and organizational antecedents, and on outcomes for patients, nurses and organizations. Very little research exists on the role of the nurse manager in relation to missed care. EVALUATION: A scoping review using studies from four databases was conducted in 2019. KEY ISSUES: Nurse managers have a role to play in relation to missed nursing care. Greater transparency around missed care, effective leadership skills and supportive relationships with staff can help reduce missed care. CONCLUSION: Nurse managers are ideally placed to influence levels of missed care. How they enact their leadership and management roles can help reduce incidents. By paying attention to nurses' concerns, managers may be better placed to understand levels of missed care. IMPLICATIONS FOR NURSE MANAGERS: Guidance for nurse managers on monitoring levels of missed care, and the skills required to influence levels within their units are necessary.

Perceptions of Clergy Regarding the Provision of Spiritual Care in Lithuanian Hospitals for Cancer Patients.

This paper presents an analysis of narratives drawn from research that examined the views of clergy in regard to the provision of spiritual care in Lithuanian hospitals. The purpose of this research was to examine the shared responsibilities between what nurses do in the provision of holistic care and that of the clergy who are employed to provide spiritual care. A thematic analysis was undertaken, guided by questions related to how spirituality was perceived by the clergy; how spiritual care was defined; clergy's perceptions to nurses' provision of spiritual care, and whether there was a delineation between these two roles. Findings showed that although the clergy believed that their role was important in the provision of spiritual care, both nurses and clergy acknowledged that both played a role in spiritual support. However, scope of practice for each role was not yet defined. For nurses and clergy to understand their roles and the boundaries between them, clear standards of practice need to be developed.

Mentors' self-assessed competence in mentoring nursing students in clinical practice: A systematic review of quantitative studies.

AIMS AND OBJECTIVES: To examine registered nurses' self-evaluation of their competence in mentoring nursing students in clinical practice. BACKGROUND: Clinical mentors have significant roles and responsibility for nursing students' clinical learning. Moreover, the mentors' role is becoming increasingly important internationally, as the role of nurse teachers in mentoring students in clinical practice has declined. However, in most EU countries there are no specific educational requirements for clinical mentors, although they need targeted education to increase their competence in mentoring nursing students. DESIGN: The systematic review of quantitative studies was designed according to guidelines of the Centre for Reviews and Dissemination and PRISMA protocol. METHODS: Studies published during 2000-2019 that met inclusion criteria formulated in PiCOS format were systematically reviewed by three independent reviewers. CINAHL (Ebsco), PubMed (MEDLINE), Scopus, ERIC and Medic databases were used to retrieve the studies. Three independent reviewers conducted the systematic review process. The studies were tabulated, thematically compared and narratively reported. RESULTS: In total, 16 peer-reviewed studies met the inclusion criteria. The studies identified various dimensions of mentors´ competence and associated environmental factors. Generally, participating mentors rated competences related to the clinical environment, mentoring, supporting students' learning processes and relevant personal characteristics fairly high. They also rated organisational practices in their workplaces, resources in the clinical environment and their mentor-student and mentor-stakeholder pedagogical practices, as respectable or satisfactory. CONCLUSION: The results indicate considerable scope for improving mentors' competence, particularly through enhancing organisational mentoring practices and relevant resources in clinical environments. RELEVANCE FOR CLINICAL PRACTICE: Pedagogical practices of mentors in relations with both students and stakeholders should be enhanced to improve future nurses' learning. This systematic review addresses a gap in knowledge of mentors' self-evaluated competence that could assist the formulation of effective educational programmes for mentors internationally and improving clinical environments.

Development and testing of an evidence-based model of mentoring nursing students in clinical practice.

BACKGROUND: Mentoring in clinical settings is an important factor in the development of nursing students' professional knowledge and competences, but more knowledge of mentors' current and required competences is needed to improve nursing students' clinical learning. OBJECTIVES: This study aimed to develop and test an evidence-based model of mentoring nursing students in clinical practice. DESIGN: An international cross-sectional survey coordinated in five European countries: Finland, Italy, Lithuania, Slovenia and Spain. METHODS: Mentors, 4980 registered nurses working in both primary and specialist healthcare organizations, were invited to participate in the study during 2016-2019. The final sample consisted of 1360 mentors (mean age 41.9 ± 11). Data were collected with background questions and the Mentor Competence Instrument. The instrument was psychometrically validated then the data were used to construct a Structural Equation Model (SEM) with Full Imputation Maximum Likelihood (FIML) estimation. RESULTS: All of six hypotheses were verified. In summary: mentors' characteristics related to their motivation and reflection are positively related to mentoring practices in the workplace, which (together with constructive feedback) are positively related to and foster goal-orientation in students' clinical learning and student-centered evaluation. All parameters in the SEM model were significant and the model's fit indexes were verified (RMSEA = 0.055; SRMR = 0.083; CFI = 0.914, TLI = 0.909). CONCLUSION: Our evidence-based modeling confirms the research hypotheses about mentorship, and identifies focal competences for designing mentors' education to improve students' clinical learning and establish a common European mentoring model. Mentorship is important for both healthcare organizations and educational systems to enhance students' clinical competences, professional growth and commitment to the nursing profession and organizational environments.

Spiritual needs and their association with indicators of quality of life among non-terminally ill cancer patients: Cross-sectional survey.

PURPOSE: The study addresses the spiritual dimension of care of non-terminally ill cancer patients by measuring their spiritual needs in association with indicators of quality of life (i.e., happiness, satisfaction with life, pain intensity, functional capacity) and personal and illness characteristics. METHOD: A descriptive, cross-sectional survey included 227 patients with cancer. All patients that underwent treatment at a nursing and supportive treatment unit were interviewed face-to-face between January and November 2018. Regression models were used to control for gender, education, religiosity, pain intensity, functional capacity, life satisfaction and happiness. RESULTS: The non-terminally ill cancer patients experienced the exceptional importance of Inner Peace and Giving/Generativity and Forgiveness, while Religious and Existential needs were scored marginally lower, but nevertheless much higher as compared to patients with cancer from West-Europe. Correlation analysis revealed strong positive and in one case moderate interconnections among each of four spiritual needs, with the strongest association between Existential needs and the other three domains. Unmet Religious needs were positively associated with pain intensity and reduced physical capacity of patients, but less with life satisfaction. Pain intensity was the strongest predictor of cancer patients' Existential, Inner Peace and Giving/Generativity and Forgiveness needs. CONCLUSION: This study provides the first empirical evidence about the spiritual needs of cancer patients' care in Lithuania. Findings will serve as the basis for specific strategies to enhance the holistic well-being of these patients. The insights into oncology patients' unmet spiritual needs may be relevant to other Eastern European and former Soviet Union countries with similar developmental histories.

Measuring the validity and reliability of the Lithuanian missed nursing care in infection prevention and control scales using Rasch analysis.

AIM: The aim was to translate and validate the Missed Nursing Care in Infection Prevention and Control Survey for its use in the Lithuanian context. METHODS: A convenience sample of 331 nurses was surveyed. The study instrument explored missed care in the context of infection prevention and control practices. Rasch analysis was undertaken using Winsteps® Rasch measurement computer program and the generalized item response modelling software. RESULTS: The Missed Nursing Care in Infection Prevention and Control Survey in the Lithuanian language demonstrated unidimensionality and provided evidence of item fit to the modified instrument. The reliability of both sub-scales was 0.78 and 0.98, respectively. Differing consensus between the nurses based on their perceived frequencies and reasons of missed care was demonstrated. CONCLUSIONS: The final Lithuanian version of the Missed Nursing Care in Infection Prevention and Control Survey consists of 29 items that assess type and frequency of missed care and 17 items that identify reasons for missed care. IMPLICATIONS FOR NURSING MANAGEMENT: Unit managers will be able to use the modified scales to generate evidence as to the sources of missed infection control practices in their clinical areas and the rationale for the breaks in the hierarchy of mandatory infection prevention.