Experiences and challenges of enrolled nurses undertaking a Bachelor of Nursing Science programme in Namibia.

BACKGROUND:  Globally, enrolled nurses (ENs) are embarking on an educational journey to become registered nurses (RNs) in order to enhance their knowledge and career opportunities. However, their aspiration is not without challenges. In Namibia, the experiences of these nurses have not been extensively researched. OBJECTIVES:  This study aims to explore and describe the experiences and challenges of ENs undertaking a Bachelor of Nursing Science at the University of Namibia. METHOD:  A qualitative, exploratory, descriptive and contextual research strategy was followed as the basis of conducting the study. A sample of 15 nursing students was purposively selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes. The collected data were analysed thematically using an inductive approach. RESULTS:  Three main themes subsequently emerged from the study: ENs' positive experiences advancing in the Bachelor of Nursing Science (BNSc) programme; nurses' negative experiences advancing in the BNSc programme; and recommendations to ensure effective advancement in the BNSc programmeConclusion: The findings of this study revealed that ENs positively experience becoming a RN when it comes to self-development; however, they have negative experiences such as not receiving exemptions for prior learning and having to learn a new curriculum.Contribution: These findings may be used by the Faculty of Health Sciences, School of Nursing and Public Health management in order to develop targeted interventions and ongoing strategies during their curriculum review cycles to ensure positive student experiences and success within the programme.

Association between body mass index and mental health among nurses: a cross-sectional study in China.

PURPOSE: To examine the correlation between body mass index (BMI) and mental well-being in Chinese nurses during the COVID-19 epidemic. METHOD: This study was conducted in a tertiary hospital using a cross-sectional design. A total of 2,811 nurses were enlisted at Shengjing Hospital in China during the period from March to April, 2022. Information was gathered through a questionnaire that individuals completed themselves. The mental health of the participants was assessed using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Assessment-7. Binary logistic regression was used to calculate adjusted odds ratios (ORs) and their corresponding 95% confidence intervals. RESULTS: The prevalence of nurses experiencing depression and anxiety was 7.8% (219) and 6.7% (189), respectively. Regarding depression after adjustment, the odds ratios (ORs) for each quartile, compared to the lowest quartile, were as follows: 0.91 (95% confidence interval [CI]: 0.53, 1.56), 2.28 (95% CI: 0.98, 3.77), and 2.32 (95% CI: 1.41, 3.83). The p-value for trend was found to be 0.001. The odds ratios (ORs) for anxiety after adjustment were 2.39 (0.83, 4.36), 4.46 (0.51, 7.93), and 2.81 (1.56, 5.08) when comparing the highest quartiles to the lowest quartile. The p-value for trend was 0.009. CONCLUSION: This study found a positive association between BMI and poor mental health among nurses during the COVID-19 pandemic, particularly in those who were overweight or obesity. The findings could assist in developing interventions and help policy-makers establish appropriate strategies to support the mental health of frontline nurses, especially those who are overweight or obesity.

Cell Phones in the OR: A Cross-Sectional Study of Norwegian Perioperative Nurses' Knowledge, Practice, and Attitudes.

Few studies have focused on the use of cell phones in the OR. In Norway, researchers sought to assess perioperative nurses' knowledge, practice, and attitudes associated with cell phone use in the OR and distributed a nationwide questionnaire via a social media platform. More than 80% of the 332 respondents thought that cell phones were contaminated and that pathogens could contaminate hands. Almost all respondents brought their phone to work; approximately 61% of respondents carried it in their pocket in the OR. Responses to questions about phone cleaning showed that 39 (11.7%) of the respondents routinely cleaned their phone before entering the OR and 33 (9.9%) of the respondents cleaned it when leaving the OR. Less than 20% of respondents indicated their facility had guidelines for cleaning personal cell phones. Opportunities for improvement in cell phone cleaning in ORs exist and additional research involving all perioperative team members is needed.

Development and validation of impact of early integration of palliative care and oncology(IEI PCO) questionnaire: a survey for medical oncologists and nurses.

OBJECTIVES: Many associations have recently recommended early integration of oncology and palliative care for more standard cancer care and better quality of life. We aimed to create a questionnaire to assess the opinion of medical oncologists and nurses about the clinical impact of the integrated palliative care and oncology (PCO) program. METHODS: A novel semi-structured questionnaire called Impact of Early Integration of Palliative Care Oncology (IEI PCO) questionnaire was developed and tested for validity and reliability then distributed to the oncologists and nurses working in Kuwait Cancer Control Center. RESULTS: After the pilot stage, testing the final questionnaire for validity and reliability was done with satisfactory results. Finally, the complete questionnaires were 170 out of 256 (response rate 66.41%). More awareness about the available palliative care services and the new available PCO services (p-value < 0.001 for all). Most of the oncologists and nurses agreed with the currently available structure of PCO, appreciated the patients' discharge plan and continuity of care of palliative medicine, admitted less work burden, a better attitude, and higher satisfaction (p-value for all < 0.001) toward palliative care. Significant improvements in symptoms were appreciated by oncologists and nurses after the integration of palliative care (p-value for all < 0.001. Oncologists and nurses valued repeated honest communication, discussion of the goals of care, dealing more effectively with ending active treatment, and higher acceptance of patients and families of PC policy of transfer, and significant progress in the care of end-of-life symptoms (p-value for all < 0.001). CONCLUSIONS: The IEI PCO questionnaire demonstrated the psychometric criteria for content, face, and construct validity and reliability. It provides a valuable tool to assess the impact of PCO integration. The opinion of medical oncologists and nurses was significantly positive toward the early integration of PCO in Kuwait in most aspects of care. This integration led to improved symptom control, end-of-life care, communication, and planned discharge and follow-up plans. Moreover, decreases the work burden, improves attitude, higher satisfaction of the oncology staff, and continuity of care.

Knowledge, attitude, and practice toward the prevention of occupational exposure in public health emergencies among nurses in Wuhan.

Background and objective: Nurses have an essential role in dealing with public health emergencies (PHE). This study explored the knowledge, attitude, and practice (KAP) towards preventing occupational exposure in PHE among nurses in Wuhan. Methods: This cross-sectional study was conducted in May 2023 to assess the KAP of nurses in Wuhan, China. Questionnaires were created and distributed to evaluate the KAP of nurses and explore the factors associated with KAP. Univariate and multivariate logistic regression analyses were used to assess the association between baseline demographic characteristics and KAP, and structural equation modeling (SEM) was used to explore complex relationships and causal pathways among relevant factors. Results: A total of 440 valid questionnaires were collected. The mean knowledge, attitude, and practice scores were 11.84 ± 2.37, 39.87 ± 3.10, and 44.05 ± 3.76, respectively. The univariate and multivariate logistic regression analyses revealed that age >50 years old (p = 0.039), working experience of 1-3 years (p = 0.060) and 4-6 years (p = 0.024), participation in PHE training, and scene rescue (p < 0.001) were significantly associated with knowledge score. In addition, the attitude of the nurses was significantly related to knowledge scores (p = 0.002). Moreover, practice was significantly associated with knowledge scores (p = 0.005) and attitude scores (p < 0.001). The correlation analysis showed that the practice was significantly associated with knowledge (r = 0.336, p < 0.001) and attitude (r = 0.449, p < 0.001). Conclusion: Nurses exhibited moderate knowledge, relatively positive attitude, and practice, which needed to be improved regarding occupational exposure in PHE. The practice of the nurses could be promoted by paying more attention to the working experience, participation in training and scene rescue in PHE, and their knowledge and attitude.

Ethnic disparities and temporal trends in health resource allocation: a retrospective decadal analysis in Sichuan, a multi-ethnic Province of Southwest China (2009-2019).

BACKGROUND: Research on health resource allocation trends in ethnic minority and impoverished areas in China is limited since the 2009 Medical Reform. This study aimed to investigate the variations and inequalities in health resource distribution among ethnic minority, poverty-stricken, and non-minority regions in Sichuan Province, a multi-ethnic province in Southwest China, from 2009 to 2019. METHODS: The numbers of beds, doctors and nurses were retrospectively sourced from the Sichuan Health Statistics Yearbook between 2009 and 2019. All the 181 counties in Sichuan Province were categorized into five groups: Yi, Zang, other ethnic minority, poverty-stricken, and non-minority county. The Theil index, adjusted for population size, was used to evaluate health resource allocation inequalities. RESULTS: From 2009 to 2019, the number of beds (Bedp1000), doctors (Docp1000), and nurses (Nurp1000) per 1000 individuals in ethnic minority and poverty-stricken counties consistently remained lower than non-minority counties. The growth rates of Bedp1000 in Yi (140%) and other ethnic minority counties (127%) were higher than in non-minority counties (121%), while the growth rates of Docp1000 in Yi (20%) and Zang (11%) counties were lower than non-minority counties (61%). Docp1000 in 33% and 50% of Yi and Zang ethnic counties decreased, respectively. Nurp1000 in Yi (240%) and other ethnic minority (316%) counties increased faster than non-minority counties (198%). The Theil index for beds and nurses declined, while the index for doctors increased. Key factors driving increases in bed allocation include preferential policies and economic development levels, while health practitioner income, economic development levels and geographical environment significantly influence doctor and nurse allocation. CONCLUSIONS: Preferential policies have been successful in increasing the number of beds in health facilities, but not healthcare workers, in ethnic minority regions. The ethnic disparities in doctor allocation increased in Sichuan Province. To increase the number of doctors and nurses in ethnic minority and poverty-stricken regions, particularly in Yi counties, more preferential policies and resources should be introduced.

Dietary inflammatory pattern and risk of hip fracture in the Nurses' Health Study.

Our immune system activity is impacted by what we eat and can influence fracture risk under certain conditions. In this article, we show that postmenopausal women with a pro-inflammatory dietary pattern have an increased risk of hip fracture. PURPOSE: The immune system influences bone homeostasis and can increase the risk of fracture under certain pro-inflammatory conditions. Immune system activity is impacted by dietary patterns. Using the empirical dietary inflammatory pattern (EDIP), we investigated whether postmenopausal women with a pro-inflammatory dietary pattern had an increased risk of hip fracture. METHODS: The study population consisted of postmenopausal women participating in the Nurses' Health Study from 1980 to 2014, who reported information on lifestyle and health, including hip fractures, on biennial questionnaires, while semiquantitative food frequency questionnaires (FFQs) were completed every fourth year. Hazard ratios (HR) for hip fracture were computed using Cox proportional hazards models, adjusting for potential confounders. RESULTS: EDIP was calculated using intake information from the FFQ for 87,955 postmenopausal participants, of whom 2348 sustained a non-traumatic hip fracture during follow-up. After adjustment for confounders, there was a 7% increase in the risk of hip fracture per 1 SD increase in EDIP (HR 1.07, 95% CI 1.02-1.12), and the uppermost quintile had a 22% greater risk compared to the lowest (HR 1.22, 95% CI 1.06-1.40). For the separate components of the EDIP, we found that higher intakes of low-energy beverages (diet sodas) were independently associated with an increased risk of hip fracture, while higher intakes of green leafy vegetables were associated with a reduced risk. CONCLUSION: A pro-inflammatory dietary pattern was associated with an increased risk of hip fracture among postmenopausal women.

Traumatic perinatal events and educational needs of labor and delivery room nurses in Korea: a cross-sectional survey.

PURPOSE: The present study investigated experiences of traumatic perinatal events, the provision of related education, and educational needs of nurses working in the labor and delivery room (LDR). METHODS: Nurses working in the LDRs of six institutions and two nurse portal sites were invited to participate in the survey, delivered on paper or online. The data were collected from October 1 to November 25, 2022. Data from 129 nurses were analyzed using frequency, the chi-square test, the Fisher exact test, the t-test, and analysis of variance. RESULTS: Virtually all participants (98.6%) reported having experienced at least one traumatic perinatal event (dystocia, postpartum hemorrhage, neonatal congenital anomalies, severe maternal or neonatal injury, stillbirth, and maternal or neonatal death) while working in the LDR. The most shocking traumatic perinatal event experienced was the maternal or neonatal death (40.3%), but 24.8% of participants did not recall ever receiving education on the topic. About 63% of participants experienced traumatic perinatal events within a year of working in the LDR. The average score for education needs regarding traumatic perinatal events was 3.67±0.37 out of 4, and participants preferred simulation education as the most effective educational method. CONCLUSION: Since most of the participants had experienced various traumatic perinatal events in the early stages of working in the LDR and expressed a high level of need for education on traumatic perinatal events, it is necessary to provide more effective stimulation education programs in the early period of work in the LDR.

Prevalence and predictors of workplace sexual harassment of nurses in the Central Region of Ghana: a cross-sectional online survey.

OBJECTIVE: We investigated the prevalence and predictors of workplace sexual harassment against nurses in the Central Region of Ghana. DESIGN: A cross-sectional online survey. SETTING: Central Region of Ghana. PARTICIPANTS: A total of 1494 male and female nurses from various healthcare facilities in the Central Region participated in this survey from August to September 2021. MAIN OUTCOME MEASURES: The prevalence of sexual harassment was determined using the Sexual Experiences Questionnaires and the Workplace Violence in the Health Sector Questionnaires. We used descriptive statistics to analyse participants' characteristics and the occurrence of sexual harassment. Binary logistic regression was used to determine the predictors of sexual harassment. The survey instrument yielded a reliability value of 0.82. RESULTS: The prevalence of sexual harassment was 43.6% when behaviour-based questions were applied and 22.6% when a direct question was used. The main perpetrators of sexual harassment were male physicians (20.2%), male nurses (15.4%), male relatives of patients (15.1%) and male patients (11.6%). Unfortunately, only a few victims lodged complaints of harassment. Compared with males, female nurses were more likely to be sexually harassed (adjusted OR, aOR 1.59, 95% CI 1.23 to 2.07). Moreover, nurses with higher work experience (aOR 0.86, 95% CI 0.80 to 0.93), those married (aOR 0.54, 95% CI 0.41 to 0.72) and those working in private or mission/Christian Health Association of Ghana health facilities (aOR 0.49, 95% CI 0.36 to 0.68) were less likely to be sexually harassed. CONCLUSIONS: The prevalence of workplace sexual harassment against nurses in the Central Region of Ghana is high and may compromise quality healthcare delivery in the region. Therefore, managers of healthcare facilities and the Ghana Health Service need to institute antisexual harassment interventions, including education, training and policy, with a focus on females in general, but especially those who are not married, less experienced and those working in public health facilities.

Metformin and other anti-diabetic medication use and breast cancer incidence in the Nurses' Health Studies.

We aimed to examine the association between the use of metformin and other anti-diabetic medications and breast cancer incidence within two large prospective cohort studies. We followed 185,181 women who participated in the Nurses' Health Study (NHS; 1994-2016) and the NHSII (1995-2017), with baseline corresponding to the date metformin was approved for type 2 diabetes (T2D) treatment in the US Information on T2D diagnosis, anti-diabetes medications, and other covariates was self-reported at baseline and repeatedly assessed by follow-up questionnaires every 2 years. Breast cancer cases were self-reported and confirmed by medical record review. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between medication use and breast cancer were estimated using Cox proportional hazards regression models, adjusting for breast cancer risk factors. During 3,324,881 person-years of follow-up, we ascertained 9,192 incident invasive breast cancer cases, of which 451 were among women with T2D. Compared with women without T2D (n = 169,263), neither metformin use (HR = 0.97; 95% CI = 0.81-1.15) nor other anti-diabetic medications use (HR = 1.11; 95% CI = 0.90-1.36) associated with significantly lower breast cancer incidence. Among women with T2D (n = 15,918), compared with metformin never users, metformin ever use was not significantly inversely associated with breast cancer (HR = 0.92; 95% CI = 0.74-1.15). Although we observed that past use of metformin was inversely associated with breast cancer in the T2D population (HR = 0.67; 95% CI = 0.48-0.94), current use (HR = 1.01; 95% CI = 0.80-1.27) and longer duration of metformin use were not associated with breast cancer (each 2-year interval: HR = 1.01; 95% CI = 0.95-1.07). Overall, metformin use was not associated with the risk of developing breast cancer among the overall cohort population or among women with T2D.

Changes in work schedule affect headache frequency among Norwegian nurses: a 3-year-follow-up study.

OBJECTIVES: To explore whether changes in work schedule, number of night shifts and number of quick returns were related to changes in headache frequencies. METHODS: A longitudinal study with questionnaire data from 2014 (baseline) and 2017 (follow-up) on work schedule (day only, shift work without nights and shift work with nights), number of night shifts, number of quick returns (less than 11 hours in-between shifts) and validated headache diagnoses among 1104 Norwegian nurses. Associations were explored by adjusted multivariate regression analyses. RESULTS: The median age at baseline was 37 years (IQR 31-43) and 90.5% were women. In the adjusted logistic regression analysis of changed work schedule between baseline and follow-up, changing from night work was associated with increased odds for reversion from headache >1 days/month to no headache at all last year (OR 2.77 (1.29; 5.95)). Changes towards less night shifts (>10) or quick returns (>10) during the last year were associated with increased odds of reversion of headache to no headache (OR 2.23 (1.20; 4.17) and OR 1.90 (1.04; 3.49)). Only decrease in number of night shifts (>10) during the last year reduced risk of onset of any new headache between baseline and follow-up (OR of 0.39 (0.18; 0.84)). CONCLUSION: Changing from night work and reducing the number of night shifts and quick returns were associated with less headache in this 3-year-follow-up of Norwegian nurses. This adds to the growing body of evidence that night work may have direct negative health consequences.

The Experiences of Nurses as Double-Duty Caregivers for a Family Member at the End of Life: Interpretive Description.

Increasing numbers of individuals with complex, advanced illnesses are living longer and being cared for in the home by family members. As a result, family caregivers often experience physical, emotional, psychological, and social distress. A unique subset of this population are nurses who find themselves providing care in both their family lives and work lives, a phenomenon known as "double-duty caregiving." This study explored the experiences of nurses providing end-of-life care for family members while continuing to work as a nurse and the consequences of this experience. A qualitative design, using semistructured, in-depth interviews, was used to capture the double-duty caregivers' experiences. Four overarching themes were identified: It Takes a Village, Driving the Bus, Juggling Many Hats, and Moving Through and Looking Back. These themes captured the components of a support system that are essential for the double-duty caregiver to perform this work, the multifaceted expectations placed upon the double-duty caregiver, the double-duty caregiver's relentless need to balance multiple roles, and the immediate and long-term impact of double-duty caregiving. As nurses, we must acknowledge the need for self-care during this experience, and as a profession, we must provide support for the double-duty caregiver to preserve their personal and professional well-being.

Overview of Occupational Injuries Among Registered Nurses in Washington State, 2007 to 2019.

BACKGROUND: Registered nurses (RNs) represent the largest segment of the health care workforce and have unique job demands and occupational health considerations. The purpose of this study was to describe the incidence, cost, and causes of occupational injuries among RNs in Washington State and to quantify the cumulative cost and burden of each type of injury, relative to all injuries among RNs. METHODS: Annual injury claims data covered under Washington State workers' compensation (WC) fund were analyzed over a 13-year period (2007-2019). Annual mean incidence and cost of injuries were calculated and stratified by nature, source, and event/exposure. Negative binomial regression models were used to examine trends in injury incidence over time, for injury incidence overall, and by the most common injury classifications. RESULTS: Between 2007 and 2019, 10,839 WC claims were filed and accepted for Washington State RNs (annual M = 834), totaling more than US$65 million. No significant trend in overall injury incidence was observed (incidence rate ratio [IRR]: 0.99, 95% confidence interval [CI] = [0.94, 1.05]). The most common injury exposures were bodily reaction and exertion, contact with objects and equipment, falls, and assaults and violent acts. DISCUSSION: To our knowledge, this is the first broad study of the incidence and costs of occupational injuries among RNs across all workplace settings. We identified high-cost, high-frequency incidence rates of musculoskeletal, sharp, and violence-related occupational injury claims, highlighting intervention targets. Implications for Occupational Health Practice: Policy makers, health systems, and occupational health nurse leaders can use this information to identify priority areas where evidence-based occupational health and prevention programs are most needed.

Occupational stress, respect, and the need for psychological counselling in Chinese nurses: a nationwide cross-sectional study.

OBJECTIVES: This study aimed to explore occupational stress, perceived respect, and the need for psychological counselling among nurses in China. STUDY DESIGN: This was a nationwide cross-sectional study. METHODS: Chinese nurses from 311 cities were randomly selected through a simple random sampling method. Occupational stress, perceived respect, and psychological counselling need were assessed using an online questionnaire validated by experts. The underlying associated factors were analysed using multiple logistic regression analyses. RESULTS: We collected and analysed 51,406 valid online questionnaires. Family factors and low income were the most commonly cited sources of occupational stress, and 91.9% and 80.0% of nurses, respectively, perceived that individuals in society and patients did not give adequate respect. Furthermore, 75.5% and 79.7%, respectively, believed they were not respected by clinical managers and doctors. As a result, 64.7% nurses believed they had a moderate or high need for psychological counselling. However, 80.7% indicated that receiving adequate respect could decrease the need for stress-related psychological counselling. Indeed, multiple logistic regression analyses showed that lower respect perceived by nurses was associated with higher need for psychological counselling, particularly regarding criticism that nurses perceived from nursing managers (a little: odds ratio [OR], 1.597; 95% confidence interval [CI], 1.176-2.170; P = 0.003; moderately: OR, 1.433; 95% CI, 1.180-1.741; P < 0.001) and the difficulty of receiving respect from patients and their families (a little: OR, 1.389; 95% CI, 1.044-1.850; P = 0.024). CONCLUSIONS: Nurses in China perceive high levels of occupational stress and low levels of respect and often seek psychological counselling.

Self-reported incidents of violence towards nurses working in acute psychiatric units.

BACKGROUND:  Acute psychiatric units are found to be stressful working environments because of the nature of illness patients present with. OBJECTIVES:  This study aimed to determine self-reported incidents of physical and verbal violence towards nurses working in acute psychiatric units in Western Cape, South Africa. METHOD:  A questionnaire was used to collect data. Chi-square test was performed to determine association between gender, category and experience of violence. Mann-Whitney U test was carried out to determine associations between years of employment and the likelihood of experiencing physical violence and verbal abuse. RESULTS:  Overall physical violence 35 (34.3%) and verbal abuse 83 (83%) incidents. Most female respondents reported both physical violence (74.2%, n = 26) and verbal abuse (72.2%, n = 60), with (56.2%, n = 18) professional nurses reporting physical violence. Years of employment was statistically significantly associated with the likelihood of nurses experiencing physical violence (p = 0.007). CONCLUSION:  Most respondents (74.2%, n = 26) were females and they mostly experienced physical violence and verbal abuse while 28.2% (n = 29) were males. Years of service were associated with the likelihood of experiencing physical violence.Contribution: The knowledge gained will add on existing knowledge about the challenge of violence experienced by nurses in the workplace and might have an influence on policymakers.

The mediating role of attention deficit in relationship between insomnia and social cognition tasks among nurses in Saudi Arabia: A cross-sectional study.

Purpose: Insomnia-related affective functional disorder may negatively affect social cognition such as empathy, altruism, and attitude toward providing care. No previous studies have ever investigated the mediating role of attention deficit in the relationship between insomnia and social cognition. Methods: A cross-sectional survey was carried out among 664 nurses (Mage = 33.03 years; SD ± 6.93 years) from December 2020 to September 2021. They completed the Scale of Attitude towards the Patient (SAtP), the Athens Insomnia Scale (AIS), a single-item numeric rating scale assessing the increasing severity of attention complaints, and questions relating to socio-demographic information. The analysis was carried out by examining the mediating role of attention deficit in the relationship between insomnia and social cognition. Results: The prevalence of insomnia symptoms was high (52% insomnia using the AIS). Insomnia was significantly correlated with attention problems (b = 0.18, standard error (SE) = 0.02, p < 0.001). Attention problems were significantly negatively correlated with nurses' attitudes towards patients (b = -0.56, SE = 0.08, p < 0.001), respect for autonomy (b = -0.18, SE = 0.03, p < 0.001), holism (b = -0.14, SE = 0.03, p < 0.001), empathy (b = -0.15, SE = 0.03, p < 0.001), and altruism (b = -0.10, SE = 0.02, p < 0.001). Attention problems indirectly mediated the effect of insomnia on attitudes toward patients (99% CI = -0.10 [-0.16 to -0.05]), respect for autonomy (99% CI = -0.03 [-0.05 to -0.02]), holism (99% CI = -0.02 [-0.04 to -0.01]) empathy (99% CI = -0.03 [-0.04 to -0.01]), and altruism (99% CI = -0.02 [-0.03 to -0.01]). Conclusion: Nurses with insomnia-related attention problems are likely to have poor explicit social cognition such as attitude toward patients, altruism, empathy, respect for autonomy, and holism.

Study on the influence of patient safety culture on the pain and turnover intention of Chinese nurses in adverse nursing events.

AIM: Exploring the influence of patient safety culture on nurses' pain and turnover intention the job as a second victim. DESIGN: The study employed a cross-sectional design. METHODS: From July 2020 to August 2020, a convenience sampling method was used to select 1525 clinical nurses from hospitals of different levels in Shandong Province as the research subjects, and the general data survey method, patient safety culture scale and the assessment entries on pain in the second victim experience and support scale, using a convenience sampling method. RESULTS: Patient safety culture is an influencing factor that affects the second-victim pain and turnover intention. Among them, the non-punitive response to errors, open communication, cooperation between different departments, organizational learning and promotion has a statistically significant influence on the second-victim pain and turnover intention.

Primary healthcare nurses' experiences of addressing intimate partner violence in supportive legal and health system contexts.

AIM: To explore the experiences of primary healthcare (PHC) nurses caring for women experiencing intimate partner violence (IPV) in a context of institutional support for the management of this health issue. DESIGN: Secondary qualitative analysis. METHODS: A purposeful sample (n = 19) of registered nurses, working in a PHC setting, with experience providing care to women who had disclosed intimate partner violence completed an in-depth interview. Thematic analysis was used to code, categorize and synthesize the data. RESULTS: Four themes were developed from the analysis of the interview transcripts. The first two themes address the characteristics of the type of violence most frequently encountered by participants, and how these characteristics shape the needs of women and the care nurses provide them. The third theme encompasses uncertainties and strategies developed to deal with the aggressor during the consultations as the woman's companion or as the patient himself. Finally, the fourth theme reflects the positive and negative consequences of caring for women exposed to intimate partner violence. CONCLUSION: When there is a supportive legal framework and health system to address IPV, nurses are able to implement evidence-based best practices in caring for women experiencing intimate partner violence. The predominant type of violence experienced by women at the time they enter the healthcare system shapes their needs and the service/unit they reach. These varying needs should be considered in the development of training programmes for nurses and should be adapted for different healthcare services. Caring for women experiencing intimate partner violence implies an emotional burden even in an institutional supportive context. Therefore, actions to prevent nurses' burnout should be considered and implemented. IMPACT: Lack of institutional support usually hinders the potential role nurses can play in the care provided to women who have experienced intimate partner violence. Findings from this study demonstrated that primary healthcare nurses are able to implement evidence-based best practices in the care for women experiencing intimate partner violence when there is a supportive legal framework and the health system context is openly favourable to addressing intimate partner violence. Findings from this study could inform the design and implementation of programmes and/or policies to improve nurses' responses to intimate partner violence in primary healthcare services.

How well do nurses know their patients? Agreement between patients' degree-of-worry and nurses' estimation of patients' degree-of-worry-An observational study.

AIM: To assess the agreement between patients' self-reported degree-of-worry (DOW) and nurses' evaluation of patients' DOW. DESIGN: An observational cohort study with patients and their primary nurses. METHODS: Between 22 February and 27 March 2021, data collection among patients and their nurses in an emergency department was carried out. Patients ≥18 years, cognitively intact and Danish or English speaking were eligible to participate. Nurses regardless of seniority and gender were eligible for participation. The single-item degree-of-worry measure, 'how worried are you about the condition you are here today on a scale from 1 to 10, where 1 is minimally worried and 10 is maximum worried' as well as information on gender, age, co-morbidity, triage level and medical reason for encounter was collected from patients. The corresponding nurses were asked; 'how worried do you think your patient is about the condition he/she is there today on a scale from 1 to 10, where 1 is minimally worried and 10 is maximum worried?' Nurses also supplied data on gender, age, seniority as a Registered Nurse and in the ED. Agreement between patients' self-reported degree-of-worry and nurses' evaluation of patients' degree-of-worry was assessed with weighted Cohen's Kappa. RESULTS: A total of 194 patient-nurse pairs were included for analysis. The agreement between patients' DOW and nurses' evaluation of patients' DOW categorised as DOWlow , DOWmiddle and DOWhigh was in total agreement in n = 85 pairs (43.8%) of the ratings, which corresponds to a weighted Cohen's Kappa of 0.19 (0.08-0.30; p < 0.001). CONCLUSION: Nurses estimate of their patients' DOW was in very poor agreement. This indicates that nurses are not able to assess the patient's DOW to a satisfactory level. This result is troubling as it may have serious consequences for patient care as it indicates that the nurses do not know their patients' perspectives.