Exploring workaholism determinants and life balance: A mixed-method study among academic nurse educators.

BACKGROUND: Academic nurse educators play a crucial role in the educational environment, but the demands of their profession can lead to workaholism, which could result in an imbalance between work and personal life. PURPOSE: The study aimed to explore workaholism and life balance among academic nursing educators, as well as investigate the factors associated with workaholism. METHODS: A mixed-methods design based on the "concurrent triangulation" approach was employed. A convenience sample of 76 nurse educators completed the Dutch Work Addiction Scale (DUWAS) and the Life Balance Inventory (LBI), while a purposive sample of 20 nurse educators participated in semi-structured interviews. Inferential statistics and thematic analysis were used to analyze the data. RESULTS: The researchers found a notable prevalence of workaholism among nurse educators, with 59.0 % reporting a mean score above 2.5 and 86.8 % perceiving an unbalanced life. Regression analysis indicated that workaholism negatively predicted life balance (B = -0.404, p < 0.001). The qualitative findings derived three themes as determinants of workaholism: antecedents, consequences, personal and institutional strategies to mitigate workaholism among nursing educators. CONCLUSION: Educational institutions should develop comprehensive approaches to support and develop their academicians, fostering a positive work environment, work-life balance, employee well-being, and professional development.

Neuroleadership: A Concept Analysis and Implications for Nursing.

ABSTRACT: BACKGROUND: Neuroleadership in nursing is a specialized leadership approach that integrates insights from social neuroscience with nursing leadership practices, aiming to proficiently lead healthcare teams to enhance patient care, staff productivity, and organizational outcomes. Yet, the exploration of neuroleadership in nursing remains limited. AIM: The aim of this study was to provide an analysis of the concept of neuroleadership and its implications in the nursing context. METHODS: Walker and Avant's 8-step methodology was used for this concept analysis, including identifying the concept, clarifying the purpose of the analysis, exploring the uses of the concept, and defining its attributes, model and contrary cases, antecedents and consequences, and its empirical referents. A comprehensive search included PubMed, CINAHL, and ERIC, between 2000 and 2023. RESULTS: This concept analysis significantly contributes to the literature by providing a comprehensive overview of neuroleadership as a distinct form of nursing leadership. It covers key aspects such as definition, attributes, uses, cases, antecedents, consequences, and empirical evidence, and highlights the importance of specialized education, practical experience, and leadership attributes in this domain. The findings could serve as determinants for establishing a neuroleadership framework and developing a structured questionnaire to measure neuroleadership among nurses and nurse leaders, thereby addressing existing empirical reference gaps. CONCLUSION: Nurse leaders adopting a neuroleadership approach can gain insights into how cognitive processes shape nurses' behaviors and motivation, which directly impact patient outcomes and care quality. Further research is needed to assess the practical impact of neuroleadership and validate its factors and model case in clinical nursing practice.

The relationship between organizational justice and bullying behaviors among nurses: the role of nurse managers' caring behaviors.

BACKGROUND: Organizational justice is pivotal in fostering a fair and supportive workplace culture, which strengthens the connections between managers and nurses, among nurses themselves, and ultimately, between nurses and their patients. Assessing the perceived levels of organizational justice and managerial behaviors can identify key areas for improving nurses' commitment and loyalty, while simultaneously reducing incidents of workplace bullying. PURPOSE: This study aims to investigate how bedside nurses perceive organizational justice, nurse managers' caring behaviors, and their exposure to workplace bullying. Additionally, it seeks to explore the relationship between organizational justice, nurse managers' caring behaviors, and nurses' perceived exposure to workplace bullying. METHODS: A descriptive-correlational study was conducted in the inpatient care unit of a Saudi hospital. A convenience sample of 256 nurses participated, completing the Organizational Justice Questionnaire (OJQ), the Caring Factor Survey: Caring of the Manager (CFS-CM), and the Negative Acts Questionnaire-Revised (NAQ-R). The collected data were analyzed using descriptive statistics and regression analysis. RESULTS: Descriptive statistics revealed moderate levels of perceived organizational justice and managerial caring behaviors among nurses, alongside low reported exposure to workplace bullying. Significant correlations were found among the studied variables, indicating that higher perceived organizational justice was associated with higher managerial caring and lower workplace bullying (p < 0.05). Mediation analysis demonstrated a significant indirect effect of organizational justice on workplace bullying through the mediating role of nurse managers' caring behaviors (a×b = -0.0652, p < 0.001). Furthermore, the direct effect of organizational justice on workplace bullying remained significant even when accounting for the mediator (c = -0.5509, p < 0.001). CONCLUSION: This study highlights the vital role of organizational justice and managerial caring in cultivating a positive work environment and mitigating workplace bullying. Implementing clear policies and procedures while promoting fairness and equality in resource allocation, decision-making processes, and interactions are essential strategies for fostering positive attitudes and work behaviors among nurses.

Faculty and students perspectives towards game-based learning in health sciences higher education.

Background: Game-Based Learning (GBL) is an innovative pedagogical approach that utilizes digital applications to enhance health sciences higher education. Therefore, analyzing faculty and students' perspectives on GBL can help educational administrators, educators, and researchers tailor GBL to students' needs. Purpose: This study aimed to explore faculty (teachers) and students' perspectives towards GBL in health sciences higher education. Further to identify barriers affecting the use of GBL as well as recommendations for its use from their perspectives. Methods: A descriptive-qualitative approach was conducted at a Saudi university. A total of 42 semi-structured interviews were completed with a purposive sampling of 22 faculty members and 20 students until data saturation. The data were analyzed using a thematic content analysis approach. Results: Faculty members and students reflected on their personal experiences using GBL, and the data presented seven themes and 30 categories emerged from the content analysis: common digital apps, purpose and uses, effect or benefits of GBL, personal experience with GBL, challenges and barriers affecting the use of digital games, and recommendations for educators on using GBL apps. Conclusion: The experiences of both students and faculty demonstrated that GBL can enhance classroom learning and complement traditional teaching approaches in health sciences higher education. GBL's safe, immersive environment lets students practice many generic skills, boosting interest, motivation, and peer-mediated learning. Faculty and students shared their GBL experiences, responsibilities, and enthusiasm. Health sciences higher education institutions should consider ways to increase flexibility in providing resources and training to educators who want to build and use the GBL approach in their classroom.

Digital proficiency: assessing knowledge, attitudes, and skills in digital transformation, health literacy, and artificial intelligence among university nursing students.

BACKGROUND: Implementing digital transformation and artificial intelligence (AI) in education and practice necessitates understanding nursing students' attitudes and behaviors as end-users toward current and future digital and AI applications. PURPOSE: This study aimed to assess the perceived knowledge, attitudes, and skills of nursing students regarding digital transformation, as well as their digital health literacy (DHL) and attitudes toward AI. Furthermore, we investigated the potential correlations among these variables. METHODS: A descriptive correlational design was employed in a Saudi nursing college utilizing a convenience sample of 266 nursing students. A structured questionnaire consisting of six sections was used, covering personal information, knowledge, skills and attitudes toward digital transformation, digital skills, DHL, and attitudes toward AI. Descriptive statistics and Pearson correlation were employed for data analysis. RESULTS: Nursing students exhibited good knowledge of and positive attitudes toward digital transformation services. They possessed strong digital skills, and their DHL and positive attitude toward AI were commendable. Overall, the findings indicated significant positive correlations between knowledge of digital transformation services and all the digital variables measured (p = < 0.05). Senior students reported greater digital knowledge and a positive attitude toward AI. CONCLUSION: The study recommends an innovative undergraduate curriculum that integrates opportunities for hands-on experience with digital healthcare technologies to enhance their digital literacy and skills.

The Relationship Between Authentic Leadership and Nurses' Resilience: A Mediating Role of Self-Efficacy.

Introduction: Authentic leadership has been identified as a style needed to promote quality patient care and nurses' retention. Objective: The objective of this study was to investigate the correlation between the authentic leadership exhibited by nurse managers and the levels of resilience and self-efficacy among nurses. Methods: A descriptive correlational study was conducted in an Egyptian hospital. A sample of convenience nurses (N = 285) completed the Authentic Leadership Inventory, the Connor-Davidson Resilience Scale, and the General Self-Efficacy Scale. The data were analyzed with correlation and structural equation modeling. Results: The highest percentages of nurses (53.33% and 45.96%) perceived their nurse managers as having either moderate or high levels of authentic leadership. The majority of nurses rated themselves as moderately resilient (63.98%, 25.59 ± 6.56) and highly efficacious (76.70%, 30.68 ± 4.95). Furthermore, the analysis conducted using SPSS-AMOS reveals a significant positive association between the variables. Specifically, authentic leadership, along with its constituent components, accounts for approximately 22% of the overall variance observed in nurses' resilience. Additionally, it is shown that these same factors explain approximately 34% of the variance in nurses' self-efficacy. Moreover, the mediating role of self-efficacy was found to explain 49.3% of the variability in nurses' resilience. Conclusion: Nurse leaders should be aware of and implement effective and authentic leadership behaviors and apply tailored strategies for fostering nurses' resilience and self-efficacy to deal with the challenging healthcare environment.

Predictors and outcomes of patient safety culture at King Abdulaziz Medical City, Jeddah, Saudi Arabia. A nursing perspective.

BACKGROUND: Patient safety culture assessment is viewed as the starting point from which action planning begins and helps hospitals get a good idea of the patient safety features that need immediate attention, identify the strengths and weaknesses of their safety culture, help units find their most common patient safety problems, and compare their scores to those of other hospitals. This study aimed to assess nurses' perceptions of patient safety culture composites in a Saudi hospital in the Western region and to explore the association between patient safety culture predictors and outcomes, taking into consideration nurses' characteristics. METHODS: This study employed a cross-sectional descriptive design with a convenience sample of 184 nurses who are working at inpatient care units at King Khaled Hospital- King Abdulaziz Medical City in Jeddah, Western region, Saudi Arabia. The data were collected through a structured questionnaire consisting of nurses' demographics and work characteristics, and the Patient Safety Culture Hospital Questionnaire (HSOPSC), which proved valid and reliable. Descriptive status, correlation, and regression analysis were applied to patient safety culture composites for statistical analysis. RESULTS: The overall positive response rate of the predictors of patient safety culture in the HSOPSC survey was 63.46%. The mean percent score for predictors ranged from 39.06% to 82.95%. "Teamwork within units" (82.95%) was the highest mean, followed by "organizational learning" (81.88%) and "feedback and communication about errors" (81.25%). In addition to the overall perceived patient safety (59.0%), safety grade, frequency, and number of events are also reported as safety outcome measures. CONCLUSIONS AND RECOMMENDATIONS: Regardless of the percentage of the safety culture domains, this study agrees that all the domains should be considered high-priority and focused areas for continuous improvement. The results confirmed the need for continuous staff safety training programs to improve their perception and performance of the safety culture.

Relationship between nurses' ethical ideology, professional values, and clinical accountability.

BACKGROUND: Nurses are challenged with many situations that require them to solve ethical dilemmas and make moral decisions based on professional values and a sense of accountability and responsibility. To support their decisions, it is important to know how they perceive and relate their ethical ideology, professional values, and clinical accountability in their workplace. PURPOSE: The study's aim was twofold: to investigate the ethical ideology and perceived importance of professional values and accountability among nurses. Further, explore the relationship between each of ethical ideology and professional values with nurses' work accountability. METHODS: A correlational study was conducted in an Egyptian hospital. All nurses were invited to participate = 192, and 150 nurses (78.3%) completed the study questionnaires. The Ethical Position Questionnaire, the Professional Values Scale, and the Clinical Vignettes Assessment for Clinical Accountability were proven to be reliable study measures. ETHICAL CONSIDERATIONS: Ethics Committee approval, written informed consent, data privacy and confidentiality, and participants' right to voluntary participation and withdrawal were maintained. RESULTS: Nurses showed good ethical ideology (75 ± 6.2) and are more idealistic while maintaining professional values (108 ± 10.8). Most nurses believed they were accountable for documenting errors, completing incident reports, and calling physicians to discuss or manage the situations. Ethical ideology and the idealism subscale were positively correlated with overall nurses' professional values (r = 0.321, p < 0.004, r =0.464, p 0.000), respectively. On the other hand, work accountability showed a partial correlation in some areas with ethical ideology and professional values. DISCUSSION: Professional values and nurses' accountability appear to be influenced by ethical positions and ideology. CONCLUSION: Healthcare organizations should provide a supportive work environment to help nurses develop self-awareness, and knowledge of their ethical ideologies, which improve professional values and clinical accountability in their practice. Ethical ideology and professional values should be emphasized more in nursing curricula.

Shift handover quality in Saudi critical care units: determinants from nurses' perspectives.

BACKGROUND: Nurses' effective handover communication is vital for patient safety and quality of care. Few studies have empirically tested how certain factors influence the quality of handover in the Saudi context. METHODS: A descriptive correlational design was used with a convenience sample of all nurses (N = 201) working in Saudi hospital CCUs in 2022. Demographics and handover quality instruments were used to collect the necessary data in addition to two open-ended questions that asked about perceived barriers and facilitators to handover. The analysis was conducted using descriptive statistics and regression analysis. RESULTS: The majority of nurses reported good-quality handover. The regression analysis showed that staffing, cognitive capacity, the focus of attention, relationships, and safety climate factors contributed positively to the variance of handover quality. In contrast, intrusions, distractions, anxiety, time stress, and acute and chronic fatigue factors negatively affected the prediction of handover quality (p < 0.05). Nurses added types of shifts and languages as barriers to handover while emphasizing training and the use of standardized tools for handover as facilitators. CONCLUSION AND RECOMMENDATIONS: Nursing handover is a multidimensional phenomenon. By understanding the determinants that contribute to or hinder handover quality, it is possible to develop targeted interventions aimed at improving communication and the quality of shift handover in CCUs. The current study's findings highlight the need for nurses to work in a more supportive environment, receive better training, and follow a standardized handover protocol. Additionally, nurse managers should pay more attention to nurses' well-being to control or mitigate the effect of psychological precursors on the quality of nurses' handover. Future research should investigate handover practices and outcomes on units that have both good and bad practice environments.

The Relationship Between Coping Strategies, Compassion Satisfaction, and Compassion Fatigue During the COVID-19 Pandemic.

Introduction: The rapid spread of COVID-19 poses a significant threat to nurses' lives and health, resulting in varying degrees of mental distress. Nurses may experience compassion fatigue, and their professional quality of life and satisfaction may suffer as a result. Their coping mechanisms may vary as well, influencing their compassionate and safe care. Objectives: The study's objectives are to explore levels of compassion satisfaction and fatigue among nurses and identify their coping strategies. Further, to investigate the relationship between coping strategies, compassion satisfaction, and compassion fatigue during the COVID-19 pandemic. Methods: Using a descriptive correlational design, this study was conducted with a convenience sample of 443 nurses working in an Egyptian university hospital. Nurses completed the coping strategy indicator scale and the professional quality of life (compassion satisfaction and compassion fatigue) scale. The data were analyzed using descriptive statistics, Pearson correlation, and regression analysis. Results: Nurses' professional quality of life was average in terms of compassion satisfaction (2.95 ± 0.92) and compassion fatigue (2.38 ± 0.35). Nurses have a moderate use of coping strategies (2.13 ± 0.35). Problem-solving was rated as the highest coping strategy, while avoidance was rated as the lowest. Coping strategies showed a positive correlation with compassion satisfaction (r = 0.503, p < .001) and a negative correlation with compassion fatigue (r = -0.352, p < .001). In addition, coping strategies could predict 25.4% and 12.4% of compassion satisfaction and compassion fatigue, respectively (p < .001). Conclusion: Compassion satisfaction and fatigue are key determinants of nurses' quality of work life. Coping strategies, especially problem-solving and support systems, are vital to increase compassion satisfaction and mitigate burnout and secondary stress syndrome. Nurse managers should establish supportive work environments that promote nurses' well-being. Resilience-building programs and coping strategies' training are recommended to enhance the nurses' quality of work life and positive work attitudes.

Enjoyment of Physical Activity among Children and Adolescents: A Concept Analysis.

Although enjoyment has been linked to participation in physical activity (PA), a thorough analysis of the concept is lacking. Health-related behavior research emphasizes the necessity of focusing on individual psychological requirements, such as enjoyment in PA, to boost children and adolescents' motivation for PA. The current paper is a report on a conceptual analysis of the enjoyment of PA among children and adolescents. We adopted the concept analysis procedure by Walker and Avant. Several databases (PubMed, CINAHL, ERIC, PsychInfo, and Sport Discus) were searched and used to extract relevant articles about the enjoyment of PA. The review process yielded a final set of 72 papers. A refined definition of enjoyment in PA, attributes, cases, antecedents, and consequences of enjoyment in PA were presented. A conceptual understanding of enjoyment in PA can enable nurses to plan interventions that help children and adolescents get appropriate PA and improve their health habits.

The online learning experience and reported headaches associated with screen exposure time among Saudi health sciences students during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has become a global health issue and has significantly impacted university education. As a result, learning methods have been shifted to be delivered through online learning. Online learning has increased reliance on computer screens, which can cause visual discomfort and may cause or exacerbate headaches due to prolonged screen exposure. However, time spent using electronic devices has not yet been examined in relation to the online learning experience. PURPOSE: This study assessed the online learning experiences and reported headaches associated with screen exposure time among health sciences university students. METHODS: A cross-sectional study was conducted among a convenience sample of 353 students at Saudi University. Online learning experiences, screen time exposure, and reported headache questionnaires were used to collect the data. RESULTS: Students were moderately satisfied with the online learning experience. Nevertheless, they faced many challenges with online learning that affected their communication efficacy, and they preferred that blended learning be continued. In addition, this study found a high prevalence of headache (65.72%) and a high screen exposure time among the studied students (52.69%). Increased screen time exposure is linked with increased headache and migraine reporting among students (p < 0.05). CONCLUSION: Headache is a common health issue among health professional students, and it can harm their academic performance and quality of life, especially related to online learning. Greater awareness of headaches, stress reduction and prevention programs, and ergonomic practices to deal with headaches are essential. Blended learning approaches can improve student learning and performance in health science courses.

Occupational Fatigue and Associated Factors among Saudi Nurses Working 8-Hour Shifts at Public Hospitals.

Introduction: Shift work and demanding work schedules contribute to occupational fatigue, negatively affecting patient safety and nurses' well-being, consequently placing nurses and patients at risk for injury and adverse health outcomes. For preventing fatigue and minimizing its negative consequences, information about its characteristics and associated factors is required. Objectives: This study aimed to assess occupational fatigue "acute fatigue, chronic fatigue, and inter-shift recovery" among Saudi nurses working 8-h shifts. Further, we explored factors associated with fatigue from nurses' perspectives. Methods: We conducted a mixed-method study with a convenience sample of Saudi nurses (N = 282) working in four public hospitals in Saudi Arabia. Data were collected using the nurses' profile form; the occupational fatigue exhaustion recovery (OFER) scale, for relevant quantitative data; and open-ended questions for qualitative data. We used descriptive and inferential statistics for analysing the quantitative data and content analysis of the qualitative data. Results: The results showed that Saudi nurses rated themselves moderately fatigued with working 8-h shifts. The inter-shift recovery subscale showed a negative correlation with chronic fatigue and acute fatigue (r = -0.518, r = -0.356, P < 0.001). Sleeping problems, meals per day, and frequency of exercise showed significant relations with chronic fatigue among nurses (p < 0.05). In addition, three categories were derived from the qualitative content analysis. Saudi nurses reported work-related, psychosocial, and individual factors as major contributors to fatigue and recovery. Conclusion: Occupational fatigue is a multidimensional issue, and nurses and nurse managers are challenged with reducing its prevalence and negative impact on nurses and patients. Our quantitative and qualitative findings suggest the need for a comprehensive approach to fatigue management and mitigation, including organizational support, creative workforce planning, flexible work schedules, and psychosocial support. Fatigue reduction and prevention policies and educational programs are vital strategies to improve nurses' well-being and inter-shift recovery.

The Relationship Between Transformational Leadership Practices of First-Line Nurse Managers and Nurses' Organizational Resilience and Job Involvement: A Structural Equation Model.

BACKGROUND: Nurse leaders play a unique role in seeking ways to promote a strong nurse workforce and positive work attitudes and behaviors among nurses to assist in their success. The leadership practice of nurse managers could be an important factor in promoting nurses' organizational resilience and job involvement. AIM: To determine the relationship between transformational leadership practices of first-line nurse managers and nurses' organizational resilience and job involvement. METHODS: A descriptive correlational research design was conducted at a Saudi university hospital. The study consisted of 60 nurse managers and 211 nurses. Measures included Leadership Practices Inventory, organizational resilience, and job involvement questionnaires. Results were analyzed using inferential statistics and Structural Equation Modeling. RESULTS: In addition to the positive significant correlation found among the studied variables, First-Line Nurse Managers' Leadership practices accounted for 43% and 40% of the variance of nurses' organizational resilience and job involvement. LINKING EVIDENCE TO ACTION: Nurse leaders perform a crucial role in embracing and executing effective strategies through their transformational leadership and managerial caring to support nurses' resilience and job involvement. Shared governance and a respectful working atmosphere that conveys gratitude to nurses are popular strategies that enhance the efficacy of nursing leadership and promote positive work attitudes among nurses.

Relationship between ethical ideology and moral judgment: Academic nurse educators' perception.

BACKGROUND: Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. PURPOSE: This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. METHODS: A descriptive correlational research design was conducted at Faculty of Nursing, Alexandria University. All academic nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. ETHICAL CONSIDERATIONS: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects' informed consent. FINDINGS: This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p < 0.001; p = 0.031) respectively. Also, there is a positive significant moderate correlation between relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. DISCUSSION: The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. CONCLUSION: Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing students. More emphasis in nursing curricula is needed on ethical concepts for developing nursing competencies.

Relationship between ethical work climate and nurses' perception of organizational support, commitment, job satisfaction and turnover intent.

BACKGROUND: Healthcare organizations are now challenged to retain nurses' generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses' dedication, commitment, satisfaction, and loyalty to their organization. PURPOSE: This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses' organizational commitment, job satisfaction, and turnover intention. METHODS: A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects' informed consent to participate in the research before data collection. FINDINGS: The result revealed positive significant correlations between nurses' perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses' turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention. RECOMMENDATION: Strategies to foster and enhance ethical and supportive work climates as well as job-related benefits are considered significant factors in increasing nurses' commitment and satisfaction and decreasing their turnover intention.