An Observational Cross-Sectional Analysis of the Correlation between Clinical Competencies and Clinical Reasoning among Italian Registered Nurses.

Ability, knowledge, aptitude, and skill are the terms identified in the literature as the attributes of the concept of clinical competence. This implies that in order to act competently in their own context, the nurse must be able to make decisions which mainly depend on the ability to put clinical reasoning into practice. However, the evaluation of clinical reasoning in the various clinical-care activities of nursing competence is a necessary operation to prevent routine attitudes. From the perspective of an assessment of nursing competences, the aim of this study is to validate the relationship between the degree of competence recognized in a specific clinical setting and the amount of clinical reasoning executed by nurses. The study design was a cross-sectional observational design, following the guidelines of the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) of observational studies. Both the Italian Nurse Competence Scale and the Nurse Clinical Reasoning Scale were used. The data was collected between 25 January and 5 March 2022. Four hundred twenty-four clinical nurses participated by completing and returning the questionnaires. The instruments underwent assessment to ensure internal consistency and test-retest reliability. Their validity was tested with the validity of known content, construct, and groups. This is supported by statistically significant correlations between the different variables examined and the scores of the different dimensions of the Italian Nurse Competence Scale and the Italian Nurse Clinical Reasoning Scale. The data collected showed an excellent average level of competencies and clinical reasoning, M = range of 72.24 and 63.93, respectively. In addition, we observed satisfactory scores across all dimensions of I-NCS (significance range: 0.000-0.014) and I-NCRS (significance range: 0.000-0.004). The understanding and development of clinical reasoning has also brought out new aspects that require further research. This study provides a fresh perspective on the correlation between clinical competences and clinical reasoning, representing a novel attempt to analyze their relationship.

Nurses' Perceptions of Spirituality and Spiritual Care and Influencing Factors in Türkiye, Italy, and Albania: A Multicultural Study.

The present study aimed to explore the perceptions of spirituality and spiritual care among nurses who work in three different countries with different cultures as well as the factors influencing their perception. This is a cross-sectional multicultural study conducted with a total of 1090 nurses from Türkiye, Albania, and Italy. Data were collected through the "Individual Information Form" and the "Spirituality and Spiritual Care Rating Scale". Nurses' mean score on the Spirituality and Spiritual Care Rating Scale was above average. It was also found that country, marital status, religious belief, Islamic religion, training for spiritual care, and using spiritual practices to cope with difficulties or illnesses influenced nurses' perception of spirituality and spiritual care. It was concluded that nurses from the three countries associated spirituality and spiritual care with religion and that some personal characteristics influenced their perceptions of spiritual care. The results highlight the need for training in spiritual care to improve nurses' perceptions and practices of spiritual care.

Empowering Nurse Health Education: Linguistic and Cultural Validation of the Nurse Health Education Competence Instrument (NHECI) in the Italian Context.

BACKGROUND: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguistically and culturally in the Italian context. METHODS: Following Beaton et al.'s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. RESULTS: The Italian version demonstrates a good internal consistency and stability, making it suitable for assessing nursing students during clinical internships and practicing nurses. The availability of Italian tools promotes healthcare research, ensuring patient-centric care. CONCLUSIONS: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

Describing the readiness for interprofessional education among university students attending healthcare programs: insights from a monocentric cross-sectional study.

BACKGROUND AND AIM: Readiness for interprofessional education (IPE) was recognized by international authorities as a key approach for educating students attending healthcare programs. Thus far, there are no descriptions of readiness for IPE in the Albanian context. For this reason, this study aimed to describe readiness for IPE, assessed by measuring "teamwork and collaboration" and "positive professional identity, roles, and responsibilities" among students attending healthcare programs in an Italian-speaking university based in Albania, and describe the correlations between readiness for IPE and the characteristics of the respondents. METHODS: This study had a descriptive observational design, a cross-sectional data collection, and a convenience sampling procedure performed in a single centre. The study was accomplished between April 2020 and June 2021, involving 688 students, 38.2% of the entire population of students attending healthcare programs in the context of the investigation. RESULTS: The teamwork and collaboration mean score was 4.40 (standard deviation = 0.56), and no differences were found between programs (p-value=0.159). The positive professional identity, roles, and responsibilities mean score was 4.33 (standard deviation = 0.64) with no differences between programs (p-value=0.340). Females attending nursing or midwifery reported higher positive professional identity, roles, and responsibilities scores (p-value=0.020), and females in dentistry reported higher teamwork and collaboration scores than males (p-value=0.045). CONCLUSIONS: Future research should evaluate readiness for IPE longitudinally to ascertain its trajectories over time and analyze any potential individual- or organizational-level variables that may impact IPE and sex-related differences regarding factors influencing IPE.

An Observational Cross-Sectional Study on the Correlation between Professional Competencies and Self-Efficacy in Albanian Registered Nurses.

(1) Background: The assessment and application of registered nurses' professional skills are essential to providing quality and safe care. Self-efficacy can positively affect the professional competence of registered nurses. This study analysed professional competence and its association with self-efficacy among registered nurses. (2) Methods: A cross-sectional observational study was conducted. The sampling was conventional. The data collection took place through the Albanian version of the Nurse Professional Competence Scale Short Form (A-NPCS-SF), which was used to assess their professional skills, and the Albanian version of the Nursing Profession Self-Efficacy Scale (A-NPSES), which was used to assess their self-efficacy. The study was based on a convenience sample of 985 registered nurses from the 12 Albanian provinces. (3) Results: The Cronbach alpha value for the A-NPCS-SF scale was 0.947, while for the A-NPSES scale, it was 0.875, proving both scales to be reliable. Self-efficacy does not play an essential role in the development of the professional competence of registered nurses since our survey found only one dimension correlates with these two elements. (4) Conclusions: The results of our analysis have instead highlighted the importance of a close relationship between job satisfaction and the development of professional skills.

Translation, validation and psychometric properties of the Albanian version of the Nurses Professional Competence Scale Short form.

BACKGROUND AND AIM: The primary aim of this study was the translation and psychometric validation of the Albanian Nurse Professional Competence Scale Short Form (A-NPCS-SF) for further application in Albanian healthcare settings. METHODS: The multiphase design used to develop the A-NPCS-SF comprised (1) cultural and linguistic validation, (2) content and face validity, and (3) construct validity. RESULTS: The A-NPCS-SF showed adequate content validity. Confirmatory factor analysis supported the six-factor structure of the A-NPCS-SF to explain the data obtained from the nurses. CONCLUSIONS: The A-NPCS-SF showed evidence of validity and reliability in measuring four professional competencies. Having an appropriate scale in Albanian for professional competence self-assessment by nurses constitutes an essential step in measuring these competencies.  (www.actabiomedica.it).

Psychometric Evaluation of the Nurse Clinical Reasoning Scale (NCRS): A Validation Study Among Italian Nurses.

Background and Purpose: Clinical reasoning for nurses is considered a valuable component of clinical nursing competencies, but there are few tools to ascertain this. This study tested the Italian Nurses Clinical Reasoning Scale (I-NCRS) psychometric properties based on Levett-Jones' theoretical clinical reasoning model. Methods: Content, face, and construct characteristics were ascertained for their validity. The study had a two-phase design: (a) content and face validity and (b) construct validity. Results: Three factors emerged from the factorial analysis of our reference sample: nursing problems of health, nursing information of health, and nursing assessment of health. Conclusions: The scale represents a valuable tool for the self-assessment of the clinical reasoning skills of nurses. I-NCRS showed evidence of validity and reliability, being also useful for assessing clinical reasoning for educational and research purposes among Italian nurses.

Psychometric Characteristics of the Self-Care of Chronic Illness Inventory in Older Adults Living in a Middle-Income Country.

Chronic illness requires numerous treatments and self-care is essential in the care process. Evaluation of self-care behaviors facilitates the identification of patients' needs and optimizes education and care processes. This study aimed to test the psychometric characteristics (validity, reliability, and measurement error) of the Albanian version of the Self-Care of Chronic Illness Inventory (SC-CII). Patients with multiple chronic conditions and caregivers were recruited in outpatient clinics in Albania. The patients completed the SC-CII, which includes three scales: self-care maintenance, self-care monitoring, and self-care management. Factorial validity was tested for each scale, with confirmatory factor analysis. Reliability was evaluated with the composite coefficient, Cronbach's alpha, and the global reliability index for multidimensional scales. The construct validity was tested using hypothesis testing and known differences between groups. The measurement error was tested to assess responsiveness to changes. The self-care maintenance and self-care monitoring scales showed a unidimensional factorial structure, while the self-care management scale showed a bidimensional structure. Reliability estimates were adequate for all reliability coefficients. Construct validity was supported. The measurement error was adequate. The Albanian version of the SC-CII shows good psychometric properties in the Albanian sample.

Psychometric Properties of the Albanian Version of the Nursing Self-Efficacy Scale.

There are few tools to ascertain self-efficacy, which is a valuable component of nursing skills. This study has tested the psychometric properties of an Albanian translation of the Nursing Profession Self-Efficacy Scale (NPSES), which is based on Bandura's theory of social cognition. Data were collected using questionnaires which were filled out by 423 nurses from the twelve provinces of the Albanian health system. The scale's content, face, and construct validity were evaluated. Reliability was verified using Cronbach's α and test-retest and by calculating the intraclass correlation coefficients. The original NPSES has two factors; for the A-NPSES analyzed in this study, four factors emerged from the factorial analysis of our reference sample: nursing care procedure situation, nursing research situation, nursing ethics situation, and nursing practice situation. Cronbach's α was 0.91, indicating that the tool is reliable. The results of this study demonstrate the validity and reliability of the Albanian version of the NPSES. This scale is a valuable tool for self-assessing nurses' self-efficacy. An adequate scale for measuring nurses' self-efficacy can be used to improve the quality of clinical nursing care.

Measuring professional competencies of registered nurses and nursing students. A cross-sectional comparative study.

BACKGROUND AND AIM OF THE WORK: Professional competence is essential in providing nursing care based on standards. This concept can be measured, among various instruments, with the Nurses' Professional Competence Scale Short Form (NPCS-SF). The main aim of this study was to explore the perceptions of Registered Nurses (RNs) and Student Nurses (SNs) of their competencies and investigate their differences in the development of nursing competencies using the Italian version of the NPCS-SF. METHODS: A cross-sectional observational study design was accomplished. The research was based on a convenience sample of 328 RNs and SNs (response rate: 81.95%) recruited at the University of Our Lady of Good Counsel, Tirane, Albania and Tor Vergata University Hospital, Rome, Italy. RESULTS: RNs averaged higher than SNs' (m= 86.11 ± 9.53 SD) in professional competencies development. The factor for which the mean was highest for RNs was 'ethics of nursing care' (m = 89.54 ± 8.31 SD). SNs scored the lowest in leadership and coordination of nursing care (m = 78.36 ± 14.55 SD). CONCLUSIONS: The factors that scored the highest and lowest on the scale were similar with the results of using NPCS-SF in other countries. The study results may indicate that specific training for RNs and SNs could be accomplished based on different competence factors that show low scores of the NPCS-SF. The NPCS-SF has also shown excellent reliability in the Italian context. Furthermore, these findings have implications for teaching competencies in educational institutions and further research.

Nursing in Albania: A Catalytic Force in Transforming Health Professionals and Health Care.

PURPOSE: Transitions in nursing education and professionalism that align with global nursing standards are elucidated as critical success factors in transforming health professionals and health care in Albania. Progressive educational and regulatory pathways throughout the 2000s (1999-2020) are emphasized for their impact on the Albanian health system, including the achievement of universal healthcare coverage. METHODS: Data collected by the Ministry of Health and Sport and the Regulatory Authority for nursing and other healthcare professions in Albania were analyzed and outcomes explicated with regard to Albania's major health challenges. DISCUSSION AND CONCLUSIONS: Three milestones affirmed nursing as a driving force in the Albanian healthcare system: (a) nurses constitute the largest health professional workforce via a nurse-patient ratio of 1:400 in contrast to a physician-patient ratio of 1:2,500; (b) nurses are frontline care providers via clinical leadership in the management of primary healthcare centers, which ensure universal healthcare coverage; and (c) nurses are first responders via their presence and compassionate caring in the primary healthcare centers, including making critical shifts in converting primary healthcare centers to urgent care centers as needed. CLINICAL RELEVANCE: Nursing advancements have implicated quality care and professionalism in Albania across the health professions via three critical pathways: (a) health professional education at a university degree level for entry into practice (since 1999), which was prompted by and driven by nursing's quest to be a self-regulated profession (achieved in 2007); (b) healthcare global standards sparked by nursing's mandate toward professional autonomy, as achieved via regulatory procedures and policies; and (c) interprofessional healthcare initiatives that serve as collaborative platforms for innovative educational, clinical, and research projects.

Nursing education in Albania: Evolution and future prospects of health policy.

BACKGROUND: Nursing in Albania has grown rapidly over the past decade in response to government initiatives to strengthen primary care. There is limited data on how this expansion has impacted the role of the nurse leadership, the scope of practice, and the characteristics of the workforce. AIM: The purpose of this study is to try to describe the current demographic and occupational characteristics of Albanian nurses. METHOD: A national survey was undertaken to describe the demographics, clinical roles, and skills of nurses. This retrospective study will attempt to describe the situation of nurses from 2009-2021 and the analysis in the processed dataset was carried out to explore changes in the workforce over time. RESULTS: This study presents a retrospective analysis of Albanian nursing regarding the evolution of nursing. It also provides some information on the preparations for vocational training. In this study it is highlighted that there has been a reformulation of the theme of nursing professional qualification, and the need to improve the quality of educational processes and a wide offer of continuing education for Albanian nurses. CONCLUSION: This study identified that some of the structural barriers to nursing in Albanian general care have been addressed over time. However, it also identifies ongoing barriers that impact the development of the nurse s role. Understanding and addressing these issues is critical to optimizing both the effectiveness of the nursing workforce and undergraduate education. NURSING IMPLICATIONS: There is a clear indication of increased intellectual and conceptual accumulation in the decades when professional nursing education at the technical level has been part of the public policy agenda. This knowledge serves as a reference for the formulation of new actions aimed at other professionals who provide direct assistance to the population.