Factors Influencing Generation Z Bachelor of Nursing Students' Decision to Choose Nursing as a Career: A Pilot Study.

Introduction: Despite nurses representing the largest healthcare professional group, the number is not enough for global health coverage. Understanding Generation Z students' intrinsic and extrinsic motivations, internal and external influences, and beliefs in choosing nursing education is crucial. This knowledge empowers universities to enhance nursing program enrollment through targeted promotion and recruitment strategies. Objective: The aim was to understand why Italian students of Generation Z choose the Nursing Degree Course. Methods: In this pilot study, a cross-sectional design was used. A survey with closed and open answers analyzing demographics, opinions, and motivations among new enrolled nursing students was administered on the first day of the Bachelor of Nursing Degree course. Descriptive statistics were used. Quantitative data were analyzed with Chi-square and ANOVA tests and qualitative data underwent content analysis and coding. Correlation analysis explored relationships between qualitative and quantitative results. Results: Forty first-year students (85% female, average age 22) completed the questionnaire. The choice of the degree pathway, as the first or second option, is influenced by intrinsic and extrinsic motivations, the student's opinions, and family and social influences. Significant positive and negative associations were evidenced. Negative factors affecting choice included location and the responsibility for nursing care, while positive factors included role models, family advice, passion, curiosity for healthcare, the desire to help others, and family influences on decision-making. Conclusions: Among Italian generation Z students, the choice of the nursing degree pathway is influenced by social models, family advice, passion, the desire to help others, and curiosity. Universities should be more proactive in their recruitment and promotion efforts, transforming these events into vibrant meeting points for professionals from diverse nursing specialties. They should also implement robust information policies that highlight career possibilities spanning clinical practice, management, education, and research areas within the field.

Self-Perceived Clinical Competence of Nurses in Different Working Experiences: A Cross-Sectional Study.

BACKGROUND: Competence is an essential concept for measuring nurses' performance in terms of effectiveness and quality. To this end, our analysis highlighted the process of acquiring competencies, their self-evaluation into clinical practice, and how their proficiency levels change throughout the nursing career. In detail, this research explored nurses' perceived level of competence and the factors that influence it in different contexts. METHODS: A cross-sectional survey using a structured questionnaire to assess the nursing participants' perception of their competencies in different clinical settings was accomplished. RESULTS: A descriptive and bivariate analysis was performed on 431 nurses. Most respondents assessed their level of competence to be higher than their roles required. The Kruskal-Wallis test confirmed that nursing experience was a relevant factor influencing nursing competencies. CONCLUSIONS: We suggest improving the competence of practicing nurses, using experience as a measurable effect of their development.

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.

Assessment of the Psychometric Characteristics of the Italian Version of the Nurse Manager Actions Scale.

Nurse managers play a vital role in healthcare organizations, wielding the ability to substantially enhance work environments, foster nurses' autonomy, and bolster retention within workplaces. In this context, this study focuses on the Nurse Manager Actions scale, aiming to evaluate its items' scalability as well as the scale's validity and reliability among nurses and nurse managers operating within the Italian healthcare context. The study protocol was not registered. To ensure linguistic and cultural alignment, an iterative and collaborative translation process was undertaken. Subsequently, a multi-center cross-sectional design was adopted. Using a web-survey approach, data were collected among 683 nurses and 188 nurse managers between August 2022 and January 2023. The Nurse Manager Actions scale was found to be a valid and reliable instrument in Italian after a Mokken Scale Analysis. For nurses (HT= 0.630, Molenaar-Sijtsma rho = 0.890), the scale included 6 items, while 11 items were confirmed for nurse managers (HT= 0.620, Molenaar-Sijtsma rho = 0.830). Nurse Manager Actions scale scores were correlated with increased satisfaction and decreased intention to leave for both nurses and nurse managers. The employed validation process enhanced the scale validity for use in Italy and provided a model for other researchers to follow when assessing similar measures in different populations. Measuring and empowering nurse manager actions in work contexts is essential to improve the general well-being and retention of nurses, especially in the current nursing shortage.

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).

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.

Development and Validation of the Nursing Care and Religious Diversity Scale (NCRDS).

(1) Background: In response to the impact of religious intervention on health outcomes and the importance of documenting how nurses experience the spiritual need of 392 hospitalized patients, it is vital to provide the nursing profession with instruments to evaluate these spiritual aspects. This study describes the development and validation of the Nursing Care and Religious Diversity Scale (NCRDS); (2) Methods: A two-step design was used for NCRDS translation and psychometric validation. The tool design was developed in the first step, while the psychometric characteristics were tested in the second step. An inductive study was conducted to test the validity and reliability of the NCRDS tool. The overall sample consisted of 317 nurses; (3) Results: The final instrument comprised 25 items in five dimensions. The construct validity indicated five dimensions. The face and content validity were adequate. Test-retest reliability displayed good stability, and internal consistency (Cronbach's α) was acceptable (0.83); (4) Conclusions: Initial testing of the NCRDS suggested that it is a valid and reliable instrument to evaluate individuals in religious diversity, with five dimensions for evaluating the meaning of spirituality and individual belief, the religious healthcare environment, educational adequacy, spiritual and religious needs, and religious plurality.

Psychometric Properties of the Italian Version of the Leader Member Exchange Scale (LMX-7): A Validation Study.

For decades, scholars have studied leader-member exchange (LMX) relationships to understand and explain the effects of leadership on follower attitudes and performance outcomes within work settings. One available instrument to measure these aspects is the LMX-7 scale. This measurement has been widely used in empirical studies, but its psychometric properties have been poorly explored. The aim of this study was to test the psychometric characteristics (content, structural and construct validity, and reliability) of the Italian version of the LMX-7 scale and to support its cultural adaptation. We used a cross-sectional multi-center design. The forward-backward translation process was used to develop the Italian version of the scale. The scale was administered through an online survey to 837 nurses and nurse managers working in different settings. The factorial structure was tested using both exploratory and confirmatory factor analyses (EFA and CFA), and reliability was evaluated using Cronbach's alpha. For the construct validity, we used hypothesis testing and differentiation by known groups. The Italian version of the LMX-7 scale presented one dimension. All the psychometric tests performed confirmed its validity and suggested its usefulness for future research.

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.

Evaluation of Standard Precautions Compliance Instruments: A Systematic Review Using COSMIN Methodology.

BACKGROUND: Standard precautions (SPs) are first-line strategies with a dual goal: to protect health care workers from occupational contamination while providing care to infected patients and to prevent/reduce health care-associated infections (HAIs). This study aimed at (1) identifying the instruments currently available for measuring healthcare professionals' compliance with standard precautions; (2) evaluating their measurement properties; and (3) providing sound evidence for instrument selection for use by researchers, teachers, staff trainers, and clinical tutors. METHODS: We carried out a systematic review to examine the psychometric properties of standard precautions self-assessment instruments in conformity with the COSMIN guidelines. The search was conducted on the databases PubMed, CINAHL, and APA PsycInfo. RESULTS: Thirteen instruments were identified. These were classified into four categories of tools assessing: compliance with universal precautions, adherence to standard precautions, compliance with hand hygiene, and adherence to transmission-based guidelines and precautions. The psychometric properties of instruments and methodological approaches of the included studies were often not satisfactory. Only four instruments were classified as high-quality measurements. CONCLUSIONS: The available instruments that measure healthcare professionals' compliance with standard precautions are of low-moderate quality. It is necessary that future research completes the validation processes undertaken for long-established and newly developed instruments, using higher-quality methods and estimating all psychometric properties.

Appraisal and Evaluation of the Learning Environment Instruments of the Student Nurse: A Systematic Review Using COSMIN Methodology.

BACKGROUND: Nursing education consists of theory and practice, and student nurses' perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently available tools for measuring the clinical and educational learning environments of student nurses and to evaluate their measurement properties in order to provide solid evidence for researchers, educators, and clinical tutors to use in the selection of tools. METHODS: We conducted a systematic review to evaluate the psychometric properties of self-reported learning environment tools in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Guidelines of 2018. The research was conducted on the following databases: PubMed, CINAHL, APA PsycInfo, and ERIC. RESULTS: In the literature, 14 instruments were found that evaluate both the traditional and simulated clinical learning environments and the educational learning environments of student nurses. These tools can be ideally divided into first-generation tools developed from different learning theories and second-generation tools developed by mixing, reviewing, and integrating different already-validated tools. CONCLUSION: Not all the relevant psychometric properties of the instruments were evaluated, and the methodological approaches used were often doubtful or inadequate, thus threatening the instruments' external validity. Further research is needed to complete the validation processes undertaken for both new and already developed instruments, using higher-quality methods and evaluating all psychometric properties.

Cultural Adaptation and Psychometric Properties of the Trust Me Scale-Italian Version: A Validation Study.

BACKGROUND: The Trust Me Scale is a widely used instrument to measure trust in healthcare providers. However, no Italian version of the scale exists yet, limiting its use in Italian-speaking populations. The aim of this study is to translate and validate the Trust Me Scale for use in Italian-speaking populations in nurses and nurse managers. METHODS: The translation process involved methodological steps of collaborative and iterative translation with cultural adaptation. The validation process included a cross-sectional study enrolling a convenience sample of 683 nurses and 188 nurse managers who completed the Italian version of the Trust Me Scale and measures of intention to leave, satisfaction, and organizational commitment. RESULTS: Item 5 was removed for poor factor loading, and items 11 and 13 were removed following an a priori strategy focused on deleting items with correlations between residual variables different than expected based on theoretical expectations derived from previous research. The final model fit well to sample statistics with a three-factor structure (harmony, reliability, and concern) and 13 items. A multiple-indicator multiple-cause model showed a measurement invariance between nurses and nurse coordinators. Construct validity was also supported by the evidence that the measured domains of trust align with the theoretical expectations and are related to the intention to leave, job satisfaction, and organizational commitment. Each dimension showed adequate scale reliability. CONCLUSIONS: The Italian version of the Trust Me Scale is a valid and reliable instrument to measure trust in nurses and nurse managers in Italian-speaking contexts. It can be used for research in nursing and leadership and evaluation of interventions aimed at improving trust in healthcare contexts.

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.

An example of evaluation of tuning nursing competences in the licensure exam: An observational study.

Introduction The licensure exam in nursing has always focused on the curricula used in universities. 'Tuning' was the first project that sought to harmonize training purposes regarding competences and learning outcomes in Europe. The Tuning educational structures have been offered in various disciplines, including nursing with the development of the Tuning Nursing Project. The study describes which of 47 Tuning Nursing Competences were evaluated during the licensure exam in nursing degree courses, and what types of trials were used for their assessment. Methods A multicentric observational study was conducted in 4 universities in Italy. Data were collected in academic years 2017-2019, using two grids: one for cognitive and one for psychomotor tests. Results The Tuning competences were requested 7522 times. The most frequently demanded were those associated with domain number two, "Nursing practice and clinical decision making". The level of performance most required in cognitive tests was the autonomy of judgement, and both tests concerned the fields of non-communicable diseases and the hospitalized adult patient. Conclusions The competences most often assessed coincided with those deemed core for the first cycle of studies at the European level. Unfortunately, it has been detected a high degree of discrepancy in the types of tests used in different schools.

Self-assessment the competencies of surgical and critical area nurses. A cross-sectional study.

BACKGROUND AND AIM: This study aims to measure the competencies of surgical and critical area nurses, and to compare the nurses' involved competencies in relation to the area to which they belong Methods: A cross-sectional study. The study was based on a convenience sample. The registered nurses were recruited from a hospital of the Friuli Western Health Authority. The Italian version of the Nurse Competence Scale composed from 58 items and validated in Italy in 2018 as a self-assessment tool for nursing competencies in the surgical and critical area, was self-administrated in October- November 2020. RESULTS: The average competence level was found to be 68.7, with a median of 70 and a standard deviation of 19.7. The nurses felt more competent belongs to "Management of the care process", specifically in "Recognizing critical situations for the patient's life early" (82.0). Most deficient was found in "Raising problems to be deepened with research" (50.9). CONCLUSIONS: The study found that nurses perceive a good level of competence with differences related to care settings. The results obtained from the study can provide nurses with the opportunity to reflect on their behaviours and periodically evaluate their knowledge and competencies, to promote professional development and continuing education. (www.actabiomedica.it).

The effects of a structured educational program on preparedness for self-employed careers in Italian undergraduate nursing students.

BACKGROUND AND AIM OF THE WORK: In the Italian and also international contexts, there is a paucity of evidence testing whether a structured educational intervention delivered from remote might be useful in increasing the levels of preparedness for self-employed careers among third-year nursing students, despite freelance nursing careers are a promising component of the current labour market. This study aimed to test the effects of a structured educational program on the preparedness for self-employed careers in Italian undergraduate nursing students. METHODS: The study was quasi-experimental and nonrandomized and employed a pre/post-intervention approach with convenience sampling. Data were collected before the structured education program was delivered (T0) and up to one day after the instruction was delivered (T1). RESULTS: In this study, 717 third-year nursing students were enrolled. The most significant difference between T0 and T1 was in the domain of knowledge about pensions and retirement issues, followed by administrative rules knowledge. There were substantial variations between T0 and T1 in the area of logistic characteristics in determining the price of a freelance nursing activity, as well as scores in the domain of care complexity in determining the price of the independent nursing occupation. CONCLUSIONS: This study proved the short-term impacts of a structured educational program on enhancing levels of preparation for self-employed professions among Italian undergraduate nursing students. This topic requires more attention as the demands of prepared healthcare workers to undertake self-employed careers necessitate a greater capacity to properly educate nursing students for self-employed occupations within their undergraduate path.

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.

Spirituality and Religious Diversity in Nursing: A Scoping Review.

Spirituality is a common theme in the field of healthcare research. This study aimed to examine nurses' perceptions of spirituality in the context of the religious diversity of patients in pluri-religious settings. We performed a scoping review following the methodology on studies conducted between 2010 and 2020. We searched the following databases: CINAHL Plus, PubMed, and PsycINFO. For the identification of grey literature, the OpenGrey database was used. In total, 789 articles were reviewed. Of these, 16 met predetermined inclusion criteria. Two main overarching themes emerged from our inductive analysis: (a) the intertwining of spirituality and spiritual care in diverse religious landscapes and (b) obstacles impeding the inclusion of spiritual care in pluri-religious settings. According to our results, nurses consider that spirituality is interconnected with spiritual care for individuals from different religious backgrounds. Interpretations of spirituality in nursing practice vary widely, with spirituality and religiosity often shaped and influenced by culture and the experience of the professionals. Nurses attribute various meanings to spiritual care, most of which center on respecting personal, interpersonal, and relational aspects of religious and cultural beliefs and practices. Lack of education and specific skills, insufficient time, role ambiguity, and different religious beliefs were identified as hurdles to spiritual care. A poor work environment, a lack of patient privacy, including personal space, and a lack of compassion were also reported as deterrents to spiritual healing. More knowledge and training on different religions and spirituality are required to meet patients' spiritual needs to better overcome these hurdles.

Italian Translation and Validation of the Readiness for Interprofessional Learning Scale (RIPLS) in an Undergraduate Healthcare Student Context.

Interprofessional education requires that two or more professionals learn from and with each other to allow effective collaboration and improve health outcomes. Thus far, the interprofessional collaboration of healthcare students might be assessed using the Readiness for Interprofessional Learning Scale (RIPLS), which is currently not available in its Italian version. This study aimed to provide the intercultural adaptation of the RIPLS in Italian (I-RIPLS) and assess its validity and reliability. A two-phase validation study was performed in 2020, using a single-centre approach in students enrolled in the medical degree, physiotherapy, nursing, and dentistry courses at an Italian-speaking university in Albania. The first phase of the study determined the cross-cultural adaptation of the items by involving two translators who followed a forward and backward translation process. In the second phase, a sample of 414 students was enrolled. The preliminary corrected item-total correlations showed that five items did not show significant item-to-total correlations. Even if their deletion was not mandatory for generating a suitable correlation matrix for factor analysis, the advantages of keeping only items contributing to a more stable measurement with a shorter scale represented the rationale for removing items with non-significant item-to-total correlation from the correlation matrix before testing the dimensionality of the I-RIPLS with factor analysis. The answers from the first 50% of responders (n = 207) were used to determine the most plausible dimensionality of the I-RIPLS by employing an exploratory factor analysis (EFA), and the second 50% were used to cross-validate the most plausible dimensionality derived from EFA by employing confirmatory factor analysis (CFA) models. The most plausible dimensionality from EFA, by acknowledging the interpretation of the scree plot, the eigenvalues greater than 1, a parallel analysis, and the previous theoretical dimensions of the tool had two factors with adequate internal consistency. The CFA confirmed the two-factor solutions and the internal consistency for each domain. The I-RIPLS has 14 items with adequate evidence of validity and reliability. Future research should revise the tool for pursuing cross-cultural multigroup measurement invariance.