Staying with nursing: the impact of conflictual communication, stress and organizational problem-solving.

AIM: To predict nurses' intent to stay on the job as a function of organizational culture. BACKGROUND: Organizational climate significantly contributes to retention of nurses. Communication by conflict and organizational control over problem-solving has not thoroughly been studied. METHODS: A cross-sectional design was used with a randomly selected final sample of 367 nurses from regional hospitals in Hungary. Organizational climate, perceived stress, locus of control and self-esteem were assessed as main measures. Nurses indicated their intent to stay for the next 5 years. Spearman correlation coefficients were calculated to evaluate associations. Bivariate logistic regression was performed to predict intent to stay in nursing. FINDINGS: Organizational climate was negatively correlated with perceived stress and personal locus of control and positively with personal self-esteem. Organizational level internal locus of control (belief that employees have control over problem-solving) doubled the probability of staying on the job. Conflictual communication and perceived stress both decreased intent to stay by 50%. DISCUSSION AND CONCLUSIONS: Organizational internal locus of control, stress and conflictual communication were main predictors of intent to stay. The belief that nurses had collective control over problem-solving capabilities had a positive and greater impact on nurse retention compared to other measures. IMPLICATION FOR NURSING POLICY: Healthcare organizations should routinely scan workplace culture for conflictual communication, stress and organizational problem-solving capacities. Graduate nurse and nurse manager training should include practices that enable developing positive work atmospheres. Hospital managements should allocate training budget to stimulate and achieve cultural change. IMPLICATIONS FOR NURSING PRACTICE: Nurse managers should promote internal trainings to help staff nurses adopt techniques that minimize conflict and emphasize positive impact of collaborative problem-solving.

Does self-care agency change between hospital admission and discharge? An Orem-based investigation.

AIMS: To assess whether nursing care improved patients' self-care agency between admission to hospital care and discharge. METHODS: A pre-test-post-test comparative research design with random subject selection was used. One hundred and sixty patients and 52 nurses rated identical self-care agency assessment forms, based on Orem's framework, both at admission and discharge. Patient satisfaction with nursing care and nurse satisfaction with working conditions were also assessed. Repeated measures ancova as well as paired and independent t-tests were used to test differences at both time points. Level of significance was set at 0.05 in this study. RESULTS: Patients in general reported high self-care agency pre- and post-test. Compared with a reference group of elderly residents, the study sample showed significantly lower levels of self-care agency. We found no difference between patient and nurse assessments of self-care agency on admission and discharge. Better patient-nurse relationships were associated with greater self-care agency reported by patients. CONCLUSIONS: Authors found no change in patient self-care agency between hospital admission and discharge. Outcomes may have been due to the inappropriate choice of the conceptual framework applied for acute care settings or to the insufficient length of the study. A longitudinal approach to observe long-term improvement of self-care capabilities is recommended.

The influence of staff-patient interactions on adherence behaviours.

The research assessed the influence of staff-patient interactions on adherence to a dietary regimen in dialysis patients. A random sample of 147 subjects provided data on clinical, psychosocial, and demographic measures. Results indicated that staff-patient interactions determine and predict adherence behaviours. However, the lack of association between the laboratory data and either individual adherence behaviours or staff-patient interactions raised questions about the validity of these proxy measures of adherence. To better understand the nature of these determinant variables of adherence, more extensive research is suggested.

[Controlled drug delivery systems. Paradigm change in pharmacology]. / Szabályozott hatóanyag-leadó rendszerek. Paradigmaváltás a gyógyszerészetben.

This article is to introduce the readers in the colourful world of controlled drug delivery. These structures are to carry the drug into the place of release for let it there out with proper velocity. So the aim of the researches are not to find the best drug, but to get it into the right place in the right time. Some controlled drug delivery processes are already in use. However it comes everyday a physical, chemical or biological idea for making a new style of controlled drug delivery system. This is the reason way we find this part of the pharmacology worth to the attention. We like to introduce it with short presenting of drug delivery systems, they classes, they working and the physical chemistry of drug release.

Magnetic and Mössbauer Studies of Magnetite-Loaded Polyvinyl Alcohol Hydrogels.

Materials producing strain in a magnetic field are known as magnetoelastic or magnetostrictive materials. A new type of material that is able to produce giant strain in a nonhomogeneous magnetic field has been developed. In these magnetic-field-sensitive gels (ferrogels) fine colloidal particles having superparamagnetic behavior are incorporated into a highly swollen elastic polymer network. Magnetic properties of ferrogels have been investigated using electron microscopy, static magnetization measurements, and Mössbauer spectroscopy. Analysis of the data yielded information on the superparamagnetic behavior of ferrogels and made it possible to estimate the size distribution of the magnetic cores of magnetite particles made by chemical precipitation and built into a chemically cross-linked polyvinyl alcohol matrix. The results are interpreted on the basis of a core-shell model. Copyright 2000 Academic Press.