Work climate, work values and professional commitment as predictors of job satisfaction in nurses.

AIM: To investigate the effect of some psychosocial variables on nurses' job satisfaction. BACKGROUND: Nurses' job satisfaction is one of the most important factors in determining individuals' intention to stay or leave a health-care organisation. Literature shows a predictive role of work climate, professional commitment and work values on job satisfaction, but their conjoint effect has rarely been considered. METHODS: A cross-sectional questionnaire survey was adopted. Participants were hospital nurses and data were collected in 2011. RESULTS: Professional commitment and work climate positively predicted nurses' job satisfaction. The effect of intrinsic vs. extrinsic work value orientation on job satisfaction was completely mediated by professional commitment. CONCLUSIONS: Nurses' job satisfaction is influenced by both contextual and personal variables, in particular work climate and professional commitment. According to a more recent theoretical framework, work climate, work values and professional commitment interact with each other in determining nurses' job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management must be careful to keep the context of work tuned to individuals' attitude and vice versa. Improving the work climate can have a positive effect on job satisfaction, but its effect may be enhanced by favouring strong professional commitment and by promoting intrinsic more than extrinsic work values.

Missed care and support figures: Preliminary investigation in some surgical ward.

INTRODUCTION: Missed Nursing care (MNC) is defined as planned care in the patients care process that is omitted or delayed. Despite their importance in Italy, there are just few studies that measure MNC's prevalence and causes. We are not aware of studies published in literature that have related MNC with the presence or absence of support staff. OBJECTIVES: This study's objective, was to measure nurse's perception and reasons for missed care in surgical wards with or without Health Care Assistants (HCA), and, to assess whether there is a significant difference between the two groups of nurses. METHODOLOGY: A Cross-sectional observational study was conducted through the administration of the "Missed Nursing Care Survey" in the Italian Version to nurses of the wards surveyed. RESULTS: Results have confirmed that the most frequent MNC are hygiene and mobilisation activities as reported in other Italian and foreign studies, with higher frequency in wards without HCAs. Also, the study confirmed other Italian and foreign study results recognising the most significant motivation for MNC's as the lack of staff and unexpected events. CONCLUSIONS: Without wishing to attribute a cause/effect relation, it is interesting to assess the results, which seem to show that the presence of HCAs contributes to reduce the prevalence of missed activities. The lack of staff has revealed higher average of MNC for both groups, which seems to direct our attention not only towards the presence of HCAs but in regards to their inclusion in care activities. It may be necessary to reflect on the priority that nurses give to certain activities.

Education nursing students' in Palliative Care and Pain Therapy: an observational study.

BACKGROUND AND AIM: University education plays an important role in the preparation of future nurses, especially in the care of dying patients, which is one of the most emotionally engaging aspects. The objectives of the study were to describe the attitudes of students in end-of-life care and to analyze the possible relationship with some socio-demographic variables, through an observational study. METHODS: Preliminarily, an analysis of the educational context of the Nursing Course  of the University of Parma was started, through a comparison of the university course with the recommendations of the MIUR concerning the teaching and learning of Palliative Care and Pain Therapy. Subsequently, a questionnaire containing the Frommelt Attitude Toward Care of the Dying Scale Form B and some socio-demographic context variables was administered to a sample of 109 students belonging to the CoS of Nursing in Parma. RESULTS: From the data collected, it emerged that university planning partly reflects the recommendations of the MIUR and how, on average, nursing students have described positive attitudes in all the dimensions investigated. Interesting is the presence of a positive relationship between the personal experiences of bereavement and the attitudes of the students. CONCLUSIONS: Nurses are essential in ensuring the quality of care provided to patients at the end of life; Nursing training in Palliative Care and Pain Therapy should include a complete and varied program (frontal activity, simulation, internship paths...) in order to develop positive student attitudes associated with high levels of satisfaction and improvement of the quality of care provided.

Health coaching for undergraduate nursing students: a pilot study for an action research.

BACKGROUND AND AIM: The Nursing undergraduate degree educational program represents an intensive and complex course, and includes a number of professionalizing practical internships, and for these reasons it requires an action to support and improve. Coaching is based on the premise that people have personal strengths and abilities which, through a interview, can be directed to solving their problems. Several studies demonstrate the efficacy of Health Coaching in different University, but never have been measured benefits regard skills improving. The objective of the study is to assess the impact of a health coaching program on the nursing students. METHOD: A pre-post quasi-experimental study was conducted, involving the activation of a Health Coaching Program for 25 nursing students selected through convenience sampling, based on their fulfillment of the inclusion criteria. The Health Coaching Program was administered by the Health Coaching Academy. RESULT: This study also evaluated parameters such as: level of concentration in study, motivation, problem solving and reorganization skills, study organization skills, psycho-physical-emotional state comprehension, decision-making skills and self-esteem, noting a statistically significant increase post-HC program. A statistically significant improvement was also found in the students' perception of their own stress management skills after the course. CONCLUSION: This study strengthens the hypothesis that HC programs contribute to improving performance of nursing students. Those conclusions need to be corroborated by future studies on the topic to further support the hypothesis that programs of HC within the learning nursing contexts can lead to a tangible benefit for students of the health professions.

Medication administration and anxiety: an observational study with nursing students.

BACKGROUND AND AIM: Medication administration errors represent a topic of great scientific interest. Medication administration is considered by nursing students a complex process during which it is easy to make mistakes; therefore, institutional measures have been adopted in order to reduce medication errors. However, it remains a critical issue in nursing practice for which several causes have been identified, including environmental factors and individual knowledge. Mistakes can be made by nurses and especially by students who must cope with additional causal factors including anxiety management. The aim was to investigate state anxiety levels among nursing students when it comes to medication administration. RESEARCH DESIGN AND METHODS: An observational study involving a convenience sample of 150 nursing students from a Northern Italy University has been conducted; they were asked to complete a questionnaire to measure the levels of state anxiety in relation to medication administration.   Results. There were no particularly high levels of state anxiety among students associated with medication administration; however, state anxiety levels were slightly higher in third-year students than in second-year students, and this is most likely due to the growing complexity of the medication administration process compared to the lack of experience.   Conclusions. Although the results don't show statistically significant data, the effectiveness of nursing education plays a crucial role in reducing medication errors, which is why it is essential to provide suitable tools for the professionals of the future and invest in clinical simulations.

The safety of care focused on patient identity: an observational study.

BACKGROUND AND AIM: Healthcare organizations, in order to reduce errors and extend the number of safe practices, are looking for possible solutions to enhance the clients' health quality care and trying to spread the culture of safety healthcare. Although in the literature the field of research "patient safety" is very debated, there are few empirical studies that investigate about the strategies undertaken by nursing students for the patients identification process during their care pathway. The aim of this study is to investigate the knowledge of the Ministerial Recommendation No. 3/2008 among nursing students, a specific Italian directive that aims to guarantee the safety of cares. METHODS: A four-weeks single-center observational study was conducted, involving a convenient sample of 112 students of the 2nd and 3rd  year of the Nursing Course Degree of the University of Parma. The survey was conducted using an ad-hoc questionnaire. RESULTS: The use of the identification wristband is considered one of the most important strategy to make sure the patient identification; unfortunately it is in practice used just in few occasions and only when performed specific procedures; it is furthermore noted that patients are not enough informed about the use and finalities of the identification wristband. CONCLUSIONS: Considering the importance of the patient identification process to guarantee the  safety of cares, the results produced, suggest that this investigation field deserves further insights in order to collect more substantial data and expand knowledge on the specific subject, so as to fill  knowledge gaps and sensitize nursing students to the correct use of the identification wristband.

The Nursing Management of Tourniquet: the infective risk related to its use.

BACKGROUND AND AIM OF THE WORK: Reusable tourniquets should be considered and used in clinical practice as semi-critical devices, as they are colonized by potentially pathogenic agents, a possible cause of care-related infections. The aim of the study was to analyse the management of tourniquets in the clinical reality of wards, investigating the aspects related to their use in venepuncture procedures, the cleaning process after their use and storage. METHODS: It has been conducted an observational study with a questionnaire on a sample of nurses (N = 73) and nursing students (N = 60) recruited in a hospital and in an University of northern Italy. RESULTS: Data revealed a very positive attitude regarding the high standards of hand hygiene among nurses and nursing students sampled; the critical issues concern the lack of shared protocols or guidelines for the management of tourniquets that lead to discussion both on their use in clinical practice and on the disinfection process after use as well as tourniquets disposal. CONCLUSIONS: Tourniquets can represent a serious potential danger in terms of infections transmission, especially in the pandemic period we are experiencing; their use is practically transversal in all healthcare settings and it is therefore necessary to implement the use of shared management and disposal guidelines / protocols. From this research it appears that in the setting explored, although much attention is paid to hand hygiene, this aspect still seems to be a critical point of nursing care.

Nomophobia in healthcare: an observational study between nurses and students.

BACKGROUND AND AIM: The abuse of technical devices can be considered a form of addiction that is defined in current literature as Nomophobia. The phenomenon appears to be quite widespread among nurses and nursing students, and nomophobic behaviours of professionals can lead to a reduction in the quality of the care provided. The aim of this study is to investigate the situation in a University and in a hospital in northern Italy and evaluate the levels of nomophobia among nurses and students. METHODS: An observational study was conducted with a questionnaire using a sample of nursing students and nurses.  Both of the studies had the common goal of investigating the levels of nomophobia and   evaluate the comparison between the two groups. RESULTS: In general, neither nurses nor students seem to demonstrate nomophobia's critical levels. The comparison of the daily use of the smartphone between nurses and students shows that the frequent use of students is balanced by the nurses' daily trend line that progressively decreases. Both nurses and students affirm to use their smartphones at work with a certain frequency although, especially among the students, it is usually for appropriate and justified reasons. CONCLUSIONS: It is necessary to consider the development of an educational project that regulates the use of smartphones, explaining the meaning of nomophobia, right from the first year of the University experience so as to correctly address the students'  (and future professionals') behaviours  to make them aware of the misuse of mobile phones, especially in the clinical setting that can easily cause distractions and consequently irreversible  errors.

The nurses' uniform in pediatrics, the opinion of children and nurses.

BACKGROUND AND AIM: The nursing uniform represents a non-verbal mean of communication which in the case of children can arouse positive or negative emotions. The first study conducted on a sample of 107 children, aimed to define their preferences on different models of decorated nursing uniforms; the second one conducted on 101 nurses to understand the preferences, the meanings attributed to the uniform and their availability to adapt it according to the preferences expressed by the children. METHODS: We conducted an observational study with a qualitative approach. For the first objective with the children, a visual stimulus was used, showing 6 models of uniform: the traditional plus 5 models of different colors and themes (cartoons characters and videogames). For the second objective with the nurses, in addition to reproducing the same visual stimulus, a semi-structured questionnaire was used. RESULTS: Children and nurses seem to be in perfect accord, because in both groups, color models were the most chosen. Nurses defined their uniform with terms of particular moral, intellectual and professional value and declared themselves available to align with the preferences of the children. CONCLUSIONS: This study leaves little doubt about preferences; it also represents the true originality of the study because almost never in the literature have been compared the point of views of children and professionals, generally favoring the comparison between children and care givers. Our findings could represent a further landmark for guiding the choices of health organizations on currencies to be adopted in the pediatric field. (www.actabiomedica.it).

A third mission at the Nursing Study course University of Parma. Intervention report.

BACKGROUND: The term Third Mission refers to the activities with which universities interact directly with the communities and the territory of reference, combining the objectives of the third mission with the two traditional missions: teaching and research.  These were the premises that guided the Nursing Studies Course of the University of Parma, with the goal of implementing a structured path of "Intercultural Nursing" on a demo-ethno-anthropological basis. METHODS: The path taken was divided into several phases: arrangement of moments of interaction with students; teaching activity aimed at students based on the relationship between ethno-anthropological knowledge, aspects of migration medicine and social legislation; direct meetings with representatives of some communities present in the Parma area. RESULTS: The interaction with students was achieved through meetings called "Cultural Coffee". The first meetings, in the measure of 4-5, took place in the period October-December 2013, subsequently, the same number of meetings was repeated in the following years. In 2019, two important results were achieved: the creation of an ADE (teaching chosen by the student) dedicated to multiculturality. Another activity of the "Intercultural Nursing" course involve the students with some communities in the Parma area. CONCLUSION: The results of this experience and the underlying idea that these aspects, if addressed in the basic training, can be for the professionals most expendable in the workplace, provide reasons to continue the path started. The international comparison on the intercultural skills of nurses, indicates collaboration and partnership with communities, as fundamental elements for a complete and effective assistance.

Nursing students' perception of the quality of clinical learning: a mixed methods inquiry.

BACKGROUND AND AIM: As part of the Nursing Degree Course, the "internship" period represents a strategic lever to systemize the fundamental combination of theoretical study and nursing practice. However, only a few studies have examined in depth students' perception of this experience. The aim of the study was to assess the quality of the places in which the University of Parma's Nursing students did their internships based on their experience. METHODS: Through a quantitative and qualitative study, students who had completed at least one clinical internship (n.200) were asked to fill out a self-report questionnaire on the quality of learning using the CLEQUEI scale (1) and answer a few social and demographical questions. In addition to the questionnaire, 24 narrative interviews (semi-structured) were conducted; these interviews deepened the significance of the assigned internship experience. RESULTS: Throughout all the clinical contexts that were analyzed, the dimension of the perceived quality of the internship averaged a value ≥ 44 (the minimum cut-off indicating the presence of necessary elements to promote the processes of quality clinical learning). The perceived quality dimension particularly stands out in the Pediatric Area, in which it amounted to a mean value of 66 (close to the maximum cut-off value of > 66). This result indicates the opportunity to further develop the processes used in students' quality clinical learning. The latter describe the internship as a moment of both personal and professional growth of fundamental importance in one's own training process. CONCLUSIONS: Overall, the University of Parma's Nursing students have a good perception of the quality of clinical learning. The significance of assigned internship presents some elements which are a relevant part of the new paradigm. However, there are still some aspects which need improvement, such as the necessity to reevaluate certain parts of the teaching organization of the professionalizing activities and of the clinical internships throughout the duration of the three-year course.

Does contact at work extend its influence beyond prejudice? Evidence from healthcare settings.

This article reports on two studies investigating the role of intergroup contact on the reduction of prejudice against migrants and on organizational and health outcomes. Study 1 enrolled 624 native healthcare professionals and showed that frequent and positive contact with non-native co-workers was associated with a decrease in the professionals' prejudice and an increase in the professionals' perception of team functioning. These effects were mediated by reduced in-group threat perception. Study 2 enrolled 201 native patients and showed that frequent and positive contact with non-native healthcare providers was associated with a decrease in patients' prejudice and an increase in patients' satisfaction for the care received. These effects were mediated by reduced in-group threat perception. These novel findings showed that frequent and positive contact with non-native individuals can improve health and organizational outcomes along with facilitating positive intergroup relations.

The role of ingroup threat and conservative ideologies on prejudice against immigrants in two samples of Italian adults.

This research investigated the relationship among perception of ingroup threats (realistic and symbolic), conservative ideologies (social dominance orientation [SDO] and right-wing authoritarianism [RWA]), and prejudice against immigrants. Data were collected with a cross-sectional design in two samples: non-student Italian adults (n = 223) and healthcare professionals (n = 679). Results were similar in both samples and indicated that symbolic and realistic threats, as well as SDO and RWA, positively and significantly predicted anti-immigrant prejudice. Moreover, the model considering SDO and RWA as mediators of threats' effects on prejudice showed a better fit than the model in which ingroup threats mediated the effects of SDO and RWA on prejudice against immigrants. Accordingly, SDO and RWA partially mediated the effect of both symbolic and realistic threats, which maintained a significant effect on prejudice against immigrants, however.

Intergroup contact and team functioning among nursing students: the mediation role of intergroup anxiety.

BACKGROUND AND AIM OF THE WORK: The improvement of team effectivity is one of the main concerns for healthcare organizations. Moreover, healthcare organizations must cope with increasing multicultural composition of both workforce and patients. The intergroup contact theory suggests that frequent and positive face-to-face contact among professionals or students with different cultural heritage can help to reach both increasing team effectiveness and adequate care in a multicultural setting. The aim was then to verify whether intergroup contact during practical training would decrease intergroup anxiety and then increase team functioning. METHODS: A cross-sectional design was used in which a questionnaire was delivered to 83 nursing students. RESULTS: According to the intergroup contact theory, frequent and positive contact with non-native professionals decreased the intergroup anxiety which, in turn, increased prejudice and, more importantly, decreased team functioning. Moreover, intergroup anxiety showed a complete mediation effect on the relations between intergroup contact during practical training and both negative attitude toward immigrants and team functioning. CONCLUSIONS: Intergroup contact with non-native professionals or students during practical training is able to indirectly decrease prejudice and improve team functioning by lowering the anxiety that is aroused by encounter with non-native individuals.

The hypothesis of contact in nursing: a narrative review of the literature.

BACKGROUND AND AIM: In Social Psychology, in relation to the effects of contact, there are two theoretical strands apparently fighting against each other: to one side, the contact hypothesis of Allport according to which, the meeting between members of different groups can, if managed in favorable conditions, reduce prejudice, on the other side, the Social Identity Theory of Tajfel and Turner, according to which the comparison between people belonging to different groups may actually generate an attitude of ingroup favoritism and outgroup discrimination. The aim of this review was to analyze how the literature has dealt with the problem of contact with people from different cultures in relation to its outcomes taking into account the environment of nursing. METHOD: Systematic review. RESULTS: There is sufficient evidence that contacts by race / ethnicity, present in nursing-education settings, in the relationship among nurse practitioners, and between nurses and patients, they produce discriminations and prejudices. The contact in the workplace shows however, also favorable outcomes, highlighting then contradictory results. CONCLUSIONS: The scarcity of material available in the literature and the inconsistency of results, both as regards to the effects of the contact in the training nursing, and as regards to the effects of the contact in relation to the quality of care provided, does not allow definitive conclusions to support the usefulness of the contact in nursing in terms of reducing prejudices and discriminations. It would therefore be advisable to investigate more deeply the effects of contact in the nursing environment.

The complementary medicine (CAM) for the treatment of chronic pain: scientific evidence regarding the effects of healing touch massage.

BACKGROUND AND AIM: Evidence-based medicine offers effective pathways of pharmacological treatment for chronic pain that may compromise the quality of life of patients; this is one of the main reasons why more and more people resort to traditional and complementary approaches, to try to maintain or regain their health. The effectiveness of the various forms of complementary treatments often cannot be proven objectively, which is why, given the need to find more concrete evidence of the effectiveness of complementary therapies with particular reference to the method of healing touch massage, a review of the literature was conducted in order to gather evidence of the efficacy of the specific method regarding pain and other health outcomes of patients with malignant disease to support a proposal for improvement, based on the practice of healing touch massage conducted by nurses. METHOD: Systematic review. RESULTS: There are several examples (in some cases specifically regarding patients with tumors) of the positive effects of healing touch massage on pain, anxiety and fatigue, and also on biochemical parameters. CONCLUSIONS: The way to full recognition by both the institutional and the scientific community seems to promise fairly well, although it should be noted that the achievement of this goal will require further research avoiding the limitations of previous studies.