Factors predicting quality of work life among nurses in tertiary-level hospitals, Bangladesh.

AIM: This study examined the level of quality of work life and predictability of years of education, monthly income, years of experience, job stress, organizational commitment and work environment on quality of work life among nurses in tertiary-level hospitals in the People's Republic of Bangladesh. BACKGROUND: There is an acute shortage of nurses worldwide including Bangladesh. Quality of work life is important for quality of patient care and nurse retention. Nurses in Bangladesh are fighting to provide quality care for emerging health problems for the achievement of sustainable development goals. METHODS: We collected data from 288 randomly selected registered nurses, from six tertiary-level hospitals. All nurses were requested to fill questionnaire consisted of Demographic Data Sheet, Quality of Nursing Work Life Survey, Expanded Nursing Stress Scale, Questionnaire of Organizational Commitment and Practice Environment Scale of the Nursing Work Index. Data were analysed by descriptive statistics and multiple regression. RESULTS: The quality of work life as perceived by nurses in Bangladesh was at moderate level. Monthly income was found as the best predictor followed by work environment, organizational commitment and job stress. DISCUSSION: A higher monthly income helps nurses to fulfil their personal needs; positive work environment helps to provide quality care to the patients. LIMITATION: Quality of work life and predictors measured by self-report only may not reflect the original picture of the quality of work life among nurses. CONCLUSION AND POLICY IMPLICATIONS: Findings provide information for nursing and health policymakers to develop policies to improve quality of work life among nurses that can contribute to quality of nursing care. This includes the working environment, commitment to the organization and measures to reduce job stress.

Nurses' extended work hours: Patient, nurse and organizational outcomes.

BACKGROUND: Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. AIM: To examine for the first time in Thailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. METHODS: Using multistage sampling, 1524 registered nurses working in 90 hospitals across Thailand completed demographic forms: the Nurses' Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire and the Maslach Burnout Inventory. The data were analysed using descriptive statistics, Spearman's rank correlation and logistic regression. RESULTS: The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. LIMITATIONS: Patient outcomes were measured by respondents' self-reports. This may not always reflect the real occurrence of adverse events. CONCLUSIONS: Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems. Policymakers need to be aware of the issues regarding nurses' extended work hours, which has been found to contribute to burnout. Urgently, nurse and health administrators need to develop and implement appropriate nursing overtime policies and strategies to help reduce this phenomenon, including measures to overcome the nursing shortage.

Growing together: a qualitative study of leading nurse scholars in Thailand.

BACKGROUND: Asia-Pacific nursing education and research is growing but little is known about the nature and development of nursing scholarship in the region. AIM: This qualitative study explored the perspectives of 14 leading Thai scholars about the development, facilitators and barriers relating to Thailand's nursing scholarship. METHOD: In-depth interviews were digitally recorded, and data were subjected to content analysis. FINDINGS: Five themes arose: (1) growing together, (2) visionary leadership, (3) external support to grow nurse scholars, (4) developing nursing through research, and (5) barriers to scholarship. A history of visionary nursing leadership was revealed, underpinned by leaders' values of growing nursing together. Resource sharing among universities, and a significant number of scholarships for study abroad were major facilitators of scholarship growth. Barriers to scholarship included high teaching loads, especially for newly graduated faculty; a low rate of research publications; not enough mentorship for research and changes to teaching practice; and a wide range of different agencies providing courses for entry to practice. CONCLUSIONS: Scholarship development in Thailand is a role model for a number of South-East Asian countries, with inclusiveness and collaboration to facilitate the growth of nursing education inside and outside of the country as a hallmark of its character. However, against a backdrop of nursing shortages, Thai scholars are challenged, in the future, to produce meaningful research outcomes, including publications of studies; to collaborate with other health professionals; change practices to overcome high teaching loads; and provide the much needed mentorship for young scholars.

Development of quality of nursing care in Thailand.

BACKGROUND: In Thailand there is a need to establish definitions of quality of nursing care and to determine how it is measured. There is an urgent need to focus more closely on indicators of nursing quality. In Thailand there is no agreed upon definition of quality nursing care or indicators by which to measure it. PURPOSE: The purpose of this research was to develop a definition of quality of nursing care and to begin the process of defining quality of care indicator measures to evaluate the care given in acute care settings. METHODS: This descriptive study was conducted in Thailand. The process included two phases. The first phase used individual interviews and focus group discussion and the second phase included consultation with quality of nursing care experts. An interview guide was used to structure the interviews and the draft definitions of quality and suggested indicators were used when consulting with the experts in the second phase of the study. FINDINGS: The findings are organized into two sections: (1) definition of quality of nursing care and quality of nursing indicators; and (2) consultation with Thailand quality experts to refine the definition and quality of care indicators. The indicators were categorized into three groups: structure, process, and outcome. LIMITATIONS: This descriptive study using qualitative method relied upon the opinions of various stakeholders. Their opinions may or may not have any direct relationship to the scientific literature related to quality. Many of the indicators need to be further refined. CONCLUSIONS: The findings generally support the initial work done in the United States of America. There is a need to further refine the various Thailand indicators. This study is the first in Thailand that has attempted to address quality of nursing care.