Total rewards preferences: A cross-sectional study among two generations of nurses in rural and remote Thailand.

BACKGROUND: Nursing and health policy focus on retaining nurses in practice, especially because the world lacks more than 6 million nurses. Rewards are believed to be an effective strategy to attract, retain, and improve the performance of nurses in rural and remote areas where nursing shortages are more severe. However, Generations X and Y have been found to have different preferences for rewards in various settings, so a one-size-fits-all approach may not work for rewarding work. OBJECTIVE: To examine the perceptions of satisfaction and the importance of rewards among two generations of Thai registered nurses. METHODS: Using the Total Reward Scale, a descriptive comparative study design was employed and the data was collected from 354 nurses in rural and remote Thai community hospitals. This study is reported using the STROBE checklist. Descriptive statistics and the Mann-Whitney U test were used to analyze data. RESULTS: Generations X (born in 1965-1980) and Y (born in 1981-2000) were most satisfied with and rated base salary as the most important reward. However, these generations significantly differed in their perspective about importance of healthcare, leadership, long-term incentives, time-off leave, and variable pay. CONCLUSION: Different types of rewards were satisfying and essential for Thai nurses in Generations X and Y. IMPLICATIONS FOR NURSING AND HEALTH POLICY: National reward policies and management should be designed on priorities regarding reasonable base salary, and retirement benefits to address nursing shortages in rural and remote areas. Policymakers in health and nursing must invest in developing funded policies that consider the needs of different generations of nurses if they want success in retaining them on the job.

Perspectives of nurses regarding total rewards and their preferences in Thailand: A qualitative descriptive study.

BACKGROUND: In this time of global nursing shortages, investment in nursing is vital, and hospitals need to apply a range of strategies to attract and retain nurses. Rewards are an effective strategy for the retention of nurses and help improve the performance and productivity of hospitals. In rural and remote communities, however, nurses may not have access to the rewards that urban-based nurses have. AIM: To explore the preferred rewards of registered nurses in rural and remote community hospitals in Thailand. METHODS: An explanatory mixed-methods design was employed for the overall study, and the results from the qualitative descriptive phase are reported here using the COREQ checklist. We collected data during in-depth interviews with 24 informants from 8 community hospitals. Thematic analysis was used for data analysis. FINDINGS: Four major themes regarding reward types were preferred by the nurses: reasonable pay, good benefits, accessible learning and development, and a favorable work environment. CONCLUSION: A package of total rewards that best suit nurses working in rural and remote areas needs to be implemented, for a combination of different types of rewards has a greater impact than a single reward at both individual and organizational levels. IMPLICATION FOR NURSING AND HEALTH POLICY: It is crucial to identify those rewards to attract and retain nurses. In Thailand, nursing and health workforce policies need to be based on nurse preferences regarding salary, benefits, and recognition commensurate with other healthcare professionals, including civil servant status, as well as improving the work environment.

Development and psychometric testing of the Perceived Organizational Climate Scale for nurses.

AIM: Retaining nurses on the job is vital, and their successful retention is related to the organizational climates (OC) of healthcare settings. The purpose was to develop and test the psychometric properties of the Perceived Organizational Climate Scale (POCS). DESIGN: The methodologic research design was used by following the scale development strategies by DeVellis (2017). The conceptual framework for this study was based on the broader theoretical framework of the Competing Value Framework (CVF) of Quinn et al. (2015), the concept analysis and extensive literature review (1939-2018), and combined with the inductive qualitative data. METHODS: A two-phase study of scale construction and psychometric testing was conducted for content validation, construct validation and internal consistency reliabilities of the instrument. An expert panel validated the 4-point scale, followed by exploratory factor analysis, the known-group approach and split groups. Data were collected from (1161) registered nurses in eight general hospitals across Myanmar from August 2019 to September 2020. RESULTS: The 35 items with four essential dimensions: transformational climate, bureaucratic climate, team climate and strategic climate, explained almost 50% of the variation with all factor loading greater than .40. The internal consistency reliabilities of the instrument showed the Cronbach's alpha coefficient of .93, and the dimensions were from .82 to .85. As hypothesized, the known-group approach demonstrated that experienced nurses had higher mean scores than novices. The internal consistency reliabilities of the scale and dimensions across the splitting groups illustrated the stability. CONCLUSION: This evidence supports this instrument as having satisfactory initial psychometric properties with a comprehensive picture of OC by its essential components contributing to an inclusive understanding of this climate globally. IMPACT: This instrument can be used as an objective tool for evaluating OC as perceived by nurses in healthcare settings to inform improvements in working environments.

Perception of benefits and barriers associated with dementia prevention behaviors among people with diabetes.

Type 2 diabetes mellitus is a risk factor for developing dementia and a public health concern around the world. Identifying any predictive factors associated with diabetes-related dementia prevention behaviors are of value in helping to prevent dementia. From six community hospitals in Chiang Mai, Thailand, 182 people aged 30-60 years were enrolled in a cross-sectional study and completed a written questionnaire on dementia prevention behaviors and perceptions of health beliefs. Multiple linear regression analysis was applied to determine possible associations between dementia prevention behaviors and health belief perceptions. A high level of preventive behavior was associated with high perceptions of the benefits of, and barriers to, dementia prevention and longer duration of patients' diabetes. Findings indicate the predictive role of the two factors in the perception of health beliefs about dementia prevention behaviors among the participants. Although further testing with different samples and in different locations is warranted, education programs for health practitioners that integrate the findings of this study would be beneficial to improvement of dementia prevention behaviors in people with diabetes.

Nurse staffing, missed care, quality of care and adverse events: A cross-sectional study.

AIM: This study aimed to illustrate the relationship between nurse staffing and missed care, and how missed care affects quality of care and adverse events in Thai hospitals. BACKGROUND: Quality and safety are major priorities for health care system. Nurse staffing and missed care are associated with low quality of care and adverse events. However, examination of this relationship is limited in Thailand. METHODS: This cross-sectional study collected data from 1188 nurses in five university hospitals across Thailand. The participants completed questionnaires that assessed the patient-to-nurse ratio, adequacy of staffing, missed care, quality of care and adverse events. Logistic regression models were used to estimate associations. RESULTS: Higher patient-to-nurse ratio, poor staffing and lack of resource adequacy were significantly associated with higher odds of reporting missed care. Higher nurse-reported missed care was significantly associated with higher odds of adverse events and poor quality of care. CONCLUSIONS: Poor nurse staffing was associated with missed care, and missed care was associated with adverse events and lower quality of care in Thai university hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: Improving nurse staffing and assuring adequate resources are recommended to reduce missed care and adverse events and increase quality of care.

Comparison of 12 and 24-hours shift impacts on ICU nursing care, efficiency, safety, and work-life quality.

BACKGROUND: Nursing care quality is a central concern of health policy, and nurses' shift schedules affect the quality of care and their work-life status internationally. A lack of reliable information on the differences between 24- and 12-h shifts on care quality, nursing care quality, patient safety, and adverse and missed events warranted investigation in Cambodia. AIM: We aimed to examine the impacts of 12-h shifts compared with 24-h shifts. The purpose was to find evidence to support the use of maximum 12-h shifts by registered nurses working in ICU contexts. METHOD: A convergent mixed-method approach was chosen to highlight the issues around the long hours of shift work. We designed a 12-week coaching course during the implementation of 12-h shifts and assigned 30 nurses each to an experimental group and a control group. Data from quantitative surveying of 58 participants were combined with focus group discussions of 20 participants to gather qualitative insights. Pre- and post-test analysis involved descriptive statistics and the Wilcoxon sign rank test for quantitative analysis and then merged with qualitative findings from content analysis. Reporting of this study was steered by the STROBE and COREQ guidelines for quantitative and qualitative findings, respectively. RESULTS: Quantitative results showed the increased quality of nursing work-life, nursing care quality, and patient satisfaction; decreased missed care and adverse events were significantly associated with the 12-h shift. Qualitative data supported nurses preferring 12-h rather than 24-h shift options. DISCUSSION AND CONCLUSIONS: Changing rosters to 12-h shifts in the intervention caused increases in the study variables' scores. Results indicate the benefits of 12-h shifts on the quality of nursing work-life, nursing care quality, missed care, adverse events, and patient safety. IMPLICATIONS FOR NURSING AND NURSING POLICY: We found that 24-h shifts had deleterious impacts on care quality and safety and nurse satisfaction with work. Health and nursing policymakers are urged to provide resources and strategize to implement 12 h shifts as soon as possible since the current 24-h shifts of nurses affect the patient quality of care and their health and safety and that of the nurses.