How nursing practice environments limit implicit rationing of care and nurse-assessed adverse events: the role of flow at work.

BACKGROUND: The nursing practice environment is beneficial in curbing implicit rationing of nursing care and adverse patient events. However, the underlying mechanisms of these relationships remain unexplored. AIM: To test whether flow at work mediates the relationship between the nursing practice environment, implicit rationing of nursing care, and nurse-assessed adverse patient events. METHODS: This cross-sectional study involved 231 nurses from five hospitals in Port Said, Egypt. The participants completed Arabic-translated versions of the Practice Environment Scale of the Nursing Work Index, the Work-Related Flow Inventory, the Perceived Implicit Rationing of Nursing Care instrument, and the Adverse Patient Events scale. Structural equation modeling was used to test the hypothetical model. RESULTS: The favorable nursing practice environment positively predicted nurses' flow at work (ß = 0.64, p < 0.001), while inversely predicting implicit rationing of nursing care (ß = -0.23, p = 0.014) and adverse patient events (ß = -0.35, p < 0.001). Nurses' flow at work inversely predicted implicit rationing of nursing care (ß = -0.30, p = 0.002) and adverse patient events (ß = -0.29, p = 0.002). Moreover, nurses' flow at work acted as a mediator, linking the nursing practice environment to the rationing of nursing care and adverse patient events, with 500 bootstrap results for the indirect effects (ß = -0.24, p = 0.001, 95% CI: -0.43 to -0.09; and ß = -0.44, p = 0.003, 95% CI: -0.79 to -0.16, respectively). CONCLUSION: Nurses working in a favorable nursing practice environment are more likely to experience flow at work, limiting implicit rationing of nursing care and adverse patient events. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing administrators should strive to create a healthy nursing practice environment to foster nurses' flow and thereby reduce the frequency of implicit rationing of nursing care and adverse patient events.

Exploring the relationship between nursing students' knowledge and attitudes towards climate change and their psychological distress: a cross-national investigation.

BACKGROUND: Climate change poses a worldwide challenge with anticipated exacerbation in the future, resulting in irreversible consequences. Nursing students may be vulnerable to experiencing psychological effects associated with climate change. AIM: The current study aimed to investigate the relationship between nursing students' knowledge and attitudes toward climate change and their psychological distress. METHOD: This descriptive cross-sectional study recruited 377 nursing students from three universities located in Saudi Arabia, Jordan, and Egypt in the Middle East. Data collection was conducted using scales for assessing nursing students' knowledge and attitudes towards climate change and their psychological distress. Correlations were assessed and multiple regression analysis was conducted to explore the predictors of students' psychological distress. RESULTS: The current study showed that knowledge regarding climate change significantly and positively correlated to the attitude toward climate change (r = 0.213), then again, the score of psychological distress significantly and negatively correlated to the score of students' knowledge and attitude regarding climate change (r = - 0.182 and - 0.110 respectively). Regression analyses showed that academic achievement had the strongest positive impact on students' psychological distress, while knowledge regarding climate change and attitude toward climate change had negative impacts (ß = 0.381, ß=-0.205, and ß=-0.045 respectively). Moreover, knowledge and attitude regarding climate change were found to be significant predictors of students' psychological distress, collectively accounting for 18.2% of the observed variance. CONCLUSIONS/IMPLICATION FOR FUTURE PRACTICE: The findings highlight the importance of incorporating climate change into nursing education programs. By enhancing nursing students' knowledge and attitudes towards climate change, there is potential to reduce their psychological distress. This study underscores the need for curriculum reforms that integrate climate change topics, aiming to foster a well-informed and resilient future nursing workforce.

The relationship between emotional intelligence, resilience, and psychological distress among nurses in Jordan.

BACKGROUND: Nurses have significant levels of depression, anxiety, and stress as a result of their exposure to various stressors at work. Emotional intelligence and resilience are relatively new notions essential for nurses to naturalize high levels of psychological problems. The study aimed to investigate the relationship between emotional intelligence and resilience and their impact on depression, anxiety, and stress among nurses. METHODS: A cross-sectional descriptive design was used and recruited 152 nurses from three private hospitals in Jordan. Variables were measured using the Depression Anxiety Stress Scale, Brief Resilience Scale, and Brief Emotional Intelligence Scale. RESULTS: The participants' average age was 27.6 years, and they were mostly female (66.4 %). Resilience earned an average of 3.1, while emotional intelligence averaged 31.7. Depression, anxiety, and stress were all significantly higher among nurses. Also, negative relationships were found between emotional intelligence, resilience, and psychological problems (p < .001). Emotional intelligence is positively associated with resilience (r = 0.83, p < .001). In addition, emotional intelligence and resilience were both significant predictors of depression, anxiety, and stress. CONCLUSION: Emotional intelligence is critical to nurses' well-being. Higher emotional intelligence is associated with higher resilience and lower levels of depression, anxiety, and stress among nurses. Interventions and education programs emphasizing emotional intelligence and resilience are essential to improving their mental health. Healthcare organizations and governments should promote these attributes to enhance nurses' psychological wellness in challenging healthcare settings.

Mistreatment of nurses by patients and its impact on their caring behaviors: The roles of psychological detachment and supervisor positive gossip.

BACKGROUND: Mistreatment by patients is a detrimental phenomenon predominant in healthcare organizations. However, there is a lack of nursing literature regarding the underlying mechanisms and boundary conditions that exist between mistreatment by patients and its detrimental consequences. AIM: By integrating the Job Demands-Resources Model and the Conservation of Resources Theory, the study aimed to unveil the mediating role of psychological detachment from work in the relationship between mistreatment by patients and nurses' caring behaviors, as well as the moderating effect of supervisor positive gossip. METHODS: This multicenter, cross-sectional study involved 341 nurses from five hospitals across two cities in Egypt. Data were collected using an introductory information form, the Mistreatment by Patients Scale, the Psychological Detachment Scale, the Caring Behaviors Scale, and the Supervisor Positive Gossip Scale. The study's hypotheses were tested using the PROCESS macro. RESULTS: The results showed that mistreatment by patients was negatively related to nurses' caring behaviors via an increased psychological detachment. Further, higher levels of supervisor positive gossip were shown to weaken the direct effect of mistreatment by patients in increasing nurses' psychological detachment, as well as the indirect negative effect of mistreatment by patients on nurses' caring behaviors via psychological detachment. CONCLUSIONS: Mistreatment by patients contributes to nurses' psychological detachment and decreased caring behaviors; however, these negative outcomes can be mitigated by supervisor positive gossip. IMPLICATION FOR NURSING POLICYMAKING: Nursing managers should adopt strategies to deter the rise of mistreatment by patients, and utilize positive gossip to support nurses exposed to such mistreatment to alleviate its consequences.

Effect of humble leadership on proactive work behaviour: The mediating role of psychological empowerment among nurses.

AIM: This study was designed to determine the effect of humble leadership on nurses' proactive behaviours at work through psychological empowerment. BACKGROUND: Nurse leaders' humility has a profound effect on enhancing nurses' proactive work behaviour; yet, the mechanism underlying this pattern of effect remains unknown. METHODS: A descriptive cross-sectional study was conducted in all nine Universal Health Insurance hospitals in Port Said, Egypt. Using scales for assessing leader humility, psychological empowerment and proactive behaviour at work, 316 nurses were surveyed. Regression analyses and structural equation models were used to examine the study hypothetical model. RESULTS: The results revealed that humble leadership, psychological empowerment and proactive work behaviour were significantly positively correlated. Psychological empowerment fully mediated the relationship between humble leadership and proactive work behaviour. CONCLUSION: This study emphasized the value of humble leadership in psychologically empowering nurses, which results in greater proactive work behaviour. IMPLICATION FOR NURSING MANAGEMENT: Nurse managers should lead their nursing staff with humility, which could increase the level of nurses' psychological empowerment and proactive behaviours at work, which will be reflected positively on the staffs and the organization.

Advancing trauma studies: A narrative literature review embracing a holistic perspective and critiquing traditional models.

Background: Trauma is commonly understood as a psychological and emotional response to distressing events. The subjective nature of trauma experiences has led to ongoing debates about the best theoretical frameworks for understanding and addressing trauma. This review aims to comprehensively critique traditional biomedical and psychological models and advocates for more inclusive and culturally sensitive frameworks. Methods: A narrative literature review was conducted, synthesizing data from 96 peer-reviewed journal articles, books, and authoritative reports from databases such as PubMed, PsycINFO, and Google Scholar. The review focused on studies related to trauma, post-traumatic stress disorder (PTSD), complex trauma, and related disorders, emphasizing both individual and socio-cultural aspects. Results: The review identifies several key criticisms of trauma models. For biological models, critiques include the oversimplification of trauma experiences, insufficient developmental considerations, failure to capture diverse trauma responses, limited cultural sensitivity, and inadequacy of the categorical approach. For psychological models, criticisms encompass an overemphasis on internal processes, neglect of developmental impacts, limited focus on symptom diversity, challenges in addressing socio-cultural contexts, and incomplete integration of emotional and relational aspects. These findings underscore the need for more comprehensive, culturally sensitive, and developmentally informed trauma frameworks. Conclusion: The findings emphasize the importance of adopting a holistic perspective in trauma research and treatment. By integrating individual, interpersonal, and socio-cultural dimensions, future research and interventions can better support trauma survivors. This approach necessitates ongoing interdisciplinary collaboration and the inclusion of diverse voices, including those of trauma survivors, to refine current methodologies and enhance therapeutic outcomes.