Self-reported Competences of Expatriate Practicing Nurses in Kuwait: A Descriptive Study.

AIM: The aim of the study was to explore the perceived self-reported competence of nurses who worked in Kuwaiti hospitals and the predictors influencing the level of competence. BACKGROUND: Competence in nursing is found to affect patient safety and the quality of care provided to patients. The vast majority of nurses working in the health system are non-Kuwaitis. Thus, it is of the utmost importance to assess nurses' competences as the first step toward ensuring the best quality of care. METHODS: A cross-sectional, descriptive, correlational design was used. A non-random convenience sample of 220 practicing expatriate nurses working in public hospitals completed the NPC-35 scale and a demographic form. Data collection was done over a period of three weeks from January 26th, 2020 to February 16th, 2020. RESULTS: The findings of the study showed that nurses perceived their competence as good. The results also showed that years of experience, enrollment in a traditional program of study, exposure to training programs, working in accredited hospitals and nationality explained 56% of the variation in the level of Nursing Professional Competence (NPC). CONCLUSION: The results indicate that nurse leaders and policy makers need to improve nursing orientation and training programs so that they are competence based. The results of the study also point to the importance of revisiting the nursing recruitment policy and managing expatriate nurses while making better investment in educating and producing Kuwaiti national nurses.

Nurses' job burnout and its association with work environment, empowerment and psychological stress during COVID-19 pandemic.

AIM: The aim of this study was to assess the influence of perceived work environment, empowerment and psychological stress on job burnout among nurses working at the time of the COVID-19 pandemic. BACKGROUND: Nurses experienced high levels of job burnout during the pandemic, which impacted their mental health and well-being. Studies investigating the influence of work environment, empowerment and stress on burnout during the time of COVID-19 are limited. DESIGN: The study utilized a cross-sectional design. METHODS: Data were collected from 351 nurses in Oman between January and March 2021. The Maslach Burnout Inventory, the Practice Environment Scale of the Nursing Work Index, the Conditions of Work Effectiveness Questionnaire and the Perceived Stress Scale were used to assess study variables. RESULTS: About two-thirds of the nurses (65.6%) reported high levels of job burnout. Nurse managers' ability, leadership and support; staffing and resources adequacy; and nurses' access to support were significant factors associated with a reduced level of burnout. CONCLUSION: Supporting nurses during the crisis, ensuring adequate staffing levels and providing sufficient resources are critical to lower job burnout. Creating a positive and empowered work environment is vital to enhance nurses' retention during the pandemic.

Interprofessional collaboration as a mediator in the relationship between nurse work environment, patient safety outcomes and job satisfaction among nurses.

BACKGROUND: As an important organisational feature, the nurse work environment has been associated with increased work effectiveness, reduced patient safety issues and improved care quality. However, the mechanism underlying this association remains unexplored. AIM: This study aims to assess the mediating role of interprofessional collaboration in the relationships between nurse work environment, select patient safety outcomes and job satisfaction. METHODS: This cross-sectional, descriptive study used five standardized scales and included 881 clinical nurses employed in select teaching hospitals in Oman. RESULTS: Nurses who worked in teaching hospitals in Oman perceived their work environment as highly favourable. Nurse work environment was directly and indirectly associated with nurse-assessed quality of care, adverse patient events and job satisfaction, through interprofessional collaborations. CONCLUSION: Findings of the study suggest that enhancing nurse work environments can be a potential strategy to foster interprofessional collaboration and improve job satisfaction and patient safety outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Organisational strategies to improve patient safety outcomes and job satisfaction in nurses can be facilitated by improving nurses' work conditions and enhancing interprofessional collaboration through supportive leadership, theory-driven approaches, obtaining hospital accreditation/certification and relevant workplace policies.

Authentic leadership and nurses' motivation to engage in leadership roles: The mediating effects of nurse work environment and leadership self-efficacy.

BACKGROUND: Leadership styles of a nurse manager have a profound influence on staff nurses' motivation to engage in formal nursing leadership roles; however, the mechanism underlying this pattern of influence remains unknown. AIM: To assess the direct and indirect effect of nurse managers' authentic leadership on staff nurses' motivation to engage in formal leadership roles, through the intermediary role of nurse work environment and leadership self-efficacy. METHODS: This cross-sectional study involved 1534 nurses from 24 acute care hospitals in the Sultanate of Oman. FINDINGS: Nurse managers' authentic leadership was associated with staff nurses' motivation to engage in formal leadership roles. Nurse practice environment and leadership self-efficacy mediated partially the association between authentic leadership and motivation to engage in formal leadership roles. CONCLUSION: Results of this study underscore the value of authentic leadership in creating a healthy work environment and fostering nurses' leadership self-efficacy, resulting in greater motivation to engage in nursing leadership roles. IMPLICATIONS FOR NURSING MANAGEMENT: Organizational strategies to attract nurses to undertake leadership roles should include measures to bolster authentic leadership behaviours in nurse managers through theory-driven leadership development programmes or interventions, continuing education, effective succession planning and creating a supportive work environment.

Authentic leadership, nurse-assessed adverse patient events and quality of care: The mediating role of nurses' safety actions.

BACKGROUND: Authentic leadership has been consistently cited as a strong precursor of sustained job performance and work effectiveness in nurses; however, studies linking authentic leadership with nurses' safety actions, nurse-assessed adverse patient events and nursing care quality are scarce. AIM: To examine whether nurses' safety actions mediate the relationship between authentic leadership, nurse-assessed adverse events and nursing care quality. METHODS: A multi-centre, cross-sectional study involving 1,608 nurses employed in acute care facilities in Oman. Multi-stage regression analysis was conducted in testing for the mediation model. FINDINGS: Nurse managers in Oman were perceived to be highly authentic by their staff nurses. Authentic leadership significantly predicted nurses' safety actions (ß = 0.168, p < .001), decrease in nurse-assessed adverse events (ß = -0.017, p = .024) and increase in care quality (ß = 0.121, p < .001). Further, the association between authentic leadership and nurse-assessed adverse events (ß = -0.063, p = .057) and care quality (ß = 0.038, p = .002) was mediated by nurses' safety actions. CONCLUSION: Results suggest the importance of developing nurse managers' authentic leadership to foster nurses' safety actions and reduce adverse patient outcomes and promote nursing care quality. IMPLICATIONS FOR NURSING MANAGEMENT: Organizational efforts to address patient safety issues should be directed towards developing authentic leadership in nurse managers through leadership programmes, periodic evaluation of leadership competencies (e.g., 360-degree or a bottom-up performance evaluation), and a creation of a safe culture in which nurses can openly report safety concerns for corrective action.

Involvement of Jordanian Head Nurses' in Health Policy Development: A Cross-Sectional Study.

BACKGROUND: Despite the importance of involving nurses in health policy, nurse's involvement faces many challenges. Literature showed that there is a low level of nurses' and nurse leaders' involvement in health policy development. AIM: The aims of this study were to examine (a) the level of Jordanian head nurses' involvement in health policy development and their perceived benefits and barriers; (b) the relationships between level of knowledge, competence, and interest in health policy and the level of involvement in health policy development; and (c) the relationship between the level of self-efficacy (efficacy expectation and outcome expectation) and the level of involvement in health policy development. METHODS: A cross-sectional descriptive correlational study design was adopted in this study. A convenience sampling of 250 participants from hospitals affiliated to three health sectors in Jordan (private, governmental, and university) were recruited to complete a self-administered questionnaire. Descriptive statistics and Pearson correlation coefficient were used to answer the study questions. RESULTS: The results revealed a moderate level of involvement of head nurses in the policy development. The most frequent cited political activity was "providing written reports, consultations, research." "Lack of time" was the most perceived barrier, while "improving the health of the public" was the most perceived benefit. Workshops or sessions at conferences is the most indicated source of knowledge. Participants had an excellent level of skills with positive relationships between the competence and both of the levels of professional and personal involvement in health policy. Participants reported a low level of confidence in performing political activities as well as the impact of such activities on health outcomes. Positive relationship was indicated between self-efficacy and the levels of professional and personal involvement in political activities.Implications: Health policies affect nurses and their practice. Overcoming the barriers and enhancing the levels of head nurses' knowledge and competence regarding health policies can help activating their roles in health policy development process. This will help in activating nurses' role in health policy development, which in turn will have a positive impact on health outcomes.

Involvement in health policy and political efficacy among hospital nurses in Jordan: A descriptive survey.

AIM: The aims of this study were to (a) examine the levels of nurses' political efficacy and involvement in health policy; and (b) explore the relationships between political efficacy, involvement in health policy and participants' background variables. BACKGROUND: Nurses as citizens and health care providers have the right to express their opinions and beliefs in regard to issues that are concerned with the health care system or the public health domain. METHODS: A descriptive, cross-sectional design using was utilized. A self-administered questionnaire (Political Efficacy Scale & Involvement in Health Policy Scale) was completed by a convenience sample of 302 nurses. RESULTS: The results of this study showed low levels of involvement in health policy and political efficacy, and a positive weak correlation between political efficacy and involvement in health policy. The perceived level of political efficacy was associated positively with nurses' age and experience. CONCLUSIONS: Nurse administrators and managers may empower, support and encourage nurses to enhance their involvement in health policy. IMPLICATIONS FOR NURSING MANAGEMENT: The findings have implications for nursing leaders and administrators to design appropriate strategies to enhance nurses' involvement in health policy development.

Missed nursing care and its relationship with confidence in delegation among hospital nurses.

AIMS AND OBJECTIVES: To (i) identify the types and reasons for missed nursing care among Jordanian hospital nurses; (ii) identify predictors of missed nursing care based on study variables; and (iii) examine the relationship between nurses' confidence in delegation and missed nursing care. BACKGROUND: Missed nursing care is a global concern for nurses and nurse administrators. Investigating the relation between the confidence in delegation and missed nursing care might help in designing strategies that enable nurses to minimise missed care and enhance quality of services. METHODS: A correlational research design was used for this study. A convenience sample of 362 hospital nurses completed the missed nursing care survey, and confidence and intent to delegate scale. RESULTS: The results of the study revealed that ambulating and feeding patients on time, doing mouth care and attending interdisciplinary care conferences were the most frequent types of missed care. The mean score for missed nursing care was (2.78) on a scale from 1-5. The most prevalent reasons for missed care were "labour resources, followed by material resources, and then communication". Around 45% of the variation in the perceived level of "missed nursing care" was explained by background variables and perceived reasons for missed nursing. However, the relationship between confidence in delegation and missed care was insignificant. CONCLUSION: The results of this study add to the body of international literature on most prevalent types and reasons for missed nursing care in a different cultural context. RELEVANCE TO CLINICAL PRACTICE: Highlighting most prevalent reasons for missed nursing care could help nurse administrators in designing responsive strategies to eliminate or reduces such reasons.

Exploring the relationship between work environment, job satisfaction, and intent to stay of Jordanian nurses in underserved areas.

AIMS: The aims of this study are to (1) examine the relationships between work environment, job satisfaction and intention to stay at work; and (2) explore the predicting factors of intention to stay at work among nurses in underserved areas. BACKGROUND: Developing and fostering creative work environment are paramount especially in underserved areas, where the work conditions present many challenges. METHODS: A descriptive correlational design was utilized to collect data from 330 hospital nurses who worked in two underserved governorates in Jordan. A set of instruments were used to measure the variables of the study. RESULTS: The results showed a strong positive association between job satisfaction and work environment. The results of logistic regression indicated receiving housing, job satisfaction, and work environment were the predicting variables of the level of intention to stay at work. CONCLUSION: It is critical to improve work conditions and create a culture of supportive work environment in underserved area.

Perceptions of reporting practices and barriers to reporting incidents among registered nurses and physicians in accredited and nonaccredited Jordanian hospitals.

AIMS AND OBJECTIVES: To explore the awareness of the incident reporting system, incident reporting practices and barriers to reporting incidents among Jordanian staff nurses and physicians in accredited and nonaccredited hospitals. BACKGROUND: Reporting medical incidents is an important element of patient safety enhancement and quality of care improvement and it should be an integral part of the organisational culture. DESIGN: A descriptive exploratory survey was used for the present study. METHODS: A modified version of the Incident Reporting Questionnaire was used to collect data from 307 nurses and 144 physicians at seven hospitals (four accredited and three not accredited) in Jordan. The response rate was 28·8% for nurses and 58·8% for physicians. RESULTS: Nurses were more aware of the incident reporting system than physicians. Physicians were less likely to report any incident on 50% or more of occasions. The major three barriers to reporting incidents were believing that there was no point in reporting near misses, lack of feedback and fear of disciplinary actions. CONCLUSION: The study showed significant differences between nurses in accredited and nonaccredited hospitals regarding barriers to reporting incidents and reporting practices. RELEVANCE TO CLINICAL PRACTICE: Nurse administrators should modify existing systems for reporting incidents to overcome the barriers as shown in the present study.

Workplace physical violence among hospital nurses and physicians in underserved areas in Jordan.

AIMS AND OBJECTIVES: To: (1) examine the incidence, frequency and contributing factors to workplace violence among nurses and physicians in underserved areas in Jordan, and (2) identify the existing policies and the management modalities to tackle workplace violence. BACKGROUND: Workplace violence is a major problem in healthcare organisations. An understanding of the nature of violence is essential to implementing successful management. DESIGN: A descriptive exploratory research design. METHODS: The questionnaire that was developed in 2003 by the International Labor Office, the International Council of Nurses, the World Health Organization, and the Public Services International was used to collect data from a convenience sample of 521 Jordanian physicians and nurses (396 nurses, 125 physicians) who worked in hospitals located in underserved areas. RESULTS: Around 15% of the participants were exposed to physical violence. The factors that contributed to workplace violence were related to absence of policies, inadequate staffing and lack of communication skills. Only 16·9% of participants indicated that there were specific policies available for dealing with physical workplace violence. Strengthening security and providing training were some of the important factors indicated by participants for decreasing violence in the workplace. CONCLUSIONS: Workplace violence is a problem in underserved areas that needs attention from administrators. Most participants were very dissatisfied with the way the administrators dealt with the incidents. RELEVANCE TO CLINICAL PRACTICE: Instituting firm policies against perpetrators and developing protective violence guidelines to support healthcare staff in managing workplace violence are paramount to tackle the problem of workplace violence.

The impact of educational interventions for nurses on mechanically ventilated patients' outcomes in a Jordanian university hospital (pages 2205­2214).

AIMS AND OBJECTIVES: To determine the effect of educational interventions for nurses on the success of weaning trials, ventilation period and reintubation incidence for mechanically ventilated patients in a Jordanian university hospital. BACKGROUND: Sharing decision between healthcare providers about weaning should be based on specific guidelines or protocols to avoid complications associated with wrong weaning estimation. DESIGN: A nonequivalent, pretest­post-test (quasi-experimental) study. METHODS: The study used a convenience sample consisting of 135 ventilated patients. The historical control group (n = 65) data were collected from patients' files before the implementation of the educational interventions for the experimental group (n = 70), which was recruited from intensive care units at a university hospital. The experimental group received educational interventions on Burns Weaning Assessment Protocol items over one month through in-service education, bedsides and hands-on application. Data were collected about Burns Weaning Assessment Protocol scores, failed trials, reintubation incidence and ventilation period for all participants. RESULTS: The results showed that the number of failed trials and reintubation incidence was less in the experimental group compared with the control group. On the other hand, there was not any significant difference in the score of ventilation period between the experimental and control groups. CONCLUSION: Educational interventions for nurses on Burns Weaning Assessment Protocol have a significant impact on reducing incidence of failed trials and reintubation. RELEVANCE TO CLINICAL PRACTICE: The improvement of outcomes of patients on mechanical ventilators is a result of shared decision based on effective planning and communication between nurses and physicians.

Perceptions of patients and nurses towards nurse caring behaviors in coronary care units in Jordan.

AIMS AND OBJECTIVES: To (1) identify the perceptions of Jordanian patients who suffer from coronary artery diseases towards nurse caring behaviours in critical care units; (2) identify the perceptions of Jordanian nurses who work in critical care units towards nurse caring behaviours; and (3) compare the perceptions of both patients and nurses towards nurse caring behaviours in critical care units. BACKGROUND: Caring is an important concept in nursing, when nursing behaviours were perceived by patients as caring behaviours, and thus, their satisfaction with the quality of care can be improved. Therefore, it is important for nurses to be knowledgeable about the caring behaviours as perceived by patients who complained from coronary artery diseases themselves. DESIGN: A descriptive comparative design was used. METHODS: A convenience sample of 150 patients who complained from coronary artery diseases and 60 critical care unit nurses completed the demographic form and the Caring Behavior Assessment scale. RESULTS: Patients in critical care units perceived physical and technical behaviours as most important caring behaviours, whereas nurses in critical care units perceived teaching behaviours as most important caring behaviours. CONCLUSION: There were significant differences between patient participants' and nurse participants' perceptions towards four subscales of Caring Behavior Assessment scale that should be considered when caring for patients with coronary artery diseases. RELEVANCE TO CLINICAL PRACTICE: Patients with coronary artery diseases need well-trained and clinically competent nurses to meet their needs. 'Spiritual needs' was an important nurse caring behaviour that should be emphasised in nursing practice.

Nursing lecturers' perception toward E-learning approaches used in nursing colleges: Scoping review.

BACKGROUND: Nursing colleges have traditionally taught students in hospitals and laboratories. COVID-19 compelled most nursing colleges to embrace e-learning without prior experience or preparation after 2020, which may influence nursing educators' views and attitudes toward its use. OBJECTIVE: This scoping review explores the nursing educators' perception of the e-learning approaches used in nursing colleges. DESIGN: A comprehensive review of five databases, Cochrane, Ebsco (Medline), PubMed, Science Direct, and Scopus, was conducted, adhering to the Joanna Brings Institute (JBI) standards full theme, utilizing preset eligibility criteria and adhering to the PRISMA Extension for Scoping review (PRISMA-ScR) recommendations. METHODS: This scoping review examined studies published in English from January 1st, 2017-2022. Three reviewers evaluated the eligibility of the literature and retrieved data to address the research question from prior literature. A content analysis was done. RESULTS: Thirteen articles with various hypotheses and models were reviewed. The review reveals that nursing educators are novices at using e-learning approaches in their classes due to their novelty in most nursing colleges. Nursing educators have a modest positive perception, with an optimistic perspective on e-learning effectiveness in theoretical course teaching, emphasizing that it is inappropriate in teaching clinical courses. The review demonstrates that e-learning faces numerous challenges that negatively impact educators' perceptions. CONCLUSION: Institutional preparedness in terms of personnel through educator training, provision of necessary infrastructure, administrative support, and incentives are critical to improving the perception of the e-learning method and increasing its adoption in nursing colleges.

Determinants of Physicians' Job Satisfaction: A national multi-centre study from the Sultanate of Oman.

Objectives: This study aimed to examine and assess job satisfaction of physicians across several factors, such as quality of care, ease of practice, relationship with leadership and inter-professional collaboration. Methods: The data for this descriptive cross-sectional study were collected between July 2019 and January 2020. Participants provided demographic information and completed surveys related to physician job satisfaction and inter-professional collaboration. Multiple linear regressions were used to determine the relationship between overall job satisfaction and demographic features and inter-professional collaboration. Results: Out of the 396 physicians contacted, 354 responded (response rate: 89.4%). Results showed that out of the 354 physicians, 4.3% were not satisfied with their jobs, 36.5% expressed a moderate level of satisfaction and 59.2% were highly satisfied. There was no difference in the mean job satisfaction score among different groups of study participants, except for gender and the working grade (P <0.05). The overall job satisfaction rates were higher for the quality of care (mean = 3.93 ± 0.61) and ease of practice (mean = 3.89 ± 0.55) and lower for relationship with leadership (mean = 3.67 ± 0.86). Having a clinical postgraduate degree together with a PhD, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates (P = 0.003 and 0.007, respectively). Conclusion: Overall, the job satisfaction rate was high. There was no difference among different groups of study participants, except for the working grade. Having a clinical postgraduate degree, a senior level of responsibility and good inter-professional relationship were associated with higher job satisfaction rates. The overall job satisfaction rates were higher for the quality of care and for ease of practice and lower for relationship with the leadership. Relationship with leadership is a modifiable factor and efforts at enhancing the physician-leadership relationship may lead to even higher satisfaction rates.

Direct and Moderating Effects of Work Environment and Structural Empowerment on Job Stress and Job Satisfaction Among Nurses in Oman.

Objectives: This study aimed to explore the relationships between nurses' work environment, job stress and job satisfaction, along with the moderating effects of work environment and empowerment on the relationship between job stress and job satisfaction. Methods: A descriptive correlational design was utilised for this study. The study encompassed a convenience sample of 1,796 hospital nurses from the 11 governorates in Oman. Moreover, a self-report questionnaire that included a set of instruments was used to collect the data. Results: Nurses who perceived higher levels of job stress reported lower levels of satisfaction and empowerment and perceived their work environment as less favourable and supportive. The findings only confirmed the direct effects of work environment and empowerment on satisfaction, whereas no support was found for indirect or moderating effects. Furthermore, the hierarchical regression model showed that 46.5% of the variation in the level of job satisfaction was explained by the study variables. Conclusion: The results of this study demonstrate the importance of implementing strategies that empower staff, provide a supportive and positive work environment and tackle job stress to enhance levels of job satisfaction.

The influence of nurse managers' authentic leadership style and work environment characteristics on job burnout among emergency nurses.

BACKGROUND: Emergency nurses experience excessive workloads and high job burnout. Limited evidence exists exploring the role of authentic leadership and nurse work environment on job burnout among emergency nurses. OBJECTIVE: To assess the influence of nurse managers' authentic leadership and nurse work environment on job burnout among emergency nurses. METHODS: A cross-sectional study was conducted among 160 emergency nurses working in six hospitals in the Sultanate of Oman. The Maslach Burnout Inventory, Authentic Leadership Questionnaire, and the Practice Environment Scale of the Nursing Work Index were used to assess study variables. RESULTS: Of the 233 distributed surveys, 160 emergency nurses responded resulting in a response rate of 69%. More than two thirds of emergency nurses (72.1%) reported high levels of burnout. Authentic leadership and a favorable work environment were significantly associated with lower job burnout. Nurse managers' transparency (ß = - 0.481, p = 0.031), ethical/moral conduct (ß = - .408, p = 0.043), managerial ability and support (ß = - 0.497, p = 0.018), and adequate staffing and resources (ß = -.068, p = 0.028) were all associated with lower job burnout. CONCLUSIONS: Results suggest the importance of providing effective leadership, adequate support to staff, maintaining optimum staffing and resources, and developing nurse managers' authentic leadership to reduce nurses' job burnout.

Rapidly adapted community health strategies to prevent treatment interruption and improve COVID-19 detection for Syrian refugees and the host population with hypertension and diabetes in Jordan.

BACKGROUND: We evaluated community health volunteer (CHV) strategies to prevent non-communicable disease (NCD) care disruption and promote coronavirus disease 2019 (COVID-19) detection among Syrian refugees and vulnerable Jordanians, as the pandemic started. METHODS: Alongside medication delivery, CHVs called patients monthly to assess stockouts and adherence, provide self-management and psychosocial support, and screen and refer for complications and COVID-19 testing. Cohort analysis was undertaken of stockouts, adherence, complications and suspected COVID-19. Multivariable models of disease control assessed predictors and non-inferiority of the strategy pre-/post-initiation. Cost-efficiency and patient/staff interviews assessed implementation. RESULTS: Overall, 1119 patients were monitored over 8 mo. The mean monthly proportion of stockouts was 4.9%. The monthly proportion non-adherent (past 5/30 d) remained below 5%; 204 (18.1%) patients had complications, with 63 requiring secondary care. Mean systolic blood pressure and random blood glucose remained stable. For hypertensive disease control, age 41-65 y (OR 0.46, 95% CI 0.2 to 0.78) and with diabetes (OR 0.73, 95% CI 0.54 to 0.98) had decreased odds, and with baseline control had increased odds (OR 3.08, 95% CI 2.31 to 4.13). Cumulative suspected COVID-19 incidence (2.3/1000 population) was suggestive of ongoing transmission. While cost-efficient (108 US${\$}$/patient/year), funding secondary care was challenging. CONCLUSIONS: During multiple crises, CHVs prevented care disruption and reinforced COVID-19 detection.

The impact of leadership styles on nurses' satisfaction and intention to stay among Saudi nurses.

AIM: To examine the impact of leadership styles of nurse managers on Saudi nurses' job satisfaction and their intent to stay at work. BACKGROUND: Increasing nurses' satisfaction is one of the key elements in meeting challenges of quality outcomes, patient satisfaction and retention of staff nurses in hospitals. METHODS: This study used a descriptive correlational design. The Multifactor Leadership Questionnaire (MLQ-5X), Job Satisfaction Survey (JSS), the McCain's Intent to Stay Scale and a demographic form were used to collect the data from a convenience sample of 308 Saudi nurses. RESULTS: Saudi nurses were moderately satisfied in their jobs. In addition, nurses were more satisfied with leaders who demonstrated transformational leadership styles, and those who were more satisfied with their jobs intended to say at work. The background variables, the transformational leadership style and the transactional style explained 32% of the variation in job satisfaction. CONCLUSIONS: The results of the study emphasized the importance of transformational leadership, which indicates the need for further attention to training and development of effective leadership behaviours. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse administrators in Saudi Arabia should capitalize on the importance of transformational leadership style in enhancing the level of job satisfaction.

Women's career progression to management positions in Jordan's health sector.

PURPOSE: This study aims to identify and explore experiences, perspectives, barriers and enablers to women's career progression to management positions in the health-care sector and to assess women's and men's perceptions of the policies and practices of the health-care system concerning gender equality and nondiscrimination between women and men. DESIGN/METHODOLOGY/APPROACH: A cross-sectional survey was conducted among health-care professionals in ten selected hospitals, including physicians, registered nurses/midwives and pharmacists with or without managerial positions. FINDINGS: This study included a total of 2,082 female and 1,100 male health-care professionals. Overall, 70% of women and men reported that opportunities for advancement are based on knowledge and skills in their institution. However, 58.9% of women (p < 0.001) reported that women are more likely to face barriers to career advancement than men do in their workplace. Lack of women in general/line management and discrimination against women by supervisors at the point of promotion were the main barriers to women's career progression, as they were reported by two-thirds of women. The main barrier, as perceived by men (62.3%) was that women have family and domestic responsibilities. PRACTICAL IMPLICATIONS: To overcome barriers in women's career progression, there is a need to establish a career planning and capacity-building program for women in the health sector. ORIGINALITY/VALUE: Jordanian female health-care professionals face different barriers that affect their career progression, including inequity and discrimination in the workplace, negative views about women's abilities, lack of qualifications and training, hostile cultural beliefs and family responsibilities.