The effect of nurses' perceived workplace incivility on their presenteeism and turnover intention: The mediating role of work stress and psychological resilience.

AIM: This study aims to determine the effects of nurses' perceived workplace incivility on nurses' presenteeism and turnover intention and to reveal the mediating role of work stress and psychological resilience in the possible impact. BACKGROUND: Nurses directly contribute to the treatment of patients. The problems nurses encounter in the workplace can negatively affect nurses' attitudes towards work. Therefore, the problems faced by nurses should be determined. METHODS: This study complies with the STROBE checklist. This cross-sectional survey was conducted with 302 nurses working in a university hospital in the Konya province of Turkey. Data were collected in May-July 2021. The questionnaire consisted of six parts: sociodemographic characteristics form, workplace incivility scale, psychological resilience scale, work stress scale, turnover intention scale and presenteeism scale. The data were analysed using descriptive statistical methods and partial least-squares path analysis. RESULTS: It was determined that workplace incivility positively and significantly affected turnover intention, presenteeism and work stress. In contrast, it negatively and significantly affected psychological resilience. In addition, psychological resilience played a mediating role in the effect of workplace incivility on presenteeism. CONCLUSION: The results reveal that the behaviours of incivility encountered by nurses in the workplace increase their presenteeism and turnover intention, and work stress further strengthens these effects. The psychological resilience of nurses is a factor that can help them eliminate their negative emotions and attitudes. Therefore, it is recommended that nursing and health managers first identify the stress factors in the workplace and be determined to fight them. In addition, organizing training and providing psychological support to increase nurses' psychological resilience may enable nurses to develop more positive feelings about their jobs and workplaces. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing and health managers must determine workplace incivility behaviours and inform all employees about these behaviours, their consequences and how to deal with such incivility. In addition, nursing and health managers must determine the stress factors in the workplace and be adamant about combating these factors. In addition, nursing and health managers must give importance to training that will increase the psychological resilience of nurses.

The influence of patient-physician communication on physician loyalty and hospital loyalty of the patient.

OBJECTIVE: Patient-physician communication is important for an effective healthcare service and for the patient's development of loyalty to the hospital. In this regard, this study aimed to determine whether there is a relationship between the patient-physician communication, the loyalty of the patient to the physician and to the hospital. Also study aimed to determine whether there is a mediating role of the physician loyalty on the patient-physician communication effect on to the hospital loyalty. METHOD: Five hundred ten questionnaires were distributed to regular public patients of the government hospitals, clinics, and private clinic patients in Sakarya using a simple random sampling method. Data were analysed using descriptive statistics and Structural Equation Modelling (SEM). RESULTS: According to the findings, there was a significant relationship between patient-physician communication and loyalty to physician and to hospital. Patient-physician communication has a significant effect on loyalty to physician and hospital. In addition, patient loyalty has a mediating role on the patient-physician communication effect on the hospital loyalty. CONCLUSION: According to the result of the study, physician-patient communication could be used as an important tool in creating physician loyalty and hospital loyalty. This study helps physicians and health service providers to formulate strategies and tactics that will effectively develop the loyalty of patients.

The effect of stress levels of nurses on performance during the COVID-19 pandemic: the mediating role of motivation.

Background: During the COVID-19 pandemic, it is thought that nurses working at more intensive levels and in high-risk areas may increase their stress and decrease their motivations and performance. Aims: This study aimed to determine the effects of stress and work stress on nurses' motivations and performances. Methods: An online, cross-sectional survey, which used self-assessment scales to measure perceived stress, perceived work stress, motivation, and work performance was used as a data collection tool. The target population was all working nurses in a hospital. Results: One hundred and fourteen nurses completed the questionnaires. The results of the study show that the participants' perceived motivation level (3.131 ± 0.685), perceived stress level (2.885 ± 0.547), and perceived job stress level (3.202 ± 1.067) were at a medium level, while their perceived performance level (3.845 ± 0.783) was at a high level. According to correlation analyses results, increases in perceived stress levels of nurses decrease their motivations (r = -0.502) and performances (r = -0.603). Similarly, increases in perceived work stress levels of nurses decrease their motivations (r = -0.441) and performances (r = -0.534). According to the Structural Equation Modelling (SEM) analysis, motivation has a mediating role in the negative effect of perceived stresses on performance (ß = -0.694) and augments such negative effect (ß = -0.169). Similarly, motivation has a mediating role in the negative effect of perceived work stresses on performance (ß = -0.295) and increases the negative effect of perceived work stress on performance (ß = -0.097). Conclusions: Nurses' perceived stress and perceived work stress levels were not high, but an increase in these variables may decrease nurses' motivation and performance. Thus, controlling nurses' stress levels and identifying possible stress sources related to the COVID-19 pandemic are important to support nurses in their work.

The Mediating Role of Shared Decision-Making in the Effect of the Patient-Physician Relationship on Compliance With Treatment.

BACKGROUND: For a successful treatment outcome, the components of the treatment process are very important. The patient-physician relationship plays a key role in the successful therapeutic process and effective health service delivery. The patient's compliance with the treatment directly affects the success of the treatment. OBJECTIVE: This study aims to determine the effect of the patient-physician relationship on compliance with the treatment and to determine whether shared decision-making has an mediating role in this effect. PATIENT INVOLVEMENT: Most of the study participants (55%) were younger than 35 and their average age was 30. The majority of the participants have an associate degree or higher education. METHOD: The study used a 4-part survey form as the data collection tool. The sample in this study consisted of 399 participants. To analyze the obtained data, Structural Equation Modeling was used by employing the Smart PLS3 software. RESULTS: The results of the study show that the patient-physician relationship positively affects the patient's compliance with the treatment and shared decision-making. In addition, shared decision-making positively affects the patient's compliance with the treatment. The effect of the patient-physician relationship on compliance with treatment was strengthened through shared decision-making. DISCUSSION: The results of the study revealed that patient-physician relationship and shared decision-making are two important factors in patients' compliance with the treatment. Accordingly, the stronger the patient-physician relationship and the more patients participate in their treatment decisions, the higher their compliance with the treatment.