The mediating role of nurses' attitude towards reporting child abuse and neglect.

PURPOSE: Attitudes towards reporting child abuse and neglect play a significant role in determining the tendency to report abuse and neglect. In addition, Cognitive Response Theory (Shen, 2020) suggests that individuals actively process messages by producing pro and/or counter arguments referred to as "Gain - loss thoughts". However, literature positioning the variable, attitudes towards reporting, as a mediator, as well as its importance, are limited. The purpose of the study was to investigate the mediating effect of pediatric nurses' attitudes between "gain-loss thoughts" and the tendency to report child abuse and neglect. DESIGN AND METHODS: A cross-sectional study examined 124 pediatric nurses working in central Israel's hospital departments concerning nurses' tendency to report (tendency to report = TTR), attitudes towards reporting, and "gain-loss thoughts" (positive and negative consequences for the child). RESULTS: Most of the nurses had professional experience of 11 years or more (n = 75; 62.5%). According to the findings, nurses' attitudes towards reporting mediate the effect of gain-loss on the TTR child abuse and neglect. CONCLUSIONS: Findings from this study contributed to our understanding of the importance of pediatric nurses' attitudes in determining the TTR abuse and neglect. Only nurses' positive attitudes towards reporting child abuse had a mediating effect on TTR. PRACTICE IMPLICATIONS: Understanding the importance of attitudes and gain-loss thoughts can serve as a strategy for training programs and in the assimilation of reporting obligations by health professionals in general and nurses in particular.

[SAFETY CLIMATE AT WORK, ROLE PERCEPTION AND THE EFFECT OF THEIR INTERACTIONS ON PROFESSIONAL BEHAVIORAL INTENTIONS AND JOB SATISFACTION: A COMPARATIVE STUDY AMONG NURSING STAFF MEMBERS IN PSYCHIATRIC WARDS].

INTRODUCTION: Nurses in psychiatric and forensic departments encounter unique difficulties and ethical dilemmas regarding the contrast between providing care and maintaining safety. Are psychiatric nurses incarceration wardens or agents of nursing care?

Vigilance in the Decision-Making Process Regarding Termination of Pregnancy Following Prenatal Diagnosis of Congenital Heart Disease-Application of the 'Conflict Decision-Making Model'.

The decision-making process regarding termination of pregnancy following prenatal diagnosis of congenital heart disease is a stressful experience for future parents. Janis and Mann's conflict decision-making model describes seven ideal stages that comprise vigilant information-gathering as an expression of the qualitative decision-making process. In our study, we attempted to determine whether parents who face the decision regarding termination of pregnancy undertake a qualitative decision-making process. Data were collected over 2-year period using structural questionnaires. The sample consisted of two hundred forty participants; sixty-nine (28.75%) declared that their decision was to terminate the pregnancy. A significant difference in the quality of the decision-making score was noted between parents who decided to continue with the pregnancy vs. parents who opted for termination (mean score of 10.15 (5.6) vs. 18.51 (3.9), respectively, p < 0.001). Sixty-two (90%) participants within the termination of pregnancy group went through all seven stages of vigilant decision-making process and utilized additional sources for information and consultation. Parents who decided to continue with the pregnancy made swift decisions, often without considering the negative and positive outcomes; this decision-making pattern is considered non-vigilant and ineffective. Identification of future parents at risk of going through an ineffective decision-making process may help health professionals to determine the best way to provide them with information and support.

Effect of ethnicity, country of origin and workplace on health behaviors and health perception among nurses: Cross-sectional study.

PURPOSE: The study aimed to (1) examine health behaviors and perceived health among nurses; (2) analyze the effect of nurses' personal and work characteristics on these variables; and (3) explore the relationship between health behaviors and nurses' health perception. DESIGN AND METHODS: A cross-sectional study was conducted among nurses working in health care organizations (HCOs) across Israel. An email with the online questionnaire was sent to nurses working in 19 HCOs across Israel during September-December 2018. FINDINGS: Of 18,120 nurses employed, 3542 completed the survey. Mean age was 44.8 years, 91% were female), 64.6% were hospital nurses and 52.8% were clinical staff nurses. Two-thirds of nurses did not achieve the physical activity (PA) target; the majority reported unfavorable eating habits; 66% slept less than 7 h at night and 15% smoke. Hospital nurses working night shifts reported the least favorable health behaviors. Non-Jewish nurses had less eating habits compared with Jewish nurses. Nurses born in the Former Soviet Union perceived their health as significantly worse than that of the other respondents. Binomial logistic regression demonstrated that, age, Israeli origin, achieving the PA target, having food breaks during work, consuming a Mediterranean diet, sleeping at least 7 h, undergoing screening tests as recommended, and not smoking predicted better health perception among nurses. CONCLUSIONS: Nurses, particularly hospital-based, non-Jewish and immigrants from the Soviet Union, demonstrated unfavorable health behaviors that may negatively affect their wellbeing and health perception. CLINICAL RELEVANCE: Interventions aimed at improving the health promoting mindset of nurses have the potential to improve their health and wellbeing and to enable them to become role models and health educators for patients and their families.

Factors That Influence Parents' Decision-Making Regarding Termination of Pregnancy After Prenatal Diagnosis of Fetal Congenital Heart Disease.

OBJECTIVE: To explore factors that influence parents' decisions regarding the termination of pregnancy after the detection of fetal congenital heart disease (CHD). DESIGN: A prospective descriptive study. SETTING: The Institute of Pediatric Cardiology in the Schneider Children's Medical Center. PARTICIPANTS: One hundred twenty couples (240 participants) with fetuses prenatally diagnosed with CHD, which was defined as conditions requiring surgical treatment. METHODS: We obtained data from a structured questionnaire for the pediatric cardiologist, the medical records, and structured self-report questionnaires for the participants. RESULTS: Thirty-six of 120 couples (30%) decided to terminate the pregnancy after a prenatal diagnosis of fetal CHD. The main factors associated with the decision to terminate were low gestational age (OR = 0.83 per week, 95% confidence interval [CI] [0.75, 0.96]), severe cardiac malformation (OR = 2.23, 95% CI [1.40, 3.53]), religious affiliation (OR = 10.0 for secular participants vs. others, 95% CI [4.61, 22.46], population group (OR = 2.96 for Jewish participants vs. others, 95% CI [1.63, 11.3]), and education (OR = 1.34 per year of education, 95% CI [1.15, 1.55]). CONCLUSIONS: Our findings describe the profiles of couples who decided to terminate their pregnancies after a prenatal diagnosis of fetal CHD. Early identification of the couple's decision can help health care providers provide adequate support, counseling, and guidance. Future research is needed to understand parents' needs for support through the process of decision-making, with attention to their religious and cultural values and contexts.

Experiences, behaviors, and perceptions of registered nurses regarding research ethics and misconduct.

BACKGROUND: Nurses engaging in research are held to research ethics standards. RESEARCH AIM: Examine experiences, behaviors, and perceptions of nurses in Israel regarding research ethics and explore possible related factors. RESEARCH DESIGN: An original investigator-designed self-administered questionnaire measured five variables: (a) ethics in research, (b) encountered research misconduct during the course of one's studies, (c) the inclination to fabricate data, (d) the inclination to select or omit data, and (e) knowledge of research misconduct in the workplace. Additionally, demographic data were collected. PARTICIPANTS AND RESEARCH CONTEXT: The questionnaire was completed by 151 Israeli registered nurses. 10.2% hold a PhD, 34 % hold an MA, 42.2% hold a BA, and 13.6% with no academic degree. ETHICAL CONSIDERATIONS: The study was approved by the University's ethics committee; anonymity and consent of the respondents were respected. FINDINGS: Registered nurses' level of studies achieved was significantly associated with a lower inclination to fabricate data, with one exception-PhD nurses were more inclined to fabricate data than nurses with a Master's degree. A trend was found in which a higher level of studies is associated with higher knowledge of research misconduct in the workplace. DISCUSSION: Results indicate that nurses' perceptions of research ethics change throughout their academic studies, indicating a positive influence of level of studies, research experience, and work experience on ethics perceptions. Nevertheless, PhD nurses showed a greater inclination to actually select, omit, or even fabricate data than MA nurses. This may be related to pressure to publish. CONCLUSION: PhD nursing programs should include ethics training. Academic faculty members should serve as role models regarding research integrity. Research ethics deserves further emphasis on all levels of nurse education in Israel, as well as in the nurses' code of ethics and related documents. This may positively impact ethical research practices.

Psychosocial Outcomes of Sharing a Diagnosis of Cancer with a Pediatric Patient.

PURPOSE: This innovative pilot study was designed to provide research-based evidence on the variables to consider informing a child of his/her cancer diagnosis, so as to minimize the negative psychosocial effects of the cancer experience on survivors. The hypotheses of the study were that "good information" about cancer, will allow the child a better understanding way to cope with treatment and improve sociopsychological outcomes at adulthood. METHODS: Ninety-one adult childhood cancer (CC) survivors got the questionnaires while waiting to their routine checkup at a grate CC medical center in center Israel. RESULTS: To our surprise and not according to the hypothesis, there was a difference between children diagnosed up to 12 years of age and those diagnosed during adolescence. (Participants were divided into two groups according to their age at diagnosis: from birth to 12 years old and from age 12-18). In the group diagnosed at a younger age, those who had received "good information" were found to have better quality of life, lower mental pain, and higher mental pain tolerance than did those in the same group (diagnosed at a younger age) who received "not good information." By contrast, in the group diagnosed during adolescence, those who had received "not good information" scored higher on these measures than did their counterparts who had received "good information." CONCLUSION: Given that information conveyed to children diagnosed with cancer can have a significant impact on survivors' quality of life, further research is needed to determine the precise information to be divulged to children at the time of diagnosis. In the meantime, extreme caution, sensitivity, and careful judgment are required. CLINICAL RELEVANCE: Findings of the current study and of future studies can be used to formulate clear guidelines for assessing a child's readiness and the information to be divulged, so as to improve the quality of life of CC survivors.

Background Music Playback in the Preoperative Setting: Does It Reduce the Level of Preoperative Anxiety Among Candidates for Elective Surgery?

BACKGROUND: Contemporary medicine and nursing use music to stabilize mood, relieve tension and anxiety, and achieve higher treatment efficiency. Preoperative anxiety may be responsible for cognitive and behavioral changes affecting treatment efficiency. PURPOSE: To evaluate the effect of background music on preoperative anxiety in elective surgery patients and on noise levels in the surgery waiting room. DESIGN: One hundred fifty-nine elective surgery patients were divided into an intervention group (n = 82) and a control group (n = 77). Data were collected and evaluated on the evening before surgery in the department, on entering the waiting room, and 30 minutes later in the preoperative setting. Data were gathered using the State-Trait Anxiety Inventory scale and by measuring vital signs. Daily noise levels in the preoperative waiting room were recorded as well. FINDINGS: Exposure to background music was associated with decreased levels of state anxiety irrespective of age, sex, and previous exposure to surgery or anesthesia (P < .001). Background music was also related to environmental noise reduction in the surgery waiting room (P < .0001). CONCLUSIONS: Background music can be useful as a means of decreasing preoperative anxiety.

SEXUAL HARASSMENT BY PATIENTS: THE DIFFERENCE EXPERIENCE OF FEMALE DOCTORS, NURSES AND NURSE AIDES.

STUDY AIM: To examine the incidence of sexual harassment of women staff by male hospital patients, and how experiencing it differs between doctors, nurses and nurse aides. METHODS: 434 women staff in three large Israeli hospitals completed an anonymous self-administered questionnaire on (a) the frequency of sexual harassment by patients, (b) the emotional effect of a described instance of harassment, (c) what action respondents would take if confronted by the same incident. RESULTS: Sexual harassment by male patients is common, ranges from mild innuendo to threats of rape, and creates great emotional distress. The younger the staff the more the harassment. Women doctors-the youngest staff group-were beset more than nurses and nurse aides and voiced the most negative emotional and behavioral reactions.

Contact between deceased donors' families and organ recipients.

The benefits and disadvantages of posttransplant contact between a donor family and the organ recipient are disputed. In this study far more contacters reported benefits rather than disadvantages and noncontacters reported the opposite. The dissatisfaction of noncontacters with no contact was high: no less than 60% wanted some form of contact in the future. The authors conclude that contact has more benefits for the donor family than disadvantages, evidenced by families' desire to maintain contact with the organ recipient. Both donor families and organ recipients need the transplant coordinator's initiative and guidance on this issue.

Combating the maltreatment of older persons by staff in long-term care nursing homes: legal aspects.

A great deal of research has considered the dynamics of family violence and the way that family violence is processed and handled in the criminal justice system. Very little nursing research has considered the dynamics of older persons' maltreatment in long-term care. Older people living in a residential setting have the right to respectful care based on professional ethics. To fill this void, the current study proposes to identify policy implications for effectively implementing the recently developed Israeli public law designed to protect vulnerable older adults in nursing homes. In addition, this article presents the elder abuse reporting systems and the service delivery systems that have been established to protect older adults at risk of abuse and neglect.

Intentions of nurses and nursing students to tell the whole truth to patients and family members.

AIMS AND OBJECTIVES: To investigate the intentions of nurses and nursing students to telling the truth to patients and families, based on the Theory of Planned Behavior which examines intention to perform behaviours. BACKGROUND: In recent decades, the perception that patients have a moral and legal right to truthful and reliable information has become dominant. However, the study of telling the truth to non-oncology patients has received scant attention and little is known about the intention of nurses and nursing students to tell the truth. DESIGN: A cross-sectional design. METHODS: We used a scenario-based questionnaire, illustrating eight different situations in which nurses/nursing students are asked to tell the truth to a patient or family member regarding a devastating disease with which the patient is afflicted. Data were analysed using the Mann-Whitney U-test and ridge regression. RESULTS: The sample included 150 participants, 110 registered nurses and 40 third year nursing students, with a response rate of 87%. The results show that nurses and nursing students intend to tell the whole truth even if this is not easy for them. Nurses more than students think that it is important to tell the whole truth and intend to do so. Head nurses tend to tell the truth more than staff nurses. For nurses, the components of the Theory of Planned Behaviour predicted intention to tell the truth, whereas among students subjective norms were the only predictor of intention. CONCLUSION: The Theory of Planned Behaviour is a powerful predictor of nurse intention to tell the whole truth to patients and their families. Students perceive social pressure as the most important incentive of their intention to tell the truth. RELEVANCE TO CLINICAL PRACTICE: Nurses and nursing students should receive additional training in dealing with various situations involving truth telling.

The acceptance of epidural anesthesia by Israeli-Arab birthing mothers.

Israeli-Arab birthing mothers use epidural anesthesia in labor markedly less than their Israeli-Jewish counterparts. This study modeled the mothers' choice to agree to epidural anesthesia or not, using the Ajzen and Madden Theory of Reasoned Action. A convenience sample of one hundred was drawn from women coming to two hospitals to give birth. The instrument used was a structured questionnaire developed by the researcher. The variables found to influence the mothers' attitudes to epidural anesthesia were age, number of previous births, religious practice, schooling and having accepted epidural anesthesia in their previous labor. In conclusion, five practical implications of the study are set out for changing this population's choices about epidural anesthesia in labor.

Nurses' knowledge, attitudes and willingness to participate officially in workplace Healthcare Ethics Committees (HEC).

This research was designed to assess nurses' perceptions, knowledge, attitudes and intentions in relation to nurse participation in Healthcare Ethics Committees (HECs). A convenience sample of 87 nurses from five Israeli hospitals completed a self-administered questionnaire, whose data were then analyzed by quantitative statistics. The main findings were that large percentages of nurses were totally ignorant of the existence and functioning of the HEC in their workplaces. Nurses in managerial roles were (a) much more knowledgeable on these matters than staff nurses and (b) regarded more positively the idea that nurses had an obligation to sit on such committees. Workplace role and rank in the organizational hierarchy had a stronger impact on nurse attitudes to HEC work than level of education. Overall, nurse willingness to sit on an HEC and to take special training in preparation for such a role were high.

Nurses' intention to apply clinical practice guidelines.

Using Ajzen and Madden's Theory of Planned Behavior, this study investigates factors which influence nurses' intention to apply clinical practice guidelines in their daily ward work. A convenience sample of 91 nurses in internal medicine wards in three Israeli hospitals answered four questionnaires. Data were processed by Pearson correlation coefficients and multivariate regression. The main findings were that burnout was negatively correlated with the intention to work according to guidelines and that professionalism (in the sense of a tendency to follow taught procedure rather than personal judgment) was positively correlated with it. Furthermore, nurses who perceive their behavioral control and subjective norms to be positive will be the most determined to work according to guidelines, provided they personally command the necessary resources to do so.

The transplant team's role with regard to establishing contact between an organ recipient and the family of a cadaver organ donor.

AIMS AND OBJECTIVES: To understand how the recipients of cadaver-harvested organs and donor families perceive the role of the transplant team and transplant coordinator in bringing them into contact. BACKGROUND: Studies dispute the benefits and disbenefits of contact and their differential weights with the two parties. For the donor family, contact with the recipient after a successful transplant renders positive meaning to the tragedy of the family's loss, but expectations of the recipient can also be disappointed. For recipients, contact with the donor family lets them express gratitude and shake off the guilt of having their life saved by a death but can also draw them into the family's mourning and into feeling the family are owed a 'return' for their life-saving gift. The transplant team have to weigh these potential benefits and disbenefits. If the answer is positive, what should they do to bring the contact about? DESIGN: A sample of 135 donor family members and organ recipients (representing all successful transplants in Israel from 1998-2007) were interviewed by structured questionnaire. Some had made contact, some not. METHOD: Data were analysed by means, frequencies and correlation coefficients. RESULTS: Far more 'contacters' than 'non-contacters' wanted the transplant coordinator to take an active role in establishing contact. No less than 60% of non-contacters wanted contact in the future, and 50% were dissatisfied with the absence of contact. CONCLUSIONS: This is the first study to investigate the benefits and disbenefits of not making contact. Both donor families and organ recipients would respond positively to the coordinator taking the initiative in establishing mutual contact. RELEVANCE TO CLINICAL PRACTICE: Transplant coordinators are given convincing backing for taking the initiative in promoting contact between donor families and organ recipients. The coordinator's intervention, information and guidance are needed to make a success of such contact.

The intention to report medication error.

The aim of this study is to use the Azjen & Madden Theory of Planned Behavior to identify the factors influencing the intention or non-intention of community nurses to report adverse incidents. A convenience sample of community nurses completed a questionnaire. The findings fully or partially confirmed the study's three hypotheses. The factors found to exert most influence on the decision to report adverse incidents or not were the nurse's Perceived Behavioral Control and her perception of her professional and social expectations on this issue. The authors recommend that nursing staff be made aware that reporting error will make them better nurses; that staff who do report errors be given encouragement and support, not punishment; that error-reporting not be regarded as 'informing' or as evidence of personal failure and that nurses need an organizational culture and collegiate environment which supports reporting.

The intention of delivery room staff to encourage the presence of husbands/partners at cesarean sections.

Objective. In recent years, more and more delivery rooms have allowed husbands/partners to be present during a Cesarean section Nonetheless, many still oppose the idea. The study is designed to investigate the attitudes of Israeli gynecologists, anesthetists, operating-room nurses, and midwives on this issue. Design. The study's theoretical model comes from Fishbein and Ajzen's theory of reasoned action. A self-administered questionnaire was submitted to convenience sample. Subjects. 96 gynecologists, anesthetists, midwives, and operating-room nurses. Results. Significant differences were found between the occupational subgroups. Most of the findings supported the four hypotheses tested and confirmed earlier studies designed to verify the theoretical model. Conclusions. The main conclusion drawn is that delivery and operating-room staff need to be trained in the skills needed to promote the active participation of the baby's father in delivery and, if necessary, in a Cesarean section.

Perception of ethical climate and its relationship to nurses' demographic characteristics and job satisfaction.

In this study, we examined the perception of actual and ideal ethical climate type among 95 nurses working in the internal medicine wards of one central hospital in the state of Israel. We also examined whether nurses' demographic characteristics influence that perception and if a relationship between perceptions of an actual and an ideal ethical climate type influences nurses' job satisfaction. A questionnaire composed of three subquestionnaires was administered and the responses analyzed using multiple linear regressions, analysis of variance and Pearson's correlation coefficient. The results demonstrated that demographic characteristics (such as: gender, job tenure and level of education) partially influence the perception of an ideal ethical climate. Incongruence in perceptions of 'caring' and 'independence' climate types indicated a decline in nurses' job satisfaction, while perception of actual 'caring' and 'service' climates positively influenced all aspects of job satisfaction. We recommend constructing training programs emphasizing the ethics of nursing practice and also to help lead nurses to clarify an ethical framework and guide nursing staff in dealing with ethical dilemmas.

Patient violence towards nursing staff in closed psychiatric wards: it's long-term effects on staff's mental state and behaviour.

The purpose of this study was to (a) investigate in the Israeli context how patient violence towards staff (nurses and auxiliaries) affects their mental state and professional performance; and (b) to investigate how the variable, internal/external locus of control, mediates the effects of this violence. Four of the five hypotheses were confirmed: type, severity and frequency of attack was correlated with the level of staffers' psychological distress and change in professional functioning; psychological distress was correlated with a negative change in professional functioning and was higher in attacked staff than in those not attacked; internal locus of control was correlated with lower psychological distress and less negative professional functioning, whereas an external locus of control correlated with higher distress and more negative functioning. A sharper awareness of the effects of violence on staff is vital at all levels of management. Most attention is given to physical injury but verbal aggression and threats, often disregarded, may have the strongest negative influence. Emotional/psychological injury was rarely treated and needs to be.