(Dis)Agreement with Dysthanasia, Religiosity and Spiritual Experience as Factors Related to Nurses' Workload during End-of-Life Care.

This study intended to investigate whether the workload of nurses in the course of providing end-of-life care correlated with their religiousness, spiritual experience and level of agreement with dysthanasia procedures. The respondents included 279 nurses from four Croatian hospitals. A structured and validated instrument was applied. Almost 90% of respondents are religious, and almost 45% of them have daily spiritual experiences. Respondents, especially those with high levels of religiousness and spiritual experience, express a low level of agreement with dysthanasia (mean = 58.21; score = 25−125). Moreover, nurses self-rated (on a scale of 1−5) their workload as quite high, especially when performing contradictory tasks imposed on them by their superiors (mean = 3.05) and during direct contact with dying patients and their family members (mean = 2.56). This significantly highest level of workload was experienced by the youngest nurses (p = 0.01) and nurses with little work experience (p < 0.01). This study also indicated that nurses who agree with dysthanasia experienced a higher level of workload when providing end-of-life care (r = 0.178; p < 0.01), while more frequent spiritual experiences reduced the level of workload (r = −0.205; p < 0.01). A deeper understanding of nurses' attitudes toward dysthanasia, as well as of their religiousness and spiritual experiences, may ensure the collection of data beneficial to the timely identification of potential risks caused by workload.

Patients' and Nurses' Perceptions of Importance of Caring Nurse-Patient Interactions: Do They Differ?

Nurse−patient interaction is a professional and therapeutic relationship created to enable nurses to assess, plan, and deliver health care aimed at meeting patients' basic human needs. The main aim of this study was to identify distinctive characteristics and differences in perceptions between patients and nurses related to the importance of caring interactions and to examine the contribution of independent variables in explaining their perceptions. A total of 446 respondents were included in the research (291 patients and 155 registered nurses). Data were collected using the translated and standardized 70-item version of the Caring Nurse−Patient Interactions Scale (CNPI-70) version for patients and version for nurses. According to the overall CNPI-70 scale, there was a significant difference in patients' and nurses' perception (p < 0.001). Patients assessed caring nurse−patient interactions significantly higher (4.39) than nurses (4.16). Additionally, nurses assessed all subscales significantly lower than patients who assessed them high (p < 0.05), except for the subscales for "environment" (p = 0.123) and "spirituality" (p = 0.132). Independent variables did not contribute to an explanation of respondents' perceptions. Providing quality physical assistance in meeting human needs through effective communication and teaching is crucial for promoting a holistic patient approach, improving psychosocial support and nurse−patient interaction, and attaining greater satisfaction with health care provided without additional financial investments.

Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients.

A mastectomy affects the psychological, social, and sexual well-being of patients. Research has confirmed that breast reconstruction is important for improving the quality of life in patients with breast cancer. The aim of this study was to assess the quality of life of patients who underwent a mastectomy followed by immediate or delayed breast reconstruction. This prospective study was conducted from January 2018 to March 2020 at the Clinical Hospital Center Osijek, using the health questionnaire SF-36. The study included 79 patients. The results of the study showed that patients who underwent a mastectomy had the lowest scores in the domain of restriction due to physical difficulties, 18.8 (6.3−31.3), in physical functioning and limitation due to emotional difficulties, 16.7 (8.3−33.3), in mental health. In immediate breast reconstruction, patients rated better physical health (p < 0.001), while patients who underwent delayed breast reconstruction rated their mental health worse (p < 0.001) as measured by the SF-36 questionnaire. Conclusion: The results of this study show that patients without breast reconstruction rated their quality of life worse than patients who underwent immediate and delayed breast reconstruction after mastectomy. There is no difference in the quality of life between patients who underwent immediate and delayed breast reconstruction after mastectomy.

Nurses' Self-Assessment of Caring Behaviors in Nurse-Patient Interactions: A Cross-Sectional Study.

Nurse-patient interactions based on caring behaviors ensure better working conditions and better-quality healthcare. The aim of this quantitative study is to examine how nurses self-assess the frequency of applying caring behaviors in nurse-patient interactions and to identify the differences in the application frequency of caring behaviors in relation to work experience and education level. The respondents were Bachelor of Science (BSc) nurses and nurses with basic training (VET) employed in different clinical departments of the Clinical Hospital Center in Croatia. The survey used the "Caring Nurse-Patient Interactions Scale (Nurse Version)". The respondents assessed the caring behaviors from the subscale "needs" as the most frequently applied (median (Me): 4.7; interquartile range (IQR): 4.4-4.9), while the least frequently applied were the procedures from the subscale "sensitivity" (Me: 3.8; IQR: 3.2-4.3). The VET nurses reported applying caring behaviors to the subscales "hope" (p < 0.001), "problem-solving" (p = 0.003), and "environment" (p = 0.021) more frequently than BSc nurses did. Compared with less experienced respondents, the respondents with more than 30 years of work experience applied the caring behaviors on the subscales "sensitivity" (p = 0.009), "expression of emotions" (p = 0.001), "problem-solving" (p = 0.008), and especially "humanism" and "spirituality" (p < 0.001) more frequently. The results indicate that respondents are more focused on applying skills or carrying out a task than on caring behaviors which is about demonstrating compassion, loving kindness, and relationships.

Translation and validation of the clinical learning environment, supervision and nurse teacher scale (CLES + T) in Croatian language.

Clinical practice is essential to nursing education as it provides experience with patients and work environments that prepare students for future work as nurses. The aim of this study was to translate the "Clinical Learning Environment, Supervision and Nurse Teacher" questionnaire in Croatian language and test its validity and reliability in practice. The study was performed at the Faculty of medicine, Josip Juraj Strossmayer University of Osijek, Croatia in April 2014. The translated questionnaire was submitted to 136 nursing students: 20 males and 116 females. Our results reflected a slightly different factor structure, consisting of four factors. All translated items of the original constructs "Supervisory relationship", "Role of nurse teacher" and "Leadership style of the ward manager" loaded on factor 1. Items of "Pedagogical atmosphere on the ward" are distributed on two factors (3 and 4). The items of "Premises of nursing on the ward" loaded on factor 2. Three items were identified as problematic and iteratively removed from the analysis. The translated version of the aforementioned questionnaire has properties suitable for the evaluation of clinical practice for nursing students within a Croatian context and reflects the specifics of the nursing clinical education in this country.