The relationships among overcommitment, effort-reward imbalance, safety climate, emotional labour and quality of working life for hospital nurses: a structural equation modeling.

BACKGROUND: Quality of working life (QWL) is a highly important issue for nurses. Nurses with lower QWL tend to have lower job performance and intention to stay. The aim of this study was to apply a theoretical model to examine the structural relationships among overcommitment, effort-reward imbalance (ERI), safety climate, emotional labour and QWL for hospital nurses. METHODS: A cross-sectional study design and a simple random sampling method were used to recruit 295 nurses in a teaching hospital and used a structured questionnaire was used to collect data. RESULTS: Overall, the nurses' QWL was moderate. Our theoretical model showed a good model fit. Overcommintment had a significant direct positive effect on ERI (ß = 0.35, p < 0.001) and indirect effects on safety climate (ß = -0.149, p = 0.001), emotional labour (ß = 0.105, p = 0.001) and QWL (ß = -0.061, p = 0.004). Additionally, ERI not only had significant direct effects on safety climate (ß = -0.42, p < 0.001), emotional labour (ß = 0.30, p < 0.001) and QWL (ß = -0.17, p < 0.001) but also indirectly affected QWL through safety climate (ß = -0.304, p = 0.001) and emotional labour (ß = -0.042, p = 0.005). Both safety climate (ß = 0.72, p < 0.001) and emotional labour (ß = -0.14, p = 0.003) showed significant direct effects on QWL. Our final model accounted for 72% of the variance in QWL. CONCLUSION: Our results highlight the necessity of improving the QWL of nurses. Policymakers and hospital administrators should develop policies and strategies that encourage nurses to exhibit an appropriate level of commitment, balance effort and reward, establish a climate of safety, and reduce emotional labour to improve the QWL of hospital nurses.

Examining the Psychometric Properties of the Taiwanese Version of the Hospice Quality of Life Index.

Quality of life is an important outcome for people with cancer throughout their cancer trajectory. Having a valid and reliable instrument to measure the quality of life is critical. This cross-sectional study examined the psychometric properties of the Taiwanese version of the Hospice Quality of Life Index among patients with advanced cancer in Taiwan. There were 3 phases: (1) translation of the Hospice Quality of Life Index from English to Mandarin, (2) pilot testing among 30 targeted participants, and (3) field testing to examine validity and reliability. The results of confirmatory factor analysis indicated that the original factor structure of the Hospice Quality of Life Index did not fit the data. After 5 items were deleted from the original questionnaire, principal factor extraction with oblique rotation for exploratory factor analysis yielded 3 subscales: Social/Spiritual Well-Being, Psychological Well-Being, and Functional/Physiological Well-Being. For convergent validity, the small to moderate strength of associations showed shared variance with the Memorial Symptom Assessment Scale. The internal consistency was supported by Cronbach α ranging from 0.77 to 0.86. This study shows early evidence that the quality of life of people with advanced cancer can be appropriately assessed by the Taiwanese Hospice Quality of Life Index.

Daily Care Information System Requirements: Professional Service-Driven Service Blueprint Approach.

BACKGROUND: Long-term care (LTC) services are a professional service-driven (PSD) system; to deliver appropriate care services to residents, health care providers first need to collect appropriate patient data and make a professional assessment. A well-designed LTC information system should therefore consider the information requirements of multidisciplinary health care providers to adequately support their care services. OBJECTIVES: This study proposed a modified service blueprint-the PSD service blueprint-for visualizing interdisciplinary service providers' input and output information requirements, which correspond to their service activities. METHODS: The PSD service blueprint comprises five layers and seven elements. We also present a case study to illustrate the blueprint's application to daily LTC services. RESULTS: Our proposed approach could clearly illustrate the daily care activities, service providers (main actors), actors' input and output information, and suggestions for LTC information system-related applications. CONCLUSION: The proposed PSD service blueprint can not only gather interdisciplinary LTC service providers' information system requirements but also act as a mapping tool for visualizing the care service process.

The precaution strategy toward the COVID-19 pandemic in the operating room of a tertiary hospital in Taiwan.

BACKGROUND: The pandemic of SARS-CoV-2 (COVID-19), which began in December 2019, spread mostly from person to person through respiratory droplets. A recommendation was issued to postpone all elective surgical practices. However, some confirmed or suspected COVID-19 patients required life-saving emergent surgeries. METHODS: To facilitate emergent surgical interventions for these patients, we have reviewed the current literature and established an algorithm of precautions to be taken by operating room team members during the COVID-19 pandemic. RESULTS: The initial algorithm of preparation for surgical intervention during the COVID-19 pandemic was relatively simple. However, the abrupt increase of confirmed COVID-19 cases due to returned overseas travelers since mid-March 2020 disrupted the routine hospital clinical service. Due to the large number of febrile patients, the algorithm was therefore revised according to travel history, occupation, contact and cluster history (TOCC), unexplained fever/symptoms, and emergent/nonemergent surgery. TOCC (+) patients presenting with otherwise unexplained fever/symptoms would be regarded as belonging to the fifth category of "severe special infectious pneumonia." If the patient requires emergent surgery to relieve the non-life-threatening disorders, two times of negative COVID-19 tests are necessary before the operation is approved. For life-threatening situations without two negative results of COVID-19 tests, the operation schedule should be approved by the Chairman of Surgery Management Committee. CONCLUSION: The application of a clear and integrated algorithm for operating room team members aids in effective personal protective equipment facilitation to keep both healthcare providers and patients safe as well as to prevent hospital-based transmission of COVID-19.

A study of role stress, organizational commitment and intention to quit among male nurses in southern Taiwan.

Gender and sex role stereotyping are recognized as having the potential to limit the professional development of males within the nursing profession. The purpose of this study was to understand the relationships between demographic data and the dimensions of role stress, organizational commitment, and intentions to quit among male nurses in southern Taiwan. Research also investigated the correlations with three dependent variables and identified best predictors of male nurse intentions to quit the nursing profession. A total of 91 male nurses volunteered to participate in this cross-sectional research. Research results were based on data collected from questionnaires sent by mail to participants. A total of 76 valid questionnaires were returned and used in analysis (response rate = 83.5%). Findings pointed to patients, colleagues and society as the major sources of role stress for male nurses. These sources of stress, and the resultant intention to quit on the part of male nurses, are due in significant part to the widespread stereotyping of the profession of nursing as a "woman's occupation". Such stress pressures male nurses to consider quitting to take jobs in other professional fields. Role stress is correlated to intention to quit among male nurses. Role stress and years of service are highly relevant predictors of male nurse intention to quit and leave the nursing profession, explaining 33.8% of variability. We suggest that at various levels of education and society, promotion of male and female equality should be increased. There is also a need for psychological consultation as well as the promotion of male nurse role models to prevent male nurses turning away from nursing careers.

Taiwanese Version of the Work-Related Quality of Life Scale for Nurses: Translation and Validation.

BACKGROUND: The shortage of professional nurses is a global issue of critical importance. Improving the retention and recruitment of nurses is necessary to reduce this shortage. The ability to measure the quality of work life (QWL) of nurses is important to understand the current QWL status among nurses and to develop appropriate improvement strategies. The two instruments that are currently used in Taiwan both require excessive amounts of time to complete. Furthermore, the results that these two instruments generate are not easily interdisciplinary and international comparisons. PURPOSE: The aims of this study were to translate into Chinese the English version of the Work-Related Quality of Life Scale (WRQoL) that was developed by Van Laar, Edwards, and Easton (2007) and then to determine the reliability and validity of this Chinese-version scale in terms of measuring the QWL of nurses in Taiwan. METHODS: The WRQoL was translated from English into Chinese using forward-translation with group discussions, back-translation, and verification of conceptual equivalence. Concurrent validity, test-retest reliability, and internal consistency reliability were determined in two samples of nurses (n = 30 and n = 213 for Phases 1 and 2, respectively) from a medical center in Taiwan during September 2009. RESULTS: The 23-item Taiwanese version of the WRQoL showed satisfactory concurrent validity with a Taiwanese QWL scale (correlation = .75). The 3-week test-retest reliability was .89, and the Cronbach's alpha was .88, indicating high internal consistency reliability. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The Taiwanese version of the WRQoL is acceptable for measuring the QWL of nurses in Taiwan. Larger scale studies are recommended for confirmatory factor analysis. This tool may be used for human resources management and policy-making applications, providing the potential to help retain and recruit nurses in Taiwan. Furthermore, the Taiwanese-version scale may be used to compare work-related quality of life between Taiwanese nurses and their counterparts overseas.