Assessment of the Psychometric Properties of the Online Education Student Satisfaction Scale: A Methodological Study.

Background and Purpose: Assessing student satisfaction is essential in evaluating the quality of education. The number of valid and reliable tools that measure students' satisfaction with online education is limited. This methodological study aimed to assess the psychometric properties of the online education student satisfaction scale. Methods: Eleven academicians from the nursing field provided expert opinions on content validity. Separate 25 students evaluated the language clarity of the draft scale. The study sample included 525 third- and fourth-year nursing students. Finally, a group of 30 nursing students different from the sample participated in the test-retest. The study created an item pool based on the recent literature. The researchers calculated the items' content validity rates and the scale's content validity index by taking the experts' opinions. In addition, item-total score correlation analysis, exploratory factor analysis, discrimination analysis, stability test, and internal consistency analysis were performed. Results: An item with a low-correlation value was excluded from the scale. The correlation coefficients of the remained items were between .536 and .811. In the second round of exploratory factor analysis, a five-factor structure emerged that explained 72.1% of the total variance. In addition, item discrimination, stability, and internal consistency test results ensured that the scale was valid and reliable. Conclusions: The online education student satisfaction scale with five subdimensions containing 28 items is a valid and reliable tool. Researchers, educators, and managers may use it to evaluate students' satisfaction with online education.

An Evaluation of a Web-Based Crisis Management Training Program for Nurse Managers: The Case of the COVID-19 Crisis.

OBJECTIVE: The effective management of nursing services, the main power in patients' care and treatment in the front line of the fight against the COVID-19 pandemic, and nurse managers' effective leadership behaviors in the fight against the pandemic have been important key factors. It is thus critical to support nurse managers, strengthen them through training, and increase their competency so that they can successfully manage crises, disasters, or pandemics. This study aims to assess the effect of a web-based training program on the knowledge levels of nurse managers who worked during the COVID-19 pandemic. METHODS: This is a randomized controlled experimental study. The study population consisted of the members of the Nurse Managers Association. The intervention group had 30 participants, and the control group had 31 participants in the final. RESULTS: There was no statistically significant difference between the intervention and control groups' mean number of correct pre-test responses (P = 0.843). However, the intervention group's mean number of correct post-test responses was statistically significantly higher than the control group's after the web-based training program (P < 0.001). CONCLUSIONS: Web-based training programs can effectively increase nurse managers' knowledge levels. Therefore, web-based training programs should be developed in ordinary times for the management of crisis situations.

Emotional labour behavior of nursing students: A qualitative study.

AIM: This study aimed to determine the opinions of nursing students on emotional labor behavior. BACKGROUND: It is of importance to teach emotional labor behavior to nursing students, the nurses of the future. DESIGN: The research has a phenomenological qualitative design. METHOD: Participants consisted of 20 nursing students who were in face-to-face communication with patients in clinical practice. The Standards for Reporting Qualitative Research (COREQ) was used to report this research. RESULTS: Considering the theoretical structure of the subject, emotional labor behavior was examined under three main themes: surface acting, deep acting, and genuine acting. CONCLUSIONS: Emotional labor behavior affects students' approach to patients and performance in clinical practice. Education has a supportive effect on the management of emotions and the guidance of the clinical environment and clinical services.

The relationship between the conflict management strategies and ethical leadership behaviours of nurse managers perceived by nurses.

AIM: The aims of this study were to determine nurse managers' level of ethical leadership perceived by nurses and to examine its relationship with conflict management strategies. BACKGROUND: Ethical leadership is about how managers use their power in their decisions and actions, and its source is based on moral and ethical authority. Therefore, it is important to understand the impact of ethical behaviours of nurse managers in the work environment on determining conflict management strategies. METHOD: The data of this descriptive, correlational, and cross-sectional study were collected face-to-face from 285 nurses between April-June 2019. The data collection instruments included the introductory information form, the Ethical Leadership Scale, and The Rahim Organizational Conflict Inventory-II. RESULTS: Ethical leadership scores perceived by nurses in nurse managers were found 3.78, and the highest score was obtained from the behavioural ethics subscale (3.81 ± .91). In conflict management strategies perceived by nurses, it was determined that they got highest scores from collaborating style (3.76 ± .90) and lowest scores from competing style (2.90 ± .94). There was no significant relationship only between ethical leadership and its subscales and competing (r: -.038/-.041, p > .05). In other subscales, there were positive, moderate, and highly significant relationships (r: .466-.747, p < .001). The rate of explanatoriness of communicative ethics subscale in conflict management strategies ranged from 22.3% to 58.0%. CONCLUSIONS: The study shows that communicative ethics subscale significantly affects the conflict management strategies of nurse managers. Therefore, it is important for nurse managers to communicate bilaterally and be a role model for nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Ethical leaders value trust and respect in their interactions with employees and reflect what appropriate behaviour to the situation is. Nurses who perceive that their managers demonstrate ethical leadership behaviours will also evaluate their role in conflict resolution. On the other hand, the power-based, aggressive, noncompromising domination approach that the person imposes on others is not associated with the ethical leadership perception towards their managers by nurses and is a strategy that should not be preferred. Therefore, nurse managers who use appropriate conflict management strategies were seen as a role model by nurses.

Factors affecting nurses' attitudes towards risks in the work environment: A cross-sectional study.

AIM: This study aimed to examine the factors affecting nurses' attitudes towards risks in the work environment. BACKGROUND: Nurses' attitudes towards work environment-associated risks affect both risk management and employee health. METHODS: This descriptive study was conducted with 338 nurses working in a public hospital, university hospital and private hospital. Data were collected using the Personal Information Form and the Nurses' Attitudes Towards Work Environment Risks Scale. RESULTS: Nurses were found to have a positive attitude towards risk in the work environment. Regression analysis showed that nurses' attitudes towards risk was affected by institution, gender, access to unit-specific risk management training, past experiences of sharp penetrating tool injuries, acceptance of risks due to the belief that risks are unavoidable, exposure to violence from colleagues, exposure to biological hazards and neglect to take risk precautions. CONCLUSIONS: This study's results show that nurses' attitudes towards risk in the work environment are affected by both individual and organizational factors. IMPLICATIONS FOR NURSING MANAGEMENT: This study's results can help institutions and nurse managers understand the factors affecting nurses' attitudes towards work-related risks, thereby allowing them to determine the primary strategies that may be used to address these factors.

Frequency, reasons, correlates and predictors of missed nursing care in Turkey: A multi-hospital cross-sectional study.

AIM: We aimed to examine the frequency, reasons, correlates and predictors of missed nursing care in Turkey. METHODS: This descriptive and cross-sectional study sample consisted of 1310 nurses working in inpatient units of 10 public, university and private hospitals in Istanbul. Data were collected using the Nursing Teamwork Survey-Turkish and the MISSCARE Survey-Turkish between February and June 2019. Descriptive analysis, parametric comparative analysis, correlational analysis and regression analysis were used to analyse the data. RESULTS: The total occurrence of missed nursing care was 2.93 (on a scale of 1.00-4.00), which differed across 21 nursing care elements. The most frequently missed care was turning patients every 2 hours. Multiple regression analysis determined that nurses' tenure in the profession, patient-nurse ratio, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. Nursing teamwork alone accounted for 23.6% of the variance in missed nursing care. CONCLUSIONS: The level of missed nursing care was found to be high, and labour resources issues were the most important reason. Nurse professionals should apply interventions to improve nurses' work environment factors such as patient-nurse ratio and nursing teamwork to reduce the incidence of missed nursing care.

Determining the effect of neuro-linguistic programming techniques on the conflict management and interpersonal problem-solving skills of nurse managers: A mixed methods study.

AIM: This study, which used quantitative and qualitative design, was conducted to explore the effect of neuro-linguistic programming techniques on the conflict management and interpersonal problem-solving skills of nurse managers. BACKGROUND: Neuro-linguistic programming is among the methods that can enable managers to achieve the desired results in managing interpersonal problems and conflicts in an organisation. METHODS: The research was carried out with a mixed methods approach. The Personal and Professional Characteristics Information Form, Interpersonal Problem-Solving Inventory and Rahim Organizational Conflict Inventory-II were applied to 41 nurse managers and nurses to collect quantitative data for the study. Semi-structured questionnaires were used to collect qualitative data in focus-group interviews held both before and 6 months after the training. RESULTS: As a result of the content analysis of the qualitative data, the nurse managers in the training group were found to have improved abilities to plan and increased flexibility, positiveness, happiness and motivation when compared to the nurse managers in the control group. Findings supporting these data were obtained in the analyses of interviews with nurses. CONCLUSION: Neuro-linguistic programming training can make a difference in terms of helping nurse managers to develop interpersonal problem- and conflict-solving skills. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can use neuro-linguistic programming techniques for conflict management and interpersonal problem-solving occurring in their organizations. For this purpose, it is recommended that pregraduate and postgraduate neuro-linguistic programming training is provided to nurse managers.

Why do nurses choose to stay silent?: A qualitative study.

AIM: This study aimed to explore nurses' views and experiences regarding remaining silent. BACKGROUND: Silence is a barrier for organizational improvement and can occur for many reasons; it cannot be simply defined as the opposite of speaking out. METHOD: An exploratory qualitative design was used for this study. Data were collected using semi-structured interviews in 2016 with 24 nurses who were recruited by using a snowball sampling method. RESULTS: Three themes emerged as a result of the thematic analysis: fear, silence climate and disengagement. The first theme contained three subthemes: avoidance of being seen as a troublemaker, financial loss and reluctance to reveal lack of ability or knowledge. The results indicated that nurses remained silent when they felt unsupported or psychologically unsafe in their work environment. CONCLUSION: Encouraging nurses to express their opinions is essential for creating a psychologically safe nursing work environment and an organizational climate that supports open communication. Because the majority of healthcare professionals are nurses, they can act as role models and change agents for other nurses if they are encouraged to share their ideas and opinions without fear of retribution.

The relationship between nurses' personality traits and their perceptions of management by values, organizational justice, and turnover intention.

PURPOSE: To determine the relationship between nurses' personality traits and their perceptions of management by values, organizational justice, and turnover intention. DESIGN AND METHODS: It was a descriptive study. A demographic questionnaire, the big five personality scale, the organizational justice scale, the management by values scale, and the turnover intention scale were used to collect data. FINDINGS: Data analysis did not demonstrate any relationship between nurses' personality traits and their perceptions of management by values, organizational justice, and turnover intention. However, results of regression analysis concluded that perceptions of management by values affected the nurses' perceptions of organizational justice positively. PRACTICE IMPLICATIONS: Nurses' perceptions of organizational justice can be raised and turnover intention may be reduced by improving their perceptions of management by values.

Causes of workplace violence against nurses from patients and their relatives: A qualitative study.

BACKGROUND: Nurses are frequently exposed to violence in workplaces. Although the causes of workplace violence have been widely analyzed, there are only a limited number of qualitative studies dealing with violence against nurses from patient and their relatives with a comprehensive and multi-directional approach. AIM: This study aimed to explore the causes of violence against nurses exercised by patients and/or their relatives in different departments of Turkish hospitals. METHODS: This study utilized a qualitative descriptive design. Participants were chosen with purposive sampling and maximum variation sampling method from five different hospitals. Semi-structured in-depth interviews were conducted with 34 nurses working in different positions and departments. The interviews were recorded with audio recorders and the data were analyzed with a content analysis. RESULTS: Four major themes emerged from the nurses' perspective concerning causes of workplace violence including the followings: (1) health care system, (2) health institutions, (3) health professionals, and (4) patients and their relatives. The themes "health care system" and "health institutions" include four subthemes, "health professionals" include five subthemes and "patients and their relatives" include twelve subthemes. CONCLUSION: There are various causes why nurses are exposed to violence in the workplace by patients and/or their relatives. Since the causes of violence are a multifaceted issue, prevention strategies of violence against nurses should be planned and implemented accordingly.

Development and psychometric properties of the attitude scale towards female workers in the healthcare settings.

AIM: The aim of this study was to develop a new instrument to evaluate healthcare professionals' attitudes towards female workers in the healthcare settings-the Attitude Scale Towards Female Workers (ASTFW)-and test its psychometric properties. DESIGN: This is a scale development study. METHOD: A three-phase structure was used: (1) creating the item pool, (2) preliminarily evaluating items and (3) refining the scale and evaluating psychometric properties. The scale's content validity, construct validity, internal consistency and temporal stability were evaluated according to the scale development guidelines. The scale's psychometric properties were tested with 1,635 healthcare professionals working in six different hospitals. The data were collected between November 2018 and July 2019. RESULTS: The scale items were obtained from face-to-face, semi-structured, in-depth individual interviews with the healthcare professionals. The scale's content validity index was 0.96. According to exploratory factor analysis, the scale consisted of 30 items and five subdimensions; the subdimensions were found to explain 54.48% of the total variance. Fit indices obtained with confirmatory factor analysis were at acceptable and good levels. The scale was found to have high internal consistency and temporal stability. CONCLUSION: The ASTFW is a psychometrically valid and reliable measurement instrument. The 30-item scale consists of five subdimensions: performance, gender roles, recruitment and retention, career, and emotionality. Impact This scale, which has good psychometric properties, can be used to perform a multidimensional evaluation of the attitudes of healthcare professionals in healthcare workplaces towards female workers. This scale can be useful in shedding light on negative attitudes towards female healthcare professionals in the health sector.

The Turkish version of the Nursing Teamwork Survey: A validity and reliability study.

AIM: This study aimed to test the validity and reliability of the Turkish version of the Nursing Teamwork Survey, which was developed to measure the concept of nursing teamwork. METHOD: Performed as a methodological study with a cross-sectional design, the study included 486 bedside nurses in three different types of hospitals in Istanbul. The data were collected using the Nursing Teamwork Survey between October and December 2018. The scale includes five subscales and 33 items. The data were analysed using SPSS 22.0 and LISREL 8.7. RESULTS: Nurses' mean age was 29.82 (SD = 7.33). The content validity index of the scale was 0.94. Confirmatory factor analysis conducted on the original form showed that all items fell within the subscales of the original scale and that their factor loads were between 0.48 and 0.91. Following factor analysis, the factor structure of the original scale was valid; however, suggested modifications were applied to improve the results. The obtained goodness-of-fit indices were close to the excellent range according to literature. Cronbach's alpha was 0.95 for the scale. CONCLUSION: The scale is a valid and reliable tool for measuring teamwork among nurses.

Personality Traits of Nurse Managers and Evaluation of Their Traits by Their Subordinates.

AIM: To investigate personality traits (PT) of nurse managers (NM) and their subordinates' perceptions of these traits. METHODS: The study sample consisted of NM and nurses from a university hospital and a state hospital. The data were collected in September-October 2015. The study was conducted in two stages. During the first stage, a cross-sectional descriptive study was performed, and a 220-item "Five-Factor Personality Inventory" was administered to 20 NM. The second stage with 60 nurses was conducted through semi-structured interviews and results were analyzed using the qualitative content analysis. Evaluation was carried out using a qualitative method in a phenomenological research design, and the hermeneutic approach was adopted. The research was planned based on the 32-item checklist (COREQ), which is a guideline for qualitative studies. RESULTS: The Five-Factor Personality Inventory revealed that most of the NM defined themselves as responsible/determined, orderly, relaxed, outgoing, reconciliatory, rule-follower, or assertive. In addition, the nurse manger's mean score for the social desirability dimension of the inventory was quite high. The data analysis demonstrated that the clinical nurses mostly perceived the NM as softhearted, reconciliatory, and orderly, but rule-followers, and conservative. CONCLUSION: In this study, the high scores obtained by the NM, not only from the self-control/conscientiousness dimension but also from the social desirability dimension indicates that the clinical nurses perceived their managers as tender-minded, reconciliatory, orderly, and rule-followers.

Determining nursing service management standards in Turkey: A Delphi study.

OBJECTIVE: To establish the current management standards needed by nurse managers in Turkey and to share the process of establishing standards. BACKGROUND: Relevant and utilizable nursing management standards are needed for effective and efficient nursing administration to achieve better outcomes in health care. METHODS: A three-round e-Delphi method was used in this study. First, the experts were asked an open-ended question. In the second and third rounds, data analysis measurements included item-by-item per cent agreement, standard deviation, average, median and interquartile range. RESULTS: At the end of the third round, 49 standards were obtained under five main standards for nurse managers: management and organisation; leadership; human resources management; quality management; and professionalism. CONCLUSION: The results of this study, which represent a consensus on nursing management standards drawn from the views of experts across regions and institutions in Turkey, provide a baseline to design, manage and evaluate nursing services. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management standards, which are fundamental for designing, leading and evaluating nursing services, give a framework for nurse managers to provide effective and efficient administrative practices.

Development of a sensitive primer extension method for direct detection and quantification of miRNAs from plants.

MicroRNAs (miRNAs) are short non-coding RNA molecules that regulate target gene expression in various organisms. Functional studies are therefore required to determine their temporal and spatial expression patterns. Primer extension has been used as a sensitive and reliable approach to identify miRNAs (∼21-22 nt) in the mammalian system and can be used in other systems such as plants. However, a well-defined method is required for ease of application and reproducibility. Here, a radioactive primer extension method was developed for the quantitative detection of miRNAs found in total RNA samples from plants. As a proof of concept, miR173 and miR828 were detected by primer extension in total RNA samples isolated from Arabidopsis. The assay involved the extension reaction of the miRNA guide strand with a radiolabeled specific primer. Using a manual DNA sequencer, primers extended with reverse transcriptase were separated on a denaturing polyacrylamide gel. The gel was then dried and exposed to a PhosphorImager screen for size-dependent product identification up to a single base difference. Quantification was done based on the intensity of radioactive signals by normalizing the cDNA products to an internal control. The primer extension was proven to be efficient to detect and quantify miRNAs in plant total RNA samples without subsequent enrichment of low-molecular-weight RNA species. This method, optimized for Arabidopsis, can be applied to a wide variety of organisms for the detection and quantification of miRNAs as well as siRNAs.

Investigation of the Control Process in Nursing Care Management: A Qualitative Study.

AIM: This study aimed to determine how nurse managers managed nursing care control processes at hospitals. METHOD: This study was conducted using a qualitative method in a phenomenological research design. The study sample consisted of nurse managers and nurses from a research and application hospital at a state university, a state hospital, and a private hospital affiliated with the Ministry of Health. The maximum variation sampling method was used because it provided the maximum potential of reflecting the diversity of the participants that formed the groups. A total of 60 nurses, including 10 executives and 10 clinical nurses from each institution, were interviewed. The data were obtained using semi structured in-depth interview questions and analyzed using a thematic analysis method. RESULTS: Each hospital's nursing care controlling system was hierarchically structured. However, the control process, assessment criteria, and management culture differed among the hospitals. The top and midlevel executives' control methods were similar. They conducted control using data flow such as patient information and indicators. However, junior executives conducted observation-based control. In addition, nursing care executives did the planning in consideration of the subordinates' lack of experience, presence of a problematic worker, and process development studies in the determination of control intervals. CONCLUSION: There were differences in the operation of the control processes based on the organizational structure of the hospitals. The controlling systems at the university hospital and state hospital studied were not effectively planned, but they maintained ordinary control.

Organizational Citizenship Behavior among Nurses: The Influence of Organizational Trust and Job Satisfaction.

AIM: This study was conducted to determine the relationship between nurses' organizational citizenship behavior organizational citizenship behavior and organizational trust and job satisfaction. METHOD: This descriptive study was carried out in March and April 2014 among 429 nurses working in a private hospital which had an International Joint Commission International Accreditation Certificate. "A Descriptive Information Form", "Organizational Citizenship Behavior Scale", "Organizational Trust Inventory" and "Minnesota Job Satisfaction Scale" were used in data collection. The required permissions and approvals were obtained from the authors of the scales, the ethics committee and the institution. Frequency, percentage, Pearson Correlation and multiple regression analysis were used in the analysis of the data. RESULTS: In this study, it was determined that organizational citizenship behavior levels of nurses were high (M=5.45±0.59). It was determined that the nurses demonstrated the highest organizational citizenship behavior with regard to conscientiousness (M=6.10±0.56), and they demonstrated the lowest organizational citizenship behavior with regard to courtesy (M= 4.54±0.69). It was determined that organizational citizenship behavior had a significant positive relationship with organizational trust and job satisfaction (p<0.001). According to the regression analysis, it was determined that organizational trust was explained with 13.5% of the nurses' organizational citizenship behavior levels while job satisfaction was related to 80.9% of the nurses' organizational citizenship behavior levels. CONCLUSION: As a result of this study, it was found that organizational trust and job satisfaction influenced organizational citizenship behavior. Nursing managers should encourage improvements and make plans to teach nurses behaviors beyond those normally expected.

Development and psychometric testing of the Organizational Silence Behavior Scale for healthcare professionals.

Organizational silence maintained by professionals working in the healthcare sector could result in various moral dilemmas and might negatively affect patient care. The aim of this methodological study was to develop a scale that measured the organizational silence behaviors of healthcare professionals. During the development of the scale, researchers conducted in-depth interviews with 30 healthcare professionals in order to create a draft pool of 66 scale items. After content validity, a 62 item scale was drafted. In the second stage of development, psychometric properties of the scale were evaluated. The results of the confirmatory factor analysis indicated that adequate fit indices (χ2 value to degrees of freedom = 3.54; goodness-of-fit index = .92; root mean square error of approximation = .90) were achieved and resulted in a 32 item scale with four subscales. These subscales were assessed using a 5 point Likert scale. The Cronbach's alpha for the scale was .93, and for the subscales, it was as follows: silence climate: α = .91, silence based on fear: = .91, acquiesce silence: α = .93, and silence based on protecting the organization: α = .85. The Organizational Silence Behavior Scale was successfully developed and showed satisfactory validity and reliability. It is usable among healthcare professionals.

An analysis of alumni performance: A study of the quality of nursing education.

BACKGROUND: The professional performance level of their alumni is one of the quality indicators of educational institutions. Nursing education institutions can use their alumni's performance analysis results to enhance their curricula, eliminate deficiencies, improve the quality of education and graduate more highly qualified nurses. OBJECTIVE AND DESIGN: This is a descriptive, cross-sectional and comparative study, which aimed to determine the professional performances of nurses who graduated from the same nursing faculty. METHODS: The study sample included alumni of Turkey's first nursing faculty, part of the nation's first public university in Istanbul, and their administrative supervisors. The study data were collected using the self-assessment forms of 314 alumni who worked as bedside nurses in 36 Istanbul hospitals, and 314 evaluations by the 195 nurse managers who supervised them. The study's response rate was 82.6%. To collect the study data, the researchers created a performance evaluation form based on the relevant literature. The same form was administered both to the nurse managers and the alumni. The researchers obtained ethical board approval and official permissions from the relevant hospitals to conduct the study. The study data were analyzed by a statistics expert. RESULTS: According to the study results, the alumni's perceptions of themselves as well as the nurse managers' perceptions of the alumni were different from those of the other nurses with undergraduate degrees in terms of professional knowledge, expectations and ideals. The performance evaluation results showed that the alumni evaluated themselves more positively than their managers did. It was determined that there were highly significant differences (p=0.000) between the values provided by the five sub-dimensions of the scale and the total scale. In addition, the performance level was low in the sub-dimension focusing on research, and there was a significant difference in this sub-dimension (p=0.040). CONCLUSIONS: The study found that the alumni mainly had better evaluations of their own performances than their nurse managers, and that the research skills of the alumni should be enhanced.