Insights from defining nurses' career success: An integrative review.

AIMS: To review the literature and identify factors that make sense of and influence nurses' career success. We sought to provide insights into achieving nurses' career success. DESIGN: An integrative review conducted in May 2022 using Whittemore and Knafl's methodology of integrative review. METHODS: The databases searched were PubMed, Web of Science, Scopus, and CINAHL. Search criteria included the keywords "nurs*" and "career success" in the title and abstract. The quality of the reviewed papers was assessed using the JBI Critical Appraisal Tool for cross-sectional studies and qualitative research. We extracted five types of information from quantitative studies: the definition of career success, factors of career success instruments, reliability or validity of career success instruments, and factors influencing nursing career success. Furthermore, we extracted two types of information from qualitative studies: themes that imply career success and factors that influence nurses' career success. Primary data were categorized into two perspectives: (1) what nurses' career success means and (2) what influences nurses' career success. Categorized data were unified into similar contents. Themes were developed from unified subgroups. RESULTS: Fourteen studies were included in the analysis. Seven themes were integrated into the factors that make sense of nurses' career success: satisfaction, positive attitude towards work, quality work in nursing, continuation of career and professional development, positive interaction at work, person-organization fit, and enrichment of an individual's life. Three themes were integrated into the factors influencing nursing career success: personal resources, positive behavior toward nursing work and research, and job resources and environment. NO PATIENT OR PUBLIC CONTRIBUTION: Patients or members of the public were not involved in this review.

The moderating role of work-to-family spillover in the association between nurses' work values and work engagement: A cross-sectional study.

AIM: Although researchers have emphasized the importance of enhancing work engagement in nurses to ensure work-related well-being, the underlying mechanisms of the influencing factors of work engagement remain unclear. This study aimed to elucidate whether work-to-family spillover moderates the relationship between nurses' work values and work engagement. METHODS: In total, 2600 nurses from 52 hospitals in the Tohoku region of Japan were recruited, and 1587 nurses participated. The questionnaire included items on demographic characteristics, the Nurses' Work Values Scale, the Japanese version of the Work-life Balance Scale, and the Work Engagement Scale. Data were analyzed using hierarchical multiple regression. RESULTS: The interaction terms of negative work-to-family spillover with extrinsic work values and prestige work values were significantly associated with work engagement. The interaction terms of nurses' work values and positive work-to-family spillovers did not show a significant association. CONCLUSIONS: Nurses who emphasized extrinsic work values and those who did not emphasize prestige work values had the lowest work engagement in settings with high negative work-to-family spillover. To ensure nurses' work-related well-being and engagement, nursing managers could provide support for nurses in tackling work-related negative events, so that these do not carry over to family settings.

Development and psychometric evaluation of the nurses' Work Values Scale.

AIM: This study aimed to develop the nurses' Work Values Scale (WVS) to determine how important certain values are for nurses and to psychometrically test the scale. DESIGN: Instrument development and validation study. METHOD: A two-phase scale development process comprising item generation, scale improvement and psychometric property evaluation was used. In the first phase, scale items were identified. In the second phase, item and exploratory factor analyses were performed in Study 1, and confirmatory factor analysis, validity verification and reliability verification of the nurses' WVS were performed in Study 2. RESULTS: As a result of the analysis, a scale of 30 items with four subdomains was developed. In convergent validity and reliability verification, it was shown that the nurses' WVS has acceptable validity and reliability. NO PATIENT OR PUBLIC CONTRIBUTION: Patients or members of the public were not involved in this study.

Classification by Nurses' Work Values and Their Characteristics: Latent Profile Analysis of Nurses Working in Japanese Hospitals.

This study aimed to classify nurses with similar work values into subgroups by examining their intrinsic, extrinsic, social, and prestige work values. Additionally, we clarified the characteristics of the obtained subgroups using personal attributes, work engagement, and life satisfaction. Using a cross-sectional observational study design, we randomly sampled 52 hospitals in the Tohoku region of Japan and conducted a self-administered questionnaire survey with 2600 nurses. Latent profile analysis was performed to identify the number of subgroups. Of the 1627 collected questionnaires, 1587 were regarded as valid. The latent profile analysis revealed the following five subgroups with strong statistical significance: (1) self-oriented, (2) low, (3) medium-low, (4) medium-high, and (5) high types. The means of work engagement and life satisfaction gradually increased from the (2) low- to (5) high-type subgroups. There were significant differences among the subgroups in terms of marital status, child status, and job title. The (5) high-type subgroup had many nurses with job titles, high work engagement, and high life satisfaction. The (2) low-type subgroup included many nurses who were young, had few years of experience, were married, had children, and had low levels of work engagement and life satisfaction. Preregistration: This study was not registered.

A concept analysis of shame in the field of nursing.

AIM: The study aimed to conceptually define "shame" within the field of nursing. BACKGROUND: Many nurses sometimes experience and struggle with shame in their professional lives. It reduces their sense of self-worth and hampers emotional well-being and efficacy at work. DESIGN: The conceptual analysis was performed using Walker and Avant's method. DATA SOURCES: We searched using Academic Search Complete, CINAHL, PsycINFO, MEDLINE, and Psychology and Behavioral Sciences Collection databases for literature published between 1980 and 2020. REVIEW METHODS: We searched for keywords "shame," "nurse," and "nursing," with the condition that the keywords must be included in the title or abstract. RESULTS: Shame in the nursing field was defined as a negative emotion, an experience of self-blame and anger, an emotion accompanied by social anxiety, loneliness, and influenced by society and culture. Shame in the nursing field has three antecedents: negative evaluation, the involvement of others, and social and affiliated-group norms. Consequences of shame in nursing include decreased senses of self-esteem and self-efficacy, escape through defense mechanisms, depressive states, and alleviation of distress through reaffirmation of self-promotion and reflection leading to personal growth. CONCLUSIONS: We clarified the significance of self, others, others' evaluations, and differences in socio-cultural contexts while defining shame.

Psychometric properties of the Japanese version of the career competencies questionnaire for nurses: a cross-sectional study.

BACKGROUND: Career competencies, which are the knowledge, skills, and abilities essential for career development, have been shown to facilitate career success, fulfilling both work and life goals. In dynamically changing healthcare settings, nurses' career competencies are key for successfully navigating their careers and improving their nursing practice abilities. However, limited studies have examined career competencies in the nursing profession. In particular, no research has been conducted on career competencies among Japanese nurses, which remains a major challenge as voluntary effort is the main factor promoting career and professional development. Therefore, the purpose of this study was to evaluate the validity and reliability of the Japanese version of the Career Competencies Questionnaire (CCQ-J). METHODS: In this cross-sectional study conducted between June 2020 and August 2021, the English CCQ was translated into Japanese using back and forward translation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted on separate samples. In the first step, item analysis and EFA were conducted with 276 nurses from one hospital. In the second step, CFA was conducted and concurrent validity and reliability were evaluated with 522 nurses from hospitals in the Tohoku region. RESULTS: Content validity was confirmed by the back-translation report, an expert panel, and a pilot test. The EFA showed that the CCQ-J consisted of a three-factor structure that explained 66.69% of the variance. The CFA revealed that all the fit indices were acceptable [chi-square value (CMIN) = 432.26, degree of freedom (df) = 153, chi-square fit statistic/degree of freedom (CMIN/df) = 2.83, goodness-of-fit index (GFI) = 0.93, adjusted goodness of fit index (AGFI) = 0.89, comparative fix index (CFI) = 0.96, and root mean square error of approximation (RMSEA) = 0.06]. Cronbach's α for the 21-item CCQ-J and its subscales ranged from 0.85 to 0.95. Concurrent validity was demonstrated via the positive correlation between work engagement, life satisfaction, and the CCQ-J. CONCLUSIONS: The CCQ-J is a valid and reliable instrument to assess the career competencies of Japanese nurses. We hope that the findings presented in this study will contribute to a better understanding of nurses' career competencies and their successful career and professional development in the future.

Impact of Intrinsic and Extrinsic Motivation on Work Engagement: A Cross-Sectional Study of Nurses Working in Long-Term Care Facilities.

Nurses' work motivation impacts their job satisfaction and work engagement, affecting their quality of care. Work motivation, a personal resource, can be categorized into intrinsic and extrinsic motivation, each of which may function differently in the job demands-resources (JD-R) model. To study the effect of nurses' intrinsic and extrinsic work motivation on work engagement in long-term care (LTC) facilities, we randomly selected 1200 facilities from 6055 LTC facilities in eastern Japan. Two nurses from each facility completed a self-report questionnaire-newly developed for this study for evaluating intrinsic and extrinsic work motivation-to assess their work engagement, job satisfaction, and work motivation. Multiple regression analysis of 561 valid questionnaires investigated the relationship between work motivation and work engagement, indicating that intrinsic work motivation, job satisfaction, and age had a significant positive effect on work engagement, while extrinsic work motivation had no significant effect. However, half the nurses chose to work because of extrinsic work motivation, explaining the high turnover rate of nursing staff in LTC facilities. Findings indicate the importance of measures to foster nurses' intrinsic motivation to improve work engagement. Further research should investigate how to improve the intrinsic motivation of nurses working in LTC facilities.

Nurses Working in Nursing Homes: A Mediation Model for Work Engagement Based on Job Demands-Resources Theory.

This study examined the impact that the attractiveness of working in nursing homes and autonomous clinical judgment have on affective occupational commitment, and whether work engagement mediates these relationships. This analysis was based on the job demands-resources theory. The study setting was 1200 nursing homes (including long-term care welfare facilities and long-term care health facilities) in eastern Japan. An anonymous, self-report questionnaire survey was administered to two nurses from each facility, resulting in a prospective sample of 2400 participants. Overall, 552 questionnaires were analyzed, in which structural equation modeling and mediation analysis using the bootstrap method were performed. The results showed that the attractiveness of working in nursing homes does not directly affect affective occupational commitment; work engagement fully mediates the impact of attractiveness of working in nursing homes on affective occupational commitment. Additionally, autonomous clinical judgment showed a direct impact on both work engagement and affective occupational commitment, indicating that work engagement partially mediates the impact on affective occupational commitment. To increase the affective occupational commitment of nurses working in nursing homes, managers should help nurses recognize the attractiveness of working in nursing homes, and then provide appropriate support to help such nurses work in a motivated manner.

Japanese nurse practitioners' legal liability ambiguity regarding their medical practice: a qualitative study.

BACKGROUND: Nurse practitioners' role is always expanding. The Japanese Nurse Practitioner (JNP) system was initiated in 2015 to shift some aspects of doctors' work to various other healthcare professionals, including nurses. JNPs' fulfillment of their roles was shown to have a certain degree of efficacy and provide positive outcomes for patients (e.g., shortening hospitalization period). Nurse practitioners are considered legally liable for their medical practices because they are performed on doctors' behalf; however, in real life, there is ambiguity regarding such practice. It is necessary to clarify nurse practitioners' legal liability in order to ensure the safety of their medical practice and protect them in medical procedures performed on physicians' behalf. This study aimed to clarify how JNPs understand their own legal liability in medical practice. METHODS: A qualitative, inductive research design was adopted to record participants' opinions. The survey was conducted from October 2017 to February 2018. Participants were nurses working as JNPs at general hospitals in eastern Japan. We recruited participants via snowball sampling. RESULTS: With regard to JNPs' legal liability in their medical practice, three themes understanding were observed: "determining whether the JNP has the ability to perform the assigned medical procedure," "exercising caution when performing medical procedures on a doctor's behalf" and "an urge to follow up with appropriate medical practice until the end of care." CONCLUSIONS: We demonstrated that JNPs recognized their own legal liability in medical practice. They had to protect themselves because their legal position was ambiguous. Furthermore, JNPs accepted that diagnosis and drug prescription could be performed on behalf of doctors if trusting relationships had been previously established.