Factors affecting caregiver burden among parents of children with cancer: A path analysis.

AIMS: To investigate the relationships between parental resilience, illness perception and pain catastrophizing as factors affecting caregiver burden among parents of children with cancer, based on the Transactional Model of Stress and Coping. BACKGROUND: Parents, as the primary caregivers of children with cancer, often face universal challenges. These include adverse health impacts, work, financial disruptions, strained social and family relationships, and the need for specialised support and intervention. DESIGN: A cross-sectional design using path analysis. METHODS: The STROBE guidelines for cross-sectional studies were followed. An online questionnaire was distributed through Facebook pages operated by various organisations that support parents of children with cancer, such as 'The Israel Cancer Association', 'Giving Hope' and 'Hayim Association' from October 2021 to February 2022. The participants completed a questionnaire about demographic and child-related characteristics, resilience, illness perception, pain catastrophizing, social support and caregiver burden. Associations between the variables were explored using Pearson's correlations and path analyses. RESULTS: The study included 67 parents of children with cancer with an average age of 41.79 (SD = 6.31). The majority were mothers (n = 54, 80.6%) with a steady partner (n = 62, 92.5%). The level of caregiver burden was M (SD) = 25.00 (7.15) out of 48 possible, indicating a high burden level. Illness perception was directly positively associated with caregiver burden (ß = .280, p = .017) and pain catastrophizing (ß = .340, p < .01), and directly negatively with resilience (ß = -.318, p < .01). Illness perception and pain catastrophizing serially mediated the relationship between resilience and caregiver burden among parents of children with cancer (ß = -.190, p = .001). CONCLUSIONS: This study found that both illness perception and pain catastrophizing serially mediated the relationship between personal resilience and caregiver burden. RELEVANCE TO CLINICAL PRACTICE: To ease caregiver burden for parents of children with cancer, programmes should address their psychological and emotional needs, including managing perceptions of illness and coping with pain-related distress.

Factors that influence medication adherence in women with fibromyalgia: A path analysis.

AIMS: To investigate the relationships between depression symptoms, perceived stigma, disease severity, patient-provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections. BACKGROUND: Fibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient-provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear. DESIGN: A cross-sectional, correlational study. METHODS: The STROBE guidelines for cross-sectional studies were followed. Participants included Hebrew-speaking participants who were members of two Facebook groups: 'Shades of Purple' and 'Fibromyalgia- Get to Know!' Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire-9 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient-provider communication, and used the 8-item Morisky Medication Adherence Scale (MMAS-8). Associations between the variables were explored using Pearson's correlations and path analyses. RESULTS: The study included 141 women with fibromyalgia, aged 22 to 76 years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (N = 75)-low, 33.3% (N = 47)-medium and 13.5% (N = 19)-high. Depression positively correlated with stigma. Stigma negatively correlated with patient-provider communication. Patient-provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient-provider communication was found. CONCLUSIONS: Perceived stigma and patient-provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia. RELEVANCE TO CLINICAL PRACTICE: Addressing stigma related to fibromyalgia and effective patient-provider communication can positively influence treatment adherence. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Development and validation of the novel nursing activities in the care of extracorporeal membrane oxygenation-supported patients scale.

BACKGROUND: Nurses are members of multidisciplinary teams providing care to extracorporeal membrane oxygenation-supported patients (ECMO-SP). There are no valid and reliable measurements available to assess nursing activities in the care of ECMO-SP. AIM: To develop and evaluate psychometric properties of a new 27-item nursing activities in the care of ECMO-SP scale. STUDY DESIGN: A convenience sample was recruited of 76 registered nurses (mean age 41.3 ± 8.7; 71% female) in Israel. The nurses participated in an online survey with software Qualtrics, between March and June 2022. Content and construct validity, as well as internal consistency of the scale were evaluated. The participants also completed the perceived knowledge and skills in the treatment of ECMO-SP scale. The correlations between nursing activities in the care of ECMO-SP and ECMO knowledge were examined using Pearson's correlation. RESULTS: Exploratory factor analysis extracted four factors, and seven items were excluded from the 27-item scale making it a 20-item scale in its final form. Internal consistency was acceptable for the total scale (α = 0.84) and the four subscales: Factor 1: Nursing care of ECMO-SP not related to the ECMO device (α = 0.90), Factor 2: Activities on ECMO device in emergency (α = 0.82), Factor 3: ECMO device calibrating and monitoring (α = 0.72), and Factor 4: Medication and blood administration through ECMO device (α = 0.73). When examined in confirmatory factor analysis, the 20-item scale yielded acceptable fit indices. A positive correlation was found between perceived ECMO knowledge and all four factors of the nursing activities in the Care of ECMO-SP scale. CONCLUSIONS: The 20-item scale examining nursing activities in the care of ECMO-SP is ready for use for clinical, educational, and research purposes. RELEVANCE TO CLINICAL PRACTICE: Because there are still no standards for nursing care of ECMO-SP and no agreed quality indicators, this novel scale may help in building such standards and quality indicators.

Self-care behaviours of patients with left ventricular assist devices in Israel: changes during the COVID-19 pandemic.

AIMS: Left ventricular assist devices (LVADs) support the hearts of patients with advanced heart failure. Following LVAD implantation, patients face a complex regimen of self-care behaviours including self-care maintenance, self-care monitoring and self-care management. However, during the COVID-19 pandemic, symptoms of anxiety and depression may have interfered with their self-care. Currently, little is known on how specific self-care behaviours of LVAD-implanted patients changed during the COVID-19 pandemic. We aim to describe the changes in self-care behaviours among patients with an implanted LVAD in Israel during the COVID-19 pandemic and explore the factors related to self-care behaviour change. METHODS: A prospective observational cross-sectional study design. A convenience sample of 27 Israeli LVAD-implanted patients (mean age 62.4 ± 9, 86% male, 78.6% living with a partner) completed the LVAD Self-Care Behaviour Scale (1 = never to 5 = always) and Hospital Anxiety and Depression Scale (0 = not at all to 3 = most of the time). Data were collected before and after the onset of the COVID-19 pandemic in Israel. Statistical analyses included paired t-tests, Pearson's correlations, and one-way repeated measures ANOVAs. RESULTS: During the COVID-19 pandemic, a significant decrease was found in patients' adherence to checking and recording their LVAD speed, flow, power and PI (Pulsatility Index) (P = 0.05), checking their INR (P = 0.01), and daily weighing (P < 0.01). The prevalence of some behaviours (e.g. regularly exercising) increased in some patients and decreased in others. Patients living without a partner worsened their adherence to some of the self-care behaviours (e.g. taking medicines as prescribed), compared with those living with a partner (Mb  = 5.0 ± 0 and Md  = 5.0 ± 0, delta = 0 vs. Mb  = 5.0 ± 0 and Md  = 4.6 ± 0.9, delta = -0.4, respectively; F = 4.9, P = 0.04). Women, and not men, tended to improve their adherence to the self-care behaviour such as avoiding kinking, pulling, or moving the LVAD driveline at the exit site (Mb  = 4.0 ± 1.0 and Md  = 5.0 ± 0, delta = 1.0 vs. Mb  = 4.5 ± 0.9 and Md  = 4.4 ± 1.2, delta = -0.1, F = 4.7, P = 0.04, respectively). In total, 41% (11) patients reported neither anxiety nor depression, 11% (3) reported anxiety, 15% (4) reported depression, and 44% (12) reported both anxiety and depression. No associations between anxiety and/or depression and self-care behaviours were found. CONCLUSIONS: Priorities in self-care behaviours among patients with implanted LVAD changed after the onset of the COVID-19 pandemic. Factors that assisted with adherence to self-care behaviours included living with a partner and being female. The current results may guide further research on identifying behaviours that are at risk of not being maintained during a time of emergency.

Validity and reliability of the left ventricular assist device self-care behaviour scale.

BACKGROUND: Adequate self-care behaviour is essential for patients with a left ventricular assist device (LVAD) to prevent complications, prolong life, and optimise quality of life. However, there were no valid and reliable measurements available to assess self-care behaviour among patients with LVAD. We have previously developed the 33-item LVAD self-care behaviour scale. OBJECTIVES: To evaluate psychometric properties of the 33-item LVAD self-care behaviour scale. METHODS AND RESULTS: Data on 127 patients with a LVAD in Israel, Japan, and the USA were analysed (mean age 51±14.3, 81% male). Exploratory factor analysis extracted three factors, and 13 items were excluded from the scale. Internal consistency assessed by Cronbach's alpha was acceptable for the total scale (α = 0.80) and the three subscales: Factor 1: Monitoring (α = 0.81), Factor 2: Heart failure self-care (α = 0.67), and Factor 3: LVAD self-care (α = 0.63). The 20-item version of the LVAD self-care behaviour scale had sufficient convergent validity with another scale that assessed self-care related to the driveline of LVAD (r = 0.47, p<0.001). Test-retest reliability was adequate (intraclass correlation coefficient = 0.58). CONCLUSIONS: The 20-item version of the LVAD self-care behaviour scale showed adequate validity and reliability. The scale is ready for use in clinical practice and research. Additional testing might further optimise the scale.

Factors affecting how parents cope with their preterm infant's pain: A cross-sectional study.

AIMS AND OBJECTIVES: This study examined the relationships between parents' catastrophising about their infants' pain, parental self-efficacy in the management of their infants' pain, perceived social support and the parental coping strategies for their infants' pain-related stress. BACKGROUND: Preterm infants hospitalised in the neonatal intensive care unit experience painful procedures causing stress to their parents. Coping with stress may be emotion- or problem-focused. Adults' coping with their own pain has been associated with pain catastrophising, pain management self-efficacy and social support. However, little is known about the associations between parents' catastrophising, their self-efficacy to manage, their perceived social support and their coping strategies when dealing with their infants' pain. DESIGN: This was a cross-sectional, correlational study design. METHODS: The STROBE guidelines for cross-sectional studies were followed. Participants included 149 parents of preterm infants hospitalised in a neonatal intensive care unit. They completed measures to assess infant pain catastrophising, self-efficacy regarding infant pain management, social support and emotion- and problem-focused coping. RESULTS: Positive associations were found between parental self-efficacy regarding infant pain management, social support, parental catastrophising about their infants' pain and problem-focused coping. Parental catastrophising was positively associated with emotion-focused coping. Gender moderated the relationships between parental self-efficacy regarding infant pain management and emotion-focused coping. Specifically, amongst mothers, the higher their level of self-efficacy, the lower their emotion-focused coping. Amongst fathers, the relations were reversed. CONCLUSIONS: Parents coping with their preterm infants' pain were associated with catastrophising about their infants' pain, self-efficacy regarding infant pain management and social support. Mothers had different ways to cope emotionally to that of fathers in relation to their self-efficacy in managing their infants' pain. RELEVANCE TO CLINICAL PRACTICE: Nursing interventions that provide support to parents and promote parental self-efficacy in managing their infants' pain may allow parents to more effectively cope with their infants' pain. PATIENT OR PUBLIC CONTRIBUTION: Patients or public were not involved in setting the research question, the outcome measures and the design or implementation of the study. Parents of preterm infants answered the research questionnaires.

Factors affecting the professional functioning of health care workers during the COVID-19 pandemic: A cross-sectional study.

AIM: To examine personal and organisational factors related to professional functioning of nurses and physicians during the COVID-19 pandemic. BACKGROUND: Exposure to COVID-19-related stressors has been associated with lower self-reported professional functioning among health care workers. METHODS: A cross-sectional study among 115 hospital workers during the COVID-19 pandemic in Israel was designed to explore (a) personal professional functioning, (b) clarity of guidelines, (c) work organisation by the management, and (d) health care workers' feeling of contribution to a global effort. RESULTS: A feeling of contribution to a global effort while treating patients with COVID-19 mediated the relationships between work organisation by the management and professional functioning (ß = .05, p < .05). The clarity of guidelines for routine procedures (ß = .21, p < .05) and a feeling of ß contribution to a global effort (ß = .34, p < .01) positively predicted professional functioning of nurses and physicians during COVID-19 pandemic (R2 = .19, p < .01). CONCLUSIONS: In order to achieve optimal functioning of health care workers in an emergency, managers should provide clear guidelines and promote workers' feelings of contribution to a global effort. IMPLICATIONS FOR NURSING MANAGEMENT: The provision of clear guidelines and protocols is essential for efficient emergency management. Expressing appreciation for health care workers and providing positive feedback may improve professional functioning.

Practices and experiences of European frontline nurses under the shadow of COVID-19.

The COVID-19 pandemic has caused health professionals to deal with new situations they have not encountered before. Nurses were forced to cope with increased workloads, seriously ill patients, numerous patient deaths, and unresolved ethical dilemmas. This study aimed to examine the lived experiences of nurses across Europe during the first wave of the COVID-19 pandemic. This was a qualitative narrative research study. Eighteen nurses from eight European countries (four each from the UK and Israel, three from Portugal, two each from the Netherlands and Ireland, and one each from Belgium, Italy, and Sweden) submitted narratives about their professional experiences during May-June 2020. The narratives were analyzed using thematic analysis. Seven categories across the narratives were condensed and interpreted into three themes: opportunities and growth, care management, and emotional and ethical challenges. The COVID-19 pandemic has affected nurses emotionally and provided an opportunity to actively develop systems and skills needed to minimize harm and maximize benefits to patients and nurses.

Emergency and disaster response strategies to support mother-infant dyads during COVID-19.

The COVID-19 pandemic has produced an unprecedented global health crisis. Vulnerable populations, such as breastfeeding mother-infant dyads, are in a particularly delicate situation. Before, during, and after birth mothers and their infants could be exposed to the virus. Due to fear of infection transmission, there has been an increase in separation of COVID-positive mothers and their infants and a decline in breastfeeding, despite research supporting the provision of mother's milk for her infant. During this crisis, evidence-based education counseling and resources can support healthful infant feeding which is necessary for short- and long-term infant growth and development. Using a framework of disaster preparedness and response, we delineate operational guidelines and policy recommendations to support maternal-infant dyads during the COVID pandemic outbreak. Key recommendations include promotion of breastfeeding and milk expression, avoiding the use of formula, engaging healthcare providers in supporting lactation, and incorporating evidence-based breastfeeding and lactation protocols and practices in disaster preparedness and disaster response plans.

Modern problems of youth extremism: Social and psychological components.

Nowadays, the global community is confronted by an acute problem of extremism associated with the growing intolerance, aggression and hostility of modern society. The ways extremism manifests among youth, who is perceptive and sensitive to extremism due to age peculiarities, are understudied. The purpose of the study is to identify psychological characteristics, which are preconditions and elements of extremism among young people. The research methods are theoretical and methodological analysis, survey methods, methods of mathematical and statistical data processing. Illegal behaviour, a propensity to take risks appeared to be the prerequisites for display of extremist elements among full-time young employees. The research results can be used for scientific and methodologically assurance of psychological and pedagogic support of students, tactics to prevent extremism among young people.

Nurses as 'second victims' to their patients' suicidal attempts: A mixed-method study.

AIMS AND OBJECTIVES: To understand the effects of patients' suicidal attempts and events on nurses' second victim symptoms and to explore the association between these experiences and nurse absenteeism and turnover. BACKGROUND: The term 'second victim' is when a healthcare professional expresses psychological symptom following adverse patient event. This has been previously shown to be associated with absenteeism and higher staff turnover. DESIGN: A mixed-methods study with a sequential exploratory approach. METHODS: A qualitative approach was used for nurses to relate their experiences of their patients' suicidal attempts. A cross-sectional quantitative study was conducted in 150 nurses who worked in internal departments. The Second Victim Experience and Support Tool was used to substantiate and measure second victim related distress of nurses who treated suicidal patients. The qualitative data were analysed by a constant comparative analysis method. The analytic analysis of the quantitative study included Pearson's correlations and hierarchical linear regression model to assess the explanatory variables to absenteeism and staff turnover. The study adhered to the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies. RESULTS: The qualitative part identified three themes and nine sub-themes, including the new variable 'sense of being alone'. The quantitative part of the study found that nurses expressed a medium level of second victim related distress. After controlling for demographic variables, second victim distress and the sense of being alone following patients' suicidal events may explain nurse absenteeism and turnover. CONCLUSIONS: Nurses who experience suicidal attempts of their patients react as second victims. These symptoms lead to nurse absenteeism and turnover. RELEVANCE TO CLINICAL PRACTICE: Nurses who experience suicidal attempts of their patients need treatment and support as second victims, the same as in any other medical adverse event. The nursing leadership should emotionally support these nurses and prevent consequential staff organisational problems.

Recommendations From the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients.

BACKGROUND: By July 2020, the Extracorporeal Life Support Organization had documented more than 133 000 extracorporeal membrane oxygenation (ECMO) implementations, with more than 61 000 implementations in adult patients. No clear policies regarding the authority and responsibility of nursing staff in the treatment of ECMO-supported patients are currently available. OBJECTIVE: To formulate evidence-based recommendations for nursing care of ECMO-supported patients. METHODS: The National Head Nurse's office and the Professional Guidelines Department in the Nursing Division of Israel's Ministry of Health formed the Professional Advisory Committee on Nursing Practice in the Care of ECMO-Supported Patients to address concerns regarding the current state of professional nursing practice in the care of these patients. The Professional Advisory Committee brought together 15 senior Israeli ECMO nursing experts who explored the potential of registered nurses in caring for ECMO-supported patients, considered the competencies of nurses treating ECMO-supported patients, discussed training programs and health care policy, and examined nursing outcomes for quality assurance. RESULTS: The Professional Advisory Committee formulated recommendations regarding the following priority issues: (1) determining boundaries of professional authority and nurses' responsibilities, including designated activities for different professional ranks of registered nurses; (2) providing appropriate content for the training programs offered, such as generic/basic, above-basic, and clinical specialization nursing programs; and (3) defining relevant quality measures for nursing treatment of ECMO-supported patients. CONCLUSIONS: Introducing international standards would ensure the safety and effectiveness of nursing care for ECMO-supported patients through quality and risk management and establishment of new evidence-based nursing practices.

The effect of attitudes, subjective norms and stigma on health-care providers' intention to recommend medicinal cannabis to patients.

AIM: The aim of this study was to explore the effect of health-care providers' attitudes towards the medical use of cannabis, subjective norms and perceived stigma towards medicinal cannabis users on health-care providers' intention to recommend medicinal cannabis for patients with qualifying conditions. METHODS: A cross-sectional correlational study included 221 health-care providers (mean age, 42.2 ± 11.2; 74.2% women and 76.5% nurses) who completed a questionnaire examining theory-based variables and stigma towards medicinal cannabis users. RESULTS: More positive attitudes towards the medical use of cannabis were associated with lower stigma towards medicinal cannabis users, which, in turn, was associated with a higher intention of recommending medicinal cannabis for patients with qualifying conditions. The relationship between attitudes towards the medical use of cannabis and the intention to recommend medicinal cannabis varies according to subjective norms. CONCLUSIONS: Among nurses and physicians, stigma towards medicinal cannabis users mediated the relationship between attitudes towards the medical use of cannabis and the intention to recommend medicinal cannabis for patients with qualifying conditions, whereas subjective norms moderated this relationship. Effective treatment with medicinal cannabis might be compromised by health-care providers' negative attitudes, stigma and subjective norms.

The effect of evidence-based practice perception, information literacy self-efficacy, and academic motivation on nursing students' future implementation of evidence-based practice.

BACKGROUND: Evidence-based practice (EBP) in nursing is an important tool for promoting quality care and improving patient outcomes. Global evidence suggests that the rate of EBP implementation among nurses and nursing students is low. The effects of EBP perception, information literacy self-efficacy, and academic motivation on nursing students' future implementation of EBP have not been fully explored. PURPOSE: To examine the effect of EBP perception, information literacy self-efficacy, and academic motivation on future implementation of EBP among pre-registration nursing students. METHOD: A cross-sectional study used a self-administered structured questionnaire and analyzed data from 148 pre-registration nursing students at a university in central Israel. A hierarchical forced steps regression analysis was conducted to predict future implementation of EBP. RESULTS: Information literacy self-efficacy, EBP perception, and intrinsic academic motivation to experience stimulation, may predict EBP future implementation. The model explained 46.3% of the variance. CONCLUSION: The results indicate the importance of information literacy skills and positive attitudes to EBP, as well as of intrinsic academic motivation, for enhancing future implementation of EBP among nursing students.

Factors associated with body image among patients with an implanted left ventricular assist device.

BACKGROUND: Among Left Ventricular Assist Device (LVAD) implanted patients, body image modifications might occur. OBJECTIVES: To explore the associations between sexual functioning, confidence in LVAD technology, personal wellbeing, and body image. METHODS: The cross-sectional study included 30 conveniently recruited LVAD implanted patients who completed Body Image Scale, sexual functioning, confidence in LVAD technology, and Personal Wellbeing Index questionnaires. The associations between the research variables were examined with multiple regression analyses. RESULTS: The mean age of the participants was 63 (SD=10), 90% were men. The mean scores were: sexual functioning - 2.43 (SD=1.20, range 1-5); confidence in LVAD technology - 2.63 (SD=1.04, range 1-5); Well-Being Index - 6.61 (SD=1.53, range 0-10); and body image - 14.5 (SD=4.17, range 5-20). Sexual functioning (p<.01) and LVAD technology confidence (p=.04) significantly predicted body image. CONCLUSIONS: Healthcare professionals should be aware of challenges regarding body image faced by LVAD implanted patients and to address related factors.

Depression and Anxiety Moderate the Relationship Between Body Image and Personal Well-being Among Patients With an Implanted Left Ventricular Assist Device.

BACKGROUND: Left ventricular assist devices (LVADs) support the diseased heart of patients with advanced heart failure and are used as a bridge to heart transplantation or as destination therapy for patients ineligible for heart transplantation. Body image changes, as well as anxiety and depression, are prevalent among patients with an implanted LVAD. OBJECTIVE: The aim of this study was to investigate whether a relationship exists between body image and personal well-being among patients with an implanted LVAD and, if it does, whether it is moderated by anxiety and depression. METHODS: In this cross-sectional correlational study, a convenience sample of 30 adult patients with an implanted LVAD (mean age, 63 ± 10; 90% male) from the outpatient facility of a tertiary medical center completed validated instruments including the Body Image Scale, Cosmetic Scale, Hospital Anxiety and Depression Scale, and Personal Well-being Index, from October 2017 to February 2018. Results were subjected to multivariate linear regression and bootstrap moderation analyses. RESULTS: Eleven patients (37%) had below-average personal well-being scores, and 14 patients (47%) had below-average body image scores. Seven (23%) had either anxiety or depression, and 11 (37%) had both anxiety and depression. Body image was found to be a significant predictor of personal well-being (t = 2.16, P = .04). When anxiety and depression were present, body image (t = 2.08, P = .049), depression (t = 2.53, P = .018), and the interaction between body image and depression (t = -2.1, P = .047) were significantly associated with personal well-being. CONCLUSIONS: Body image significantly predicted personal well-being among patients with an implanted LVAD. Depression alone, or depression combined with anxiety, moderated the relationships between body image and personal well-being. The current results may help to heighten healthcare providers' awareness of body image perception among patients with an implanted LVAD.

Nurses' perceptions of pain management adequacy in mechanically ventilated patients.

AIMS AND OBJECTIVES: To examine how nurses' knowledge of behaviours indicating pain in mechanically ventilated patients and self-perceived collaboration between nurses and physicians affects the adequacy of departmental pain management. BACKGROUND: Pain management is a vital factor of medical treatment in a hospital setting. Inadequate pain management requires attention both from a patient-focused perspective and from a departmental one. It would be particularly troubling in the case of inadequate pain management of mechanically ventilated patients. DESIGN: The study utilised a cross-sectional design. The instruments developed were validated by a focus group of 25 pain management nurses, who reviewed the questionnaire for face validity, feasibility and comprehensibility, and who did not participate in the study. The questionnaire was revised, readjusted and formulated based on their responses and comments. METHODS: A self-administered questionnaire administered in Israel with a convenience sample of 187 registered nurses (RN) from internal medicine and surgical departments and ICUs. Data were collected during February-May 2015. The "STROBE" EQUATOR checklist was used. RESULTS: Nurses working in the ICU scored significantly higher on knowledge of behaviours indicating pain in mechanically ventilated patients and on self-perceived collaboration between nurses and physicians. Self-perceived collaboration between physicians and nurses was positively correlated with perceived departmental pain treatment adequacy. Self-perceived collaboration between nurses and physicians, knowledge of behaviours indicating pain in mechanically ventilated patients and seniority (with a borderline significance) explained 27% of the variance of perceived departmental pain management. CONCLUSION: Nurses' knowledge of behaviours indicating pain in mechanically ventilated patients, as well as self-perceived collaboration between nurses and physicians, promotes reported adequate pain management. RELEVANCE TO CLINICAL PRACTICE: Pain management would benefit from being conducted as a well-performed interprofessional self-perceived collaborative practice. Knowledgeable nurses tend to critically assess the level of departmental pain management.

Differences in knowledge of hypertension by age, gender, and blood pressure self-measurement among the Israeli adult population✰.

BACKGROUND: Hypertension (HTN) is the most important risk factor for death and disability worldwide. Hypertensive patients' HTN knowledge was shown to be associated with control of HTN. Understanding factors affecting HTN knowledge might help control HTN. OBJECTIVES: To examine differences in HTN knowledge by age, gender, ethnicity, years of education and whether HTN was diagnosed, and to explore whether HTN knowledge is affected by self-measurement of blood pressure (BP), in Israel's general population. METHODS: A cross-sectional, descriptive, correlational design was used. A convenience sample of 430 Israeli adults, sampled in community centers across Israel, in four age groups (18-34, 35-49, 50-64, and above 64) were interviewed by 17 registered nurses, using a structured questionnaire with open-ended questions, during March 2017 and March 2018. ANOVA and chi-square tests for assessing differences between age groups in sociodemographic characteristics and BP measurement were used. Factors predicting knowledge of various HTN aspects and total HTN knowledge were explored by logistic and ordinal regression analyses. RESULTS: Older participants, those with more years of education, and those who self-measured blood pressure had better knowledge of particular aspects of HTN and higher total HTN knowledge. Women had greater knowledge of normal systolic and diastolic BP. CONCLUSIONS: Higher age, more years of education, and blood pressure self-measurement were associated with higher total HTN knowledge. The attention of health authorities should be drawn to improving HTN knowledge among younger adults, and to including blood pressure self-measurement in the regular practices of the general population.