Empoderamento estrutural: potencializando as competências dos enfermeiros de um hospital de alta complexidade / Structural empowerment: enhancing the skills of nurses in a high-complexity hospital / Empoderamiento estructural: potenciar las competencias de los enfermeros en un hospital de alta complejidad

Objetivo: analisar o empoderamento estrutural de enfermeiros em um hospital de alta complexidade. Métodos: estudo quantitativo, analítico e transversal, realizado com 93 enfermeiros, utilizando um questionário sociodemográfico e ocupacional e o Questionário de Condições de Eficácia no Trabalho II. Os dados foram coletados entre fevereiro e março de 2023. A análise dos dados deu-se por meio de estatística descritiva, teste de Kolgomorov-Smirnov, teste do qui-quadrado e regressão de Poisson. Resultados: os enfermeiros apresentaram nível moderado de empoderamento estrutural, com média de 20,67 (p<0,000). O componente mais pontuado foi a oportunidade (4,22 dp±0,80). Não foram encontradas diferenças significativas nos níveis de empoderamento estrutural relacionadas às unidades de trabalho (p-Valor 0,381), vínculo empregatício (p-Valor 0,352) e grau de instrução (p-Valor 0,839). O modelo de regressão de Poisson indica que tanto pode haver altos ou baixos níveis de empoderamento a depender do setor. Conclusão: os enfermeiros demonstraram possuir níveis moderados de empoderamento estrutural.

Objective: to analyze the structural empowerment of nurses in a high-complexity hospital. Methods: a quantitative, analytical, cross-sectional study was carried out with 93 nurses, using a sociodemographic and occupational questionnaire and the Questionnaire of Conditions of Effectiveness at Work II. The data was collected between February and March 2023. The data was analyzed using descriptive statistics, the Kolgomorov-Smirnov test, the chi-square test, and Poisson regression. Results: the nurses had a moderate structural empowerment level, with a mean of 20.67 (p<0.000). The highest scoring component was opportunity (4.22 sd±0.80). No significant differences were found in the structural empowerment levels related to work units (p-Value 0.381), employment relationship (p-Value 0.352) and education level (p-Value 0.839). The Poisson regression model indicates that there can be either high or low empowerment levels depending on the sector. Conclusion: nurses showed moderate structural empowerment levels.

Objetivo: analizar el empoderamiento estructural del enfermero en un hospital de alta complejidad. Métodos: estudio cuantitativo, analítico y transversal, realizado con 93 enfermeros, utilizando un cuestionario sociodemográfico y ocupacional y el Cuestionario de Condiciones de Efectividad en el Trabajo II. Los datos se recolectaron entre febrero y marzo de 2023. El análisis de los datos se realizó mediante estadística descriptiva, prueba de Kolgomorov-Smirnov, prueba de chi-cuadrado y regresión de Poisson. Resultados: los enfermeros presentaron un nivel moderado de empoderamiento estructural, la media fue de 20,67 (p<0,000). El componente con mayor puntaje fue oportunidad (4,22 DE±0,80). No se encontraron diferencias significativas en los niveles de empoderamiento estructural relacionados con las unidades de trabajo (valor p 0,381), la relación laboral (valor p 0,352) y el nivel de formación (valor p 0,839). El modelo de regresión de Poisson indica que pueden existir niveles altos o bajos de empoderamiento dependiendo del sector. Conclusión: los enfermeros demostraron niveles moderados de empoderamiento estructural.

Fatores clínicos do bem-estar de mulheres em parturição: perspectivas deontológicas e da bioética principialista / Clinical factors of women in labor well-being: deontological and bioethical principlism perspectives / Factores clínicos del bienestar de la mujer en trabajo de parto: perspectivas deontológicas y de la bioética principialista

Objetivo: avaliar os fatores clínicos associados ao bem-estar das mulheres durante o trabalho de parto e parto à luz da bioética principialista e da deontologia. Método: estudo transversal com abordagem quantitativa. Participaram 396 puérperas internadas em um hospital municipal do sudoeste da Bahia, e os dados foram coletados no período de janeiro a maio de 2023, após aprovação do comitê de ética em pesquisa. Os dados foram organizados no software Excel e analisados via SPSS v.25. a partir da regressão logística multinomial. Resultados: a maior parte da amostra apresentou bem-estar com assistência em saúde, mulheres que tiveram parto realizado por profissionais não médicos apresentaram mais chances de níveis de bem-estar "adequado". E mulheres que não tiveram a via de parto cesárea apresentaram aumento de chances de bem-estar. Conclusão: é necessário que os profissionais reflitam sobre suas ações, condicionando-as à humanização no parto, em observância aos princípios bioéticos.

Objective: to evaluate the clinical factors associated with women's well-being during labor and delivery in the light of bioethics principlism and deontology. Method: a cross-sectional study with a quantitative approach was conducted. It involved 396 postpartum women admitted to a municipal hospital in the southwest of Bahia. Data were collected from January to May 2023, after approval from the research ethics committee. The data were tabulated using Excel software and analyzed using SPSS v.25 through Multinomial Logistic Regression. Results: majority of the sample exhibited well-being with health care assistance. Women who underwent delivery performed by non-medical professionals showed higher chances of "adequate" levels of well-being. Additionally, women who did not undergo cesarean delivery showed increased chances of well-being. Conclusion: It is necessary for professionals to reflect on their actions, conditioning them to the humanization of childbirth, according to bioethical principles.

Objetivo: evaluar los factores clínicos asociados al bienestar de la mujer durante el trabajo de parto y parto a la luz de la bioética y la deontología principialista. Método: estudio transversal con enfoque cuantitativo. Incluyó 396 puérperas ingresadas en un hospital municipal del suroeste de Bahía. Recolección de datos de enero a mayo de 2023, con aprobación del comité de ética en investigación. Los datos se tabularon en el software Excel y se analizaron mediante SPSS v.25. utilizando regresión logística multinomial. Resultados: la mayoría de las participantes de la muestra presentó bienestar con la atención para la salud; las que tuvieron partos realizados por profesionales no médicos tenían más probabilidades de tener niveles "adecuados" de bienestar; las que no tuvieron parto por cesárea tenían mayores probabilidades de tener bienestar. Conclusión: es necesario que los profesionales reflexionen sobre sus acciones y las adecuen para humanizar el parto, respetando los principios bioéticos.

AACN competency-based essentials revisit: Evidence-based validation of entrustable professional activities in Asia.

AIM: This study intended to validate the competency-based approach through an entrustable professional activity in the nursing undergraduate education arena in Taiwan. BACKGROUND: Entrustable professional activity is a recommended strategy to enhance nursing competencies and skills. It has been widely applied to nursing education in Western countries, especially graduate programs. However, its effects in eastern countries and undergraduate programs remain unclear. DESIGN: A quasi-experimental comparison design was used. METHOD: The study is conducted at the Department of Nursing at a university in southern Taiwan. A total of 72 Two-Year Nursing Program students participated in the study. After implementing the designated entrustable professional activity in the Wound Care Nursing course, outcomes were measured using the Competency Inventory of Nursing Students, Learning Satisfaction and Objective Structured Clinical Examinations. These outcomes were then compared with post-test results at the end of the semester. About 90 % of students completed the study with the test group (n=31) receiving extra activity and the comparison group (n=34) receiving usual teaching. Data were analyzed through chi-square, paired t and Student's t-test. RESULTS: The test group demonstrated significantly higher scores in perceived competency and clinical examinations than the comparison group. However, both groups experienced an increase in learning satisfaction without reaching a significant difference. CONCLUSION: Results of the study indicate that competency-based pedagogy, e.g., using entrustable professional activities, should be integrated into nursing curricula to meet the new American Association of Colleges of Nursing standards with compelling evidence.

Assessing the role and impact of research in clinical practice among acupuncturists in western countries: a multinational cross-sectional survey.

Background: Evidence-informed practice is crucial to perform safe and efficient health interventions. In recent years, the evidence base of acupuncture continuously increased leading to the integration of acupuncture into clinical guidelines by various leading medical associations worldwide. At the same time, recent studies showed that licensed acupuncturists are rarely utilizing scientific research to inform their practice. Methods: This descriptive study using an online survey assessed the role of evidence-informed practice of acupuncturists in Austria, Germany, the United States of America, Australia, and New Zealand and aimed to determine critical factors relevant for promoting research literacy including demographical data, data about the clinical practice patterns, and the role and value of different information sources of traditional, complementary and integrative medicine (TCIM) practitioners. Results: In total, 404 acupuncturists completed the online survey that included questions about demographic characteristics, the role and value of research in clinical practice, and details about the amount and type of continuing professional education. Univariate and multivariate analysis was used to determine significant predictors of the outcome variable "importance of research in clinical practice" (numerical rating scale, 0 to 100). The results showed that the majority of acupuncturists use certified courses as primary source of continuing professional education and value experts' opinions as the most reliable source of information. Multivariate analysis showed that the importance of research is dependent on the interest in research, an interdisciplinary learning environment, and positive experiences with research including if an acupuncture study ever changed the clinical practice of practitioners. Conclusion: Future educational programs should therefore focus on an interactive format aiming to promote skills to critically assess the value and practical use of research studies to improve the general practice of acupuncture.

Investigating the motivating factors that influence the adoption of blended learning for teachers' professional development.

Blended learning (BL), a teaching method merging online and face-to-face learning, is lauded for its potential to enrich educational outcomes and tackle challenges entrenched in conventional teaching practices. In countries like Pakistan, where equitable access to quality professional development remains an obstacle, BL is a promising avenue to surmount training barriers. While BL adoption has evolved swiftly, research into its integration within teacher training remains limited. Notably, no comprehensive model exists describing the motivational factors influencing teachers' perceptions and intentions regarding the blended mode of teacher training. This study aims to identify the motivational elements that motivate schoolteachers in teacher training institutions in Pakistan to incorporate blended learning into their programs. The motivational factors identified in BL literature have been employed to craft a motivation model grounded in their causal relationship. This quantitative study examines the interplay between multiple motivational factors and their impact on BL adoption within teacher training and the BL environment. Surveying 350 schoolteachers (participants) from teacher training institutions, we employed Structural Equation Modeling (SEM) techniques with Smart PLS 4.0 for data analysis. Results reveal that extrinsic and intrinsic motivational factors significantly influence teachers' motivation to adopt BL for training. Notably, "overall training quality" and "educational environment" were non-influential. Overall, the findings underscore that considering a blend of extrinsic and intrinsic factors can wield a 65 % influence on BL adoption. The study's results provide practical guidance for educational leaders, curriculum designers, and faculty members aiming to cultivate a unified blended learning environment for teacher professional development. These insights also underscore the importance of incorporating essential motivational factors into forthcoming blended learning training programs.

How to promote midwives' recognition and professional autonomy? A document analysis study.

OBJECTIVE: To identify challenges associated with midwives' professional autonomy in Belgium and develop recommendations to promote midwives' recognition and professional autonomy. DESIGN: Through a document analysis study we identified challenges, categorized them into themes and linked them with Greenwood's sociological criteria for a profession. This involved an in-depth synthesis of findings from our published studies to comprehensively examine the challenges to optimizing midwifery autonomy and to develop corresponding recommendations. FINDINGS: We identified challenges related to midwife-led continuity care models, regulation of the midwifery profession, collaboration with stakeholders, professional esteem and professional culture. Based on them, our recommendations include prioritizing midwife-led continuity of care, fostering collaboration, tailoring continuous professional development, increasing public awareness and advocating for policy changes. The attribute of a profession which is lacking the most in midwifery in Belgium is recognized authority, which may result in midwives being undervalued, underutilized and underpaid. KEY CONCLUSIONS: In this paper we identified challenges in Belgian midwives' recognition and professional autonomy and provided recommendations to address them, emphasizing the importance of recognized authority in midwifery. Implementing these recommendations can positively impact midwives' recognition and autonomy in Belgium and potentially in other countries. IMPLICATIONS FOR PRACTICE: It is essential for policy makers to address the issue of the lack of recognized authority in midwifery, as it plays a critical role in facilitating decision-making, policy development, and the professionalization of the field. Implementing the outlined recommendations can drive positive changes in midwifery recognition and autonomy in Belgium and beyond.

Examining liminality in professional practice, relational identities, and career prospects in resource-constrained health systems: Findings from an empirical study of medical and nurse interns in Kenya.

We examine new doctors' and nurses' experiences of transitioning from training to practising as health professionals, drawing on the concept of liminality. Liminality is a stage of 'in-betweenness', involving uncertainty and ambiguity as people leave one social context and reintegrate into a new one. Surprisingly little research has explored new health professionals' experiences of liminality during role and career transitions, particularly in precarious and resource-constrained settings. Drawing on 146 qualitative interviews and seven focus groups, involving 121 new graduate medical doctors and nurses transitioning through internship training in Kenya, we describe three aspects of liminality. First, liminal professional practice, where interns realise that best practices learned during medical and nursing schools are often impossible to implement in resource constrained health care settings; instead they learn workarounds and practical norms. Second, liminal relational identities, where interns leave behind being students and adopt the identities and responsibilities of qualified professionals within pre-existing professional hierarchies of status and expertise. We explain how these new doctors and graduate nurses negotiate their liminal status, including in relation to more experienced but less qualified professional colleagues. We also discuss how interns cope with liminality due to disappointing and inadequate supervision and role modelling from senior colleagues but then find peer support and their place within their own professions. Finally, we discuss how new doctors and nurses come to terms with the precarity of working in resource constrained health systems, abandon expectations of secure, permanent employment and careers, and accept the realities of liminal professional careers. We explain how all three forms of liminality influence professionals' developing practices, identities, and careers. We call for further studies with a specific liminality lens to explore this critical period in health workers' careers, to inform policy and practice responding to global transformations in healthcare professions and practice.

How Internal Medicine Clerkship Directors Are Using Entrustable Professional Activities: A National Survey Study.

BACKGROUND: In the present assessment environment in undergraduate medical education at U.S. medical schools, the prevalence and implementation of Entrustable Professional Activities (EPAs) in internal medicine (IM) clerkships are not well understood. OBJECTIVE: To describe the prevalence and approach to EPA use in U.S. IM clerkships. DESIGN: Cross-sectional, nationally representative survey of core IM clerkship directors. PARTICIPANTS: One-hundred forty IM clerkship directors at Liaison Committee on Medical Education-accredited U.S./U.S. territory-based allopathic medical schools with membership in the Clerkship Directors in Internal Medicine (CDIM) as of December 2022. MAIN MEASURES: Use of EPAs in IM core clerkships, including use for grading, types of EPAs, use of supportive measures for assessment, and current validity frameworks. KEY RESULTS: The survey response was 80% (112/140); two additional respondents completed the section on EPA use (n = 114). Approximately half of respondents (47%) reported their IM clerkship used EPAs. Among schools accredited after 1977, a higher percentage was associated with having incorporated EPAs (p = 0.03). The Association of American Medical Colleges Core EPAs for Entering Residency (CEPAER) was the most common framework used by Clerkship Directors (CDs) for developing EPAs (55%). Most CDs (56%) used EPAs for both formative and summative assessments, and approximately half of CDs (48%) used EPAs for a portion of the final grade determination. CDs who used EPAs were no more likely to report efforts to ensure the validity of assessment, the use of faculty development, or that written assessments were a valid measure of students' performance compared to those who did not use EPAs. CONCLUSIONS: Although EPAs have experienced substantial uptake in the IM clerkship and contribute to formative and summative assessment of learners, their use does not appear to be associated with enhanced efforts to obtain validity information.

A scoping review of the educator role performed by Health Information Managers in health workplace-based education: The practitioner Health Information Manager-educator.

BACKGROUND: Health Information Managers (HIMs) play a crucial role in the management and governance of health information ensuring the accuracy, confidentiality and accessibility of health data for clinical care and business operational purposes. This role also extends to education and training in the workplace. OBJECTIVE: The aim of this scoping review was to explore and elucidate the role played by HIMs when they undertake a health workplace-based (healthcare organisation or service) educational role and/or functions as evidenced in the existing body of literature. METHOD: A scoping review of the literature to investigated the importance of the educator role for HIM health workplace-based educators. A three-step search strategy was designed to ensure a comprehensive exploration of relevant research. RESULTS: Of 63 articles assess for eligibility, 14 were included in the final analysis. All included articles acknowledged the importance of the HIM-educator workplace-based role. Half of the included articles had been published within the last 7 years. Only 8 of the 14 articles provided some description of HIM-educator attributes, suggesting that these characteristics remain unexplored. DISCUSSION: Findings from this scoping review have shed light on the limitations within the current available literature concerning the attributes of HIM health workplace-based educators. The findings also highlight an important gap in knowledge concerning the qualities of these HIM-educators. CONCLUSION: This identified gap in the literature signals a need for further exploration and investigation into the specific attributes, skills, and characteristics that define effective HIM-educators undertaking a health workplace-based educational role.

Dentists and physiotherapists level of collaboration in the treatment of temporomandibular disorders in France.

OBJECTIVES: Temporomandibular disorders (TMD) affect 10% of the population in France, significantly impacting patient's health and quality of life. The multifactorial etiology of TMD complicates its treatment. Consequently, adopting a multidisciplinary approach that encourages collaboration among healthcare professionals is recommended. Nevertheless, this approach does not seem to occur on a regular basis. The aim of this study was to assess the dentist's treatment support of TMD in the context of the inter-professional collaboration between dental practitioners and physiotherapists. MATERIEL AND METHODS: A cross-sectional observational study was conducted based on an online questionnaire from January 15th to April 30th, 2023. The data are collected through Professional Broad, Regional Unions of Health Professional and Healthcare Professional Communities and Territories. RESULTS: Of the 420 responses analyzed, the main first-line treatment provided by the dentist was the correction of dental occlusion (84%). The rate of referral to a physiotherapist was 57% and was 75% for second-placed treatment. The main reason for the lack of referral was a lack of awareness of physiotherapy role in the management of TDM. We observed that 70% of dental health practitioners were interested about inter-professional collaboration and the development of postgraduate training. CONCLUSION: Given the difficulty of managing TDM, efforts should be made to improve inter professional management. CLINICAL RELEVANCE: The implementation of appropriate teaching in initial training seems to be essential to allow dentists to open the range of treatment for TMD with increased knowledge of physiotherapy techniques for an adapted prescription to the patient.

Radiation therapist education and the changing landscape in Africa.

In the changing global landscape, education programs for radiation therapists (RTTs), also known as therapeutic radiographers or radiation therapy technologists, at higher education institutions (HEIs) are non-existent in many African countries. In countries with local RTT education programs, there is evidence of a wide variety of qualification types, including in-house training, diploma and degree offerings. However, what is consistent is the integrated curriculum approach to classroom theory and clinical work-based learning that across the continent follows the general structure of a work-integrated learning (WIL) approach, to enhance clinical competence and meet the needs of the health sector. This study used a qualitative approach with thematic analysis of publicly available documents and reflective writings followed by further analysis through application of the Cultural Historical Activity Theory (CHAT) to explore the changing landscape of oncology in Africa and the impact of this on the education of RTTs. The study was guided by the reflective research question: How can the systemic understanding of RTT training in a changing landscape enable competent and caring practice? The study extends prior research on RTT education in Africa and contributes to debates on the changing role of RTTs in a rapidly changing environment.

The relationship between challenge-hindrance stress, professional identity, and emotional labor of Chinese preschool teachers.

BACKGROUND: Teaching will bring work stress and affect emotions, as well as require a high level of professional identity. However, few have examined trilateral relationships between work stress (in terms of challenge-hindrance stress), professional identity, and emotional labor among Chinese preschool teachers during COVID-19. OBJECTIVE: Based on the conservation of resource theory, this study aimed to examine the relationship between challenge-hindrance stress, emotional labor, and professional identity, as well as explore the mediating effects of professional identity between job stress and emotional labor among Chinese preschool teachers. METHODS: A cross-sectional study was conducted, with 753 preschool teachers completing a self-report questionnaire. Statistical analyses were conducted using SPSS 26.0 and included descriptive statistics, Pearson correlation analysis, regression analysis, and mediation effect testing. RESULTS: Research indicated that 1) challenge-hindrance stress was positively correlated with surface acting (r = 0.21, p < 0.01, and r = 0.28, p < 0.01) but negatively correlated with the expression of naturally felt emotions (r = -0.08, p < 0.05, and r = -0.12, p < 0.01); 2) Challenge-hindrance stress was negatively correlated with professional identity (r = -0.08, p < 0.05, and r = -0.20, p < 0.01); 3) Professional identity exhibited positive correlations with the three dimensions of emotional labor (r = 0.12, p < 0.01; r = 0.64, p < 0.01; and r = 0.56, p < 0.01) and partially mediated the relationship between challenge-hindrance stress and emotional labor. CONCLUSION: The study underscored that challenge-hindrance stress affected emotional labor directly and indirectly through the mediating role of professional identity. Interventions focusing on alleviating work stress and promoting professional identity through comprehensive training could effectively mitigate emotional labor among preschool teachers.

The Turkish adaptation study of the professional identity scale.

BACKGROUND: Professional identity encompasses the understanding of professional practices and the development of values and skills within a specific profession. OBJECTIVE: This study aimed to assess the suitability of the 9-item Macleod Clark Professional Identity Scale, originally developed by Adams et al. (2006), for Turkish culture and examine its psychometric properties in a sample of postgraduate nurses. METHODS: The study was conducted using a methodological approach. The sample consisted of 100 postgraduate nurses. Various analyses were conducted, including descriptive statistics of the scale, Cronbach's alpha coefficient, item-total score correlation, and scale response bias for reliability assessments. Validity analyses included assessments of language, content, construct validity, concurrent validity, and known group validity. RESULTS: The Cronbach's alpha coefficient for the 9-item Macleod Clark Professional Identity Scale was found to be 0.85, indicating good internal consistency. Item-total score correlations ranged from 0.34 to 0.88. The confirmatory factor analysis goodness of fit indices, except for the AGFI index, had acceptable values after two modifications. The single-factor structure of the scale was confirmed by confirmatory factor analysis. For concurrent validity, the scale demonstrated a positive and robust correlation with scores from the Nursing Professional Commitment Scale, supporting its validity. In terms of predictive validity, a regression model was established to assess the relationship between independent variables and core professional identity, and the model was found to be at acceptable levels. CONCLUSIONS: This study showed that the Turkish adaptation of the 9-item unidimensional "Macleod Clark Professional Identity Scale" demonstrates acceptable levels of validity and reliability when administered to postgraduate nurses in Turkey.

[Pharmaceutical Interventions in Benzodiazepine users during the COVID-19 Pandemic]. / Intervenciones farmacéuticas en usuarios de benzodiacepinas durante la pandemia COVID-19.

Introduction: Pharmaceutical Intervention aims to optimize and rationalize the use, effectiveness, and safety of dispensed medications resolving drug-related problems (DRPs) and negative medicine outcomes (NMOs). Objectives: To evaluate Pharmaceutical Interventions in Benzodiazepines users during the COVID-19 pandemic from a Community Pharmacy. Method: Prospective observational, descriptive, and cross-sectional study (AEMPS code: DAA-CLO-2020-01) of Pharmaceutical Interventions offered by the community pharmacy between August 2020 and February 2021. Results: A total of 306 Pharmaceutical Interventions were conducted involving 127 patients. Health education and personalized medication information were the most common Pharmaceutical Interventions after detecting a high level of unfamiliarity with the Benzodiazepines among patients. Pharmaceutical Interventions leading to medical referrals accounted for 37.8% of the total, triggered by the detection of DRPs and/or NMOs or after identifying the patient as candidate for deprescription. These referrals included patients with a very high level of depression according to the Euroqol 5D-3L test. Pharmaceutical Interventions resulting in Medication Review with Follow-up Service were performed in 3.1% of patients. The patient acceptance rate of Pharmaceutical Interventions reached 98.4%. Conclusions: The high acceptance rate of Pharmaceutical Interventions reinforces the value of Community Pharmacy in optimizing and rationalizing Benzodiazepines usage, while strengthening the pharmacist-patient relationship. The COVID-19 pandemic posed challenges to pharmacist-physician collaboration despite of the availability of telecommunication protocols among healthcare professionals.

A qualitative study of the experience of doula support to women in socially disadvantaged positions in Sweden: The voices of women and doulas.

BACKGROUND: Women in socially disadvantaged positions face increased risk of fear of birth, birth complications, and postpartum depression, highlighting the need for targeted interventions for this group. Doula support is associated with positive emotional and medical outcomes for mother and child. Experience of doula support for women in socially disadvantaged positions in Sweden remains unexplored. AIM: To describe experiences of doula support within a project for women in socially disadvantaged positions in Sweden. METHODS: In-depth interviews with seven women and focus group discussions with twelve doulas in a Doula support project were conducted. Data was analysed with inductive content analysis. RESULTS: Women and doulas described experiences of doula support as a significant relationship with challenges, due to unclear boundaries for the support, and the time and trust needed to establish the relationship. The support was perceived as comprehensive, far exceeding traditional doula support, with extensive assistance provided postpartum. The project was regarded as meaningful, and that it led to positive birth experiences. CONCLUSIONS: Women in socially disadvantaged positions may benefit from doula support during the perinatal period. The support fosters feelings of calmness, security and empowerment, and alleviates feelings of isolation, which is crucial for a positive birth experience. Support for these women is complex due to increased social needs, leading to unclear expectations of the doula's role. Support from colleagues is deemed crucial. Future projects should establish clear frameworks and a supportive structure for doulas.

The effects of profession-related films on the professional pride of nursing students: A randomised controlled trial.

AIM: This study aimed to determine the effects of profession-related films on the professional pride of nursing students. DESIGNS: The study was conducted with a randomised controlled experimental design. METHODS: The sample of the study consisted of 102 students enrolled in the first year of the School of Nursing, Zonguldak Bulent Ecevit University in Türkiye in the 2022-2023 academic year. These students were randomly assigned to the experimental (n = 57) and control (n = 45) groups. The experimental group watched two documentaries and a film on YouTube with a one-week break. Self-administered online questionnaires were distributed via WhatsApp groups for pretests and posttests. Data were collected with a "Sociodemographic Data Form" and the "Nursing Professional Pride Scale (NPPS)" included in the questionnaire forms prepared on the Google Forms platform. Data were analysed using Spearman's rho, the Mann-Whitney U Test, and the Wilcoxon Signed-Rank Test. RESULTS: The mean age of the participants was 18.80 ± 0.99 years, 80% of the participants were female, the place where 79.4% had lived for the longest duration in their lives was the city, 85.3% had information about the profession of nursing before they started university (36.8% from the internet, 34.6% from people around them). The experimental group had significantly higher NPPS scores than the control group after the intervention (p = 0.017). There was also a significant increase in the dimensions of professional feeling (p = 0.012) and desire to continue the profession in the experimental group (p = 0.002). PATIENT OR PUBLIC CONTRIBUTION: Patients and public were not involved in this research.

The Relationships among communication competence, professional autonomy and clinical reasoning competence in oncology nurses.

AIMS: To investigate the relationships among communication competence, professional autonomy and clinical reasoning and to identify the factors that influence clinical reasoning competence in oncology nurses. DESIGN: Cross-sectional descriptive design. METHODS: Participants included 147 oncology nurses with more than a year of clinical experience in cancer wards. The Global Interpersonal Communication Competence Scale, Schutzenhofer Professional Autonomy Scale and Nurses Clinical Reasoning Scale (NCRS) were used to collect data. Data were analysed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis and hierarchical multiple regression analysis. RESULTS: Communication competence (r = 0.59) and professional autonomy (r = 0.46) showed significant positive relationships with clinical reasoning competence. Clinical experience, communication competence, age and professional autonomy were statistically significant predictors and explained 48.6% of clinical reasoning competence. CONCLUSIONS: The clinical reasoning competence of oncology nurses increases proportionally with their communication competence and professional autonomy. Therefore, oncology nurses must reinforce their communication competence and professional autonomy to enhance their clinical reasoning competence. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The reinforcement of communication competence and professional autonomy is necessary for oncology nurses to enhance their clinical reasoning competence. In order to improve nurses' communication competence, practical-focused communication education programmes must be designed and deployed systematically and periodically. In addition, to increase nurses' professional autonomy, it is necessary to expand their clinical experiences through the regular rotation of working units and to make institutional efforts to retain experienced nurses. REPORTING METHOD: We have adhered to STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: Participants in the study were recruited online. They were informed of the study's purpose, method and usability and the survey could only be conducted if they consented to participate voluntarily.

Explain the professional identity of nursing during COVID-19 pandemic.

AIM: To explore the professional identity of nursing during the COVID-19 pandemic in Iran. Professional identity guides nurses' interaction with patients. In the COVID-19 pandemic, recent developments in society's view of the nursing profession are expected to change the perception of nurses' professional identities. DESIGN: The qualitative study used a conventional content analysis approach. METHODS: Data were collected using in-depth semi-structured interviews from June 2020 to January 2021. Data analysis was performed using Landman and Granheim's analysis and Lincoln and Guba's criteria to ensure the data's rigour. RESULTS: After analysing the 20 interviews with 17 participants, including 11 nurses with an average age of 32.63 ± 6.71 years and six varius community members with an average age of 38.66 ± 5.85 years, three main categories were formed: (1) The dual role of the media in the two subcategories (the positive role and the negative role of the media), (2) Changes in public view of nursing during the COVID-19 pandemic (respect for avoidance and understanding the value of nursing practice) and (3) Change of professional identity by showing self-sacrifice (dealing with adversity and commitment to professional obligations). CONCLUSION: The image in the public view of the nursing profession during the COVID-19 pandemic media differs from before and shows self-sacrifice, professional commitment and humanity in nursing. Nurses' experience of caring during the COVID-19 pandemic has positively affected their professional identity; however, they are concerned about the instability of improving the nursing image in society. IMPACT: Nursing leaders and policymakers can utilize media platforms to portray the nursing profession in a positive light and emphasize the scientific capabilities of nurses. This approach goes beyond highlighting sacrifice and compassion, aiming to shift societal perceptions of nursing and bolster the professional identity of nurses. REPORTING METHOD: We used the COREQ (COnsolidated criteria for REporting Qualitative research) checklist as a reporting method. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Prioritising nurses' and doctors' health at work: a scoping review of monitoring instruments.

OBJECTIVE: Nurses' and doctors' health at work is crucial for their overall performance and the quality of care they provide. The Jobs Demands Resources (JD-R) model offers a framework for health at work, encompassing 'job demands', 'job resources', 'personal resources', 'leadership', 'well-being' and 'outcomes'. While various instruments exist to measure health, an overview of instruments specifically designed for assessing nurses and doctors health is currently missing. This study provides a comprehensive overview of available health instruments specifically developed and validated for healthcare professionals in hospital care. DESIGN: Scoping review. DATA SOURCES: MEDLINE, Embase and CINAHL. ELIGIBILITY CRITERIA: Studies assessing the health of nurses and/or doctors in hospitals using or evaluating instruments based on the JD-R model, published between January 2011 and January 2024, excluding student-exclusive samples. DATA EXTRACTION AND SYNTHESIS: We extracted data on study and sample characteristics, as well as details of the measurement instruments, including main and subconstructs. Instruments were categorised based on the JD-R model domains. Descriptive analysis and data visualisation were performed using Excel and Python. RESULTS: We included 1204 studies, reporting 986 unique instruments. We identified 32 comprehensive instruments suitable for broad health screening, measuring four or more of the JD-R model domains. Additionally, we identified instruments focusing on specific domains for targeted screening needs. Furthermore, we present frequently reported instruments assumed to be extensively evaluated, user-friendly, accessible and available in multiple languages. CONCLUSIONS: Health at work cannot be determined by a single instrument alone, underscoring the multidimensional nature of workplace health. Alternatively, organisations should select instruments based on domains most relevant and applicable to their context. This approach ensures a more comprehensive assessment of health at work.

Entrustable professional activities for bedside clinical teachers.

BACKGROUND: Bedside teaching is an important modality for training medical students and postgraduate trainees in clinical settings. Despite its significance, the effective practice of Bedside teaching has been declining over the past few decades. The literature highlighted the need for structured training, assessment, and certification or in other words entrustment of bedside teachers. The current study aims to develop and validate the Entrustable Professional Activities (EPAs) for bedside clinical teachers. METHODS: A multi-method study with clinical teachers, medical educationists, and postgraduate medical students was conducted from July 2021-22. First, a nominal group using the jigsaw puzzle technique was conducted with 16 participants to identify EPAs. Then these EPAs were mapped and validated by the skills/competencies identified in the literature. Next, the EPAs were evaluated using the EQual rubric by 3 medical educationists. This was followed by two-rounds of modified Delphi to develop consensus among 90 participants in round-one and 69 in round-two. For qualitative data, a thematic analysis was conducted. For quantitative data, means and standard deviations were calculated. RESULTS: The study identified five EPAs for bedside clinical teachers: developing bedside teaching program, planning bedside teaching session, conducting bedside teaching, conducting bedside assessments and evaluating bedside teaching. CONCLUSIONS: This study comprehensively developed and validated a full description of EPAs for bedside clinical teachers. The EPAs identified in the study can serve as a guiding framework for bedside clinical teachers' training, assessment, and entrustment.