Optimistic thinking, satisfaction with life and job and nursing care rationing: Multicentre study in Poland.

AIMS: The aim was to examine whether the level of optimism and job and life satisfaction is a differentiating factor from the level of implicit rationing of nursing care in a sample of Polish registered nurses. BACKGROUND: Satisfaction with life and job is reflected by greater effectiveness of nurses at work and creates a positive work environment, which in turn may modulate the level of implicit rationing of nursing care. METHODS: A cross-sectional multicentre research design was adopted, employing a representative sample of 1,010 registered Polish nurses identified between the beginning of January and the end of June 2019. Four self-report scales were used in this study: Basel Extent of Rationing of Nursing Care, Satisfaction with Life Scale, Satisfaction with Job Scale and Life Orientation Test-Revised. The results were analysed using the k-means method, Student's t test and two-way ANOVA. RESULTS: Optimistic thinking, and satisfaction with job and life exerted a significant effect on the level of implicit rationing of nursing care among Polish nurses. Nurses from the group 'pessimistic' were at higher risk of nursing care rationing than those from the group 'optimistic'. CONCLUSION: Strengthening of the personal competencies, providing support and responding to all identified needs might increase job satisfaction of nurses and hence reduce the risk of nursing care rationing. IMPLICATIONS FOR NURSING MANAGEMENT: Leadership modelling and training in positive thinking might be the methods to support nurses and to prevent nursing care rationing.

Psychometric properties of Authentic Leadership Self-Assessment Questionnaire in a population-based sample of Polish nurses.

AIM: The purpose of the study was to adapt and evaluate the psychometric characteristics of the Polish language version of the Authentic Leadership Self-Assessment Questionnaire intended for use among Registered Nurses. DESIGN: A cross-sectional study where the Authentic Leadership Self-Assessment Questionnaire was administered to a representative group of 3,299 Polish Registered Nurses was carried out between September and November 2017. METHODS: Linguistic-cultural adaptation of the ALSAQ was carried out according to the WHO guidelines. The following psychometric properties of the ALSAQ were evaluated: content validity (content validity index), theoretical relevance (exploratory and confirmative factor analysis), unidimensionality of subscales (principal component analysis), internal consistency (Cronbach's alpha), test-retest reliability and criterion validity. FINDINGS: The content validity analysis revealed a need to reduce the original ALSAQ version from 16-23 items. The factor structure of ALSAQ differed from the original version. A three-factor model was better fitted to the data than a four-factor model. The three distinguished subscales (moral processing, self-awareness, and relational transparency) were characterized by unidimensionality. ALSAQ has a good internal consistency (Cronbach's alpha 0.84) and test-retest analysis confirmed stability of the measurement for subscales and particular items. Moreover, the ALSAQ-P criterion validity with external variables, being of key importance for shaping the leadership skills (self-efficacy and universal moral foundations) was confirmed. CONCLUSIONS: Authentic leadership skills in nursing practice are characterized by their individual specificity, which was indicated in the ALSAQ validation. The ALSAQ can be considered a reliable and valid tool for self-assessment of leadership skills in a group of nursing practitioners. The identified standards help measuring strengths and weaknesses of authentic leadership.

NURSE PRESCRIBING. KNOWLEDGE AND ATTITUDES OF POLISH NURSES IN THE EVE OF EXTENDING THEIR PROFESSIONAL COMPETENCES: CROSS-SECTIONAL STUDY.

In Poland, since 1 January 2016 nurses who graduated from the master studies or hold a title of a specialist may ordain and prescribe specific medicines ("independent nurse prescribing" - INP). Nurses, who completed bachelor studies or hold a title of a specialist are allowed to prescribe drugs to continue the patient's treatment as ordered by a physician ("supplementary nurse prescribing" - SNP). The aim of this paper was to analyze the knowledge and attitudes of the Polish nurse specialists to their new professional rights in the independent ordaining of some drugs and drug prescribing. Participants were 902 women and 26 men. The age average was 42.4 (min. 26, max. 65, SD = 7.56, median: 43, mode: 40). 300 respondents - secondary medical education, 325 - the bachelor degree, 277 - the master degree. Own, validated questionnaire. Attitudes with answers based on the Likert scale (1-5) assessed by the nonparametric ANOVA Kruskal-Wallis test with the post-hoc analysis. The same statistical model was used in the evaluation of potential differences for the total scale of knowledge and attitudes.On average less than half of answers about the knowledge were correct (average of difficulty index was 39%). Nurses believe that the introduction of nurse prescribing will increase the nurse's control of the therapeutic process (mean: 3.22/5). No significant differences between the attitudes of respondents with different education level (p = 0.206; H = 3.160). 55% of nurses supports the introduction of INP. Respondents with the master education significantly more frequently support INP than those with secondary education (p = 0.001; z = 3.685). The knowledge of nurses on the extension of their professional rights is unsatisfactory and requires urgent complementation. The health policy makers should consider an extensive information campaign, especially in the group of nurses with advanced practice who will have prescribing competences. Nurses' attitudes to nurse prescribing are generally positive. Concerns expressed are the same as in the opinions of nurses from countries where the professional rights underwent extension earlier.

A Model of Factors Determining Nurses' Attitudes towards Learning Communicative Competences.

The aim of the study was to assess the empirical model of factors determining the attitude towards acquiring communicative competences among nurses participating in the program of specialist training courses. Research was conducted using a cross-sectional study. A representative group of 1010 Polish registered nurses that took part in the postgraduate education course answered a self-report survey (three instruments: NEO-PI-R questionnaire, Communication Skills Attitude Scale (CSAS), and Empathy Understanding Questionnaire (KRE II)) from the beginning of March to the end of May 2018, which was evaluated using path analysis. The research results conducted confirmed the soundness of the created theoretical model (χ2 = 0.278, p = 0.598, RMSEA < 0.05). It was proved that acquiring communicative competences in nurses is determined by factors such as professional experience, empathic tendency, and the intensity of agreeableness, whereby these factors are bound with each other creating a homogeneous network. The developed model demonstrated that skills can most effectively be shaped in an individual's attitude based on positive mentoring in work environment.

Perceiving the Role of Communication Skills as a Bridge between the Perception of Spiritual Care and Acceptance of Evidence-Based Nursing Practice-Empirical Model.

Decision making using evidence-based practice (EBP) is generally universally accepted by nurses. Such acceptance may affect the personnel's behaviour towards patients, which is also demonstrated by taking into consideration the patient's preferences, including the patient's spiritual needs, in the care plan. The provision of such care requires the development of an attitude of approval and an adequate level of communicative competence, which will enable the actual implementation of the EBP. The purpose of our study was to assess the perception of spirituality and the nurse's role in providing spiritual care, as well as the perception of the significance of communication skills in the approval of EBP in professional practice. A multi-centre cross-section study was conducted on a population of 1176 participants (459 undergraduate (bachelor's programme, BP) and 717 postgraduate students (master's programme, MP)) from 10 medical universities in Poland. Three tools were used in the study to evaluate the participants' approach: Evidence-Based Practice Competence Questionnaire (EBP-COQ), The Spirituality and Spiritual Care Rating Scale (SSCRS), and Communication Skills Attitude Scale (CSAS). Structural equation modelling was used for the analysis. An analysis of structural equations revealed the presence of positive relationships of the attitude to spiritual care and the role of communicative competences with the approach to EBP regardless of the cohort. A significant difference was found related to the influence of age on the attitude towards learning communicative competences. The approval in this respect was observed to decrease with age in the MP group. Increasing approval of EBP requires strengthening the approach to activity-centred spiritual care, with the simultaneous development of a positive attitude towards learning communicative competences. The model reveals the need to integrate a humanistic approach with EBP, which can be achieved by planning different interventions in different groups of recipients: nurses, academic teachers and students.

Promoting evidence-based practice - perceived knowledge, behaviours and attitudes of Polish nurses: a cross-sectional validation study.

Purpose. Evidence-based practice (EBP) is recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. The aim was to describe nurses' knowledge, behaviours and attitudes regarding EBP. Materials and methods. A cross-sectional approach was conducted during specialty state examinations in Poland in 2014 in a sample of 548 nurses. The self-completed reliable and valid evidence-based practice profile questionnaire (Australia) was used. Statistical analysis included Cronbach's α coefficient, analysis of variance, the Guttman split-half method and calculations in Statistica version 12. Results. Although the participants' beliefs about the benefits of EBP were high, their knowledge was relatively low. Statistically significant correlations were found between barriers and practice, knowledge and attitudes in relation to the level of nurses' education (p < 0.001 to p < 0.05). Total Cronbach's α coefficient was 0.970. Conclusions. Study findings highlight the importance of further supplementation of knowledge about EBP. The difficulties in using EBP in clinical practice are objective and require changes in the Polish system of nursing care. Additionally, life-long updating knowledge in the area of EBP by participation in various forms of postgraduate education can produce improvements in the knowledge, behaviours and attitudes of nurses in creating a positive EBP profile.

Validation study and setting norms of the evidence based practice competence questionnaire for nursing students: A cross-sectional study in Poland.

BACKGROUND: Achieving high quality care through full use of potential stemming from the use of the principles of evidence based practice (EBP) requires adequate shaping of student attitudes toward EBP already at an early stage of education, as well as teaching in the scope of knowledge and skills essential to apply EBP in future professional work. Therefore, nursing educators need a tool to assess competency in EBP. This study aims to present the adaptation of the psychometric test and setting norms to the Polish version of the Evidence Based Practice Competence Questionnaire (EBP-COQ_P). METHODS: Poland-wide multicentre study, cross-sectional validation design, a representative sample of 1636 nursing students. The EBP-COQ_P was validated in terms of content validity through an expert review. The EBP-COQ_P was administered to evaluate test reliability and validity. Settings norms for the Polish nurse population were also done. RESULTS: Confirmatory factor analysis demonstrated that 25 items are grouped into three categories which define competences related to EBP: attitude, knowledge, and skills. Cronbach's alpha was 0.856 for the entire questionnaire. EBP-COQ_P had good parameters of absolute stability. EBP-COQ_P was also characterized with external construct validity. Measurement with the use of EBP-COQ_P allowed for a good differentiation of the respondents in terms of their expertise in EBP (known-groups validity). CONCLUSIONS: In terms of reliability and validity, EBP-COQ_P is compared with its original version. EBP-COQ_P may be used in educational practice (graduate and postgraduate education). Polish norms set for a representative group of nursing students may serve as a benchmark for the results obtained from individual and group measurements.

Stress at work: The case of municipal police officers.

INTRODUCTION AND OBJECTIVE: Occupational stress-related factors among working municipal police officers in Poland have not been examined in the literature. The purpose of the paper was to evaluate the impact of selected work-related factors on occupational stress in active municipal police officers in Warsaw by using configural frequency analysis (CFA). MATERIALS AND METHODS: A cross-sectional study was conducted among 578 participants, which accounted for 55.1% of all municipal police officers in Warsaw. The majority of study participants were men (72%) (mean age 43 years old). Two groups of workplace-related stress factors were analysed in the study: physical conditions and organisational working conditions causing stress. The study was carried out using the PAPI method (Paper-and-Pencil Interviewing), based on a proprietary questionnaire developed for the study. CFA searches for templates and patterns in contingency tables. RESULTS: Municipal police officers who claimed that stress did not affect health, took advantage of psychological/psychiatric advice less often than those who thought so (1.7% vs 10.1%; χ2 = 20.152, df = 2, P = 0.000). Those who declared that they often experienced stress at work were also more prone to claiming that one or two factors affected their level of stress: physical abuse, contact with infectious materials, working at uncomfortable temperatures or working in a noisy environment. In the opinion of the study population, there were some factors which contributed to the occurrence of stress at work, and these factors included: working in a hurry, lack of necessary resources, devices and materials at work, the need to be available at all times and the unpredictability of the work. The municipal police officers from the study population combined two or three methods to cope with stress, such as watching TV, surfing the Internet and talking with their families. CONCLUSION: Due to the specificity of a municipal police officer's occupation, special attention should be paid to the occupational stress risk factors characteristic for this group of professionals, and measures should be taken to reduce the number of stressors. It is important to organise training events devoted to effective methods of coping with stress. There is need to carry out more in-depth studies of occupational stress among municipal police officers.

Communication skills attitude scale: a translation and validation study in asample of registered nurses in Poland.

OBJECTIVES: To translate and validate the Communication Skills Attitude Scale in the Polish language (CSAS-P) and its adaptation for use among registered nurses. DESIGN: A cross-sectional descriptive design was used in order to translate and validate the CSAS-P. The following psychometric properties of CSAS-P were evaluated: content validity (content validity index), theoretical relevance (exploratory and confirmative factor analysis), one-dimensionality of subscales (principal component analysis), internal consistency (Cronbach's α), test-retest reliability and discriminant validity. SETTING: Participants were identified and recruited from the Centre for Postgraduate Education for Nurses and Midwives in Warsaw, Poland. PARTICIPANTS: The validation group comprised 2014 registered nurses who were undertaking a spring specialisation exam in 2017. RESULTS: The overall content validity index was >0.80, which was interpreted as indicating validity. The factor structure of CSAS-P differed from the original version, and removing three items from the scale better fit the data. The positive attitude subscale (11 items) and negative attitude subscale (12 items) were characterised by one-dimensionality and high internal consistency (Cronbach's α=0.901 and 0.802, respectively). Test-retest analysis confirmed the stability of the measurement for both subscales and particular items. Nurses with prior participation in communication courses scored significantly higher than those without such education (p<0.05), confirming the discriminant validity of CSAS-P. CONCLUSIONS: The psychometric properties of CSAS-P were comparable to the English language original. Further validation of CSAS-P in other groups of healthcare professionals may increase its applicability. CSAS-P can be used to evaluate attitudes towards learning communication skills among registered nurses.

Breast self-examination among nurses in Poland and their reparation in this regard.

INTRODUCTION AND OBJECTIVE: Working at night and in shifts, as well as an unhealthy lifestyle, may increase the risk of breast cancer in nurses who therefore should frequently perform breast self-examination (BSE). The aim of the study was to investigate the performance of BSE among Polish nurses, its accuracy, sources of knowledge and skills, self-assessment of own competences and preparation to educate women about BSE. MATERIAL AND METHODS: A descriptive, cross-sectional study was conducted in a group of female nurses (N=1,242). An anonymous, self-administrated questionnaire was used for data collection. To properly assess the BSE a four-item scale was made of the type single best answer multiple choice question. Each item referred to one agreed principle of performing BSE. RESULTS: Regularly BSE was performed by 56.1% nurses, 67.3% pre-menopause nurses 2-3 days after cessation of menstruation and 30.4% post-menopause women on a chosen day of the month. About 98% examined visually and by palpation; 58.9% did so in two positions. In the accuracy scale of BSE, the average number of points was 2.8 out of 4. All (4 points) or almost all (3 points) recommendations of accurate BSE were met by 61.4% of the nurses. Self-assessment of knowledge and BSE practical skills were considered as good or very good by 93.5% and 88.8% nurses, respectively. The self-evaluation of nurses' knowledge and BSE skills was significantly correlated with the result on the accuracy scale or this BSE. CONCLUSIONS: Many deficiencies concerning frequency, times and BSE techniques were revealed among Polish nurses. There is a discrepancy between the high self-assessment of competences and the accurate practice of BSE. Nurses' preparation in Poland in BSE is insufficient and requires improvement.

Validation of the positive health behaviours scale: a nationwide survey of nurses in Poland.

PURPOSE: The aim was to adjust the positive health behaviours scale (PHBS) to make it suitable for use by nurses, and to validate the new version of the tool. METHODS: A previously formulated PHBS was modified. The scale comprises 29 statements describing certain positive health behaviours in four subscales: nutrition, physical activity, relaxation and behaviours related to mental health, and preventive behaviours. The scale was enriched with items on avoiding risky behaviours and a question regarding respondents' own assessment of their care for health. Analyses were conducted of reliability, construct validity, criterion validity and dimensionality of subscales. The questionnaire was completed by 1017 nurses. RESULTS: Cronbach's α reached 0.844 for the entire scale and 0.623-0.761 for specific subscales. Empirical data did not confirm theoretical assumptions regarding the existence of a four-element structure of the PHBS. The scale's diagnostic criteria were validated on the basis of positive results of correlation and trend analysis. Only one of the subscales proved homogeneous and could be considered unidimensional. CONCLUSIONS: The results confirmed the high internal consistency of the scale and its subscales. The factor structure of the PHBS was equivocal. The PHBS could be used in workplace-based health promotion programmes designed for nurses.

Associations between overweight and obesity and health enhancing behaviours among female nurses in Poland.

INTRODUCTION AND OBJECTIVE: The nursing profession entails many negative factors and high risk of chronic diseases, including overweight and obesity. The aim of the study is to investigate the prevalence of overweight and obesity and health enhancing behaviours in Polish female nurses, and associations between overweight and 4 groups of such behaviours, age and shift work. MATERIAL AND METHODS: The analysis covered data obtained through cross-sectional survey carried out in a group of 994 nurses with an average age of 43. The analysis covered answers about 29 health-enhancing behaviours divided into 4 categories (subscales): 1) nutrition, 2) physical activity, 3) sleep, rest and behaviours related to mental health, 4) preventive behaviours. They were analysed through the validated Positive Health Behaviours Scale for adults. The analysis also covered answers about avoiding drinking large amounts of alcohol in one go, not smoking, avoiding passive smoking, not abusing unprescribed drugs. RESULTS: The prevalence of overweight and obesity was 44%. Of 29 health behaviours concerned with nutrition, physical activity, sleep, rest, and mental health, preventive behaviours, 3 were exhibited always or almost always by over a half of the nurses. Health behaviours were more common in nurses whose BMI was normal than in nurses with BMI ≥ 25.0. Age and low physical activity levels were related to overweight and obesity in nurses. CONCLUSIONS: The study revealed a high prevalence of overweight and obesity and many deficits in health behaviours. Obesity and health behaviour deficits pose risks to the health of nurses, limit their involvement in prevention and treatment of patient obesity and impact as health educators. It is essential to engage in actions for health promotion among nurses.