Development and Validation of a Self-Care Ability Measure.

Self-care is an outcome of nursing care that is instrumental for promoting recovery and preventing complications following hospitalization. The Therapeutic Self-Care (TSC) measure was developed to assess self-care ability in acute-care settings. Its content was derived from a conceptualization of selfcare generated from an extensive literature review. Clinical experts considered the 13 items of the TSC measure as relevant, supporting its content validity. Findings of 1 study indicate that the items are internally consistent and loaded on 1 factor. The TSC scores correlate with relevant concepts. The TSC measure quantifies patients' perceived ability for self-care, operationalized in behaviours related to taking medications, recognizing and managing symptoms, carrying out activities of daily living, and managing changes in condition. It can be used to guide and evaluate nursing care.

L'autogestion des soins est un résultat de soins infirmiers déterminant pour le rétablissement du patient et la prévention des complications après une hospitalisation. Dans le but d'évaluer la capacité d'autogestion dans un contexte de soins actifs, nous avons élaboré un instrument de mesure appelé Therapeutic Self-Care (TSC). Son contenu est dérivé d'une conceptualisation de l'autogestion fondée sur une vaste synthèse de la recherche sur le sujet. Des experts cliniques ont confirmé la pertinence de ses 13 items et corroboré la validité de son contenu. Une étude a montré que les items ont une cohérence interne et sont représentés par un seul facteur. Les scores corrèlent avec les concepts pertinents. L'instrument quantifie la capacité d'autogestion des soins telle que perçue par le patient, opérationnalisée notamment dans les comportements touchant la prise des médicaments, la reconnaissance des symptômes et leur gestion, l'exécution des activités de la vie quotidienne et la modification de l'état de santé. Il peut servir à guider la prestation des soins infirmiers et à évaluer celle-ci.

Work empowerment as experienced by nurses in elderly care.

This work describes the experiences of work empowerment among nurses engaged in elderly care in southern Finland. The data were collected with a questionnaire that included items on demographic background as well as verbal, behavioral, and outcome empowerment. The data were analyzed statistically. The nurses (N = 252, response rate = 80.8%) experienced strong verbal and behavioral empowerment. They felt clearly less confident about outcome empowerment than in the two other fields of empowerment. All fields of empowerment showed a statistically significant correlation with each another. Education and work experience were also related to behavioral empowerment. The results provide important clues for the development of elderly care.

The constancy of work-related empowerment.

OBJECTIVE: This study describes experiences of work empowerment among staff members at the Rheumatism Foundation Hospital in Helsinki, Finland. METHODS: The data were collected on two occasions in 2004 and 2005 using a structured questionnaire with background variables and items concerning verbal, behavioural and outcome empowerment. The questionnaires were sent to all (n1=115, n2=112) members of multidisciplinary teams at the Rheumatism Foundation Hospital, with the exception of physicians, departmental secretaries and administrative personnel. The response rate at both data collections was 58%. The data were analysed by statistical methods. RESULTS: No statistically significant differences were seen in work empowerment between the two data collections. Perceptions of work-related empowerment were relatively strong. CONCLUSIONS: Work-related empowerment appears to be relatively constant and independent of changes in the organization. Indeed there is good reason to ask whether work empowerment is primarily a function of the individual employee's strengths and competencies.

Work-related empowerment of the multidisciplinary team at the Rheumatism Foundation Hospital.

Carried out as part of a staff development project, this study describes the experiences of work-related empowerment within a multidisciplinary team at the Rheumatism Foundation Hospital in Finland. The data were collected using a structured questionnaire consisting of background variables and questions concerning verbal, behavioural and outcome empowerment. The questionnaire was sent to all members of the multidisciplinary team at the Rheumatism Foundation Hospital, with the exception of physicians, departmental secretaries and administrative personnel. The response rate was 58%. The data were examined using statistical methods. The multidisciplinary team felt quite strong verbal and behavioural empowerment, but was less confident in terms of outcome empowerment. Several factors were found to be associated with the different fields of empowerment. In conclusion, the multidisciplinary team felt quite strong work-related empowerment.

Work empowerment as experienced by head nurses.

BACKGROUND: Head nurses have in the past few decades gained both more power and more responsibilities in their job. Their experience of work empowerment is not known. AIM: The aim of this study was to describe the verbal, behavioural and outcome empowerment experienced by head nurses. METHODS: Data were collected using a structured questionnaire, which was sent to 259 head nurses. The data were analysed using statistical methods. RESULTS: The results suggest that head nurses experience quite strong verbal and behavioural empowerment. They feel less confident in terms of outcome empowerment. Various factors, including stress and the capacity to handle the head nurse's job, were found to correlate with the empowerment experience. CONCLUSION: It seems that head nurses do not have enough power to influence the effectiveness of their organization.

An empirical test of the Nursing Role Effectiveness Model.

AIMS OF THE STUDY: This study investigated the propositions depicted in the Nursing Role Effectiveness Model, in which nurse and patient structural variables were expected to influence nurses' role performance, which, in turn was expected to affect patient outcome achievement. RATIONALE/BACKGROUND: Increasingly, nurses are expected to demonstrate their contribution to patient outcome achievement as a basis for evaluating practice and for monitoring improvements in practice. A model was developed that describes nursing practice in relationship to the roles nurses assume in health care, and links patient and system outcomes to nurses' role functions (Nursing Economics 1998: 16, 58-64, 87). RESEARCH METHODS: A cross-sectional design was used to collect data on the structure, process, and outcome variables. Data were collected through structured questionnaires and chart audit, involving a total of 372 patients and 254 nurses from 26 general medical-surgical units in a tertiary care hospital. Patient structural variables included medical diagnosis, age, gender and education. Nurse structural variables included educational preparation and length of hospital experience. The unit structural variables included the adequacy of time to provide care, autonomy, and role tension. The quality of nurses' independent role performance was assessed by collecting data from patients on their perception of the quality of nursing care. Nurses' interdependent role performance was assessed by collecting data from nurses on the quality of nurse communication and co-ordination of care. Patient outcomes were assessed through self-report and consisted of the patients' therapeutic self-care ability, functional status, and mood disturbance at the time of hospital discharge. Structural equation modelling was used to test the hypothesized relationships among the structural, process, and outcome variables. RESULTS: Patients viewed nurses' independent role performance more effective on units where nurses reported less autonomy but more time to provide care. The quality of nurse communication was higher on units where nurses had higher education, more autonomy, less hospital experience, and lower role tension. However, the co-ordination of care was more effective on units where nurses had higher education, greater hospital experience, less autonomy and role tension. The three role performance variables were associated with patients' therapeutic self-care ability at hospital discharge. Nurses' independent role performance was associated with better patient functional status and less mood disturbance at hospital discharge. The role performance variables fully mediated the effect of the structural variables on patient outcomes, lending support for the proposition that nurses' role performance explains the relationship between structural variables, such as nurse education and autonomy, and patient outcome achievement. DISCUSSION: The Nursing Role Effectiveness Model provides a well-defined conceptual framework to guide the evaluation of outcomes of nursing care. For the most part the hypothesized relationships among the variables were supported. However, further work is needed to develop an understanding of how nurses engage in their co-ordinating role functions and how we can measures these role activities.

Nurse staffing and work status in medical, surgical and obstetrical units in Ontario teaching hospitals.

This article reports on the staff mix and work status of nurses in the adult medical, surgical and obstetrical units in Ontario's teaching hospitals. While staff nurses have extensive career experience, most have been on their unit a much shorter period of time. More than one-third of the nursing staff in the study were employed on a part-time or casual basis, with few indicating an interest in moving into full-time positions. The need for enhanced retention strategies on these units is identified, as well as the development of a better understanding of motivating factors for nurses' regarding full-time, part-time or casual work options.