Registered nurses' cultural orientation competence for culturally and linguistically diverse nurses in the hospital setting: A cross-sectional study.

AIMS: To explore registered nurses' cultural orientation competence profiles for providing culturally and linguistically diverse (CALD) nurses with orientation in the hospital setting, and to identify which factors are associated with cultural orientation competence profiles. DESIGN: A descriptive, explorative cross-sectional study. METHODS: Data were collected from December 2020 to January 2021 using the Preceptors' Orientation Competence Instrument (POCI) and Preceptors' Cultural Orientation Competence Instrument (POCCI). A total of 844 registered nurses from one university hospital district in Finland participated, reflecting a response rate of 10%. A K-means cluster algorithm was employed to identify different cultural orientation competence profiles. RESULTS: The cluster analysis identified three cultural orientation competence profiles (A, B and C). Nurses in Profile A evaluated their cultural orientation competence the highest, with members of profiles B and C demonstrating the second highest and lowest, respectively, cultural orientation competence scores. Several factors were associated with cultural orientation competence profiles, namely, orientation education and student mentoring education, support from managers and colleagues, motivation, willingness to act as a preceptor, time to provide orientation, sufficient clinical and theoretical nursing skills and current work title. CONCLUSION: Cultural diversity and acceptance of it can be enhanced by building accepting culture towards new incomers and offering continuing education to improve the cultural competence of staff, which can further benefit patient care of CALD patients. Orientation practices can be improved by rewarding staff and building collaborative teamwork culture. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE: Organizations can strengthen nurses' cultural orientation competence; for example, by providing adequate orientation education and allocating more time to the orientation process. REPORTING METHOD: The STROBE criteria were used to report the results of the observations critically. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Nurses' perceptions of desired support from their employer during the COVID-19 pandemic: a qualitative survey study.

BACKGROUND: Nurses play a crucial role in getting through the COVID-19 pandemic. However, the burden of the COVID-19 pandemic for nurses has been recognized, and thus, support for nurses is urgently needed. Support with various methods should help nurses' welfare and their ability to cope at work. Moreover, with appropriate support, it is possible to avoid anxiety, insomnia, or uncertainty caused by work. The aim of this study was to describe nurses' perceptions of desirable support from their employer during the COVID-19 pandemic. METHODS: This qualitative survey study is a part of a follow-up study for the entire personnel of Helsinki University Hospital. This study focuses on one open-ended question answered by nurses (n = 579) at baseline of a follow-up study. Answers were analysed using qualitative content analysis with an inductive approach. RESULTS: The findings reveal that various types of support desired from an employer. Qualitative content analysis raised six main categories, 39 categories, 167 sub-categories and 1235 codes from the original text. Main categories were as follows: Awarding personnel, Offering safety in working conditions, Showing appreciation to personnel, Offering a variety of support methods, Providing proper flow of information and Ensuring proper management in exceptional situations. CONCLUSIONS: This study provides a better understanding of nurses´ perspectives on support from their employer during the COVID-19 pandemic. Results of this study suggest that employers, for example, should award personnel, ensure that working conditions are safe, show more appreciation to personnel. Employers should also pay attention to offer a variety method of support and make sure that the information is provided with a proper flow. In exceptional situations is important to ensure proper management too. With appropriate support methods, employers can avoid a shortage of nurses and maintain nursing as an attractive profession in the future.

Healthcare workers' heterogeneous mental-health responses to prolonging COVID-19 pandemic: a full year of monthly follow up in Finland.

BACKGROUND: The COVID-19 pandemic strained healthcare workers but the individual challenges varied in relation to actual work and changes in work. We investigated changes in healthcare workers' mental health under prolonging COVID-19 pandemic conditions, and heterogeneity in the mental-health trajectories. METHODS: A monthly survey over a full year was conducted for employees of the HUS Helsinki University Hospital (n = 4804) between 4th June 2020 to 28th May 2021. Pandemic-related potentially traumatic events (PTEs), work characteristics (e.g., contact to COVID-19 patients), local COVID-19 incidence, and demographic covariates were used to predict Mental Health Index-5 (MHI-5) and Insomnia Severity Index (ISI) in generalized multilevel and latent-class mixed model regressions. RESULTS: Local COVID-19 log-incidence (odds ratio, OR = 1.21, with 95% CI = 1.10-1.60), directly caring for COVID-19 patients (OR = 1.33, CI = 1.10-1.60) and PTEs (OR = 4.57, CI = 3.85-5.43) were all independently associated with psychological distress, when (additionally) adjusting for age, sex, profession, and calendar time. Effects of COVID-19 incidence on mental health were dissociable from calendar time (i.e., evolved in time) whereas those on sleep were not. Latent mental-health trajectories were characterized by a large class of "stable mental health" (62% of employees) and minority classes for "early shock, improving" (14%) and "early resilience, deteriorating" mental health (24%). The minority classes, especially "early shock, improving", were more likely to live alone and be exposed to PTEs than the others. CONCLUSIONS: Healthcare workers faced changing and heterogeneous mental-health challenges as the COVID-19 pandemic prolonged. Adversity and mental ill-being may have accumulated in some employees, and factors like living arrangements may have played a role. Knowledge on employees' demographic and socioeconomic background, as well as further research on the factors affecting employees' resilience, may help in maintaining healthy and efficient workforce in the face of a prolonging pandemic.

Nurse preceptors' orientation competence and associated factors-A cross-sectional study.

AIMS: To identify distinct orientation competence profiles amongst nurse preceptors and explain the associated factors. DESIGN: A cross-sectional study design. METHODS: The data were collected during the winter of 2020-2021 from registered nurses (N = 8279, n = 844) at one university hospital in Finland through an online questionnaire that included a self-administered electronic version of the Preceptors' Orientation Competence Instrument. K-means clustering was then used to identify nurse preceptor profiles. Chi-square, Fisher's exact test, Kruskal-Wallis and Mann-Whitney tests were used to analyse factors associated with competence profiles. The results were reported as frequencies, percentages, mean and standard deviation. RESULTS: A total of three distinct orientation competence profiles (A, B, C) were identified. Profile A nurses evaluated their orientation competence at the highest level, whereas profile C nurses evaluated their competence at the lowest level. Sufficient clinical and theoretical experience, a motivation to work, willingness to orient new employees and participation in orientation and/or mentoring education were found to be associated with competence profiles. CONCLUSION: The findings expand the current knowledge base of nurse preceptors' orientation competence. Health care organizations should recognize different orientation competence profiles amongst the nursing staff since the selection of a preceptor should always be based on possessing the necessary orientation competence rather than availability. The results indicate that preceptors (who reported taking on various tasks and covering multiple roles) need support from co-workers to sufficiently concentrate on employee orientation tasks. The results also indicate that preceptors need further orientation education, which should-for example-outline the learning goals for new employees and how preceptors can assess employee performance. IMPACT: What problem did the study address? Prior research has not applied a robust theoretical framework covering all aspects relevant to a preceptor's competence. What were the main findings? A nurse's clinical and theoretical experience, motivation to work, willingness to orient new employees, and prior participation in orientation and/or student mentoring education were found to influence their level of orientation competence. Where and on whom will the research have an impact? Healthcare organizations can use the results of this study to make the selection of preceptors competency-based rather than their availability. Nurse leaders can use the results of this study to pinpoint which areas of nurses' orientation competence and associated factors need to be improved. Increased orientation competence will enable clinical nurses to provide high-quality orientation to new employees, which is crucial to the retention of nursing staff and the quality of patient care.

Experiences of living with a sexually transmitted disease: an integrative review.

PURPOSE: This integrative review describes experiences related to living with a sexually transmitted disease (STD). DESIGN: The data search was conducted using the CINAHL, MEDLINE (Ovid), PsycINFO and PubMed databases between the years 2000 and 2016. A manual search was also used. The retrieved data consisted of 33 original articles which were analysed using deductive and inductive content analysis. RESULTS: Based on the results, an infected person has a need for information about STDs and experiences emotions such as a loss of purity and control over his/her body. In addition, the ego of the infected person is wounded due to the infection. Concerns about the results of treatments, suffering side effects, and experiences of unprofessional behaviour by nursing staff are related to the treatment of an STD. Having an STD in everyday life means coping with a changing condition, but there are resources that can provide support. The quality of life can also be negatively affected by an STD, and a future with an STD can manifest different hopes and concerns. In relation to other people, an STD has a marked effect, especially concerning sexual relations. The person's sex life can fade away; however, it may remain as an enjoyable experience. The infected person may also adopt safer sexual behaviours or continue with a risk-taking behaviour. CONCLUSION: The results of this review can be used in the development of nursing practices, as well as be used in the prevention of STDs.

The development of ethical guidelines for nurses' collegiality using the Delphi method.

BACKGROUND: Nurses' collegiality is topical because patient care is complicated, requiring shared knowledge and working methods. Nurses' collaboration has been supported by a number of different working models, but there has been less focus on ethics. AIM: This study aimed to develop nurses' collegiality guidelines using the Delphi method. METHOD: Two online panels of Finnish experts, with 35 and 40 members, used the four-step Delphi method in December 2013 and January 2014. They reformulated the items of nurses' collegiality identified by the literature and rated based on validity and importance. Content analysis and descriptive statistical methods were used to analyze the data, and the nurses' collegiality guidelines were formulated. Ethical considerations: Organizational approval was received, and an informed consent was obtained from all participants. Information about the voluntary nature of participation was provided. RESULTS: During the first Delphi panel round, a number of items were reformulated and added, resulting in 32 reformulated items. As a result of the second round, 8 of the 32 items scored an agreement rate of more than 75%, with the most rated item being collegiality means that professionals respect each other. The item with second highest rating was collegiality has a common objective: what is best for patients, followed by the third highest which was professional ethics is the basis of collegiality. CONCLUSION: Nurses' collegiality and its content are well recognized in clinical practice but seldom studied. Collegiality can be supported by guidelines, and nurses working in clinical practice, together with teachers and managers, have shared responsibilities to support and develop it. More research in different nursing environments is needed to improve understanding of the content and practice of nursing collegiality.

The role of the teacher and learning in clinical practicum scales: A psychometric testing of the Finnish versions.

AIM: To test the psychometric properties of the further developed Role of the Teacher (Tc2) and the new Learning in Clinical Practicum (LCP) scales in a sample of Finnish healthcare students. DESIGN: Psychometrical testing of the Tc2 and LCP scales. METHODS: A sample consisting of 1133 healthcare students completed the further developed Tc2 scale and the new LCP scale between January and June 2020. Statistical data analysis was performed using explorative factor analysis and Cronbach's alpha coefficient. The STROBE checklist for cross-sectional studies was applied in reporting. RESULTS: Both the further developed Tc2 and the new LCP scales were shown to be valid and reliable. Explorative factor analysis confirmed a two-factor solution for the Tc2 scale with a 76.3% explained variance and a one-factor solution for the LCP scale with a 58.0% explained variance. The scales' internal consistency reliabilities were high (0.9).

Instruments assessing nurse educator's competence: A scoping review.

AIM: The aim of this review was to synthesize the instruments that assess nurse educators' competence. DESIGN: A scoping review was conducted with the five-stage process informed by Arksey and O'Malley. REVIEW METHODS: The predetermined search strategy was used including an additional hand search. The studies were selected according to inclusion and exclusion criteria to answer the research questions followed: (1) "What instruments are used to assess nurse educators' competence?", (2) "How are the psychometric properties of nurse educators' competence instruments reported in the literature?". The thematic synthesis was used. DATA SOURCES: The literature search was conducted in January 2021 using the CINAHL, MEDLINE and ERIC databases from January 2000 to December 2020. RESULTS: Of the 1,567 articles searched through, 25 met the inclusion criteria. A total of 19 instruments with 10 areas of competence were identified. Typical competence areas were pedagogical and nursing competence. In addition, leadership in managerial competence was included in several instruments. However, the theoretical backgrounds of the instruments varied and the psychometric properties were reported in varied ways in reviewed studies. IMPLICATIONS FOR THE PROFESSION: This study provides evidence about the valid and comprehensive assessment of nurse educators' competence, as competent nurse educators promote excellence in nursing education. To assess a nurse educators' competence comprehensively, a variety of theoretical backgrounds of this competence and more than one instrument for the measurement need to be considered. The selection of the instruments to assess nurse educators' competence should be based on the selected theoretical background and use of valid measurements. REPORTING METHOD: This study was reported by following the reporting recommendations of the PRISMA extension for Scoping Reviews (PRISMA-ScR). PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution was applied, since research design was a scoping review.

Development and psychometric testing of the preceptors' orientation competence instrument (POCI).

AIM: To develop and psychometrically test a Preceptors' Orientation Competence Instrument measuring orientation competence of nurses working as new employee preceptors. BACKGROUND: Competence of nurse preceptor is essential for a successful preceptorship and thus nursing staff´s commitment to the organization. DESIGN: Instrument development according to the COSMIN guidelines. METHODS AND PARTICIPANTS: Four phases were implemented: 1) establishment of the theoretical framework, modification of the validated Mentor Competence Instrument and generation of new items; 2) content validity testing; 3) structural validity testing; and 4) internal consistency testing. Content validity was evaluated by 14 experts using content validity index methods. Structural validity was evaluated using exploratory factor analysis with a convenience sample of 844 Finnish nurses. Internal consistency was evaluated by measuring Cronbach's alpha. RESULTS: The content validity index of subdimensions of the instrument ranged from 0.80 to 0.94 for relevance and 0.80-0.94 for clarity. Exploratory factor analysis resulted in a seven-factor model with 53 items (61.62% of total variance): preceptor characteristics, goal-oriented orientation, guidance in reflective discussion, knowledge of work unit orientation practices, creation of a supportive learning atmosphere, preceptor motivation and giving of developmental feedback. Cronbach's alpha values varied from 0.79 to 0.93. CONCLUSION: Preceptors' Orientation Competence Instrument demonstrated adequate psychometric properties based on content and construct validity as well as internal consistency. Therefore, it is useful for self-evaluation of orientation competence of nurses working as new employee preceptors.

COVID-19 Pandemic and Helsinki University Hospital Personnel Psychological Well-Being: Six-Month Follow-Up Results.

The COVID-19 pandemic has caused an unequally distributed extra workload to hospital personnel and first reports have indicated that especially front-line health care personnel are psychologically challenged. A majority of the Finnish COVID-19 patients are cared for in the Helsinki University Hospital district. The psychological distress of the Helsinki University Hospital personnel has been followed via an electronic survey monthly since June 2020. We report six-month follow-up results of a prospective 18-month cohort study. Individual variation explained much more of the total variance in psychological distress (68.5%, 95% CI 65.2-71.9%) and negative changes in sleep (75.6%, 95% CI 72.2-79.2%) than the study survey wave (1.6%, CI 0.5-5.5%; and 0.3%, CI 0.1-1.2%). Regional COVID-19 incidence rates correlated with the personnel's psychological distress. In adjusted multilevel generalized linear multiple regression models, potentially traumatic COVID-19 pandemic-related events (OR 6.54, 95% CI 5.00-8.56) and front-line COVID-19 work (OR 1.81, 95% CI 1.37-2.39) was associated with personnel psychological distress but age and gender was not. While vaccinations have been initiated, creating hope, continuous follow-up and psychosocial support is still needed for all hospital personnel.

Personnel Well-Being in the Helsinki University Hospital during the COVID-19 Pandemic-A Prospective Cohort Study.

In March 2020, strict measures took place in Finland to limit the COVID-19 pandemic. Majority of Finnish COVID-19 patients have been located in southern Finland and consequently cared for at the Hospital District of Helsinki and Uusimaa (HUS) Helsinki University Hospital. During the pandemic, HUS personnel's psychological symptoms are followed via an electronic survey, which also delivers information on psychosocial support services. In June 2020, the baseline survey was sent to 25,494 HUS employees, 4804 (19%) of whom answered; altogether, 62.4% of the respondents were nursing staff and 8.9% were medical doctors. While the follow-up continues for a year and a half, this report shares the sociodemographic characteristics of the respondents and the first results of psychological symptoms from our baseline survey. Out of those who were directly involved in the pandemic patient care, 43.4% reported potentially traumatic COVID-19 pandemic-related events (PTEs) vs. 21.8% among the others (p < 0.001). While over a half of the personnel were asymptomatic, a group of respondents reported PTEs and concurrent depression, insomnia, and anxiety symptoms. This highlights the need to ensure appropriate psychosocial support services to all traumatized personnel; especially, nursing staff may require attention.