The core competencies of a health education teacher.

Teachers play a crucial role in students' learning and in the development of health literacy. Hence, the aim of this study was to identify the core competencies needed for teachers of health education in supporting student learning. A three-round Delphi study was carried out over an 8-week period, through consultation with 25 Finnish experts in health education. An open-ended question was used to identify the core competencies for school health educators. The data were analysed using inductive content analysis. In subsequent rounds, experts were asked to assess the importance of the identified competencies on a 7-point Likert scale, and finally to rank the most important competencies. In total, 52 competencies were identified and categorized into eight core competence domains. Thereafter, 40 competencies were assessed and selected for the third round, in which the experts ranked the 15 most important competencies, encompassing four core domains, i.e. pedagogic and subject-specific didactic, social and emotional, content knowledge and continuous professional development. Other domains of competence identified in the present study were ethical competence, competence in school health promotion, contextual competence and professional well-being competence. The study defines health education teacher core competencies and domains, and the information can be used in teacher education programmes, for developing teaching and for teachers' self-evaluation.

The Appearance of Digital Competence in the Work of Health Sciences Educators: A Cross-sectional Study.

The digital competence of health sciences educators is important for the delivery and development of modern education and lifelong learning. The aim of the study was to assess the appearance of digital competence in the work of Finnish health sciences educators and to determine whether educators' background factors are related to the areas of digital competence appearance. The European Framework for the Digital Competence of Educators was used as a theoretical background. The participants were Finnish health sciences educators (n = 388). Data were collected by quantitative survey and statistically analyzed. Results show that health sciences educators had participated in continuing education to develop their expertise and used a variety of digital methods and materials. Educators need more competence to improve healthcare students' ability to use digital technology. In the area of Teaching and Learning, educators younger than 40 years rated the appearance of digital competence as better than did those between the ages of 40 and 49 years. In the future, health sciences educators' basic and continuing education could take into account the competence requirements for digital competence, and educators' expertise must be increased in areas where digital competence does not appear strong.

Learning Outcomes of Digital Learning Interventions in Higher Education: A Scoping Review.

Implementing digital technologies has become a policy priority worldwide among all types of education. The COVID-19 pandemic has further accelerated educational institutions' efforts to reorganize their teaching and introduce new digital learning technologies. Although using digital technologies in higher education, including nursing, is considered a modern and innovative way of teaching and learning, uncertainty exists concerning these technologies' actual usefulness in achieving positive learning outcomes. The aim of this scoping review was to examine the current evidence related to the effects of using digital technologies on learning outcomes in higher education. The authors searched five electronic databases for relevant studies and used a scoping review method to analyze and synthesize the evidence. Eighty-six articles from six disciplines met the selection criteria. As a key finding, the outcomes of the interventions were mainly positive. Increased professional knowledge, skills, and attitudes reflect the advancement of professional competence. Academic, collaborative, and study skills, in turn, contribute to general competence development. Our findings suggest that digital technology has the potential to improve learning in various disciplines.

Stress in the Clinical Learning Environment: Perceptions of First-Year Finnish Nursing Students.

AIM: The aim of the study was to examine how first-year Finnish nursing students perceive stress and the coping strategies they use in the clinical learning environment. BACKGROUND: Stress from the clinical learning environment is a recurrent problem in nursing education. This topic has not been explored in the Finnish context. METHOD: This is a cross-sectional study using data from 189 first-year nursing students. Students completed the Perceived Stress Scale and Coping Behavior Inventory; t-tests and Pearson correlation analyses were performed. RESULTS: Our sample rarely experienced stress, with a mean stress score of 1.07 (SD = 0.49). A commonly reported stressor was lack of professional knowledge and skills (M = 1.49, SD = 0.82). Transference was the most common coping strategy. CONCLUSION: Our findings may help nursing teachers understand stressors in the clinical learning environment and support their students to use effective coping strategies, such as problem-solving and optimistic attitudes.

Health-improving interventions for obtaining employment in unemployed job seekers.

BACKGROUND: Unemployment is associated with decreased health which may be a reason or a consequence of becoming unemployed. Decreased health can inhibit re-employment. OBJECTIVES: To assess the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. SEARCH METHODS: We searched (3 May 2018, updated 13 August 2019) the Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, PsycINFO, CINAHL, SocINDEX, OSH Update, ClinicalTrials.gov, the WHO trials portal, and also reference lists of included studies and selected reviews. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. The primary outcome was re-employment reported as the number or percentage of participants who obtained employment. Our secondary outcomes were health and work ability. DATA COLLECTION AND ANALYSIS: Two authors independently screened studies, extracted outcome data, and assessed risk of bias. We pooled study results with random-effect models and reported risk ratios (RRs) with 95% confidence intervals (CIs) and assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS: We included 15 randomised controlled trials (16 interventions) with a total of 6397 unemployed participants. Eight studies evaluated therapeutic interventions such as cognitive behavioural therapy, physical exercise, and health-related advice and counselling and, in seven studies, interventions were combined using therapeutic methods and job-search training. Therapeutic interventions Therapeutic interventions compared to no intervention may increase employment at an average of 11 months follow-up but the evidence is very uncertain (RR = 1.41, 95% CI 1.07 to 1.87, n = 1142, 8 studies with 9 interventions, I² = 52%, very low-quality evidence). There is probably no difference in the effects of therapeutic interventions compared to no intervention on mental health (SMD 0.12, 95% CI -0.06 to 0.29, n = 530, 2 studies, low-quality evidence) and on general health (SMD 0.19, 95% CI -0.04 to 0.41, n = 318, 1 study, moderate-quality evidence). Combined interventions Combined interventions probably increase employment slightly compared to no intervention at an average of 10 months follow-up (RR 1.12, 95% CI 1.06 to 1.20, n = 4101, 6 studies, I² = 7%). There were no studies that measured work-ability, adverse events, or cost-effectiveness. AUTHORS' CONCLUSIONS: Interventions combining therapeutic methods and job-search training probably have a small beneficial effect in increasing employment. Therapeutic interventions may have an effect on re-employment, but we are very uncertain. Therapeutic interventions may not improve health in unemployed job seekers. Large high-quality RCTs targeting short-term or long-term unemployed people are needed to increase the quality of the evidence. A cost-effectiveness assessment is needed of the small beneficial effects.

Improving employment opportunities of the unemployed by health and work ability promotion in Finland.

The study explored the impact of self-rated health (SRH) and work ability on employment, and examined the effects of meaningfulness, social networks and physical activity on health and work ability with a population-based cross-sectional survey data (n = 12 729) of full-time employed and unemployed workers. SRH, perceived work ability and levels of perceived meaningfulness, social networks and physical activity were all significantly better among employed workers compared to unemployed people. The results showed that work ability mediated the effect of health on employment and predicted employment. Meaningfulness, social networks and physical activity had direct positive effects on health and work ability, and also on employment. The results indicated that good health is a substantial element of good work ability, which in turn is needed to maintain or to get a job. Our findings suggested that perceiving one's life as meaningful, having a strong social network and being physically active are important predictors of good health as well as of good work ability. These could be contributing factors to re-employment among unemployed people.

Digital Learning Interventions in Higher Education: A Scoping Review.

This scoping review was undertaken to synthesize and describe research related to digital learning interventions in higher education, focusing on technological outcomes. Five electronic databases were searched, and 86 articles were included in the review. The data related to positive and negative technological outcomes and authors' suggestions were analyzed using inductive content analysis. The articles represented six disciplines across six continents and included quantitative (n = 65), qualitative (n = 3), and mixed-methods (n = 18) intervention studies. For positive technological outcomes, digital formats of learning were considered effective and participatory forms of learning in a majority of the articles. The students appreciated individualized and self-paced learning, and the digital form increased their motivation to learn. Automatized technical solutions that enabled learning and teaching had several advantages, and digital learning was believed to save the resources of students, teachers, and organizations. For negative technological outcomes, the technical difficulties in using the digital devices or platforms were described the most, and a need for resources was identified. Feedback from teachers was considered important from positive and negative viewpoints. Authors' suggestions for future digital teaching and learning as well as related interventions consisted of various activities, resources, environments, and methods.

Health and social care educators' ethical competence.

BACKGROUND AND PURPOSE: Educators' ethical competence is of crucial importance for developing students' ethical thinking. Previous studies describe educators' ethical codes and principles. This article aims to widen the understanding of health- and social care educators' ethical competence in relation to core values and ethos. THEORETICAL BACKGROUND AND KEY CONCEPTS: The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. METHODS: Data material was collected from nine educational units for healthcare and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. ETHICAL CONSIDERATIONS: The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. FINDINGS: The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. CONCLUSION: Educators' personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators' training regarding ethical competence.

Adherence to Treatment of Female Patients With Coronary Heart Disease After a Percutaneous Coronary Intervention.

BACKGROUND: Adherence to treatment is essential to prevent the progression of coronary heart disease (CHD), which is the most common cause of death among women. Coronary heart disease in women has special characteristics: the conventional risk factors are more harmful to women than men, accumulation of risk factors is common, and women have nontraditional risk factors such as gestational diabetes and preeclampsia. In addition, worse outcomes, higher incidence of death, and complications after percutaneous coronary intervention have been reported more often among females than among male patients. OBJECTIVE: The aim of this study was to test a model of adherence to treatment among female patients with CHD after a percutaneous coronary intervention. METHODS: A cross-sectional, descriptive, and explanatory survey was conducted in 2013 with 416 patients with CHD, of which the 102 female patients were included in this substudy. Self-reported instruments were used to assess female patient adherence to treatment. Data were analyzed using descriptive statistics and a structural equation model. RESULTS: Motivation was the strongest predictor for female patients' perceived adherence to treatment. Informational support, physician support, perceived health, and physical activity were indirectly, but significantly, associated with perceived adherence to treatment via motivation. Furthermore, physical activity was positively associated with perceived health, whereas anxiety and depression were negatively associated with it. CONCLUSIONS: Secondary prevention programs and patient education have to take into account individual or unique differences. It is important to pay attention to issues that are known to contribute to motivation rather than to reply on education alone to improve adherence.

Return-to-Work Coordinators' Practices for Workers with Burnout.

Introduction Return-to-work (RTW) coordinators facilitate RTW of workers with work disabilities. However, little is known about RTW coordinators' practices for workers with burnout. The aims of this study were to describe RTW coordinators' activities in supporting workers with burnout during the RTW process, and their experiences with factors influencing the support. Methods Interviews and essay assignments were conducted with 15 RTW coordinators employed in universities and central hospitals in Finland. Data were analyzed using qualitative content analysis. Results RTW coordinators were involved in the RTW process during early intervention, off-work, and work resumption phases. Seven groups of activities were identified: monitoring staff well-being; initiating RTW process; planning RTW; providing tools to support recovery; monitoring progress of the RTW process; supporting re-engagement with work; and monitoring coping with work. RTW coordinators' activities depended on their institutional positions. Factors influencing the support included common understanding about burnout syndrome: co-occurring illnesses, dimensions of burnout, unpredictability of the recovery, personality characteristics, private life psychosocial factors, conflicts within the work community, and openness about burnout and its causes. Conclusions Complexity of the burnout problem challenges the support from the RTW coordinators. Understanding the causes and the consequences of burnout is important for the RTW coordinators to provide adequate and timely support for the workers with burnout in collaboration with the other stakeholders involved in the RTW process. Burnout-, individual-, and work-related factors should be considered in the RTW coordination to prevent and to reduce the negative consequences of burnout.

Good work ability among unemployed individuals: Association of sociodemographic, work-related and well-being factors.

AIMS: The aims of this study were to describe the perceived work ability of unemployed individuals and to explore the association between perceived good work ability and sociodemographic, work-related and well-being factors. METHODS: The data were derived from the Finnish Regional Health and Well-being Study (ATH) collected by postal and Internet-based questionnaires in 2014-2015. The random sample was selected from the Finnish National Population Register. The present study includes data from unemployed or laid-off respondents ( n=1975) aged 20-65 years. Logistic regression was used in the statistical analysis. Perceived work ability was measured with the Work Ability Score. RESULTS: Factors significantly associated with good work ability were having young children living in the household, short-term unemployment, low or moderate physical strain in most recent job, moderate mental strain in most recent job, satisfaction with most recent job, good self-rated health and good quality of life. Good self-rated health (odds ratio=10.53, 95% confidence interval 5.90-18.80) was the most substantial factor in the multivariate model. CONCLUSIONS: The findings provide further evidence on the factors related to good work ability of the unemployed. These factors should be considered when designing interventions for promoting work ability and to minimise the harmful effects of long-term unemployment.

Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention.

AIMS AND OBJECTIVES: To identify the predictors of adherence in patients with coronary heart disease after a percutaneous coronary intervention. BACKGROUND: Adherence is a key factor in preventing the progression of coronary heart disease. DESIGN: An analytical multihospital survey study. METHODS: A survey of 416 postpercutaneous coronary intervention patients was conducted in 2013, using the Adherence of People with Chronic Disease Instrument. The instrument consists of 37 items measuring adherence and 18 items comprising sociodemographic, health behavioural and disease-specific factors. Adherence consisted of two mean sum variables: adherence to medication and a healthy lifestyle. Based on earlier studies, nine mean sum variables known to explain adherence were responsibility, cooperation, support from next of kin, sense of normality, motivation, results of care, support from nurses and physicians, and fear of complications. Frequencies and percentages were used to describe the data, cross-tabulation to find statistically significant background variables and multivariate logistic regression to confirm standardised predictors of adherence. RESULTS: Patients reported good adherence. However, there was inconsistency between adherence to a healthy lifestyle and health behaviours. Gender, close personal relationship, length of education, physical activity, vegetable and alcohol consumption, LDL cholesterol and duration of coronary heart disease without previous percutaneous coronary intervention were predictors of adherence. CONCLUSIONS: The predictive factors known to explain adherence to treatment were male gender, close personal relationship, longer education, lower LDL cholesterol and longer duration of coronary heart disease without previous percutaneous coronary intervention. RELEVANCE TO CLINICAL PRACTICE: Because a healthy lifestyle predicted factors known to explain adherence, these issues should be emphasised particularly for female patients not in a close personal relationship, with low education and a shorter coronary heart disease duration with previous coronary intervention.

Association between good work ability and health behaviours among unemployed: A cross-sectional survey.

BACKGROUND: There has been relatively little research on the possible factors promoting good work ability among unemployed people. Consequently, the role of health behaviours in good work ability among the unemployed is unknown. PURPOSE: To explore the work ability and health behaviours of unemployed people through sociodemographic factors and examine the association between good work ability and health behaviours. DESIGN: A cross-sectional survey. METHODS: The study is based on the Finnish nationwide Regional Health and Well-being Study using mailed and online questionnaires in 2014-2015. A total of 1973 unemployed or laid-off people between the ages of 20 and 65 responded to the survey. The associations of work ability with sociodemographic factors - gender, age, marital status, minors (i.e. under-18s) living in the household, education, living environment, and duration of unemployment - and health behaviours with sociodemographic factors were first explored using cross-tabulations. Health behaviours included body mass index, daily smoking, alcohol consumption, vegetable consumption, health promotion groups, physical exercise, and sitting in one's leisure time. Health behaviours were then examined using logistic regression analyses, in association with good work ability; the latter was measured with the Work Ability Score. RESULTS: Being aged below 45, being married or cohabiting, having a high level of education, and short-term unemployment were associated with good work ability. A quarter of participants were daily smokers. A proportion of women with risk level alcohol use (79%) was higher than that of men (59.9%). A third of unemployed people participated in high-intensity physical activity. In regression analyses, high-intensity physical activity (OR 2.25, 95% CI 1.06-4.78) was associated with good work ability. CONCLUSIONS: Unemployed women and men widely exhibited unhealthy behaviours such as daily smoking and a risk level use of alcohol. Health promotion actions for enhancing a healthy lifestyle and good work ability among unemployed people, particularly in emphasizing the importance of physical activity, are highly recommended.

Perceived social support following percutaneous coronary intervention is a crucial factor in patients with coronary heart disease.

AIMS AND OBJECTIVES: To describe perceived social support among patients with coronary heart disease following percutaneous coronary intervention. BACKGROUND: A low level of social support is considered a risk factor for coronary heart disease in healthy individuals and reduces the likelihood that people diagnosed with coronary heart disease will have a good prognosis. DESIGN: A descriptive cross-sectional study. METHODS: A survey of 416 patients was conducted in 2013. A self-report instrument, Social Support of People with Coronary Heart Disease, was used. The instrument comprises three dimensions of social support: informational, emotional, functional supports and 16 background variables. Data were analysed using descriptive statistics, factor analysis, mean sum variables and multivariate logistic regression. RESULTS: Perceived informational support was primarily high, but respondents' risk factors were not at the target level. The weakest items of informational support were advice on physical activity, continuum of care and rehabilitation. Regarding the items of emotional support, support from other cardiac patients was the weakest. The weakest item of functional support was respondents' sense of the healthcare professionals' care of patients coping with their disease. Background variables associated with perceived social support were gender, marital status, level of formal education, profession, physical activity, duration of coronary heart disease and previous myocardial infarction. CONCLUSIONS: Healthcare professionals should pay extra attention to women, single patients, physically inactive patients, those demonstrating a lower level of education, those with a longer duration of CHD, and respondents without previous acute myocardial infarction. Continuum of care and counselling are important to ensure especially among them. RELEVANCE TO CLINICAL PRACTICE: This study provides evidence that healthcare professionals should be more aware of the individual needs for social support among patients with coronary heart disease after percutaneous coronary intervention.

Motivation is a crucial factor for adherence to a healthy lifestyle among people with coronary heart disease after percutaneous coronary intervention.

AIM: To test the Theory of Adherence of People with Chronic Disease with regard to adherence to treatment among patients with coronary heart disease after a percutaneous coronary intervention. BACKGROUND: Increased knowledge of the concept of adherence is needed for the development of nursing interventions and nursing guidelines for patients with coronary heart disease. DESIGN: A cross-sectional, multi-centre study. METHODS: This study was conducted from February-December 2013 with 416 patients with coronary heart disease 4 months after undergoing a percutaneous coronary intervention. A self-reported questionnaire was used to assess their adherence to treatment. Data were analysed using structural equation modelling. RESULTS: The theory explained 45% of the adherence to a healthy lifestyle and 7% of the adherence to medication. Structural equation modelling confirmed that motivation and results of care had the highest association with adherence to a healthy lifestyle. Responsibility was associated with adherence to medication. Support from next of kin, support from nurses and physicians, and motivation, co-operation, fear of complications and a sense of normality were associated with adherence. CONCLUSION: Patients who are motivated to perform self-care and consider the results of care to be important were more likely to adhere to a healthy lifestyle. Responsible patients were more likely to adhere to their medication. It is important to account for these elements as a part of secondary prevention strategies among patients with coronary heart disease after a percutaneous coronary intervention.

Occupational well-being among health and social care educators: Structural equation modelling.

This study tested whether empirical data about health and social care educators' occupational well-being would fit the proposed Content Model for the Promotion of the School Community Staff's Occupational Well-being. Descriptive, cross-sectional survey was conducted with 552 health and social care educators in 2020. Results confirmed that the four-aspect Content Model for the Promotion of School Community Staff's Occupational Well-being is suitable for promoting health and social care educators' occupational well-being, with some modifications. The results strengthen the view of occupational well-being as a wide-ranging phenomenon, the development of which should take into account four aspects of promoting occupational well-being.

An Instrument to Assess the Digital Competence of Nurse Educators.

BACKGROUND: The Educators and Educator Candidates' Competence in Digital Pedagogy instrument needed to be tested before using it in nursing education. PURPOSE: This study describes the further testing of this instrument to measure nurse educators' digital competence. METHODS: The study is reported according to the 7 steps of the MEASURE Approach. Psychometric testing was conducted with a sample of 111 Finnish nurse educators from 9 universities of applied sciences. The study was conducted during the years 2020 and 2023. RESULTS: The exploratory factor analysis results explained 56% of the variance with 3 factors, including 20 items. The factors were labeled to describe the nurse educators' digital competence: implementing appropriate independent and community learning, acting safely and responsibly, and guiding learning based on the evidence. Cronbach α and McDonald ω coefficients showed good reliability. CONCLUSIONS: The instrument can be used to assess digital competence and identify the development needs to facilitate educators' continuous professional development.

An intervention to address nurse educators' occupational well-being: A process evaluation.

BACKGROUND: There is a global need for more support for the occupational well-being of educators working in nurse education, where nurse educators experience challenges when managing their own occupational well-being. However, there is a lack of research studies into occupational well-being interventions. Aim To evaluate the usability and utility of the Self-Help INtervention for Educators in nurse education. DESIGN: A process evaluation was conducted after the intervention in Spring 2022. SETTINGS: Educational organisations providing national regulated practical nurse education in Finland. PARTICIPANTS: Nurse educators (n = 37), completing the 8-workweek intervention. METHODS: Data were collected with the self-reported electronic feedback questionnaire consisting of three sections: 1) 10-item System Usability Scale, 2) 7-item Utility scale developed for this study and 3) 4 open ended questions. The data were analysed statistically and with content analysis. RESULTS: The intervention was found to be usable; especially the easy learnability and usage of the digital Smart Break-SHINE program and the applicable exercises. It was estimated to be moderately useful as a well-being and break promoter at work. The utility of the intervention to promote physical activity and recovery during working hours was statistically more positive for educators with <5 years of work experience than those with over 15 years. Usability and utility barriers were found especially regarding workload issues. CONCLUSIONS: The Self-Help INtervention for Educators supports the occupational well-being of nurse educators and includes well-being actions suitable for different work surroundings (e.g., remote working) without the need for constant facilitating. The intervention was found to be most beneficial for early career nurse educators. The Self-Help INtervention for Educators needs more development to overcome the usability and utility barriers related to workload issues.

Effectiveness of an Occupational Well-being Intervention Among Nurse Educators: A Quasi-Experimental Study.

BACKGROUND: Occupational well-being supports the retention of the nurse educator workforce and their ability to manage workload. There is a research gap regarding interventions promoting occupational well-being. PURPOSE: To evaluate the effectiveness of an 8-workweek digital occupational well-being intervention using self-conducted exercises among nurse educators in secondary vocational nursing schools in Finland. METHODS: A quasi-experimental study design was applied using an intervention group (n = 37) and a control group (n = 40). Data were collected at baseline, post, and 1-month follow-up using a questionnaire and a heart rate sensor to assess the resource-workload-balance and its associating and promoting factors. RESULTS: This study found no statistical effects on the resource-workload-balance. Positive effects were found on associating factors (general well-being) and promoting factors (recovery experiences and self-regulation). CONCLUSIONS: Self-Help INtervention for Educators (SHINE) has the potential to promote recovery experiences during working hours; however, the intervention needs more investigation.

Professional competence, personal occupational well-being, and mental workload of nurse educators - A cross-sectional study in four European countries.

BACKGROUND: Nurse educators need a high level of professional competence to educate future health care professionals. Professional competence supports occupational well-being whilst high mental workload can undermine it. There is little existing research into nurse educators' professional competence, occupational well-being, mental workload, and the relationships between them, particularly in the European context. OBJECTIVES: To describe the professional competence, personal occupational well-being, and mental workload of nurse educators in four European countries, and to explore how the professional competence and mental workload of nurse educators relate to their personal occupational well-being. DESIGN: Cross-sectional study design with quantitative survey data. SETTING: Nurse educators from Finland, Spain, Slovakia, and Malta. METHODS: The data were collected from 302 nurse educators through an online questionnaire which used the Health and Social Care Educator's Competence (HeSoEduCo) instrument. This contains 43 items which measure areas of professional competence. Statistical analysis involved descriptive and multivariate analysis. RESULTS: Nurse educators self-assessed their overall professional competence as high. Competence in evidence-based practice was assessed as the highest whilst cultural competence was perceived to be the lowest of the six competence areas. Nurse educators perceived their levels of personal occupational well-being and the balance of mental workload as moderate. However, these levels varied between the four countries. Professional competence, more specifically administrative and curriculum competence, and a balanced mental workload were positively related to personal occupational well-being. CONCLUSIONS: The educators who perceive themselves to have very good professional competence and a balanced mental workload are more likely to report high occupational well-being. The findings suggest that nurse educators' cultural competence needs to be strengthened and intervention research is needed to determine ways of reducing mental workload and increasing the occupational well-being of nurse educators.