Nurs. Rep., Volume 11, Issue 4 (December 2021) – 22 articles

Patient safety incidents (PSIs) prevention is important in healthcare because PSIs affect patients negatively and increase medical costs and resource use. However, PSI knowledge in homecare is limited. To analyze patient safety issues and strategies, we aimed to identify the characteristics and contexts of PSI occurrences in homecare settings. A prospective observational study was conducted between July and November 2017 at 27 Japanese homecare nurse (HCN) agencies. HCNs at each agency voluntarily completed PSI reports indicating whether they contributed to PSIs or were informed of a PSI by the client/informal caregiver/other care provider during a period of three months. A total of 139 PSIs were analyzed, with the most common being falls (43.9%), followed by medication errors (25.2%). Among the PSIs reported to the HCN agencies, 44 were recorded on formal incident report forms, whereas 95 were reported as PSIs that required a response (e.g., injury care) but were not recorded on formal incident report forms. Most PSIs that occurred when no HCN was visiting were not recorded as incident reports (82.1%). Developing a framework/system that can accumulate, analyze, and share information on PSIs that occur in the absence of HCNs may provide insights into PSIs experienced by HCN clients. Full article

(1) Background: Self-reported measures play a crucial role in research, clinical practice, and health assessment. Instruments used to assess life satisfaction need validation to ensure that they measure what they are intended to detect true variations over time. An adapted instrument measuring life satisfaction for use among Ethiopian elders was lacking; therefore, this study aimed to culturally adapt and evaluate the psychometric properties of the Life Satisfaction Index for the Third Age—Short Form (LSITA-SF12) in Ethiopia. (2) Methods: Elderly people (n = 130) in Metropolitan cities of northwestern Ethiopia answered the LSITA-SF12 in the Amharic language. Selected reliability and validity tests were examined. (3) Result: The scale had an acceptable limit of content validity index, internal consistency, test-retest, inter-rater reliabilities, and concurrent and discriminant validities. (4) Conclusion: The Amharic language version of LSITA-SF12 appeared to be valid and reliable measures and can be recommended for use in research and clinical purposes among Amharic-speaking Ethiopian elders. Full article

Knowledge hiding—an intentional attempt to withhold or conceal knowledge from others—has been reported by recent studies to be a negative phenomenon in the workplace. Considering the importance of knowledge for organizational performance, this study intends to advance understanding by investigating the mediating role of knowledge hiding on the relationship between perceived organizational support and affective commitment as predictors and organizational citizenship behaviors and turnover intentions as outcomes. Using a cross-sectional design, the study was conducted in emergency ambulance healthcare settings on 305 medical or paramedical professionals. As indicated by structural equation modeling results, perceived organizational support and affective commitment positively predicted organizational citizenship behaviors but negatively predicted turnover intentions. Also, knowledge hiding was negatively associated with perceived organizational support, affective commitment, and organizational citizenship behaviors and positively with turnover intentions. Moreover, knowledge hiding mediated the relationship between perceived organizational support and affective commitment as predictors and organizational citizenship behaviors, respectively turnover intentions, as dependent variables. Full article

Given its importance to psychological issues, the COVID-19 pandemic has created numerous challenges for all individuals, but healthcare professionals and particularly nursing staff are at front lines, and their performance is significantly affected. The current study relates COVID-19 fear with psychological strain, i.e., stress amongst the nursing staff. Moreover, the intervening role of COVID-19 stress between COVID-19 fear and the performance of the nursing staff has also been tested. An online survey was conducted to collect data from nurses. A total of 471 responses of nurses were received during the process of online data collection from 16 November 2020 to 30 April 2021. Results revealed the significant effect of COVID-19 fear on COVID-19 stress and the performance of nurses. Additionally, the results substantiate that COVID-19 stress mediates between COVID-19 fear and the health care performance of nurses. COVID-19 fear has become a psychological consequence that increases stress among nursing staffs. This study fills the research gap about the performance of the health care sectors, particularly with respect to COVID-19 fear and COVID-19 stress among nurses. Hence, COVID-19 fear plays a significant role in COVID-19 stress in terms of influencing the health care performance of nurses. Overall, the results give pragmatic insights for the consequences of the COVID-19 pandemic. Full article

Our objective is to critically review the literature addressing the strategic role of nurses in the daily primary care of arterial hypertension in Indigenous communities in Brazil. We selected studies based on an initial keyword search of major bibliographic indexing databases for the years 2000 to 2020 and manual search. Further selection was based on topical, methodological, and thematic relevance, as well as evaluation of scholarship quality and pertinence to our chosen narrative. The literature demonstrates Indigenous peoples do not receive health services that measure up to national standards in large part due to a marked lack of academic and employer preparation for nurses operating in transcultural settings. Inequities were apparent in recurrent reports of victim-blaming, deficient clinical communication with patients, clinical malpractice, devaluation of hypertension as a problem for Indigenous peoples, insufficient intercultural training for nurses, and discrimination against Indigenous students in nursing education programs. This systemic problem needs to be addressed by universities and the Indigenous Health Care Subsystem in Brazil. Full article

(1) Background: Malnutrition in hospitalized patients is prevalent worldwide, but the severity of the issue is often underestimated by practitioners. The purpose of this study is to investigate the prevalence of malnutrition and inadequate eating behaviour in a geriatric sample. (2) Methods: Two hospitals participated with six wards on nutritionDay in 2017, 2018 and 2019. Nutritional status, food intake, and nutritional interventions were analyzed for all patients ≥ 65 years (n = 156), using the official nutritionDay questionnaires. Malnutrition risk is identified by Malnutrition Universal Screening Tool (MUST), malnutrition by the ESPEN criteria (European Society of Clinical Nutrition and Metabolism). (3) Results: According to MUST (n = 136) 16.9% (n = 23) were at medium risk of malnutrition, 33.8% (n = 46) at high risk of malnutrition, 28.1% (n = 38) were malnourished. Overall, 62.8% (n = 98) showed an inadequate eating behaviour during hospital stay. Moreover, patients with inadequate nutrition had significantly worse self-reported health statuses (p = 0.001; r = −0.276), were less able to walk on nutritionDay (p = 0.002; r = −0.255), had eaten little in the week before admission to hospital (p < 0.001; r = −0.313), and had an increased length of stay (p = 0.036; r = −0.174). (4) Conclusion: To identify malnourished patients is a significant barrier for practitioners seeking to administer specific, tailored interventions. Malnutrition screening protocols must be improved, just as nutrition monitoring in general. Full article

Background: The postpartum period is often portrayed as a blissful, calm and loving time when mothers, partners and family members bond with their newborn babies. However, this time may be experienced quite differently when mothers are monitored by Child Protection Services. Having a baby under these circumstances can be very difficult and traumatizing. While all new parents require support and information to help them through the transition to parenthood and address physical and psycho-social changes, mothers who are involved with Child Protection Services require more specialized support as they encounter higher incidences of postpartum stressors and higher rates of poverty, mental illness and substance abuse. The impact of support for mothers involved with Child Protection Services is not well-understood from the perspective of mothers. Aim: The aim of the study was to understand how new mothers in Nova Scotia prioritized their postpartum needs and where they went to obtain information and support. Methods: Feminist poststructuralism was the methodology used to understand how the experiences of five mothers who accessed a family resource center and had been involved with Child Protection Services in Nova Scotia Canada had been personally, socially and institutionally constructed. Results: Themes include: (1) We are Mothers, (2) Being Red Flagged, (3) Lack of Trust, (4) Us Against Them and (5) Searching for Supportive Relationships. Conclusion: Personal stories from all participants demonstrated how they experienced stigma and stereotypes from healthcare workers and were often not recognized as mothers. They also struggled to find information, supports and services to help them keep or regain their babies. Full article

Sixty-four percent of adults in America drink coffee daily, and caffeine is the main reason people tend to drink coffee habitually. Few studies have examined the association between caffeine and all-cause and cause-specific mortality. The objective of this study was to examine the association between caffeine and all-cause and cause-specific mortality using the National Health and Nutrition Examination Survey (NHANES) 1999–2014 database. The multivariate Cox proportional hazards regression model was used to examine 23,878 individuals 20 years and older. Daily caffeine intake was measured once at baseline. A total of 2206 deaths occurred, including 394 cardiovascular (CVD) deaths and 525 cancer deaths. Compared to those with a caffeine intake of <100 mg/day, the hazard ratios (HRs) for CVD mortality were significantly lower in the participants with a caffeine intake of 100–200 mg/day (HR, 0.63; 95% confidence interval [CI], 0.45–0.88), and those with a caffeine intake of >200 mg/day (HR, 0.67; 95% CI, 0.50–0.88) after adjusting for potential confounders. The HRs for all-cause mortality were significantly lower in the participants with a caffeine intake of 100–200 mg/day (HR, 0.78; 95% CI, 0.67–0.91), and those with a caffeine intake of >200 mg/day (HR, 0.68; 95% CI, 0.60–0.78). Subgroup analyses showed that caffeine may have different effects on all-cause mortality among different age and body mass index (BMI) groups. In conclusion, higher caffeine intake was associated with lower all-cause and CVD mortality. Full article

Previous research on the fears and anxieties of expectant mothers has focused mostly on their fears about giving birth rather than parenting. This study aims to describe mothers’ fears and concerns about parenthood during pregnancy and to examine the similarities and differences in the perspectives of primiparous and multiparous mothers. The qualitative research for this study was conducted in three postpartum units in Finland and focused on the responses to an open-ended question about parenting fears and concerns that was part of a questionnaire given to 250 mothers after they had given birth. The responses from the 128 mothers who answered this question were subject to inductive content analysis. Fears and concerns on parenthood included worries about coping with the future and everyday life with their new baby, the psychological burden of parenthood, their maternal resources and self-efficacy, meeting their baby’s needs, their baby’s health, concerns about their relationship with their partner and financial issues. Primiparous and multiparous mothers shared many of the same concerns, but some differences emerged. The findings contribute an interesting perspective to the social debate about declining birth rates and their psychosocial causes. Further studies are needed to examine the fears and concerns of younger adults, and even teens, about parenthood. Full article

The lack of gender diversity in the nursing profession has long been recognized as a cause for concern. Female nurses in many practice settings across nations continue to outnumber their male counterparts. Male nursing students may have perceived differences in the way they are treated in clinical practice; however, limited studies have been conducted to determine the unique perspectives of these students in terms of gender bias in their clinical learning. To address this knowledge gap, this study employed a qualitative descriptive approach to explore the experiences of male nursing students in clinical learning in an Asian context. Specifically, we examined the insights emerging from the thoughts and feelings of male nursing students from interactions with their clinical mentors, patients, and peers in their encounters during their clinical placement. From November 2019 to July 2020, data were collected through semi-structured interviews from 22 male participants aged 21–30 years (mean age: 22.7), enrolled in a prelicensure Bachelor of Nursing (honors) program in Hong Kong. Four themes emerged after a qualitative content analysis: (1) while the School of Nursing welcomes men, clinical settings are another story due to pragmatic considerations; (2) you are welcomed because you may be seen as a helper with greater physical strength; (3) male nursing students feel alienated in the obstetrics and gynecology practicum; (4) more male role models are desired in the clinical setting. Our findings indicate the need to promote gender awareness among faculty and clinical mentors, understand the factors hindering and facilitating the clinical practicum for male nursing students, improve the male nursing experience during the maternity practicum, and ensure access to more male role models to boost role socialization and learning. Full article

Background: While the global maternal mortality ratio (MMR) shows a decreasing trend, there is room for improvement. Midwifery education has been under scrutiny to ensure that graduates acquire knowledge and skills relevant to the local context. Objective: To review the basic professional midwifery qualification and pre-practice requirements in countries with lower MMR compared with Malaysia. Methods: A rapid review of country-specific Ministry of Health and Midwifery Association websites and Advanced Google using standardised key words. English-language documents reporting the qualifications of midwives or other requirements to practise midwifery from countries with a lower MMR than Malaysia were included. Results: Sixty-three documents from 35 countries were included. The minimum qualification required to become a midwife was a bachelor’s degree. Most countries require registration or licensing to practise, and 35.5% have implemented preregistration national midwifery examinations. In addition, 13 countries require midwives to have nursing backgrounds. Conclusion: In countries achieving better maternal outcomes than Malaysia, midwifes often have a degree or higher qualification. As such, there is a need to reinvestigate and revise the midwifery qualification requirements in Malaysia. Full article

This cross-sectional survey study examined the relationship between Canadian nurses’ work environment characteristics, emotional intelligence, compassion fatigue and compassion satisfaction (n = 1271). Psychological demands, decision latitude, supervisor and coworker support, and emotional intelligence (EI) were significantly correlated with nurses’ compassion satisfaction and compassion fatigue, except for two EI subscales. Furthermore, these relationships were stronger for compassion satisfaction than compassion fatigue, suggesting that they are influenced by different factors. Our results highlight the importance of creating reasonable psychological demands, empowering nurses to make decisions in their jobs, supportive relationships at work, and fostering the development of nurses’ EI. Full article

Background: Nursing is considered to be a primarily female profession, particularly in Saudi Arabia, despite the fact that male nurses have contributed to the advancement of the nursing profession in various specialties, such as military nursing, mental health, and critical care. Purpose: We explore the factors influencing Saudi male nursing interns to study within the nursing profession in Saudi Arabia. Methods: A descriptive qualitative study was conducted. A convenience sample of 12 Saudi male nursing interns from different nursing colleges were recruited, alongside four hospital internship coordinators. The data were collected by conducting two semi-structured focus group interviews and four individual interviews. All the interviews were analyzed using a comparative analytical approach. Results: Role models and the role of the internship year were identified as factors influencing Saudi male nurses’ decision to study nursing. However, hospital placements, cultural preferences, and the preferences of patients and their families for female nurses were the key challenges encountered. Importantly, this study demonstrated that social media plays a critical role in raising awareness regarding the importance of Saudi male nurses. Conclusion: Awareness needs to be raised of the nursing profession as a gender-diverse field through volunteering programs for the community. It is recommended that Saudi male nurses act as role models for students in the Academic Orientation Forum and on social media. Full article

The percentage of women working regular nightshift work has increased in the past decade. While nightshift work has the potential to exert adverse effects on dietary habits, little is known about the impact of a parent working nightshifts on dietary habits in the family. We analysed energy intake, meal timing, and diet quality among dependent children and male partners of 20 female UK National Health Service (NHS) nurses working rotational nightshifts. Comparing nightshift against non-nightshift conditions, we hypothesised that maternal nightshift work would affect the evening energy intake, diet quality and time of eating of dependent children and adult partners. Primary outcomes were absolute energy intake and the proportion of daily energy intake consumed in the evening (16:00–23:59 h). Our results show that in pre-teen children aged 8–12 years (n = 13, mean ± SD, 9.9 ± 1.6 yrs; 9 males), the proportion of total daily energy intake consumed during periods of nightshift work was significantly greater compared to periods of non-nightshifts (45.7% ± 8.8% vs. 39.7% ± 7.0%, mean ± SD, p = 0.012). There was no effect of nightshift work on dietary habits in teenage children or partners. The finding of a greater proportion of daily energy consumed in the evening period in pre-teen children is noteworthy, as it suggests that pre-teen children more dependent than older teenage children may be more vulnerable to disruptions to dietary patterns associated with maternal nightshift work. Full article

This study aimed to investigate subjective health and its associations with perceived body image (body appearance and body functioning), physical activity, perceived wellbeing in school, perceived family financial situation, and body mass index among 13- to 15-year-old boys and girls. The study was a cross-sectional study performed in four municipalities in Southern Sweden. Data were obtained from questionnaires completed by adolescents (median age 14; range: 13–15) in Sweden (n = 1518, 51% girls), with a participation rate of 73%. Body weight and body height were measured by school nurses and body mass index was calculated. Logistic regression analyses were carried out with subjective health as the dependent variable. Independent variables included in the model were perceived wellbeing in school, perceived family financial situation, perceived body image, physical activity, body mass index, sex, and residency. Variables significantly associated with good subjective health were good wellbeing in school, a perceived good family financial situation, perceived positive body appearance, perceived positive body functioning, being a boy, and high physical activity. Residency and body mass index were not associated with subjective health. Good subjective health is associated with good wellbeing in school, good family financial situation, positive body image, and high physical activity levels. The results highlight the importance of good school climates, the promotion of positive body image, and increased physical activity for adolescents. Full article

The COVID-19 pandemic has increased the demand and workload on nurses. In addition, the number of critical cases, the uncertainty about the disease, and the incidence rate of death from the disease impose a psychological stress on nurses. Considering the alarming issues of stress, burnout, and turnover among nurses even before the pandemic, the pandemic might have amplified such issues. Thus, the impact of the COVID-19 pandemic on nurses’ turnover and turnover intention warrants investigation. The aim of this review is to appraise and integrate the current pre- and post-coronavirus disease (COVID-19) literature on nurse turnover, published between 2016 and 2021. Forty-three studies on nurses’ turnover intention were appraised and synthesized. The reviewed literature suggested that nurses’ turnover intention increased significantly after the COVID-19 pandemic. Post-COVID-19-pandemic studies focused more on predicting nurses’ turnover intention through the pandemic’s negative impact on the nurses’ psychological wellbeing. The findings of this review should be considered by nurse managers and leaders in the development of policies and programs to reduce the negative impact of COVID-19 on nurse retention. Full article

Background: The postpartum or puerperium period is the first 6 weeks after giving birth to an infant. The postpartum period can have negative implications, especially in first-time mothers. With their transition into motherhood, new mothers adopt new lifestyles, which can affect their physical wellbeing. Childbirth has physical, psychological, and emotional effects on women as they try to adapt to their new roles in order to get through this period with no or minimal health issues. Study Aim: The current study aims to explore primiparous adaptations with postpartum health issues in Jeddah City at Kingdom of Saudi Arabia. Methods: The research design is quantitative cross-sectional. A structured questionnaire was developed to collect data in relation to depression and weight gain, which consider the most common postpartum health issues. The inclusion criteria of the participants are: primipara, 2 to 6 months postpartum, and living in Jeddah. Results: 140 participants were included in the study. Mothers gained approximately 9.2 kg within the fifth to ninth month after giving birth. Discussion: Postpartum weight retention is a primary challenge in the majority of primiparous mothers and results in reduced quality of life. Nurses were always available to answer questions related to the postpartum health issues and explained the expectations to the family members. Conclusions: Childbirth and the postpartum period for first-time mothers are crucial in their lives as they try to adapt to a new way of life. The postpartum period can have negative implications, especially in first-time mothers. With their transition into motherhood, new mothers adopt new lifestyles, which can affect their physical wellbeing. More research is needed to explore the impact of postpartum health issues in Saudi Arabia. Full article

(1) Background: evidence-based nursing has been widely adopted by healthcare facilitators, and it is predicated on the connection between research evidence and clinical practice. The knowledge and implementation of evidence-based practice (EBP) depend on a variety of long-established barriers and attitudes. The purpose of this study was to translate and validate the Greek version of the evidence-based practice competence questionnaire (EBP-COQ) and test it on a sample of Greek undergraduate nursing students. (2) Methods: a cross-sectional analysis was conducted on data obtained between November 2018 and January 2019. A convenience sample of 320 Greek undergraduate nursing students participated in a survey to examine the psychometric properties of the tool. The reliability and validity of the tool was examined. Cronbach’s coefficient alpha was used to determine the scale’s internal consistency reliability. (3) Results: the EBP-COQ was translated and validated. The estimated Cronbach’s alpha was higher than 0.70 for all scales. Of the participants, 22.5% were men and 77.5% were women, while 31% of them were in their final year of nursing education. A total of 61% of the students stated that they had not participated in an EBP seminar in the past. High Spearman’s correlation coefficients were found for “Knowledge in EBP” with “Personal attitude towards EBP” (rs = 0.329, p < 0.001). (4) Conclusions: the Greek version of the EBP-COQ is a valid instrument that can be used in the Greek population. It provides information about attitude, knowledge and skills in the EBP approach. Full article

Background. Workplace violence (WPV) is a major healthcare problem with important consequences in healthcare areas and may impact negatively not only healthcare workers but also the quality and safety of patient care. Objectives: This an observational online web-based survey using Google^® Modules, specifically aiming to investigate the phenomenon of WPV in Italian healthcare services. Methods. Data collection for this study lasted one month, with the questionnaire available from 1 May 2021 to 31 May 2021. Continuous variables were considered as either mean ± standard deviation (SD) or median and interquartile range (IQR) based on their distribution. Comparison between groups was assessed by unpaired t-test or Mann–Whitney U test according to variable distribution. Categorical variables were analyzed using the chi-squared test. Results. The study population consisted of 203 healthcare workers, represented by nurses (61.6%), medical doctors (16.8%), patient care assistants (4.9%), and others (16.7%). Female gender was associated with a 2.6 times higher risk for the presence of aggression (p = 0.034), and nurse as a job with about 4 times increased risk for the presence of aggression (p = 0.006). The risk for aggression increased by 5% for each year of work experience. Conclusions. WPV is still matter of concern in Italian healthcare services. A strong organizational effort is demanded from healthcare institutions in order prevent internal and external violence in healthcare settings. Full article

The year 2020 was established by the World Health Organization as The Year of the Nurse and Midwife to emphasize the importance of this profession to the healthcare system. Strange but true, nurses around the world celebrated it by being frontline workers during the COVID-19 pandemic. Thus, the phrase “Nursing Now” has become more important than ever. The main aim of this article was to draw attention to the fact that 2020 was the Year of the Nurse and Midwife and, indeed, their role in the fight against the pandemic is difficult overlook. Through the use of available scientific databases, documents and scientific publications related to the subject were collected and analyzed. Nurses are able to fulfill their duties as long as they are properly rewarded and provided not only with support but also better terms and conditions of employment. The investment in nurses should also be treated as an investment in the healthcare system. Full article

Despite the availability of the South African cervical cancer screening guidelines at clinics, women still present in district hospitals of Thulamela Municipality with no cervical cancer screening results. Thus, many cervical cancer screenings done at the hospitals often come back positive for cervical cancer at advanced stages. This study was conducted to investigate the compliance of professional nurses at primary health care facilities (PHCs) in Thulamela Municipality to the South African cervical cancer screening guidelines. The study adopted a qualitative approach. Purposive, non-probability sampling method was used to select PHCs and recruit eligible participants. Sample size was determined by data saturation. A digital recorder was used to log individual responses during interview sessions. Data from the digital recordings were transcribed verbatim. Results were analysed and interpreted in accordance with the consolidated criteria for reporting qualitative research (COREQ) checklist. This study established that clinic professional nurses are non-compliant to the South African cervical cancer screening guidelines owing to several challenges they face, such as inadequate knowledge of the cervical cancer screening guidelines, shortage of resources, shortage of staff and patients’ factors. We recommend a strengthening of the South African cervical cancer screening guideline, in-service trainings and workshops on cervical cancer and cervical cancer screening guideline as well as improvement on patients’ education. Full article