The inaccuracy of nurses' perception of elderly patients' well-being

Abstract

Thirty elderly day hospital patients rated two aspects of their well-being: life-satisfaction and depression. The key-nurse estimated these values for each patient, using the same, validated scales. Patients' ratings of life-satisfaction and depression intercorrelated. as did the nurses' estimates, but the nurses' scores were unrelated to those of the patients. Patients' well-being correlated with their estimates of the time they spent in solitary activity, whereas nurses' estimates correlated with overt engagement and behavioural dependency. It is likely that general nurses' lack of perception of their elderly patients' well-being arises, in part, because their assessments are based on aspects of their patients' overt behaviour which are unrelated to actual well-being.     

Reducing obstacles to the provision of quality diabetic care

Abstract

High quality diabetic care is seen as influenced by the organisation of care, health care workers' involvement in diabetes-specific areas, co-operation among staff members, the availability of resources, and the competence of medical staff (including both physicians and nurses). In a prospective study we have tested a programme for improvements of the quality of diabetes services which combined organisational development and continuing medical education (CME) measures. The study involved 34 primary health care centres over an 18 month period and was based on the responses to questionnaires answered by 123 general practitioners and 247 registered nurses at the 34 PHCCs.

The combined programme had a considerable influence on inter-group co-operation, staff members' perceptions of resources available, and nurses' involvement in diabetic care (54 versus 30% seeing diabetic patients for regular check-ups).

The results show that, in order to diminish obstacles to high quality care, organisation of care as well as care workers' theoretical knowledge has to be focused.     

Patients are not fully human: a nurse's coping response to stress

In this article, dehumanization of patients was studied as a strategy used by nurses to cope with stress. Affective organizational commitment (AOC) and affective commitment to patients (ACP) were tested as moderators. We also explored how nurses' humanity attributions to their in‐group relate to stress symptoms. Participants were nurses working in different wards of an Italian urban hospital. Findings showed that perceiving patients as not fully human was related to lower levels of stress symptoms for nurses with high AOC and ACP, but not for nurses with low AOC and ACP. Moreover, for highly committed nurses, the attribution of uniquely human traits to the in‐group was associated with increased stress symptoms. Implications of findings for the relationship between nurses and patients are discussed.     

Understanding the Ageing Process: A Developmental Perspective of the Psychosocial and Spiritual Dimensions

SUMMARY

This chapter describes a perspective of psychosocial and spiritual development in the later years of life. It outlines a study of nurses conducted in six nursing homes using pre and post workshop tests to identify changes in nurses' assignment of a list of behaviours as psychosocial or spiritual. Use of SPSS found significant changes between the pre and post tests. Pre workshop tests only identified items as spiritual if they included the word God, or Bible. Results from this study highlight the potential role for nurses in aged care to provide spiritual care as part of holistic care. It also highlights the fact that many nurses feel ill prepared for this role.     

Awareness of Hospital Environment and Organizational Commitment

Abstract

This research examined possible differences between physicians and nurses in their commitment to their hospital and the relationship of their organizational commitment to their awareness of both the internal and the external environments of the organization. Data came from a public hospital in India. Questionnaires were developed for the measurement of the two predictor variables (awareness of the organization's internal environment and awareness of the organization's external environment) and the one predicted variable (organizational commitment). The results indicated significant differences in organizational commitment across hierarchies. The nurses' organizational commitment was predicted by their awareness of internal environment; the physicians' organizational commitment was predicted by their awareness of external environment.     

When do multiple dimensions of procedural justice predict agreement to publicly endorse your employer in recruitment advertisements?

This field study linked multiple dimensions of procedural justice to working nurses' (N=198) agreement to permit their names to appear in recruiting advertisements for their employer. Using a longitudinal design, surveys were completed at two different times. After controlling for differences in gender, tenure, job involvement, and distributive justice; nurses who perceived higher procedural justice of work schedules and work assignments were more likely to permit their names to appear in recruitment advertisements. Unlike prior research that found high procedural justice offset the negative impact of low distributive justice, in this study high procedural justice interacted with high distributive justice to produce a positive organizational citizenship behaviour.     

The mediating role of work locus of control on the relationship among emotional intelligence,organisational citizenship behaviours,and mental health among nurses

Using a cross‐sectional design to evaluate the perceptions of 242 nurses working in a Malaysian hospital, this study investigates the mediating role of work locus of control (WLOC) on the relationship among emotional intelligence (EI), organisational citizenship behaviours (OCBs), and mental health among nurses. Additionally, the role of EI is examined. Findings indicate that EI correlates positively with OCBs and negatively with mental health and that WLOC mediates the relationship between EI and OCBs. However, WLOC does not mediate the relationship between EI and mental health. An in‐depth understanding of nurses' EI provides insights into health institution management to increase organisational outcomes. Results of this study are interpreted to indicate that EI should be part of nurse training and that OCBs are associated with performance and productivity. It is suggested that EI could also be included in selection processes to encourage growth and development of a health institution.     

The effects of prediction,understanding, and control: A test of the stress antidote model

Abstract

A study was undertaken to examine further the effects of perceived work control on employee adjustment. On the basis of the stress antidote model, it was proposed that high levels of prediction, understanding, and control of work-related events would have direct, indirect, and interactive effects on levels of employee adjustment. These hypotheses were tested in a short-term longitudinal study of 137 employees of a large retail organization. The stress antidote measures appeared to be indirectly related to employee adjustment, via their effects on perceptions of work stress. There was weak evidence for the proposal that prediction, understanding, and control would buffer the negative effects of work stress. Additional analyses indicated that the observed effects of prediction, understanding, and control were independent of employees' generalized control beliefs. However, there was no support for the proposal that the effects of the stress antidote measures would be dependent on employees' generalized control beliefs.     

Psychiatric nurses' attitudes towards inpatient aggression: preliminary report of the development of attitude towards aggression scale (ATAS)

Professional skills to adequately manage patient aggression are a prerequisite for nurses working in psychiatric hospitals. These ‘technical’ skills, however, are necessary but not sufficient for effective nurse intervention. The attitude of nurses' towards client aggression also contributes to their response to a patient's behaviour. In order to study the domains (types) of attitudes towards aggression, a sample was taken of nurses working in the fields of general psychiatry (n=288), psychiatry for children and adolescents (n=242) and psychogeriatrics (n=88). A cross‐sectional survey design was adopted for the study. The Attitudes Towards Aggression Scale (ATAS) consisting of 32 items is presented, representing three types of attitudes towards aggression: aggression as a ‘harming’ reaction, a ‘normal’ reaction and a ‘functional’ reaction. The strongest predictors of the type of attitude respondents had towards the aggressive behaviour of their clients were (1) field, (2) setting they worked in, (3) gender and (4) type of shifts they predominantly had. Although the measure of domains of nurses' attitudes towards aggression needs further psychometric testing, it can be a useful tool in clinical practice for the assessment of staff attitudes towards aggression. This can support the decision‐making about the management of aggressive behaviour on a ward. Aggr. Behav. 00:1–10, 2005. © 2005 Wiley‐Liss, Inc.     

Adversity quotients,environmental variables and career adaptability in student nurses

The cross-sectional study aimed to investigate the career adaptability and its associated factors among 431 student nurses. Participants completed questionnaires on demographics, career adaptability, adversity quotient, clinical learning environment and social support. Findings revealed that student nurses' adversity quotients, individualized clinical learning environment, and family social support associated positively with their degree of career adaptability, even after multiple adjustments. Additionally, career adaptability scores were higher among associate degree student nurses and those who had served as student leaders. These findings may provide referable evidence for schools and educators to improve student nurses' career adaptability.     

A Longitudinal Study of Nurses’ Work-Life Balance: a Case of a Regional Teaching Hospital in Taiwan

Work-life balance is essential for nurses who are in direct contact with patients in healthcare organizations. This study employs the measurement of nurses’ behaviors rather than the measurement of their perceptions to identify critical demographic variables influencing the work-life balance. A work-life balance dimension measured by a four-point frequency scale from the Chinese version of the Safety Attitudes Questionnaire is used to assess nurses’ behaviors in practice from a longitudinal viewpoint based on a regional teaching hospital in Taiwan. The results show that experience in organization, respondents reporting events in the past 12 months, and experience in position are three critical factors to impact nurses’ work-life balance. Moreover, “work all day without break,” “change the individual or family plan because of the work,” and “work overtime” are the most critical questions in the work-life balance that can be the targets for hospital management to enhance the balance of nurses’ work-life conditions in the hospital.

     

Examining antecedents and outcomes of part‐time working nurses' motives to search and not to search for a full‐time position

Grounded in self‐determination theory, this study sought to examine the antecedents and outcomes of part‐time working nurses' (n = 404) motives for searching and not searching for full‐time employment. After controlling for various background variables, autonomous motivation and economic motivation to search for a full‐time job related positively to job search intensity, controlled motivation to search related negatively to experienced positive experiences of part‐time work, whereas autonomous motivation not to search related negatively to job search intensity and positively to positive experiences from part‐time work. Finally, experienced managerial autonomy support toward part‐time work and negative feedback from colleagues regarding part‐time work were established as contextual antecedents of part‐time nurses' autonomous and controlled motives to search and not to search.     

The Dark Side of Helping: Does Returning the Favor from Coworkers Hurt Employee Work Engagement?

This study investigated the potential "dark side" of helping behavior at work -- operationalized as provision of social support to coworkers. Drawing from the emotional contagion literature and Conservation of Resources (COR) theory, we proposed and tested a moderated mediational model to examine the mechanisms by which social support received from one's coworkers contribute to the support recipient's work engagement. Employing data from a 12-week-long weekly diary among 142 acute care nurses, we did not find support for the proposed negative relationship between providing social support to coworkers and support providers' work engagement, nor for the overall mediational effect of the relationship between received coworker support and work engagement through support provision. However, we found that some work contextual factors (i.e., stable social support climates from coworkers and supervisors) moderated the weekly processes through which nurses' repaying social support received from coworkers predicts their subsequent work engagement. Specifically, providing support to coworkers had stronger beneficial effects on providers' engagement when coworker/supervisor support climates were relatively low; support received from coworkers had stronger indirect beneficial effects on nurses' engagement when coworker/supervisor support climates were relatively low. Our study findings highlight the complexity of the relationship between social support dynamics and work engagement, and that emotional contagion and COR theory may be insufficient, on their own, to explain social support dynamics between coworkers. We also discuss implications of the findings for managerial practices related to support dynamics at work.     

Self-Concept and Moral Reasoning among Batswana Adolescents

Abstract

On the basis of Herzberg, Mausner, and Snyderman's (1959) motivatorhygiene theory, it was hypothesized that intrinsic but not extrinsic work values would be inversely related to stress. Also investigated was the question of which work values provide the most relief from stress. Elementary school teachers and administrators (N = 607) from nine school boards in southern Ontario completed a survey that included Pines, Aronson, and Kafry's (1981) stress scale and Elizur's (1984) work values scale. Almost all of the 12 intrinsic work values investigated were negatively correlated with stress, but the 4 extrinsic work values studied were not consistently related to stress. Five work values explained 11% of the variance in physical stress, 9 work values explained 22% of the variance in emotional stress, and 6 work values explained 26% of the variance in mental stress. Four work values emerged as meaningful predictors of all three types of stress: being esteemed by others, achieving through work, doing meaningful work, and being able to use one's knowledge and abilities.     

Time Limited Treatment and C. G. Jung's Analytical Psychology

Abstract

The work of C. G. Jung has been largely neglected in recent discussions of time-limited psychotherapy. Notwithstanding this state of affairs, this paper argues that much is to be gained from familiarity with Jung's view on treatment. A brief overview of Jung's general system of psychology is presented, and contrasts are drawn to the work of Freud. Several distinctive characteristics of Jung's view of the clinical process are then identified, and a discussion of the course of treatment is provided with a brief reference to a case of Jung's and to the author's experience working with gay men.     

Hospital downsizing,individual resources,and occupational stressors in nurses

Abstract

Restructuring and downsizing are occurring increasingly throughout the workplace. As a result, many individuals are losing their jobs. Many others experience job insecurity as a result of the threat of downsizing. As with most other work spheres, several hospitals are closing, resulting in thousands of layoffs. Since nurses constitute one of the main groups employed in hospitals, they are faced with increasing job shortages. This study examines psychological reactions of nurses in response to stressors resulting from hospital downsizing. Individual resources, particularly coping strategies and self-efficacy, can affect the extent to which individuals experience distress as a result of downsizing. A self-report, anonymous questionnaire was filled out and returned by 1363 nurses employed in hospitals in Canada. Results of this study show that amount of work was a consistent and significant stressor in nurses. The greater the nurse's workload, the greater her emotional exhaustion, cynicism, depression and anxiety. Further results reported here indicated that control coping and self-efficacy lessened distress on the job and increased job satisfaction, while escape coping was associated with greater psychological distress and less job security.     

Effects of guided imagery with relaxation training on anxiety and quality of life among patients with inflammatory bowel disease

Background: Inflammatory Bowel Disease (IBD) impacts quality of life (QoL). Psychological factors influence the course of the disease and should be targeted for intervention.

Methods: Our study was a prospective, randomised control trial. Fifty-six outpatients were randomly chosen and allocated to a treatment group or a waiting-list control group. Treatment group patients attended three relaxation-training sessions and received an audio disc for home practice. Evaluations performed pre and post-treatment: state anxiety was assessed with the State-Trait Anxiety Inventory, QoL with the IBD Questionnaire. The Visual Analogue Scale assessed pain, depression, stress and mood. Patients completed a symptom monitoring diary. The control group's symptoms were monitored without study-related treatment.

Results: Thirty-nine subjects completed the study and were included in the data analysis. Following the relaxation-training intervention, the treatment group's (n?=?18) measured results showed a statistically significant improvement as compared to the control group (n?=?21) (time by treatment interaction): anxiety levels decreased (p?<?0.01), QoL and mood improved (p?<?0.05), while levels of pain and stress decreased (p?<?0.01).

Conclusions: Findings indicate IBD patients may benefit from relaxation training in their holistic care. New studies as well as further investigation of the subject are warranted.     

Student essay competition prize winner creativity and inhibition: A comparison of freud and klein

Abstract

This essay reviews Freud's and Klein's approaches to the question of the nature of creativity. It attempts to show that a fuller understanding of creativity involves some linking between these two apparently divergent approaches. The work of Marion Milner and the Winnicottian School is suggested as a possible way forward in our understanding.     

Workload and burnout in nurses

This paper examines the relationship between workload, burnout and somatization in nurses. The respondents consisted of 1363 nurses employed in hospitals, which were undergoing extensive restructuring. Results of structural equation analyses showed that workload was positively related to emotional exhaustion. Emotional exhaustion led to cynicism and somatization, and cynicism was negatively related to nurses' professional efficacy. Implications of the results for nursing practice are discussed. Copyright © 2001 John Wiley & Sons, Ltd.