A feasibility study of mindfulness-based interventions for children.

BACKGROUND: Children's overall psychological well-being is a concern for parents and adults worldwide. Mindfulness appears to be a promising intervention for enhancing children's psychological well-being, and its effectiveness has been well-documented. However, there is a paucity of data on the feasibility and acceptability of implementing mindfulness-based interventions (MBIs) for children; this is a crucial factor in determining whether MBIs can be utilized to benefit children. The aim of this study was to determine the feasibility and acceptability of implementing MBIs among Hong Kong children. METHODS: Seventy-eight children (mean age = 9.06, SD = .375) were recruited from a primary school in Hong Kong and received MBIs in a single session that lasted about 2 h. The intervention's feasibility was determined in terms of retention rates, while acceptability was based on qualitative feedback from the children. RESULTS: The results show that there were high retention rates (96%). Qualitative analyses of children's feedback revealed that they experienced enhanced well-being, and enjoyed and benefited from the interventions. CONCLUSIONS: This study shows the high feasibility of MBIs in children, supporting the conduct of an efficacy trial to examine the effects of MBIs among children. Support from school teachers and measures to raise and maintain children's interest in mindfulness could facilitate the conduct of a study.

A Phenomenological Study of the Work Environment in Long-Term Care Facilities for the Older Adults.

Attempts to meet the increasing demand for long-term care (LTC) services have been hindered by acute staff shortages and high turnover. Distinct from previous studies, a descriptive phenomenological approach with van Kaam's controlled explication method was adopted in this study, to delineate how attributes of the LTC work environment shape the workforce crisis. Individual interviews were conducted with 40 LTC workers from 10 facilities in Hong Kong. The results suggest that the work environment in LTC facilities is not only characterized by organization- and job-related attributes that influence staff outcomes but also is a socially constructed concept with derogatory connotations that can influence staff recruitment and retention. Concerted efforts from facility administrators and policy makers are needed to improve the quality of the work environment. Future initiatives should focus on developing a vision and strategic plan to facilitate the rise of the LTC sector as a profession.

A field study of the role of nurses in advocating for safe practice in hospitals.

AIM: To explicate nurses' role and the underlying processes involved in advocating for safe practice in hospitals. BACKGROUND: Nurses' role as patient advocates in safeguarding patients' interests and well-being is constantly upheld. As previous studies have fallen short in delineating the processes of how and in what conditions the patient advocate role is operationalized, this study was conducted to fill the evidence gap through examining nurses' advocacy role and practices in real clinical contexts. DESIGN: A field study approach that involved multiple methods of data collection was adopted. METHODS: This study was conducted from February 2010-March 2011 in four medical units in two public hospitals in Hong Kong. Empirical data were generated from weekly field observations, review of relevant documents and individual semi-structured interviews with 28 nurses and were then analysed through a comparative analysis process. RESULTS: Nurses play an integral role in ensuring safe practice in hospitals through mitigating risk arising from sudden changes in patients' health conditions and the hospitalization process and correcting near-misses for co-workers to prevent harm. The modelling of expert nurses and team-based learning emerged as essential factors facilitating the development of nurses' advocacy role and practices. The state of 'limited advocacy', as characterized by the adoption of disempowering and coercive measures to ensure patient safety, clearly indicates a need to re-examine the concept of advocacy in contemporary health care. CONCLUSION: The findings contribute to a more complete understanding of nurses' advocacy role and practices, which have a significant bearing on patient safety.

Attributes of nursing work environment as predictors of registered nurses' job satisfaction and intention to leave.

AIM: To examine how front-line registered nurses' perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. BACKGROUND: Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses' perception of their work environment beyond the Western context. METHODS: This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses' perception of their work environment. RESULTS: Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses' turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. CONCLUSIONS: Attributes of the nursing work environment have a significant bearing on nurses' job satisfaction and intention to leave. IMPLICATIONS FOR NURSING MANAGEMENT: Managerial effort should focus on improving nurses' work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice.

Stabilizing and destabilizing forces in the nursing work environment: a qualitative study on turnover intention.

BACKGROUND: The nursing work environment, which provides the context of care delivery, has been gaining increasing attention in recent years. A growing body of evidence points to an inseparable link between attributes of the nursing work environment and nurse and patient outcomes. While most studies have adopted a survey design to examine the workforce and work environment issues, this study employed a phenomenological approach to provide empirical evidence regarding nurses' perceptions of their work and work environment. AIM: The aim of this study was to advance our understanding of the phenomenon of increasing nurse turnover through exploring frontline registered nurses' lived experiences of working in Hong Kong public hospitals. METHODS AND PARTICIPANTS: A modified version of Van Kaam's controlled explication method was adopted. Individual semi-structured interviews were conducted with 26 frontline nurses recruited from ten acute regional, district and non-acute public hospitals in Hong Kong. Their perspectives in regard to their work and work environment, such as workload, manpower demand and professional values, were extensively examined, and a hypothetical description relating the nursing work environment with nurses' turnover intention was posited. RESULTS: Contemplation of nurses' experiences revealed the vulnerable aspects of nursing work and six essential constituents of the nursing work environment, namely staffing level, work responsibility, management, co-worker relationships, job, and professional incentives. These essential constituents have contributed to two sets of forces, stabilizing and destabilizing forces, which originate from the attributes of the nursing work environment. Nurses viewed harmonious co-worker relationships, recognition and professional development as the crucial retaining factors. However, nurses working in an unfavorable environment were overwhelmed by destabilizing forces; they expressed frustration and demonstrated an intention to leave their work environment. CONCLUSIONS: The nursing work environment is a complex entity comprising multiple constituents; its attributes affect nurses' perceptions of their work and work environment, which warrant special attention in addressing the phenomenon of increasing nurse turnover.