An Evaluation of a Web-Based Crisis Management Training Program for Nurse Managers: The Case of the COVID-19 Crisis.

OBJECTIVE: The effective management of nursing services, the main power in patients' care and treatment in the front line of the fight against the COVID-19 pandemic, and nurse managers' effective leadership behaviors in the fight against the pandemic have been important key factors. It is thus critical to support nurse managers, strengthen them through training, and increase their competency so that they can successfully manage crises, disasters, or pandemics. This study aims to assess the effect of a web-based training program on the knowledge levels of nurse managers who worked during the COVID-19 pandemic. METHODS: This is a randomized controlled experimental study. The study population consisted of the members of the Nurse Managers Association. The intervention group had 30 participants, and the control group had 31 participants in the final. RESULTS: There was no statistically significant difference between the intervention and control groups' mean number of correct pre-test responses (P = 0.843). However, the intervention group's mean number of correct post-test responses was statistically significantly higher than the control group's after the web-based training program (P < 0.001). CONCLUSIONS: Web-based training programs can effectively increase nurse managers' knowledge levels. Therefore, web-based training programs should be developed in ordinary times for the management of crisis situations.

A Cross-Sectional Survey Study on Homophobia Among Medical, Nursing, Pharmacy, and Other Health Sciences Students.

Since the lesbian, gay, bisexual, transgender, and intersex (LGBTI) community may be exposed to violence, discrimination, stigma, exclusion, and maltreatment due to their sexual orientation while accessing healthcare services, understanding, and improving the attitudes of future's health care professionals toward LGBTI individuals seem essential. This descriptive and cross-sectional study aimed to investigate the homophobia among medical, nursing, pharmacy, and healthcare sciences students and examine the related factors. The study included 2,531 students from medicine, nursing, pharmacy, and other health sciences (midwifery, nutrition and dietetics, physiotherapy, management of healthcare facilities) disciplines. Homophobia was measured with the Hudson and Ricketts Homophobia Scale. After getting ethical and institutional approvals, data were collected and analyzed using descriptive and inferential statistical tests. Medical students had the lowest homophobia score, and their mean score was significantly lower than other students. There was a significant difference between students' scores according to years of study, age, sex, acquaintance with LGBTI individuals, providing healthcare services to an LGBTI person, and opinions on providing care. Although homophobia scores of nursing, pharmacy, and other health sciences students were lower than the medical students', policies and expansive content regarding LGBTI should be in place in all health science educational institutes, including medical schools, to prevent students from holding homophobic and prejudicial attitudes against LGBTI individuals.

The relationship between ethical position and whistleblowing: A cross-sectional study among nurses.

AIM AND OBJECTIVES: The aim of this study is to determine nurses' ethical positions, whistleblowing intention and its causes, and to analyse the correlation between them, while revealing the personal and professional characteristics causing significant difference. BACKGROUND: In today's challenging healthcare settings, ethical dilemmas are inherent to nursing practices, leading to situations whereby nurses must consider whistleblowing and reasons such as reporting medical errors or misbehaviors. DESIGN: The study is descriptive, cross-sectional and correlational. METHODS: The data were collected from a convenience sample consisting of 294 nurses between 1 April and 30 June 2019, in four hospitals in two cities. An introductory information form, Ethics Position Questionnaire, Whistleblowing Scale and Causes of Whistleblowing Scale were employed to collect data. The data were analysed with descriptive, correlational, comparative and internal consistency analyses (Guidelines for reporting cross-sectional studies (Data S1)). RESULTS: It was found that nurses encountered (31.3%) and reported (85.9%) unethical incidents. According to the subscales, they obtained higher scores from idealism (4.37 ± 0.52), supportive whistleblowing (3.75 ± 0.72), and moral and professional values (3.77 ± 0.67). The Ethics Position Questionnaire, as well as the Whistleblowing Scale (r = .302) and the Causes of Whistleblowing Scale (r = .211) had a positive weak correlation (p < .001). Nurses' age, marital status, and professional and institutional experiences all created a significant difference (p < .05). CONCLUSIONS: The nurses mostly encountered unethical incidents associated with management. The rates of reporting the unethical incidents were high, and they were found not hesitating to report using whistleblowing, yet intended to keep the incidents within the institution. In addition, idealistic nurses were more likely to whistleblow, and their causes for whistleblowing were mostly associated with moral and professional values. RELEVANCE TO CLINICAL PRACTICE: It is recommended that nurses' ethical position, and whistleblowing intentions and causes should be supported and improved through the corporate culture.

Nomophobia, netlessphobia, and fear of missing out in nursing students: A cross-sectional study in distance education.

BACKGROUND: In the pandemic, along with distance education, nursing students' smartphone and internet usage habits have changed and their duration has been extended. However, the effect of this situation on problems that may develop due to excessive/inappropriate use of smartphones and the internet such as nomophobia, netlessphobia, fear of missing out is unknown. This study was conducted to measure nursing students' nomophobia, netlessphobia, and fear of missing out levels and identify the correlations between them. METHODS: This descriptive, correlational, and cross-sectional study was conducted on 802 students studying in 3 nursing faculties between November 2021 and February 2022. Introductory Information Form, Nomophobia Questionnaire, Firat Netlessphobia Scale and Fear of Missing Out Scale were used to collect the data. RESULTS: The nursing students used their smartphones for 5.13 ± 2.26 h on average per day and used internet from their smartphones for 4.65 ± 2.74 h. They considered themselves as partly smartphone addicts and they were active users on social media platforms such as WhatsApp (97.3 %) or Instagram (82.2 %). The students' nomophobia mean score was 2.98 ± 0.78, their netlessphobia mean score was 2.53 ± 0.87, and their fear of missing out mean score was 2.18 ± 0.80. Netlessphobia alone accounted for 44.4 % of nomophobia and there was a positive and moderate correlation between them (r = 0.666; p < .001). Fear of missing out alone accounted for 18.5 % of nomophobia and there was a positive and moderate correlation between them (r = 0.430; p < .001). Both of them affected nomophobia by 45.4 %. CONCLUSIONS: Despite the increase in the digital activities of nursing students in the distance education process, it is positive that the netlessphobia and fear of missing out scores are low. However, higher nomophobia scores and strong relationships between concepts require being aware of possible problems, monitoring and taking precautions.

Adaptation of the pain management self-efficacy questionnaire into Turkish.

OBJECTIVES: The aim of this study is to examine the Turkish validity and reliability of the Pain Management Self-Efficacy Ques-tionnaire (PMSEQ). METHODS: The study was carried out descriptively and methodologically between September and December 2018 with 214 nurses and 248 nursing students. The data were collected using the descriptive characteristics form and the PMSEQ. RESULTS: Cronbach's alpha internal consistency coefficient was 0.90 in the total scale. In repeated measurements to test time reliability, there was no statistically significant difference between the two measurements (t=0.320, p=0.751), and there were a high power and positively highly significant relationship (r=0.997, p<0.001). CONCLUSION: Turkish version of the PMSEQ can be used as a valid and reliable scale in assessing the self-efficacy of clinical nurses and nursing students in pain management.

Compassion satisfaction, compassion fatigue, burnout, working environments, and musculoskeletal disorders among nurses.

PURPOSE: It was aimed to determine the perceptions of nurses' working environment and professional quality of life and to compare nurses with and without musculoskeletal discomfort. DESIGN AND METHODS: It is a descriptive and comparative study. The data were collected from 333 nurses working at different units. FINDINGS: Those, who did not have discomfort in their body parts, had a higher mean score in the Practice Environment Scale of the Nursing Work Index; whereas, those having discomfort in all parts of the body had a higher mean score in the Professional Quality of Life Scale (p < 0.05; p < 0.01; p < 0.001). PRACTICE IMPLICATIONS: Attempts to reduce nurses' musculoskeletal discomfort can positively increase perceptions of the working environment and professional quality of life.

The relationships between self-regulated learning in clinical nursing practice and self-efficacy: A cross-sectional study among nursing students.

PURPOSE: The aim is to examine self-regulated learning and self-efficacy levels of nursing students, the relationship between them, and to reveal the variables that make a significant difference. DESIGN AND METHODS: This descriptive, cross-sectional study was conducted with a total of 417 nursing students. The data were collected using the Self-Regulated Learning Scale in Clinical Nursing Practice and Self-Efficacy Scale. FINDINGS: Nursing students have high self-regulated learning (60.28 ± 11.47) and moderate self-efficacy (62.72 ± 11.04) scores, and there is a weak positive and significant relationship between them (r = 0.349, p < 0.001). Students' gender, grade, and self-confidence in practice made a significant difference in the scores (p < 0.05). PRACTICAL IMPLICATIONS: Developing the self-regulated learning levels of nursing students can help increase the clinical practice performance of students by affecting their self-efficacy levels.

The Relationship Between Musculoskeletal Discomfort and Professional Quality of Life Among Nurses.

BACKGROUND: Harsh working conditions lead nurses to experience musculoskeletal discomfort and impair their professional quality of life. AIMS: The aim was to determine musculoskeletal discomfort of nurses and to compare its relationship with their professional quality of life in terms of their socio-demographic characteristics. DESIGN: It is a cross-sectional, descriptive, and correlative study. SETTINGS: Different units of a public hospital. PARTICIPANTS: 333 nurses working at different units. METHODS: The data were collected from 333 nurses working at different units in a public hospital between July and December 2018. The data collection tools include an 8-question participant information form, Cornell Musculoskeletal Discomfort Questionnaire, and Professional Quality of Life Scale. RESULTS: The nurses suffered mostly from lower back pain (90.4%) and their pain slightly interfered with their works (49.8%). There was a weak positive but significant correlation between musculoskeletal discomfort and professional quality of life of the nurses (r = 0.215; p < .001). The nurses, who were younger, were male, were working in executive positions, had less institutional and professional experience, and had higher mean score of musculoskeletal discomfort (p < .05). CONCLUSIONS: The professional quality of life of the nurses experiencing musculoskeletal discomfort in their bodies was negatively affected. For example, as the musculoskeletal disorders increase, the levels of burnout and compassion fatigue, which constitute the quality of life, also increase.

The relationships between nurses' positive psychological capital, and their employee voice and organizational silence behaviors.

PURPOSE: This study aims to determine nurses' positive psychological capital (PsyCap) levels and to examine their relationships with employee voice (EV) and organizational silence (OS) behaviors. DESIGN AND METHODS: This descriptive cross-sectional and correlational study collected data from 341 nurses working at a public university and a private university hospital. The data were collected with the positive PsyCap, EV, and OS scales. FINDINGS: Statistically significant positive relationships were found between positive PsyCap and EV, and between positive PsyCap and relational silence. However, there was a statistically significant negative relationship between positive PsyCap and individual silence. PRACTICE IMPLICATIONS: Nurse managers should support nurses and allow them to participate in decisions that can contribute to nursing, healthcare institution, and the quality of healthcare services.

Does the glass elevator still work: A descriptive and cross-sectional study in the context of gender in Turkey.

AIM: To analyse the glass elevator in nursing, evaluating this concept within the conceptual context of nurse managers' perceptions of gender. BACKGROUND: Glass elevator is defined as the rapid promotion of men to upper positions in certain professions in which women comprise the majority, such as nursing. METHODS: Data were collected from 134 nurse managers. Participants selected one of four resumes belonging to four virtual candidates for an open management position. They, then completed the Perception of Gender Scale. RESULTS: Nurse managers mostly selected men among the four candidates submitted to them for promotion to upper positions. None of the nurse managers' characteristics caused a statistically significant difference regarding the gender of the candidate they selected. No statistically significant difference was found between the perception of gender scores of those who selected female or male candidates. CONCLUSIONS: Men are two times more likely to be selected than women when selecting candidates for promotion with the same qualifications. This was not caused by the decision-makers' or nurse managers' personal and professional characteristics nor their perceptions on gender. IMPLICATIONS FOR NURSING MANAGEMENT: The psychological mechanisms that operate the 'glass elevator' in favour of men should be analysed in greater depth.

Relationship Between Professional Quality of Life and Work Alienation Among Healthcare Professionals.

AIM: This study aimed to determine the levels of professional quality of life and work alienation of healthcare professionals. METHODS: This study is descriptive and cross-sectional. A total of 1523 healthcare professionals from 13 cities across Turkey participated in the research. The data were collected in June 2019 using the Professional Quality of Life scale and the Work Alienation scale. Descriptive, correlational, and parametric comparative analyses were used to analyze data. RESULTS: The mean professional quality of life score of healthcare professionals was 2.23 ± .61, and the subscale with the highest score was Compassion Satisfaction (M = 3.44 ± 1.29). The mean score for work alienation in healthcare professionals was 2.84 ± .29, and the subscale with the highest score was Powerlessness (M = 2.94 ± .50). A negative, very weak and significant relationship (r = -.073; p < .05) was determined between the scores obtained from the two scales. The total professional quality of life score of healthcare professionals significantly differed according to gender, profession, and unit. The total work alienation score of healthcare professionals significantly differed depending on the age groups, marital status, education level, position, professional experience, weekly working hours, working overtime, and working shift (p < .01; p < .001). CONCLUSION: It was determined that the professional quality of life and work alienation levels of the healthcare professionals were slightly below the average and there was a very weak and negative relationship between them. Managers can improve the professional quality of life by implementing intervention programs in their work environment and decrease work alienation by assigning them to positions suitable to their values and beliefs.

Under the same rainbow: A study on homophobia and discrimination among private sector health care professionals.

AIM: To determine the homophobic and discriminatory attitudes of health care professionals and associated factors in the private sector. BACKGROUND: Examining possible homophobic and discriminatory attitudes of health care professionals is very important to eliminate barriers such as access to and use of health services. METHOD: This descriptive and cross-sectional study included 626 health professionals in 20 private hospitals throughout Turkey. The data were collected in May 2020 using an online questionnaire containing the Hudson and Ricketts Homophobia Scale and the Discriminatory Attitudes Scale. RESULTS: Most of the health professionals (64.4%) said that they did not know any LGBTQ+ people, almost half (44.2%) had cared LGBTQ+ people before, and most (95.4%) said that they would be willing to care them. The health professionals' homophobia score was 3.60 (SD = 1.23), and their discrimination score was 2.10 (SD = 0.71). A positive relationship was found between their homophobia and discrimination scores(r = .642). Significant differences in their scale scores were found to be related to their personal and professional characteristics. CONCLUSIONS: The homophobic attitudes of health professionals were above average and had a positive relationship with discriminatory attitudes. IMPLICATIONS FOR NURSING MANAGEMENT: Private hospital administrators should plan initiatives and training programmes to improve health care professionals' attitudes towards LGBTQ+ people.

"I'm a hero, but ": An evaluation of depression, anxiety, and stress levels of frontline healthcare professionals during COVID-19 pandemic in Turkey.

PURPOSE: It was aimed to evaluate depression, anxiety, stress symptoms of health professionals during the COVID-19 pandemic and to reveal the risk factors. DESIGN AND METHODS: Four hundred and sixteen professionals participated in this study. Data were collected online by Depression-Anxiety-Stress Scale. FINDINGS: A statistically significant, positive relationship was determined between professionals' perceptions of COVID-19 risk and scale scores. PRACTICE IMPLICATIONS: The professionals involved in the struggle against the COVID-19 have high levels of depression, anxiety, stress. It is recommended to revise the content to enable individuals to increase skills in coping with similar situations and to take measures to protect their health.

A cross-sectional study of the determinants of missed nursing care in the private sector: Hospital/unit/staff characteristics, professional quality of life and work alienation.

AIM: To analyse missed nursing care in a sample of private hospitals. BACKGROUND: The nursing research on understanding and preventing missed nursing care, a critical element in omitted patient safety, is increasing. METHODS: This is a descriptive, correlational and cross-sectional study. Data were collected from 897 nurses working in 25 private hospitals in Turkey through an online survey, which included an Introductory Information Form, MISSCARE Survey, Professional Quality of Life and Work Alienation Scales. RESULTS: The most frequently missed nursing care was ambulation, and the least was patient assessment. Measurements of the missed nursing care statistically differed in terms of nurses' gender, weekly work hours, overtime work and perception of nurse adequacy, and the hospital's accreditation status. There was a correlation between the missed nursing care and Powerlessness subscale of work alienation. CONCLUSION: Nurses missed less complex care more frequently, and long working hours and inadequacy of nurses increased missed care. There is no correlation between the professional quality of life and missed care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should plan actions to reduce nursing workloads and the instances of missed nursing care. Furthermore, they should develop solutions to make nursing care meaningful and allow nurses to feel empowered.

Psychometric testing of the Turkish version of the Health Professional Education in Patient Safety Survey: H-PEPSSTR.

Nursing students are trained in patient safety issues in clinical settings during their undergraduate nursing education both theoretically and practically. This study aims to test the psychometric properties of the Turkish version of the "Health Professional Education in Patient Safety Survey" which was developed to measure healthcare professional candidates' patient safety knowledge and competence both in the classroom and clinical settings during their education. The data for this methodological study were collected from 305 nursing students in 2017. The tool consisted of 23 items, two main dimensions as classroom and clinical settings and six subscales. Content validity ratings of the scale items were over 0.80. Five modifications were made during the Confirmatory Factor Analyses. Three of the modifications were among classroom items and two of them were from clinical settings items. After modifications, fit indices were calculated as: χ2/df = 2.58, RMSEA = 0.072 and CFI = 0.95 for the classroom. They were χ2/df = 2.23, RMSEA = 0.063 and CFI = 0.96 for the clinical settings. Cronbach's alpha coefficient was 0.97 for both classroom and clinical settings. In conclusion, The Turkish version of the scale is valid and reliable in assessment of patient safety knowledge and competence of nursing students.

Organisational silence among nurses and physicians in public hospitals.

AIMS AND OBJECTIVES: To define the underlying reasons that lead physicians and nurses who provide patient care and treatment, to maintain silence in their work and how they perceive the consequences of such silence in public hospitals. BACKGROUND: The concept of organisational silence is described as employees' avoidance of stating his/her opinions, thoughts and suggestions, which would improve the organisation and enable it to provide better processes or services. This concept has been examined more frequently in the international literature in the past decade, and it has drawn attention as one of the most important barriers to employees' contributions to their organisation. DESIGN: Descriptive and cross-sectional study. METHODS: The study sample consisted of 601 physicians and nurses who work in five hospitals with bed capacities of 100 or more. The data were collected using a two-part form: an introductory information form and an organisational silence scale. RESULTS: Administrative and organisational topics were prominent among the reasons for employees of healthcare organisations to remain silent for both physicians and nurses. CONCLUSIONS: The results of this study should be considered by physicians and nurses to realise and improve themselves. Also, decision makers and managers of public hospitals might evaluate and remove organisational and communicative barriers to employees' contributions to their organisations based on these results. RELEVANCE TO CLINICAL PRACTICE: Physicians and nurses are responsible for the fulfilment of highly important tasks for their organisations. Their contributions help their organisations remain competitive, improve the health services, ensure and sustain patient safety. Hence, these results will provide information to facilitate an understanding of the topics, causes and consequences of organisational silence among physicians and nurses, two key healthcare professions, and will be helpful in the development of medical and nursing human resources in clinical settings.

Reliability and Validity of the Turkish Version of the Job Performance Scale Instrument.

BACKGROUND: Objective measurement of the job performance of nursing staff using valid and reliable instruments is important in the evaluation of healthcare quality. A current, valid, and reliable instrument that specifically measures the performance of nurses is required for this purpose. PURPOSE: The aim of this study was to determine the validity and reliability of the Turkish version of the Job Performance Instrument. METHODS: This study used a methodological design and a sample of 240 nurses working at different units in four hospitals in Istanbul, Turkey. A descriptive data form, the Job Performance Scale, and the Employee Performance Scale were used to collect data. Data were analyzed using IBM SPSS Statistics Version 21.0 and LISREL Version 8.51. RESULTS: On the basis of the data analysis, the instrument was revised. Some items were deleted, and subscales were combined. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The Turkish version of the Job Performance Instrument was determined to be valid and reliable to measure the performance of nurses. The instrument is suitable for evaluating current nursing roles.