How Work-Family Guilt, Involvement with Children and Spouse's Support Influence Parents' Life Satisfaction in a Context of Work-Family Conflict.

Work-family guilt (WFG) is sometimes perceived as an adaptive characteristic, since it has been found to encourage working parents to engage in more activities with their children in off-work time (Cho & Allen, 2012). However, while it may be an adaptive characteristic for the parent-child relationship, the same may not be true for parents' psychological health. Using insights from the work-home resources model (W-HR), this study aims to determine WFG's influence on parents' life satisfaction. This study also investigates if parents' belief regarding the investment of their spouse in recreational activities with their children is a resource that could foster their life satisfaction. A cross-sectional design was used with a sample of 289 working parents with at least one child aged between 5 and 10. A path analysis shows a significant moderated mediation model. Parent-child activities were found to partially mediate the relationship between strain-based work interference with family and parents' life satisfaction. Furthermore, WFG moderated this mediation. Specifically, it worsened the detrimental effect of doing fewer parent-child activities on parents' life satisfaction. Results also show that a spouse's investment in activity with their child is a resource that motivates parents to invest more in their children and directly contributes to parents' life satisfaction.

Group mentorship programme for graduating nursing students to facilitate their transition: A pilot study.

AIM: The present study aims to describe and evaluate a group mentorship programme for graduating nursing students following the first pilot testing. BACKGROUND: A mentoring relationship has been found to be beneficial in easing the challenging transition from nursing student to nurse. However, very few mentoring programmes have been formally developed to pair students with clinical nurses before graduation. METHODS: A group mentoring programme for graduating nursing students was developed where clinical nurse mentors met with student mentees twice before graduation and once shortly after graduation to address relevant challenges. Mentees and mentors completed a survey after the last session. RESULTS: Eighteen mentees and 12 mentors completed the survey. Results suggest a high level of satisfaction with the programme from both mentees and mentors, as well as a positive impact on mentees' transition into the workplace and levels of stress and self-confidence. CONCLUSIONS: The pilot testing of the group mentorship programme is believed to have been successful. IMPLICATIONS FOR NURSING MANAGEMENT: This pilot project highlights the value to nursing leadership of group mentoring partnerships between academic and clinical settings, which can improve the integration of new nurses in the workplace and increase mentors' awareness of the needs of these nurses.

The Effects of the Transforming Care at the Bedside Program on Perceived Team Effectiveness and Patient Outcomes.

The objective of the study was to document the impact of Transforming Care at the Bedside (TCAB) program on health care team's effectiveness, patient safety, and patient experience. A pretest and posttest (team effectiveness) and a time-series study design (patient experience and safety) were used. The intervention (the TCAB program) was implemented in 8 units in a multihospital academic health science center in Montreal, Quebec, Canada. The impact of TCAB interventions was measured using the Team Effectiveness (TCAB teams, n = 50), and Clostridium difficile-associated diarrhea and vancomycin-resistant Enterobacter rates (patient safety) and Hospital Consumer Assessment of Healthcare Providers and Systems (patient experience; n = 551 patients). The intervention was composed of 4 learning modules, each lasting 12 to 15 weeks of workshops held at the start of each module, combined with hands-on learning 1 day per week. Transforming Care at the Bedside teams also selected 1 key safety indicator to improve throughout the initiative. Pretest and posttest differences indicate improvement on the 5 team effectiveness subscales. Improvement in vancomycin-resistant Enterococcus rate was also detected. No significant improvement was detected for patient experience. These findings call to attention the need to support ongoing quality improvement competency development among frontline teams.

Neonatal Intensive Care Unit Nurses Working in an Open Ward: Stress and Work Satisfaction.

There is some research on the impact of open-ward unit design on the health of babies and the stress experienced by parents and nurses in neonatal intensive care units. However, few studies have explored the factors associated with nurse stress and work satisfaction among nurses practicing in open-ward neonatal intensive care units. The purpose of this study was to examine what factors are associated with nurse stress and work satisfaction among nurses practicing in an open-ward neonatal intensive care unit. A cross-sectional correlational design was used in this study. Participants were nurses employed in a 34-bed open-ward neonatal intensive care unit in a major university-affiliated hospital in Montréal, Quebec, Canada. A total of 94 nurses were eligible, and 86 completed questionnaires (91% response rate). Descriptive statistics were computed to describe the participants' characteristics. To identify factors associated with nurse stress and work satisfaction, correlational analysis and multiple regression analyses were performed with the Nurse Stress Scale and the Global Work Satisfaction scores as the dependent variables. Different factors predict neonatal intensive care unit nurses' stress and job satisfaction, including support, family-centered care, performance obstacles, work schedule, education, and employment status. In order to provide neonatal intensive care units nurses with a supportive environment, managers can provide direct social support to nurses and influence the culture around teamwork.

Transformational and abusive leadership practices: impacts on novice nurses, quality of care and intention to leave.

AIMS: To investigate the impact of nurse managers exercising transformational vs. abusive leadership practices with novice nurses. BACKGROUND: In a nursing shortage context, it is important to understand better the factors that potentially influence the retention of nurses in the early stages of their career. A large body of research has found that transformational leadership practices have a positive influence on employee functioning. However, very little research exists about the detrimental impact of abusive leadership practices, much less in a nursing context. DESIGN: A cross-sectional design where 541 nurses from the province of Quebec (Canada) were questioned in the fall of 2013. METHODS: A self-administered questionnaire was completed by nurses with less than five years of nursing experience. RESULTS: Results from three linear regression analysis indicated that transformational leadership practices potentially lead to high quality care and weak intention to quit the healthcare facilities. Conversely, abusive leadership practices potentially lead to poorer quality care and to strong intention to quit the healthcare facilities and the nursing profession. CONCLUSION: Paying close attention to the leadership practices of nurse managers could prove effective in improving patient care and increasing the retention of new nurses, which is helpful in resolving the nursing shortage. Our results specifically suggest not only that we promote supportive leadership practices (transformational leadership) but, most of all, that we spread the word that abusive leadership creates working conditions that could be detrimental to the practice of nursing at career start.

Expectations predict chronic pain treatment outcomes.

Accumulating evidence suggests an association between patient pretreatment expectations and numerous health outcomes. However, it remains unclear if and how expectations relate to outcomes after treatments in multidisciplinary pain programs. The present study aims at investigating the predictive association between expectations and clinical outcomes in a large database of chronic pain patients. In this observational cohort study, participants were 2272 patients treated in one of 3 university-affiliated multidisciplinary pain treatment centers. All patients received personalized care, including medical, psychological, and/or physical interventions. Patient expectations regarding pain relief and improvements in quality of life and functioning were measured before the first visit to the pain centers and served as predictor variables. Changes in pain intensity, depressive symptoms, pain interference, and tendency to catastrophize, as well as satisfaction with pain treatment and global impressions of change at 6-month follow-up, were considered as treatment outcomes. Structural equation modeling analyses showed significant positive relationships between expectations and most clinical outcomes, and this association was largely mediated by patients' global impressions of change. Similar patterns of relationships between variables were also observed in various subgroups of patients based on sex, age, pain duration, and pain classification. Such results emphasize the relevance of patient expectations as a determinant of outcomes in multimodal pain treatment programs. Furthermore, the results suggest that superior clinical outcomes are observed in individuals who expect high positive outcomes as a result of treatment.

Effective Strategies to Spread Redesigning Care Processes Among Healthcare Teams.

PURPOSE: The purpose of this study was to describe how spread strategies facilitate the successful implementation of the Transforming Care at the Bedside (TCAB) program and their impact on healthcare workers and patients in a major Canadian healthcare organization. DESIGN: This study used a qualitative and descriptive design with focus groups and individual interviews held in May 2014. Participants included managers and healthcare providers from eight TCAB units in a university health center in Quebec, Canada. The sample was composed of 43 individuals. METHODS: The data were analyzed using NVivo according to the method proposed by Miles and Huberman. FINDINGS: The first two themes that emerged from the analysis are related to context (organizational transition requiring many changes) and spread strategies for the TCAB program (senior management support, release time and facilitation, rotation of team members, learning from previous TCAB teams, and engaging patients). The last theme that emerged from the analysis is the impact on healthcare professionals (providing front-line staff and managers with the training they need to make changes, team leadership, and increasing receptivity to hearing patients' and families' needs and requests). CONCLUSIONS: This study describes the perspectives of managers and team members to provide a better understanding of how spread strategies can facilitate the successful implementation of the TCAB program in a Canadian healthcare organization. CLINICAL RELEVANCE: Spread strategies facilitate the implementation of changes to improve the quality and safety of care provided to patients.

Transforming Care at the Bedside: managers' and health care providers' perceptions of their change capacities.

BACKGROUND: The Transforming Care at the Bedside (TCAB) project engages frontline health care providers as the leaders of change and improvement efforts in their work environment. This study explored how health care providers and managers from three TCAB units in a university-affiliated health care center perceived the development of their change capacities following their involvement in this program. METHOD: This descriptive, qualitative study involved focus groups and individual interviews. RESULTS: Participants learned to work as a team and to expand their outlook. They had access to processes and tools to learn new skills. New relationships also developed among the various players, and they shared new roles, which enabled them to translate the desired changes into action and make the results visible. CONCLUSION: The study showed the TCAB program helps develop health care providers' and managers' change capacities.

Impact of a pedometer program on nurses working in a health-promoting hospital.

The aim of this research was to describe the impact of a pedometer-based activity program on a subset of nurses in a university-affiliated, multisite health care center in Canada. This study used a longitudinal design with preintervention-postintervention (8 weeks) and follow-up (6 months). At baseline, 60 nurses participated; 51 (85%) remained for the postprogram assessment and 33 (55%) also completed the follow-up questionnaire. Data were collected through self-administered questionnaires (weight, height, fatigue, insomnia, stress and step data) and blood tests (total cholesterol and low-density lipoprotein and high-density lipoprotein cholesterol). At postprogram, participants reported 12 thinsp;912 steps on average per day. At follow-up, 79% of participants indicated that they maintained their physical activity after the pedometer program. A significant decrease in insomnia was evident in postprogram scores compared with baseline scores, and this decrease was maintained at follow-up. A significant decrease in minutes spent sitting per week was also observed from baseline to postprogram and also maintained at follow-up. Participants' stress and low-density lipoprotein cholesterol levels decreased from baseline to postprogram (marginally significant). Finally, their weight decreased from baseline to follow-up (marginally significant). The pedometer program generated some positive outcomes for nurses after 6 months.

Determinants and benefits of physical activity maintenance in hospital employees.

This study investigated whether the positive behavioral and anthropometric outcomes of a pedometer-based physical activity 8-week challenge were maintained 6 months after the end of the program. It further investigated the motivational profile of those who maintained their physical activity levels in the months following the end of the program and of those who did not. Hospital employees from a university-affiliated multisite health care center in Canada participated using a questionnaire. Of the 235 participants who completed the 8-week challenge, 157 questionnaires were returned 6 months later. Paired-samples t tests were conducted between the baseline and follow-up scores as well as between the postprogram and follow-up scores to detect significant differences between the measurement points. This study shows that the pedometer-based physical activity helped hospital employees maintain a high level of physical activity as well as maintain a healthy body mass index after 6 months. The results demonstrated that during maintenance the high physical activity group obtained higher scores for identified regulation and intrinsic regulation compared with the other groups. The results of the study revealed that identified and intrinsic regulations are important contributors to maintaining physical activity among hospital employees.

The effect of transforming care at the bedside initiative on healthcare teams' work environments.

BACKGROUND: Different initiatives have been implemented in healthcare organizations to improve efficiency, such as transforming care at the bedside (TCAB). However, there are important gaps in understanding the effect of TCAB on healthcare teams' work environments. AIM: The specific aim of the study is to describe findings regarding the TCAB initiative effects on healthcare teams' work environments. METHODS: A pretest and posttest study design was used for this study. The TCAB initiative was implemented in fall 2010 in a university health center in Montreal, Canada. The sample consisted of healthcare workers from four different care units. RESULTS: Statistically significant improvement was observed with the communicating specific information subscale from the measure of processes of care variable, and a significant difference was found between the support from colleagues variable, which was higher at baseline than postprogram. The differences for psychological demand, decisional latitude, and effort-reward were not significant. CONCLUSIONS: TCAB is an intervention that allows healthcare teams to implement change to improve patients' and families' outcomes. Ongoing energy should focus on how to improve communication among all members of the team and ensure their support.

Validation of the French and English versions of the Worklife Pulse Survey.

A clear and rapid understanding of a health care organization's Quality Work Life is highly important as it can inform decision makers of issues that could impact their workers' psychological and physical health. Research has shown there is a relationship between workers' psychosocial work environment and their health and well-being. The Worklife Pulse Survey is a 21-item questionnaire providing a snapshot of health care organizations' Quality Work Life. This tool is deployed as part of Accreditation Canada's Qmentum accreditation program and is available both in English and in French. The present research sought to validate the 2 versions of the survey as well as the comparability of the generated data. The results obtained from 9578 French-speaking and 16 398 English-speaking respondents support the validity of both versions of the Worklife Pulse Survey as well as the comparability of the responses for all participants, for each gender separately, and for each age group separately.

Nurse Executives' Perceptions of the Executive Training for Research Application (EXTRA) Program.

BACKGROUND: To improve the overall quality and effectiveness of the Canadian health care system through better decisions supported by research-based evidence (RBE), the Canadian Health Services Research Foundation (CHSRF) and partners have created the Executive Training for Research Application (EXTRA) program. OBJECTIVES: To evaluate how nurse executive fellows perceive changes in their levels of knowledge of RBE and in their level of use of RBE following participation in the EXTRA program. METHODS: Nurse executives in the first four cohorts of the program (2004-2007) completed a survey during their 2-year fellowship period. RESULTS: Statistically significant improvements were observed regarding nurse executives' perceived knowledge and use of RBE. According to the participants, the EXTRA fellowship contributes to their role and function in their organization by providing tools, learning, and access to resources and networking, which contributes to their credibility, leadership, and knowledge transfer skills. CONCLUSIONS: The EXTRA program has been structured to reduce barriers and to enhance the facilitators found in the literature on the implementation of evidence-based practices (EBP) in health care settings. Overall, nurse executives perceived that the benefits of participating in the EXTRA program were both individual and organizational.

The fundamental need to belong: on the distinction between growth and deficit-reduction orientations.

The need for belongingness (the universal need to form and maintain positive, stable interpersonal relationships) has led to much research over the past decade. Although such a need is universal, some qualitative differences exist in its orientation. Specifically, two belongingness need orientations are proposed: a growth orientation (a belongingness need directed toward interpersonal actualization) and a deficit-reduction orientation (a belongingness need directed toward interpersonal deficit reduction or repair). It is hypothesized that a deficit-reduction orientation to the need to belong is associated with lower levels of intrapersonal and interpersonal psychological functioning compared to a growth orientation. The results of a series of four studies supported the proposed hypotheses. Implications of the proposed model for future research on the need to belong are discussed.

Implementation of diagnosis-related mental health programs: impact on health care providers.

Mental health services are in the midst of change in different countries. In Quebec (Canada), the government has adopted a Mental Health Action Plan (2005-2010). In this context, 2 psychiatric institutions have developed and implemented a mental health services organization model based on diagnosis-related mental health programs and support for frontline services. This article presents the impact on health care providers of implementation of diagnosis-related mental health programs in the context of transformation of mental health services.

Contribution of the psychosocial work environment to psychological distress among health care professionals before and during a major organizational change.

The aim of this study was to investigate the relationships between 4 dimensions of the psychosocial work environment (psychological demands, decision latitude, social support, and effort-reward) among health care professionals as well as their psychological distress during a reorganization process. A correlational descriptive design was used for this quantitative study. A total of 159 health care professionals completed the questionnaire at T1, and 141 at T2. First, before the work reorganization, effort-reward imbalance was the sole variable of the psychological work environment that significantly predicted psychological distress. Second, the high overall level of psychological distress increased during the process of organizational change (from T1 to T2). Finally, effort-reward imbalance, high psychological demands, and low decision latitude were all significant predictors of psychological distress at T2, during the organizational change. In conclusion, to reduce the expected negative outcomes of restructuring on health care practitioners, managers could increase the number of opportunities for rewards, carefully explain the demands, and clarify the tasks to be performed by each of the employees to reduce their psychological burden and increase their perceptions of autonomy.

Passion for an activity and quality of interpersonal relationships: the mediating role of emotions.

Our purpose in this research was to investigate the role of passion (Vallerand et al., 2003) for a given activity in the quality of interpersonal relationships experienced within the context of that activity in 4 studies. Study 1 demonstrated that a harmonious passion was positively associated with the quality of interpersonal relationships within the context of the passionate activity, whereas an obsessive passion was unrelated to it. Furthermore, in line with the broaden-and-build theory (Fredrickson, 2001), results also showed that positive emotions experienced at work fully mediated the relation between harmonious passion and quality of interpersonal relationships. Obsessive passion was not associated with positive emotions. Study 2 replicated the results from Study 1 while controlling for trait extraversion. Also, in Study 2, we examined the negative mediating role of negative emotions between obsessive passion and quality of interpersonal relationships. Finally, Studies 3 and 4 replicated the results of Study 2 with prospective designs and with objective ratings of interpersonal relationships quality. Implications for the dualistic model of passion and the broaden-and-build theory are discussed.

On the costs and benefits of gaming: the role of passion.

The dualistic model of passion defines passion as a strong inclination toward a self-defining activity that a person likes and values and in which he or she invests time and energy. The model proposes two distinct types of passion: harmonious and obsessive passion that predict adaptive and less adaptive outcomes respectively. In the present research, we were interested in assessing both the negative and positive consequences that can result from gaming. Participants (n = 222) were all players involved in massively multiplayer online games. They completed an online survey. Results from a canonical correlation revealed that both harmonious and obsessive passion were positively associated with the experience of positive affect while playing. However, only obsessive passion was also positively related to the experience of negative affect while playing. In addition, only obsessive passion was positively related to problematic behaviors generally associated with excessive gaming, the amount of time spent playing, and negative physical symptoms. Moreover, obsessive passion was negatively related to self-realization and unrelated to life satisfaction. Conversely, harmonious passion was positively associated with both types of psychological well-being. This general pattern of results suggests that obsessive passion for gaming is an important predictor of the negative outcomes of gaming, while harmonious passion seems to account for positive consequences. Future research directions are discussed in light of the dualistic model of passion.

On passion and sports fans: a look at football.

The purpose of the present research was to test the applicability of the Dualistic Model of Passion (Vallerand et al., 2003) to being a sport (football) fan. Three studies provided support for this dualistic conceptualization of passion. Study 1 showed that harmonious passion was positively associated with adaptive behaviours (e.g. celebrate the team's victory), whereas obsessive passion was positively associated with maladaptive behaviours (e.g. risking losing one's job to go to a game). Study 2 used a short Passion Scale and showed that harmonious passion was positively related to the positive affective life of fans during the 2006 FIFA World Cup, psychological health (self-esteem and life satisfaction), and public displays of adaptive behaviours (e.g. celebrate the team's victory into the streets), whereas obsessive passion was predictive of maladaptive affective life (e.g. hating opposing teams' fans) and behaviours (e.g. mocking opposing teams' fans). Finally, Study 3 examined the role of obsessive passion as a predictor of partner's conflict that in turn undermined partner's relationship satisfaction. Overall, the present results provided support for the Dualistic Model of Passion. The conceptual and applied implications of the findings are discussed.