The Uncertainty in Family Caregivers of Hospitalized Persons With a Stroke in Saudi Arabia: Unitary Caring Perspective.

Uncertainty is a universal experience of family caregivers caring for persons with a stroke and affects caregivers' readiness to care for their family members with a stroke. Guided by the unitary caring theory and unitary-caring hermeneutic-phenomenological research method, this study was conducted among 15 family caregivers of persons in the hospital who have survived strokes through in-depth semi-structured interviews. Five essences emerged from the analysis: living in a dark reality; yearning for professional support; enduring a life full of tribulations; attempting resolution; and creating new patterns of living. Each of the 5 essences was interpreted from Smith's unitary caring theory perspective.

The Influence of the Health Belief Model on the Decision to Get the COVID-19 Vaccine: An International Survey Study of College Students.

To better prepare for a potential future pandemic, it is important to investigate factors that influenced responses to the recent COVID-19 pandemic. The aim of the present study was to investigate factors that influenced the decision to get the COVID-19 vaccine. The COVID-19 pandemic has affected almost everyone throughout the world. Vaccines are a significant factor in managing a pandemic. As vaccines are developed, governments develop vaccine roll-out plans. Unfortunately, vaccine hesitancies can slow the implementation of any vaccine program. A question arises as to the factors that are associated with the decision to get vaccinated. The present study explored associations between vaccine hesitancy, and the Health Belief Model (HBM) in student samples from the Czech Republic, Israel, and the United States. From August, 2021 through December, 2021, an online survey was distributed in Czech, Hebrew, and English. A total of 447 participants completed the survey. A binomial logistic regression was conducted to ascertain the influence of perceived susceptibility, severity, benefits, and barriers on the likelihood that participants are vaccinated. Results revealed that the factors of perceived severity and perceived benefits explained 52.6% (Nagelkerke R2) of the variance in vaccination. An analysis of Variance (ANOVA) found significant differences between countries for the 4 HBM factors. Based on these findings, it is recommended that policymakers put forth added emphasis on the severity of a virus and the benefits associated with the vaccine. Further, since there appears to be variability between countries in perceptions of the virus, and associated vaccine, governments should consider factors within their own environment when developing a strategy to combat a pandemic. More specifically, government could explore their own strengths, weaknesses, opportunities, and threats as they develop a pandemic strategy. Additional practical and theoretical implications are discussed.

Perceptions of Breastfeeding for Women with Perinatal Depression: A Descriptive Phenomenological Study.

Women with perinatal depression have an increased risk for breastfeeding cessation, yet few studies have explored their lived experience. In this qualitative study, semistructured interviews were conducted with a purposeful sample of women (N = 10) who self-reported perinatal depression. Using Giorgi's descriptive phenomenological method of data analysis, five components were found to embody their lived experience of breastfeeding: (a) choosing selflessness, (b) harboring inadequacy, (c) deliberate persevering, (d) discerning meaning, and (e) cherishing intimacy. Findings contribute to understanding the experience of breastfeeding for this population and could provide guidance to improve lactation management and perinatal mental health education for nurses.

The Effect of Bullying Vignettes on Negative Affect.

The purpose of this study was to examine the influence of reading workplace bullying vignettes on negative affect. A within-subjects descriptive design and convenience sample was used. Fifty participants completed the Negative Affect Scale after reading written bullying vignettes and completed the Transportation Narrative questionnaire. Results provide evidence that the participants were transported into the vignettes. Additionally, descriptive statistics and a repeated measure ANOVA revealed a significant increase in negative affect over time. Written vignettes can provide a means to better understand how workplace events can impact cognitive performance. Practical and theoretical implications are discussed.

Development of Vignettes to Explore Workplace Bullying.

Incivility and bullying in healthcare can impact care delivery and quality. There are challenges in research to making a direct link between the behaviors and patient outcomes. One way to address the challenges is through the creation of bullying vignettes that induce mood changes that reflect a feeling of being bullied. The purpose of this study was to develop workplace bullying textual vignettes and to test content validity. Cognitive interviewing was used by engaging content experts to rate 21 author-created vignettes for relevance, realism, and severity. Eleven vignettes were identified and have potential use in research, education, and practice.

Charge Nurses' Experiences With Horizontal Violence: Implications for Leadership Development.

HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Charge Nurses' Experiences With Horizontal Violence: Implications for Leadership Development," found on pages 493-499, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until October 31, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe types of horizontal violence experienced by charge nurses. Identify the skills needed for charge nurses to combat horizontal violence. DISCLOSURE STATEMENT Neither the planners nor the author have any conflicts of interest to disclose. BACKGROUND: A safe work environment is a prerequisite for the provision of high-quality patient care. Horizontal violence can undermine the culture of safety and the well-being of the nurses in the work unit. Charge nurses, whose role encompasses both staff and manager responsibilities, play an important role in team building and care delivery. Yet, little is known about their experience with horizontal violence. A lack of adequate leadership education and role delineation may predispose charge nurses to horizontal violence. METHOD: A descriptive study was conducted to describe the incidence of horizontal violence of charge nurses. The Horizontal Violence Scale was used to collect data from a convenience sample of 366 charge nurses. RESULTS: Charge nurses reported experiencing horizontal violence with some regularity. DISCUSSION: Nurse leaders must critically evaluate the work culture and provide appropriate education and support to charge nurses to combat horizontal violence. J Contin Educ Nurs. 2016;47(11):493-499.

Social Justice as a Lens for Understanding Workplace Mistreatment.

Workplace mistreatment can be viewed as a social injustice that prohibits one from achieving optimal well-being. Cognitive and interpersonal skills required of nurses can be impacted by workplace mistreatment, thus extending injustices by violating the rights of patients to optimal care. The purpose of this article is to view workplace mistreatment through the lens of Powers and Faden's theory of social justice. Workplace mistreatment is explored through the 6 dimensions of well-being, including health, personal security, reasoning, respect, attachment, and self-determination, identified in the theory. The implications for practice and policy are discussed and recommendations for research made.

The development and psychometric testing of the horizontal violence scale.

Inappropriate behaviors of healthcare workers can threaten the delivery of safe, quality care. The purpose of this research was to develop a research instrument specific to the construct of horizontal violence and conduct foundational psychometric testing of the newly developed instrument. The overall findings on the fit indices suggest that this model does adequately measure the underlying construct of horizontal violence. The instrument can be used as a way to determine the existence and extent of horizontal violence in practice settings and used to augment the study of the work environment, particularly in relation to healthy work environments.

Bullying: a hidden threat to patient safety.

Patient safety is a crucial element for quality care in hemodialysis facilities. When evaluating possible threats to safety, an important factor to consider is the behavior of the healthcare staff. Inappropriate behaviors, such as bullying, have been associated with poor clinical outcomes. In addressing inappropriate behaviors, it is necessary to consider the role of the work environment. Healthy work environment initiatives provide a possible strategy to prevent and/or address the behaviors.

Bullying and the older nurse.

AIM: The purpose of this article is to discuss bullying from the perspective of the older nurse. BACKGROUND: Inappropriate behaviours, such as bullying, are being scrutinised in health care because of the potential negative impact on patient care and safety and worker wellbeing and satisfaction. Although this phenomenon is often referred to as 'nurses eating their young', the implications for the older nurse cannot be ignored. EVALUATION: The work environment is instrumental in the retention of workers. Older nurses are essential for knowledge transfer. When developing strategies to retain the older worker, issues such as bullying need to be examined. KEY ISSUES: Without proper identification and the willingness of management to acknowledge it, bullying may become a cultural norm. Once this occurs, it is necessary to examine the underlying structures that support its continued presence. Hierarchical and disempowering work environments may be contributors. CONCLUSIONS: Nurses of all ages can be affected by bullying, so empowering initiatives need to be developed to prevent perpetuation and victimisation. IMPLICATIONS FOR NURSING MANAGEMENT: To prevent bullying, initiatives that recognise the skills and knowledge that nurses contribute to patient care need to be developed.

A prescription for disruptions in care: community building among nurses to address horizontal violence.

In the health care environment, threats exist that can impact a nurse's ability to provide safe, quality care. One of these threats is disruptive behavior among health care workers in which negative interactions adversely affect communication and collaboration. When this occurs among nurses, it is identified as horizontal violence. An underlying concept is power. When attempting to address these behaviors in the workplace, it is important that nurses recognize the context in which they occur so sustaining changes can be made. Community building among nurses may be an appropriate approach to give nurses the skills to make these changes.

It starts with a conversation: a community approach to creating healthy work environments.

A healthy work environment is needed to retain nurses. Among the factors that contribute to a healthy work environment are collaboration and communication. Through the leadership of the Palm Healthcare Foundation, Inc., a dialogue was started among health care stakeholders in Palm Beach County, Florida, resulting in a health care work force partnership community collaboration and initiatives to address the retention of nurses. One initiative was sponsoring a "train-the-trainer" program to raise awareness and provide skills for addressing factors that could affect work relationships, including emotional intelligence, generational differences, cultural competency and health literacy, employee crisis, and horizontal violence. A 6-month program evaluation was completed by the participants. A community approach provides a means for providers and educators to address common work force issues collaboratively.

Acts of caring: nurses caring for nurses.

Caring behaviors displayed toward nurses by nurse managers and nurse peers play a significant role in establishing relationships that promote a healthy work environment. A qualitative study was done to identify behaviors perceived to be caring toward nurses. The theoretical background used for the study was Nursing as Caring by Boykin and Schoenhofer. Data were collected from focus groups consisting of registered nurses currently employed in the practice setting. Content analysis was used for the analysis. The overarching category that was identified was tending to a caring environment. The following emergent categories were also found: caring through helping and supporting, caring through appreciating, and acknowledging unappreciated caring. The findings suggest that nurses demonstrate caring behaviors toward their colleagues by coming to know them on both a professional and a personal level. These behaviors form the foundation for an environment that supports a consistent demonstration of caring.

Horizontal violence among nursing students.

In a research study student nurses in the clinical setting reported experiencing horizontal violence or "nurses eating their young." The types of behaviors most frequently encountered were emotional and verbal attacks. Some students did not report incidences of horizontal violence to their instructors, so it is important that the faculty be cognizant that such behaviors can occur and establish open communication to assist students in dealing with such behaviors.