Psychometric Examination of the Dutch Objective Burden Inventory in Heart Failure Caregivers.

BACKGROUND: Psychometric properties of the 38-item version of the Dutch Objective Burden Inventory (DOBI) have been evaluated primarily in older female caregivers, with no published studies that vary by a different gender and age distribution. OBJECTIVE: The aim of this study was to test the construct validity and reliability of the DOBI in caregivers of individuals with heart failure from the United States and other countries. METHODS: This secondary analysis from a cross-sectional study used an online survey. Factorial validity was tested with confirmatory factor analysis, item performance was examined with ordinal item response analysis, and convergent validity was tested correlating DOBI subscale scores with Bakas Caregiving Outcomes Scale scores. Internal consistency reliability was assessed with Cronbach α. RESULTS: Item response analysis removed 14 items. Confirmatory factor analysis retained the original 4-factor solution. Original and reduced instruments demonstrated good internal consistency. Validity was supported by meaningful associations with the Bakas Caregiving Outcomes Scale. CONCLUSIONS: Both the original 38-item DOBI and the reduced 24-item DOBI had support for their construct validity and internal consistency. The 24-item DOBI may be a useful alternative to the 38-item version, because it maintains psychometric properties of the original instrument while decreasing data collection burden. However, more research is needed to assess whether the shorter version is useful in assessing objective caregiving burden.

An Exploratory Study of the Influence of Perceived Organizational Support, Coworker Social Support, the Nursing Practice Environment, and Nurse Demographics on Burnout in Palliative Care Nurses.

Burnout, a condition characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment, has been studied in many disciplines in health care, including nursing, medicine, and social work. The purpose of this study was to examine the relationship between perceived organizational support, coworker social support, the nursing practice environment, and nurse demographics (age, years of nursing experience, education level, marital status, and sex) on burnout in a national sample of palliative care nurses. The study aims were (1) to examine the relationship between perceived organizational support, coworker social support, and nursing practice environment on burnout in palliative care nurses; (2) to examine the relationship between age, years of nursing experience, education level, marital status, and sex on burnout in palliative care nurses; and (3) to examine potential moderators (perceived organizational support and coworker social support) on the relationship between demographic characteristics and palliative care nurse burnout. A convenience sample of 73 Hospice and Palliative Nurses Association registered nurses who were bedside caregivers was recruited from Hospice and Palliative Nurses Association's membership. Data were analyzed using Pearson correlation and regression modeling. Findings indicated palliative care nurses had moderate to high levels of burnout. There was a negative correlation between burnout and perceived organizational support, and between burnout and coworker social support. The nursing practice environment of palliative care nurses was favorable; perceived organizational support and coworker social support were not moderators for demographics of age and years of experience and their relationship to burnout.

Variables associated with missed nursing care in Alabama: A cross-sectional analysis.

AIM: To discover the extent of and factors associated with missed nursing care in Alabama. BACKGROUND: Missed nursing care is a well-documented phenomenon. However, it has not been studied in U.S. southern states that consistently rank poorly in health outcomes, such as Alabama. METHODS: The Perceived Implicit Rationing of Nursing Care Instrument was administered as part of the Alabama Hospital Staff Nurse Study. Analyses were run on 950 surveys completed by inpatient registered nurses. RESULTS: Overall missed nursing care scores vary significantly by gender, unit type, job satisfaction and quality of nursing care. Overall missed nursing care scores are correlated with the work environment and number of patients assigned to each nurse. Unit type, quality of nursing care and the work environment are important factors associated with missed nursing care. CONCLUSION: The results of this study advance nursing science by adding to the growing body of knowledge surrounding missed nursing care. The results reveal opportunities where nurses may need support in their bedside practice. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing management must monitor the nursing work environment, periodically measure missed nursing care to assess for improvement opportunities, and watch for interventions that could decrease missed nursing care.

Misaligned core body temperature rhythms impact cognitive performance of hospital shift work nurses.

Circadian rhythms greatly influence 24-h variation in cognition in nearly all organisms, including humans. Circadian clock impairment and sleep disruption are detrimental to hippocampus-dependent memory and negatively influence the acquisition and recall of learned behaviors. The circadian clock can become out of sync with the environment during circadian misalignment. Shift work represents a real-world model of circadian misalignment that can be studied for its physiological implications. The present study aimed to test the hypothesis that circadian misalignment disrupts vigilance and cognitive performance on occupationally relevant tasks using shift work as a model. As such, we sought to (1) explore the general effects of night- and day-shift worker schedules on sleep-wake parameters and core body temperature (CBT) phase, and (2) determine whether shift-type and CBT phase impact cognitive performance and vigilance at the end of a 12-h shift. We observed a sample of day-shift and night-shift hospital nurses over a 10-day period. At the end of three, consecutive, 12-h shifts (7 pm-7am or 7am-7 pm), participants completed a cognitive battery assessing vigilance, cognitive throughput, and medication calculation fluency (via an investigator developed and tested metric). Night-shift nurses exhibited significantly greater sleep fragmentation as well as a greater disparity between their wake-time and time of CBT minimum compared to day-shift nurses. Night-shift nurses exhibited significantly slower cognitive proficiency at the end of their shifts, even after adjustment for CBT phase. These results suggest that circadian disruption and reduced sleep quality both contribute to cognitive functioning and performance.

Predictors of Back Pain in Firefighters.

The purpose of this study was to identify variables-that is, demographic factors (age, history of back pain, body mass index [BMI], and waist circumference), occupational stress, job satisfaction, perceived supervisor support, and physical fitness-that predict back pain in firefighters. Firefighters, an occupational group at high risk for back injury, perform many job tasks under hazardous work conditions. A nonexperimental, correlational design was used to study a convenience sample of 298 male firefighters who completed study questionnaires. Almost one third (30.20%) of the firefighters reported current back pain. The set of factors that predicted current back pain in firefighters included occupational stress, age, history of back pain, and BMI-pseudo R2 = .351. Further studies should validate the model and explore relationships among perceived supervisor support, occupational stress, and job satisfaction in other occupational groups, including nurses and police officers.

Mapping and Sustaining Leadership Development: An Innovation Academic Service Partnership.

OBJECTIVE AND BACKGROUND: To improve leadership competency, academic and clinical partners planned and implemented a 2-day facilitated workshop that actively engaged nurse leaders in preparing for their current and future careers by focusing on "The Leader Within." We anticipated that an emphasis on this particular dimension of leadership, that is, knowing oneself, would lead to improvements in the science and the art of leadership among nurse managers (NMs) and assistant NMs (ANMs). METHODS: Using the Nurse Manager Skills Inventory (NMSI), we conducted precompetency and 8-month postcompetency surveys and interviews. Although 41 nurses completed the pretest, only 17 completed the posttest. RESULTS: The sample of 50% NMs and 50% ANMs had an average age of 38.4 (SD, 8.2) years' and 8.2 (SD, 6.3) years' experience. Self-rated leadership competency scores were improved at the 8-month posttest period on all NMSI sections: the Science, the Art, and the Leader Within. CONCLUSIONS: Actively cultivating "The Leader Within" facilitates reflective practice that may lead to more deliberate leadership competency attainment and career planning.

Conservation of resources theory in nurse burnout and patient safety.

AIMS: To examine how the Conservation of Resources theory explains burnout in the nursing profession. BACKGROUND: Burnout, which is an accumulation of work-related mental stress in people-oriented occupations, has been an issue of concern for decades for healthcare workers, especially nurses. Yet, few studies have examined a unified theory that explains the aetiology, progression and consequences of nurse burnout. DESIGN: This discussion article integrates current knowledge on nurse burnout using Conservation of Resources theory, which focuses on four resources (i.e., objects, conditions, personal characteristics and energy). DATA SOURCES: The databases that were used in this study included CINAHL, PubMed and PsycINFO. All reviewed articles were published between January 2006 - June 2016. FINDINGS: The Conservation of Resources theory explains that burnout will occur as a result of perceived or actual loss of these four resources. Furthermore, nurse burnout could affect work performance, leading to lower alertness and overall quality of care. IMPLICATIONS FOR NURSING: Healthcare organizations and nursing administration should develop strategies to protect nurses from the threat of resource loss to decrease nurse burnout, which may improve nurse and patient safety. The Conservation of Resources theory can guide interventions to decrease burnout and future research that examines the relationship between professional nurse burnout and patient safety. CONCLUSION: The Conservation of Resources theory explains the aetiology, progression and consequences of nurse burnout. Future studies must explore whether nurse performance is a mediating factor between nurse burnout and patient safety.