Understanding the experiences of PHC nurses in caring for older patients in the post-fifth wave of the COVID-19 pandemic: an exploratory qualitative study.

Objective: To ensure the best possible care, the perspective of PHC nurse work experience during the COVID-19 pandemic should be considered when developing nursing care protocols for older patients who receive PHC services. Method: This exploratory qualitative study was conducted with 18 nurses working continuously in PHC between the first and fifth waves of the pandemic. Semi-structured thematic interviews were undertaken. Qualitative thematic content analysis was conducted to identify and group the themes that emerged from the discourse. Interviews were transcribed and analyzed using thematic analysis. Results: The first topic describes the nurses' experiences of physical and mental suffering in caring for older patients in response to the pandemic. The second topic covers the experience of reorganizing PHC work. The third topic focuses on the difficulties of caring for older patients. The final topic includes issues of support needs for nurses in PHC work. Conclusion: The experience and understanding of PHC nurses in caring for older people during the COVID pandemic should lead to significant changes in the system of nursing care for geriatric patients and in the cooperative role within geriatric care specialist teams. Drawing on the experience of COVID-19, it is necessary to work on the weak points of PHC exposed by the pandemic in order to improve the quality of care and life for geriatric patients.

Burnout and Life Satisfaction among Healthcare Workers Related to the COVID-19 Pandemic (Silesia, Poland).

Background: The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as "COVID-19 burnout." The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic. Materials and Methods: The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA). Results: The study group included 900 participants. There were 300 physicians (mean age 38 ± 7 years), 300 nurses (mean age 35 ± 6 years), and 300 paramedics (mean age 31 ± 5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA (p = 0.001). We found a negative correlation between life satisfaction and EE (p = 0.001), DEP (p = 0.001), and SRPA (p = 0.002). Conclusions: The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.

Factors affecting nurses' compassion fatigue: A path analysis study.

BACKGROUND: Nurses often experience compassion fatigue as a result of exposure to chronic work-related stress. It is thought that nurses' mindfulness levels and patience attitudes might be effective on compassion fatigue. AIM: Therefore, in this study, it is aimed to examine the relationship between nurses' compassion fatigue, mindfulness levels and patience levels. METHODS: The study was carried out in a descriptive and relation-seeking type and was completed with the participation of 469 nurses. Data Form of Demographic and Professional Characteristics, Compassion Fatigue-Short Scale, Mindful Attention Awareness Scale and The Patience Scale were used as data collection tools. FINDINGS: As a result of the research, it was determined that there was a relationship between the mindfulness and patience levels of nurses and compassion fatigue. As the mindfulness and patience levels of nurses increase, compassion fatigue decreases (p < 0.05). As the mindfulness levels of the nurses increase, their patience levels increase as well (p < 0.05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Accordingly, it is recommended to increase the level of patience and reduce compassion fatigue by applying interventions that will increase the mindfulness levels of nurses.

Emotional intelligence and perceived social support as predictors of psychological well-being among nurses in hospitals in metro manila: Basis for psychological wellness program.

An important factor related to psychological well-being is emotional intelligence and perceived social support. Nurses are exposed to different stressors that are triggered by failing to meet personal needs, taking care of patients, heavy workloads, being exposed to dying patients, fear of committing errors in practice, and experiences of discrimination. Literature suggests that emotional intelligence and perceived social support are associated with psychological well-being. This study aimed to test whether emotional intelligence and perceived social support significantly predict psychological well-being among nurses working in hospitals in Metro Manila through multiple regression analysis. The result shows a high level of emotional intelligence and perceived social support among the respondents. Furthermore, it was also found that nurses have an average level of psychological well-being. There is also a positive relationship between the domains of emotional intelligence, perceived social support, and psychological well-being. Lastly, the results show that the domains of emotional intelligence and perceived social support significantly predict psychological well-being among nurses.

Understanding child development and care integrality: Primary Health Care doctors and nurses' view.

OBJECTIVE: To identify perceptions of primary care health professionals regarding the conceptual aspects of child development and propose strategies to address difficulties. METHODS: This descriptive-analytical study was conducted in a small municipality in the countryside of the State of São Paulo, Brazil. The primary health care in this region is comprised of Family Health Units and Basic Health Units. The sample included 52 participants, consisting of doctors and primary care nurses. A questionnaire with open and closed questions was utilized, covering knowledge and practices related to child development. For this study, the first question of the questionnaire, which asked for a descriptive response about participants' understanding of child development, was employed. The responses were transcribed, and content analysis using the thematic approach was conducted. RESULTS: Among the participants, 54% were nurses, and the average duration of working with the pediatric population was ten years. 80% reported never having undergone training in child development. The analysis of the responses revealed heterogeneity in the professionals' understanding of the conceptual dimension of child development. Additionally, there was an insufficient grasp of the theoretical and practical aspects and a scarcity of resources to support comprehensive care for children. A predominant biomedical model focusing on disease and biological aspects of child health was evident in defining the understanding of the subject. CONCLUSIONS: The findings underscore the necessity of implementing health education initiatives and service projects in primary care settings. It is crucial to strengthen a comprehensive perspective of child health within the biopsychosocial model of the health-disease process.

Experiences and challenges of enrolled nurses undertaking a Bachelor of Nursing Science programme in Namibia.

BACKGROUND:  Globally, enrolled nurses (ENs) are embarking on an educational journey to become registered nurses (RNs) in order to enhance their knowledge and career opportunities. However, their aspiration is not without challenges. In Namibia, the experiences of these nurses have not been extensively researched. OBJECTIVES:  This study aims to explore and describe the experiences and challenges of ENs undertaking a Bachelor of Nursing Science at the University of Namibia. METHOD:  A qualitative, exploratory, descriptive and contextual research strategy was followed as the basis of conducting the study. A sample of 15 nursing students was purposively selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes. The collected data were analysed thematically using an inductive approach. RESULTS:  Three main themes subsequently emerged from the study: ENs' positive experiences advancing in the Bachelor of Nursing Science (BNSc) programme; nurses' negative experiences advancing in the BNSc programme; and recommendations to ensure effective advancement in the BNSc programmeConclusion: The findings of this study revealed that ENs positively experience becoming a RN when it comes to self-development; however, they have negative experiences such as not receiving exemptions for prior learning and having to learn a new curriculum.Contribution: These findings may be used by the Faculty of Health Sciences, School of Nursing and Public Health management in order to develop targeted interventions and ongoing strategies during their curriculum review cycles to ensure positive student experiences and success within the programme.

Medical Error Prevalence, Nursing Power, and Structural Empowerment: A Serial Mediation Analysis.

Aim: To investigate how structural empowerment and power may contribute to and predict the reduction of medical errors. Background: Medical errors threaten patient well-being, leading to adverse outcomes. Improving work conditions holds promise for reducing medical errors among nurses. Methods: A multisite correlational cross-sectional design was utilized. Data were completed by 375 nurses from four hospitals in Jordan. Data collection occurred between September and November 2023 using sociodemographic, structural empowerment, and medical error questionnaires. The study employed descriptive statistics, Pearson r correlation, and serial mediation analysis. Informed consent was obtained from each participant. Results: Pearson r correlation revealed significant negative correlations between medical error and structural empowerment, formal power, and informal power. The conceptual framework was significant and predicted 16% of the variance in medical errors. The mediation analysis confirmed that formal power and informal power mediate the relationship between structural empowerment and medical error. Conclusions and Implications. This study sheds light on the intricate connection of structural empowerment, formal and informal power, and their collective impact on reducing medical errors. Understanding and addressing these dynamics allows nurses and administrators to achieve a culture of patient safety. Reduction of medical errors is paramount to a safe healthcare environment that prioritizes patient outcomes. Strategies should be fostered to enhance structural empowerment, refine formal power structures, and leverage the positive aspects of informal networks.

Nurses' experience of end-of-life care for patients with COVID-19: A descriptive phenomenology study.

The mortality rates among critically ill patients with COVID-19 have been high. The national and institutional infection control policies and resource shortages caused by the pandemic led patients to undergo deaths without dignity and inevitably changed intensive care unit (ICU) end-of-life care (EOLC) practices. This study explores ICU nurses' experiences of providing EOLC for patients with COVID-19 who died. Eight nurses participated in a qualitative phenomenological study. Semi-structured interviews were conducted from July to September 2022. Colaizzi's data analysis method was used, and the following four main themes emerged: (i) only companion in the death journey; (ii) helping families prepare for death; (iii) EOLC trapped within a framework; and (iv) EOLC in retrospect. To secure high-quality EOLC in ICU, it is important to promote practical support for nurses and EOLC-related discussions/education. Technical support, such as digital communication technologies, should be reinforced to help patients and their families participate in EOLC.

Perceived stress, optimism-pessimism, psychological adjustment, and death distress of nurses during the COVID-19 pandemic.

OBJECTIVE: the aim of this study is to investigate the relationship between death distress, psychological adjustment, optimism, pessimism and perceived stress among nurses working during the COVID-19 pandemic. METHOD: this study was designed as cross-sectional/cohort. The population of the study involved 408 nurses from Northern Cyprus, which are registered as full members of the Nurse Council. The sample comprised 214 nurses, who volunteered to participate in the study. The study data was collected using a web-based online survey (Demographic form, the Coronavirus Stress Measure, The Optimism and Pessimism Questionnaire, The Brief Adjustment Scale-6, The Death Distress Scale). RESULTS: the results indicated that perceived stress significantly and negatively predicted optimism (ß = -0.21, p < 0.001) and pessimism (ß = 0.38, p < 0.001). Perceived stress had significant and positive predictive effects on psychological adjustment (ß = 0.31, p < 0.001) and death distress (ß = 0.17, p < 0.01). Further analysis results revealed that pessimism mediates the association of stress with psychological adjustment and death distress; however, optimism only mediates the effect of stress on psychological adjustment among nurses. CONCLUSION: a low level of pessimism is effective in strengthening nurses' psychological adjustment skills againt perceived stress and death distress. Nurses should consider behavioral strategies to help reduce the level of pessimism during periods such as pandemics. BACKGROUND: (1) High levels of perceived stress increased higher score of psychological adjustment. (2) Pessimism mediates the association of stress with adjustment and death distress. (3) Optimism only mediates the effect of stress on psychological adjustment among nurses.

Nurses' perception of the impact of professional development sessions on their pre-hospital clinical practice with trauma victims.

Background: Continuing education is important for the quality of clinical practice because it complements it and focuses primarily on producing qualified pre-hospital nurses with operationally defined competence in nursing standards. The objective of this study was to assess pre-hospital nurses' opinion of the impact of professional development sessions on their clinical practice. Method: A descriptive and quantitative study was carried out involving Portuguese pre-hospital nurses. Six professional development sessions were presented in 2020 to pre-hospital registered nurses in four of Portugal's main cities. To collect the data, at the end of each session, we apply a questionnaire designed specifically for this study. This data collection instrument consists of 11 questions, six designed to evaluate the session and five designed to evaluate the trainer responsible for the session. A five-point Likert scale was used for each question, where 1 corresponds to very dissatisfied and 5 to extremely satisfied. Results: Two hundred and two nurses, which represents 55% of all Portuguese pre-hospital nurses, took part in the assessment of the professional development sessions. The nurses were from the Northern region of Portugal (51%; n = 102), the Centre region (29%; n = 59) and the Southern region of Portugal (20%; n = 41). Nurses found the session extremely satisfactory. All the assessment scores ranged between 4.4 and 4.7 points, on a scale of 1 to 5. 76.2% of the participants considered that the knowledge acquired could have a major impact [score = 5] on their future clinical practice. The majority of pre-hospital nurses (96.5%) felt that the session could have a major impact [score = 5; 76.2%, n = 154] or a very important impact [score = 4; 20.3%, n = 41] on their clinical practice. Conclusion: The professional development sessions provide pre-hospital nurses with the latest research findings and the majority of nurses considered that the training had a huge impact on their clinical practice. However, it is important that future research aims to explore the cause-effect relationship between training and improved clinical practice.

Translation and validation of the Chinese version of the Self-awareness Scale for Nurses.

Background: Levels of self-awareness may affect the decision-making ability of clinical nurses and may also be related to mental health. Therefore, it is crucial to develop tools to identify nurses' level of self-awareness. The purpose of this study was to investigate the reliability and validity of a short scale among Chinese nurses and to explore the factors associated with nurses' self-awareness. Methods: A total of 957 participants were recruited, 549 participants were used for reliability tests and 408 subjects were used for impact factor studies. They completed the General Information Questionnaire, the Self-Awareness Scale for Nurses, and the Psychological Distress Scale. Exploratory factor analysis, confirmatory factor analysis, Cronbach's alpha, and retest reliability were used to investigate the psychometric properties of the Self-Awareness Scale for Nurses. Multiple regression analyses were used in this study to investigate the relationship between nurses' self-awareness and the independent variables. Results: A 4-factor model of the Chinese version of the Self-Awareness Scale for Nurses was validated. The overall Cronbach's alpha value for the Chinese version of the Self-Awareness Scale for Nurses was 0.873. Cronbach's alpha values for each subscale ranged from 0.808 to 0.979. Significant predictors of each dimension of the Self-awareness and the total score of the scale were age and work experience. Conclusion: The Chinese version of the Self-Awareness Scale for Nurses is a valid and reliable scale.

Socio-cognitive mindfulness in nursing: A scoping review.

BACKGROUND: While research on meditative mindfulness in nursing is abundant, research on socio-cognitive mindfulness is in its early stages despite its potential advantages to nursing practice and nursing education. This study introduces the under-examined concept of socio-cognitive mindfulness to the nursing field. OBJECTIVE: To identify what is known in the research field of socio-cognitive mindfulness in nursing. Specific aims were to identify the effects of socio-cognitive mindfulness on nurses and nursing students, and the application of socio-cognitive mindfulness interventions and their effectiveness in nursing. DESIGN: A scoping review following the Arksey and O'Malley framework. METHODS: An electronic search of PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, ERIC, and ProQuest databases was conducted. The search included full-text papers published in peer-reviewed journals in English. The included studies were independently examined by the two authors to ensure the thorough inclusion of relevant research by screening of titles and abstracts and screening of full-texts. The selected papers were categorized based on the specific objectives of the review. RESULTS: Out of 5,798 papers, six quantitative studies and one mixed method study were included in the review. Among the seven studies, two studies investigated the effects of socio-cognitive mindfulness on nurses, four examined the effects of socio-cognitive mindfulness on nursing students, and one conducted an intervention study applying socio-cognitive mindfulness and identified its effects on nurses. The findings revealed several benefits of applying socio-cognitive mindfulness to nursing practice and nursing education. Specifically, socio-cognitive mindfulness enhanced nurses' and nursing students' positive emotions and effective emotion regulation, which would positively influence nurses' nursing performance as well as students' academic outcomes and quality of college life. CONCLUSIONS: This study raises researchers' awareness of the significance of socio-cognitive mindfulness in nursing, and strongly recommends applying socio-cognitive mindfulness to nursing practice and nursing education and evaluating its effects.

Association between body mass index and mental health among nurses: a cross-sectional study in China.

PURPOSE: To examine the correlation between body mass index (BMI) and mental well-being in Chinese nurses during the COVID-19 epidemic. METHOD: This study was conducted in a tertiary hospital using a cross-sectional design. A total of 2,811 nurses were enlisted at Shengjing Hospital in China during the period from March to April, 2022. Information was gathered through a questionnaire that individuals completed themselves. The mental health of the participants was assessed using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder Assessment-7. Binary logistic regression was used to calculate adjusted odds ratios (ORs) and their corresponding 95% confidence intervals. RESULTS: The prevalence of nurses experiencing depression and anxiety was 7.8% (219) and 6.7% (189), respectively. Regarding depression after adjustment, the odds ratios (ORs) for each quartile, compared to the lowest quartile, were as follows: 0.91 (95% confidence interval [CI]: 0.53, 1.56), 2.28 (95% CI: 0.98, 3.77), and 2.32 (95% CI: 1.41, 3.83). The p-value for trend was found to be 0.001. The odds ratios (ORs) for anxiety after adjustment were 2.39 (0.83, 4.36), 4.46 (0.51, 7.93), and 2.81 (1.56, 5.08) when comparing the highest quartiles to the lowest quartile. The p-value for trend was 0.009. CONCLUSION: This study found a positive association between BMI and poor mental health among nurses during the COVID-19 pandemic, particularly in those who were overweight or obesity. The findings could assist in developing interventions and help policy-makers establish appropriate strategies to support the mental health of frontline nurses, especially those who are overweight or obesity.

Sense of failure in end of life care: Perspectives from physicians and nurses.

Limited knowledge exists regarding sensed failure resulting provision of end-of-life (EOL) care. Among medical health professionals (MHP), a sense of failure is associated with impaired patientcare and reduced worker wellbeing, including higher rates of burnout and secondary traumatic stress. As part of a larger mixed-methods study on the effects of EOL-care provision on MHP in general hospitals, semi-structured in-depth interviews were conducted with 22 physicians and nurses at three tertiary Israeli hospitals, representing a wide range of medical specialties, training, experience, and cultural backgrounds. Qualitative thematic analysis of the interviews led to the identification of the theme 'sense of failure' with the sub-themes 'sources' and 'lived meanings' of the sensed failure. Apart from the source 'losing a patient' all other identified sources were recognized as work-related risk factors, including 'unsupportive environments' and 'shortcomings of the medical practice.' Two of the lived meaning 'sense of personal responsibility' and 'moral injury' were also recognized as work-related risk factors. Surprisingly, albeit the adverse context of EOL-care, the two remaining lived meanings 'learning from failure' and 'sense of purpose' were recognized as protective resilience factors. Changes in workplace norms by focusing on leadership and mentoring programs and implementation of evidence based interventions aimed at reducing the sense of failure and enhancing feelings of purpose are recommended. Finally, the findings described in the study would benefit from continued studies on larger scales.

Cell Phones in the OR: A Cross-Sectional Study of Norwegian Perioperative Nurses' Knowledge, Practice, and Attitudes.

Few studies have focused on the use of cell phones in the OR. In Norway, researchers sought to assess perioperative nurses' knowledge, practice, and attitudes associated with cell phone use in the OR and distributed a nationwide questionnaire via a social media platform. More than 80% of the 332 respondents thought that cell phones were contaminated and that pathogens could contaminate hands. Almost all respondents brought their phone to work; approximately 61% of respondents carried it in their pocket in the OR. Responses to questions about phone cleaning showed that 39 (11.7%) of the respondents routinely cleaned their phone before entering the OR and 33 (9.9%) of the respondents cleaned it when leaving the OR. Less than 20% of respondents indicated their facility had guidelines for cleaning personal cell phones. Opportunities for improvement in cell phone cleaning in ORs exist and additional research involving all perioperative team members is needed.

Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review.

Background: Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves. Aim: To improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions. Methods: Realist synthesis methodology consistent with realist and meta-narrative evidence syntheses: evolving standards' reporting guidelines. Data sources: First round database searching in Medical Literature Analysis and Retrieval System Online Database ALL (via Ovid), cumulative index to nursing and allied health literature database (via EBSCO) and health management information consortium database (via Ovid), was undertaken between February and March 2021, followed by supplementary searching strategies (e.g. hand searching, expert solicitation of key papers). Reverse chronology screening was applied, aimed at retaining 30 relevant papers in each profession. Round two database searches (December 2021) targeted COVID-19-specific literature and literature reviews. No date limits were applied. Results: We built on seven key reports and included 75 papers in the first round (26 nursing, 26 midwifery, 23 paramedic) plus 44 expert solicitation papers, 29 literature reviews and 49 COVID-19 focused articles in the second round. Through the realist synthesis we surfaced 14 key tensions in the literature and identified five key findings, supported by 26 context mechanism and outcome configurations. The key findings identified the following: (1) interventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressors; (2) it is difficult to promote staff psychological wellness where there is a blame culture; (3) the needs of the system often override staff well-being at work ('serve and sacrifice'); (4) there are unintended personal costs of upholding and implementing values at work; and (5) it is challenging to design, identify and implement interventions to work optimally for diverse staff groups with diverse and interacting stressors. Conclusions: Our realist synthesis strongly suggests the need to improve the systemic working conditions and the working lives of nurses, midwives and paramedics to improve their psychological well-being. Individual, one-off psychological interventions are unlikely to succeed alone. Psychological ill-health is highly prevalent in these staff groups (and can be chronic and cumulative as well as acute) and should be anticipated and prepared for, indeed normalised and expected. Healthcare organisations need to (1) rebalance the working environment to enable healthcare professionals to recover and thrive; (2) invest in multi-level system approaches to promote staff psychological well-being; and use an organisational diagnostic framework, such as the NHS England and NHS Improvement Health and Wellbeing framework, to self-assess and implement a systems approach to staff well-being. Future work: Future research should implement, refine and evaluate systemic interventional strategies. Interventions and evaluations should be co-designed with front-line staff and staff experts by experience, and tailored where possible to local, organisational and workforce needs. Limitations: The literature was not equivalent in size and quality across the three professions and we did not carry out citation searches using hand searching and stakeholder/expert suggestions to augment our sample. Study registration: This study is registered as PROSPERO CRD42020172420. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020172420. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR129528) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 9. See the NIHR Funding and Awards website for further award information.

The National Health Service needs healthy, motivated staff to provide high-quality patient care. Nurses, midwives and paramedics experience poor psychological health (e.g. stress/anxiety) because of pressured environments and the difficulties of healthcare work. This study planned to better understand the causes of poor psychological ill-health in nurses, midwives and paramedics and find which interventions might help and why. We analysed the literature using a method called 'realist review' to understand how interventions work (or not), why, and for who. We tested our findings with patients, the public, nurses, midwives and paramedics in our stakeholder group. We reviewed over 200 papers/reports and identified five main findings: (1) existing solutions (interventions) are disjointed, focus mainly on the individual (not the system) and do not recognise enduring stressors enough; (2) when there is a blame culture it is difficult to encourage staff psychological well-being; (3) the needs of the system often override staff psychological well-being at work; (4) upholding and implementing personal and professional values at work can have negative personal costs; and (5) it is difficult to design, identify and implement solutions that work well for staff groups in different circumstances with varied causes of poor psychological health. Healthcare organisations should consider: (1) changing (rebalancing) the working environment to help healthcare professionals rest, recover and thrive; (2) investing in multiple-level system (not just individual) approaches to staff psychological well-being; (3) continuing to reduce stigma; (4) ensuring the essential needs of staff are prioritised (rest-breaks/hydration/hot food) as building blocks for other solutions; (5) addressing the blame culture, assuming staff are doing their best in difficult conditions; (6) prioritising staff needs, as well as patient needs. We will provide guidance and recommendations to policy-makers and organisational leaders to improve work cultures that tackle psychological ill-health and suggest new areas for research.

Development and validation of impact of early integration of palliative care and oncology(IEI PCO) questionnaire: a survey for medical oncologists and nurses.

OBJECTIVES: Many associations have recently recommended early integration of oncology and palliative care for more standard cancer care and better quality of life. We aimed to create a questionnaire to assess the opinion of medical oncologists and nurses about the clinical impact of the integrated palliative care and oncology (PCO) program. METHODS: A novel semi-structured questionnaire called Impact of Early Integration of Palliative Care Oncology (IEI PCO) questionnaire was developed and tested for validity and reliability then distributed to the oncologists and nurses working in Kuwait Cancer Control Center. RESULTS: After the pilot stage, testing the final questionnaire for validity and reliability was done with satisfactory results. Finally, the complete questionnaires were 170 out of 256 (response rate 66.41%). More awareness about the available palliative care services and the new available PCO services (p-value < 0.001 for all). Most of the oncologists and nurses agreed with the currently available structure of PCO, appreciated the patients' discharge plan and continuity of care of palliative medicine, admitted less work burden, a better attitude, and higher satisfaction (p-value for all < 0.001) toward palliative care. Significant improvements in symptoms were appreciated by oncologists and nurses after the integration of palliative care (p-value for all < 0.001. Oncologists and nurses valued repeated honest communication, discussion of the goals of care, dealing more effectively with ending active treatment, and higher acceptance of patients and families of PC policy of transfer, and significant progress in the care of end-of-life symptoms (p-value for all < 0.001). CONCLUSIONS: The IEI PCO questionnaire demonstrated the psychometric criteria for content, face, and construct validity and reliability. It provides a valuable tool to assess the impact of PCO integration. The opinion of medical oncologists and nurses was significantly positive toward the early integration of PCO in Kuwait in most aspects of care. This integration led to improved symptom control, end-of-life care, communication, and planned discharge and follow-up plans. Moreover, decreases the work burden, improves attitude, higher satisfaction of the oncology staff, and continuity of care.

Perception and needs: a qualitative study on sense of job security among nurses in central and western China.

AIMS: To explore nurses' perceptions of sense of job security and their needs to improve it. DESIGN: A descriptive qualitative study employed an in-depth, in-person interview from February to April in 2021. The data analysis software NVivo V.11.0 was used to assist with the data organisation, and content analysis methods were conducted to explore key concepts. SETTING: Three tertiary hospitals in central and western China were selected by convenience sampling method. PARTICIPANTS: A total of 20 nurses participated in this study. RESULTS: Four categories and 13 subcategories were extracted. The four main categories included: (1) enrich connotation of sense of job security; 2) challenges to sense of job security; (3) consequences of a sense of insecurity; and (4) the need to improve nurses' sense of job security. CONCLUSIONS: Nurses expressed a multidimensional perception of a sense of security about the nursing profession, and they highlighted the importance of communication skills training and supervisors' humanistic care and support. It is necessary to improve the training system for nurses' ability improvement, a harmonious work environment, policies and psychological health support to enhance their sense of job security.