Factors Influencing COVID-19 Vaccination among Primary Healthcare Nurses in the Pandemic and Post-Pandemic Period: Cross-Sectional Study.

The decision to vaccinate against COVID-19 is primarily a personal choice influenced by numerous factors. Vaccine acceptance and a positive attitude towards vaccination among nurses have an impact on patients' willingness to vaccinate. To assess COVID-19 vaccination coverage among primary healthcare nurses and to associate socio-demographic factors, comorbidity, self-rated health, and unhealthy lifestyle with the decision to be vaccinated, we conducted an online cross-sectional study from March to May 2023 using a self-administrated questionnaire. Probability sampling was used to select 32 health centers and nurses were invited via email. Among the 560 participants who completed survey, 78.3% and 50.8% received the primary two-dose course and at least one booster dose of COVID-19 vaccine, respectively. Primary care nurses who were ≥41 years of age, physically less active, and those who were overweight opted statistically significantly more often for the primary vaccination scheme (p = 0.00, 0.015 and 0.017, respectively). Education and the living environments of primary care nurses did not significantly influence the decision to receive two primary COVID-19 doses. Likewise, good self-rated health and comorbidity did not contribute significantly to the vaccination decision. Nurses that were vaccinated with booster doses were significantly more often overweight (p = 0.034) and ≥41 year of age (p = 0.000).

Patient Outcomes and Hospital Nurses' Workload: A Cross-Sectional Observational Study in Slovenian Hospitals Using the RN4CAST Survey.

Introduction: Higher nursing workload increases the odds of patient deaths, as the work environment has a significant effect on patient outcomes. The aim of the study was to explore the relation between patient outcomes and nurses' working conditions in hospitals. Methods: Administrative data on discharges of surgical patients for the year 2019 in eight general hospitals and two university medical centres in Slovenia were collected to determine in-hospital mortality within 30 days of admission. The RN4CAST survey questionnaire was used to gather data from nurses in these hospitals, with 1,010 nurses participating. Data was collected at the beginning of 2020. The number of nurses per shift and the nurse-to-patient ratio per shift were calculated. Univariate, bivariate and multivariate statistical methods were used to analyse the data. Results: The 30-day in-hospital mortality for surgical patients was 1.00% in the hospitals sampled and ranged from 0.27% to 1.62%. The odds ratio for staffing suggests that each increase of one patient per RN is associated with a 6% increase in the likelihood of a patient dying within 30 days of admission. The mean patient-to-RN ratio was 15.56 (SD=2.50) and varied from 10.29 to 19.39. Four of the 13 tasks checked were not performed on patients during the last shift. Conclusion: The results are not encouraging, with an extremely critical shortage of RNs and thus a high RN workload. The number of patients per RN is the highest in Europe and also higher than in some non-European countries, and represents an extreme risk to the quality of nursing and healthcare as a whole. The recommendation for acute non-emergency internal medicine and surgery departments is four patients per RN per shift.

How nurses' job characteristics affect their self-assessed work environment in hospitals- Slovenian use of the practice environment scale of the nursing work index.

BACKGROUND: Nurses' work environment influences nursing practice. Inappropriate working conditions are the result of underdeveloped workplace infrastructure, poor work organisation, inadequate education, and inappropriate staffing norms. The aim of this study was to describe and examine the predictors that affect nurses' work environment using the Practice Environment Scale of the Nursing Work Index (PES-NWI). METHODS: The validation of the PES-NWI was made. Nurse-reported job characteristics were used as independent variables. The sample included 1,010 nurses from adult surgical and medical units at 10 Slovenian hospitals. The Nurse Forecasting (RN4CAST) protocol was used. Permission to conduct the study was obtained from the National Medical Ethics Committee. RESULTS: The PES-NWI mean (2.64) was low, as were job and career satisfaction at 2.96 and 2.89, respectively. The PES-NWI can be explained in 48% with 'Opportunities for advancement', 'Educational opportunities', 'Satisfaction with current job', 'Professional status', 'Study leave', and 'Level of education'. A three-factor solution of PES-NWI yielded eight distinct variables. CONCLUSIONS: The obtained average on the Nursing Work Index was one of the lowest among previously conducted surveys. Nurses should be recognized as equals in the healthcare workforce who need to be empowered to develop the profession and have career development opportunities. Inter-professional relations and equal involvement of nurses in hospital affairs are also very important. TRIAL REGISTRATION: This is a non-intervention study - retrospectively registered.

Positive digital communication among youth: The development and validation of the digital flourishing scale for adolescents.

Research has extensively studied the negative effects of digital communication on adolescents' well-being. However, positive digital experiences and behavior in adolescence are still poorly understood. The recently developed Digital Flourishing Scale addresses this gap and focuses on the positive perceptions of a user's experiences and behaviors in digital communication among adults. In this paper, we developed an adolescent version of this scale. Study 1 demonstrated the internal consistency of the scale and the same factor structure for adolescence as for adulthood: connectedness, civil participation, positive social comparison, authentic self-presentation, and self-control. Study 2 confirmed the identified factor structure with a second sample of adolescents and established measurement invariance across genders. The construct validity of the scale was confirmed by investigating associations with related constructs, including the basic psychological needs from self-determination theory (competence, autonomy, and relatedness), secure attachment to a close friend, Internet aggression, social media-induced inspiration, authenticity of posted positive content, and social media self-control failure. The results indicated that not all adolescents flourish equally online. Differences occurred depending on the adolescents' gender and socioeconomic status. The paper concludes that the newly developed scale is a valid and reliable measure for assessing adolescents' perceptions of digital thriving and digital empowerment.

Perceptions of Slovenian elementary schoolchildren on nursing and nurses-Exploratory study.

AIM: The research aimed to assess the perception on nursing and nurses among schoolchildren of Slovenian elementary schools. BACKGROUND: Among the general public, nursing remains under-recognized as an occupation and a science. Especially young people have unrealistic perceptions of nurses. DESIGN: A cross-sectional research design was undertaken. METHODS: The study included 1984 eighth grade schoolchildren from 103 elementary schools. Data were collected with a structured questionnaire. RESULTS: The research results revealed a positive general perception of nursing. Surprisingly, only 2.5% of respondents would consider a career in nursing. Girls had more understanding of nursing compared to boys (p < 0.001); having a nurse relative meant better understanding of nursing (p = 0.032). The influence of the traditional view of nursing and the biomedical model of care which describes nursing not as autonomous, but as subordinate to medicine, was considerate (p < 0.001). CONCLUSIONS: The study shows that elementary school children do not express an interest in a career in nursing. They perceive the job of a nurse as female-dominated, they cling to the traditional perception of nursing being subordinate to medicine, and they indicated dominance of the biomedical model of care. Healthcare policy makers must remember that healthcare systems cannot function without nurses, so developing nursing is crucial. To increase interest in the profession, a national campaign promoting nursing programs and the nursing profession and presenting horizontal and vertical career opportunities is needed. Young people must have realistic information on nursing as an occupation and a science, its role in the healthcare system, and career opportunities. Activities aimed at changing public opinion on nursing must be planned.

Differences in beliefs on and implementation of evidence-based practice according to type of health care institution-A national cross-sectional study among Slovenian nurses.

AIM: To explore the differences in beliefs on and implementation of evidence-based practice in nurses working in different types of health care institutions. BACKGROUND: Optimal organizational context and knowledge are essential to support evidence-based practice and sustain the use of evidence in professional nursing practice. METHOD: A cross-sectional study was conducted. A total of 1,014 nurses from 20 Slovenian hospitals and 29 primary health care centres participated. Variables included the following: Evidence-Based Practice Beliefs and Implementation Scale, educational and training activities, job satisfaction, job training, perceived research and evidence-based practice knowledge, and access to databases. RESULTS: Beliefs on evidence-based practice were explained by evidence-based practice (ß = 0.249) and research (ß = 0.162) knowledge, length of employment (ß = 0.124), job satisfaction (ß = 0.117), training in evidence-based practice (ß = -0.092) and holding a master's degree (ß = 0.077). Implementation of evidence-based practice depended on beliefs (ß = 0.306) and the type of health care institution (ß = 0.132). The highest implementation result was seen in primary health care centres (<0.001). CONCLUSION: Training in evidence-based practice and perceived knowledge of evidence-based practice significantly influence the beliefs on and implementation of evidence-based practice. Nurses employed at primary health care centres who had completed a task-shifting training programme achieved significantly better results for implementation of evidence-based practice. IMPLICATIONS FOR NURSING MANAGEMENT: The indirect effects of development training programmes for the implementation of EBP have not yet been studied. Development activities and change implementation processes in nursing foster education and training opportunities, which have significantly influenced the implementation of EBP.

Occupational Therapists' Creativity: Tapping Into Client Centeredness Using a Novel Creativity Questionnaire.

IMPORTANCE: To further the understanding of client centeredness in the context of creativity. OBJECTIVE: This study's objective was to explore the client's uniqueness as the key motivator of creativity in the occupational therapy process using a novel assessment tool, the Creativity in Occupational Therapy Questionnaire (COTQ). Our hypothesis was as follows: "Clients and their characteristics are more important to the creativity of an occupational therapist than the occupational therapist's personality." DESIGN: This study is part of a mixed-methods study. The COTQ, consisting of five clusters of items, was pretested for clarity and reliability in a pilot study (α = .90). It was then used in an online survey of Slovenian occupational therapists. To analyze data, factor and regression analyses were used. SETTING: The survey was completed online. PARTICIPANTS: The survey was sent to all electronic addresses obtained from the Association of Occupational Therapists of Slovenia and the Faculty of Health Sciences at the University of Ljubljana. It was completed by 250 occupational therapists, which represented more than 40% of all Slovenian occupational therapists. RESULTS: Occupational therapists included in the study reported that clients triggered and encouraged their creativity. Both the client's uniqueness, B = .574, t(197) = 12.24, p < .01, and the occupational therapist's personality, B = .388, t(197) = 6.51, p < .01, had a statistically significant influence on creativity in the occupational therapy process. CONCLUSIONS AND RELEVANCE: This study supports the importance of creativity in client-centered practice and provides a quantitative measure of this concept, which could be used in future longitudinal studies. WHAT THIS ARTICLE ADDS: This article suggests that the individual client is the most important factor in the creative process of an occupational therapist. It introduces a novel assessment tool and provides suggestions on how to facilitate a client-centered approach using creativity.