The effect of nurses' perceived workplace incivility on their presenteeism and turnover intention: The mediating role of work stress and psychological resilience.

AIM: This study aims to determine the effects of nurses' perceived workplace incivility on nurses' presenteeism and turnover intention and to reveal the mediating role of work stress and psychological resilience in the possible impact. BACKGROUND: Nurses directly contribute to the treatment of patients. The problems nurses encounter in the workplace can negatively affect nurses' attitudes towards work. Therefore, the problems faced by nurses should be determined. METHODS: This study complies with the STROBE checklist. This cross-sectional survey was conducted with 302 nurses working in a university hospital in the Konya province of Turkey. Data were collected in May-July 2021. The questionnaire consisted of six parts: sociodemographic characteristics form, workplace incivility scale, psychological resilience scale, work stress scale, turnover intention scale and presenteeism scale. The data were analysed using descriptive statistical methods and partial least-squares path analysis. RESULTS: It was determined that workplace incivility positively and significantly affected turnover intention, presenteeism and work stress. In contrast, it negatively and significantly affected psychological resilience. In addition, psychological resilience played a mediating role in the effect of workplace incivility on presenteeism. CONCLUSION: The results reveal that the behaviours of incivility encountered by nurses in the workplace increase their presenteeism and turnover intention, and work stress further strengthens these effects. The psychological resilience of nurses is a factor that can help them eliminate their negative emotions and attitudes. Therefore, it is recommended that nursing and health managers first identify the stress factors in the workplace and be determined to fight them. In addition, organizing training and providing psychological support to increase nurses' psychological resilience may enable nurses to develop more positive feelings about their jobs and workplaces. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing and health managers must determine workplace incivility behaviours and inform all employees about these behaviours, their consequences and how to deal with such incivility. In addition, nursing and health managers must determine the stress factors in the workplace and be adamant about combating these factors. In addition, nursing and health managers must give importance to training that will increase the psychological resilience of nurses.

A survey of health information seeking by cancer patients indicates some problems over medical explanations and terminology.

BACKGROUND: Cancer patients may experience stress because of insufficient information about their illness, health condition, or treatment, but some may fear what the information reveals. OBJECTIVE: This study aims to determine health information-seeking behaviour, the attitudes of cancer patients, the barriers they face in seeking health information and their sociodemographic and disease characteristics. METHODS: A survey was conducted with 84 cancer patients in Turkey. Descriptive statistics were performed to determine the characteristics of information seeking and barriers found. RESULTS: Cancer patients are likely to seek health information, often confident about finding resources easily. The main problems are as follows: (1) insufficient information from health care providers; (2) understanding medical terminology; and (3) lack of help from health care providers to explain information retrieved. DISCUSSION: The information-seeking behaviour of cancer patients in this sample in Turkey resembles studies elsewhere, with (overall) evidence of monitoring behaviour (wanting to find out more about the disease, treatment and effects on lived experience). CONCLUSIONS: The cancer patients in this survey were generally willing and confident in their information seeking to find out more about the disease, treatment and effects on lifestyle. The main barriers were medical terminology, insufficient explanations and information from healthcare providers.

The Mediating Role of Resilience in the Effect of Perceived Social Support on Fear of COVID-19: A Research on Healthcare Employees.

The aim of this research was to determine the mediating role of resilience in the effect of perceived social support on fear of COVID-19. The research was conducted in the Marmara region of Turkey in July and August 2020. The present research showed that the perceived social support has a positive effect on resilience. Furthermore, the research determined that both perceived social support and resilience has a negative effect on the fear of COVID-19. Finally, it was determined that resilience has a mediating role in the effect of perceived social support on the fear of COVID-19.

The influences of corporate policies for COVID-19 on work stress and anxiety among healthcare employees.

BACKGROUND: During the coronavirus disease (COVID-19) pandemic, if it is considered that educated manpower is the most valuable resource of countries, it can be thought that various policies should be developed both at the macro- and micro-levels to minimize the loss of healthcare employees. OBJECTIVE: This study aims to determine the effects of the corporate policies for COVID-19 on the work stress and anxiety of healthcare employees. METHOD: The sample of the study consists of 136 of 265 healthcare employees in Sakarya Provincial Health Directorate Emergency Health Services in Turkey. The average age of the participants was 34.43 years, and the average duration of professional experience was 12.12 years. Approximately 61% of the participants are male and 51% have a bachelor's degree or higher level. A questionnaire form was used in the study as the data collection tool consisting of socio-demographic characteristics, institutional policies on COVID-19, work stress, and the Status Anxiety Scale. Process Macro Model 4, descriptive statistics and correlation analysis were used for the data analysis. RESULTS: According to the results of the study, the corporate policies for COVID-19 perception of participants were above average (3.30±0.82) while work stress (2.99±0.88) and anxiety (2.65±0.56) were below average. The corporate policies for COVID-19 perception of participants reduced their work stress (ß= - 0.430) and anxiety (ß= - 0.361). Additionally, anxiety played a mediating role in the effect of the corporate policies for COVID-19 perception on work stress, and it further raised the impact of corporate policies for COVID-19 perception on the work stress reduction (ß= - 0.169). CONCLUSIONS: During the COVID-19 pandemic, health managers should determine and control the anxiety and stress levels of the health employees on their staff and take a number of steps to reduce their anxiety and stress.

The effect of stress levels of nurses on performance during the COVID-19 pandemic: the mediating role of motivation.

Background: During the COVID-19 pandemic, it is thought that nurses working at more intensive levels and in high-risk areas may increase their stress and decrease their motivations and performance. Aims: This study aimed to determine the effects of stress and work stress on nurses' motivations and performances. Methods: An online, cross-sectional survey, which used self-assessment scales to measure perceived stress, perceived work stress, motivation, and work performance was used as a data collection tool. The target population was all working nurses in a hospital. Results: One hundred and fourteen nurses completed the questionnaires. The results of the study show that the participants' perceived motivation level (3.131 ± 0.685), perceived stress level (2.885 ± 0.547), and perceived job stress level (3.202 ± 1.067) were at a medium level, while their perceived performance level (3.845 ± 0.783) was at a high level. According to correlation analyses results, increases in perceived stress levels of nurses decrease their motivations (r = -0.502) and performances (r = -0.603). Similarly, increases in perceived work stress levels of nurses decrease their motivations (r = -0.441) and performances (r = -0.534). According to the Structural Equation Modelling (SEM) analysis, motivation has a mediating role in the negative effect of perceived stresses on performance (ß = -0.694) and augments such negative effect (ß = -0.169). Similarly, motivation has a mediating role in the negative effect of perceived work stresses on performance (ß = -0.295) and increases the negative effect of perceived work stress on performance (ß = -0.097). Conclusions: Nurses' perceived stress and perceived work stress levels were not high, but an increase in these variables may decrease nurses' motivation and performance. Thus, controlling nurses' stress levels and identifying possible stress sources related to the COVID-19 pandemic are important to support nurses in their work.

The effect of the fatalistic perception on the perceptions of occupational health and safety practices: The case of a hospital.

BACKGROUND: Many factors threaten occupational health and safety, such as technology and production systems used by businesses as well as employee qualifications. This research addresses the issue of how these factors have become a threat to occupational health and safety. OBJECTIVE: This study aims to determine whether healthcare professionals' fatalistic perceptions affect their perceptions of occupational health and safety practices. METHOD: The population of the study consists of 538 nurses and other auxiliary healthcare professionals working in a private hospital in Istanbul. The study initially intended to reach the whole population without establishing a sample, but 221 (41.1%) employees were reached due to reasons such as the shift system, employees' unwillingness to participate, and personnel on leave. The study employed a survey form consisting of three parts as data collection tool. The first part of the survey includes demographic information, the second part is a Fatalism Scale and the last part is the Occupational Health and Safety (OHS) Practices Scale. Descriptive statistical analyses and SEM analysis were used for data analysis. The analyses were performed within the 95% confidence interval. RESULTS: A negative relationship was found between fatalism and occupational health and safety practices. In addition, employees' fatalistic perceptions negatively affect their occupational health and safety practices. CONCLUSION: Fatalistic perception plays an important role in occupational health and safety practices. For this reason, employees can be shown through trainings that occupational accidents are not fate and can be prevented by certain measures they can take.

Turkish Adaptation of the Frommelt Attitude Toward Care of the Dying Scale.

The aim of the research was to conduct the Turkish validity and reliability study of the Frommelt Attitude toward Care of the Dying Scale. The study used a cross-sectional research design. The sample of the study consists of 236 intensive care nurses. The data were analyzed using SPSS 22.0 and SPSS AMOS 22.0 programs. Descriptive statistical methods, reliability analysis, exploratory and confirmatory factor analyses were used in the analysis of the data. According to the findings of the exploratory factor analysis, the scale was divided into six factors as in its original. According to results of the confirmatory factor analysis showed that the goodness of fit of the scale was acceptable level. Cronbach's alpha coefficients of the Frommelt Attitude toward Care of the Dying and subdimensions were found to be between 0.606 and 0.800. These results showed that the Turkish form of scale was valid and reliable and it had the necessary conditions for using Turkish form.

Defensive Medicine Practices: Scale Development and Validation.

AIM: Defensive medicine refers to practices with low marginal benefit to patients that doctors may undertake to protect themselves from legal liability. We aimed to develop a scale to measure the practice of defensive medicine. METHOD: We identified aspects of defensive medicine previously reported in the literature and conducted and analyzed semi-structured interviews with 21 physicians in Sakarya to augment and clarify these aspects between May 15, 2018, and June 15, 2018. Informed by these results, we developed, pilot tested, refined, and fielded a 10-item survey to 1724 doctors in Turkey between April 1, 2019, and July 16, 2019. We examined the psychometric properties of the scale using exploratory (EFA) and confirmatory factor analyses (CFA). RESULTS: The 10-item scale provided measures of 2 factors: positive defensive medicine (assurance) and negative defensive medicine (avoidance), with Cronbach's alpha >0.8 for the scale and both subscales in both the EFA and CFA subsamples and excellent goodness-of-fit measures. CONCLUSIONS: We developed a highly reliable scale to measure positive and negative defensive medicine practice that may be suitable for future research on physician decision making.

Assessment of healthcare professionals' perceptions and attitudes towards the COVID-19 pandemic in Turkey.

BACKGROUND: Determining the healthcare professionals' perceptions and attitudes towards the COVID-19 pandemic will contribute to managing and struggling their efforts against COVID-19. OBJECTIVE: This study aimed to determine the perceptions and attitudes of healthcare professionals who are at the forefront in the fight against this pandemic. METHODS: In the study, the survey technique used as the data collection method and 216 participants agreed to participate. The questionnaire consisted of three sections. Reliability analysis and descriptive statistical methods used to analyze the data obtained using the SPSS package program. RESULTS: According to the study results, 80.4%of the participants perceive the probability of being infected with the COVID-19 to be very high, and 64%of them consider that the conditions are very favorable for them to be infected. More than half of them are afraid of being infected and believe that if they contract COVID-19, adverse effects may continue for a long time. Furthermore, almost all participants (96.20%) consider personal protective equipment beneficial and will protect them from the COVID-19 as a wise preventive measure. However, 82.30%of the participants stated that using personal protective equipment is uncomfortable, and 76.60%said it is challenging to take care of patients while using personal protective equipment. CONCLUSIONS: The current study results show that healthcare professionals are aware of how serious COVID-19 is, understand the importance of protective equipment in protection from COVID-19, and are seriously afraid of COVID-19. Given that the fears of healthcare professionals may have adverse effects on them, it is recommended that healthcare administrators take measures to comfort healthcare workers and ensure that they maintain their positive attitude towards COVID-19.

The mediating role of patient satisfaction in the effect of patient visit experiences on word-of-mouth intention.

The purpose of this study is to find out whether patient experiences of examinations affect their word-of-mouth (WOM) intention and to identify the role of patient satisfaction with the physician in this effect. Data were collected via survey form (N = 1,100). Descriptive statistical methods, reliability analysis, exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were used in the data analysis. According to the result of the study, patient visit experiences had a positive effect on patient satisfaction with the physician, and WOM intention and patient satisfaction with the physician played a mediating role in this effect.

The Mediating Role of Shared Decision-Making in the Effect of the Patient-Physician Relationship on Compliance With Treatment.

BACKGROUND: For a successful treatment outcome, the components of the treatment process are very important. The patient-physician relationship plays a key role in the successful therapeutic process and effective health service delivery. The patient's compliance with the treatment directly affects the success of the treatment. OBJECTIVE: This study aims to determine the effect of the patient-physician relationship on compliance with the treatment and to determine whether shared decision-making has an mediating role in this effect. PATIENT INVOLVEMENT: Most of the study participants (55%) were younger than 35 and their average age was 30. The majority of the participants have an associate degree or higher education. METHOD: The study used a 4-part survey form as the data collection tool. The sample in this study consisted of 399 participants. To analyze the obtained data, Structural Equation Modeling was used by employing the Smart PLS3 software. RESULTS: The results of the study show that the patient-physician relationship positively affects the patient's compliance with the treatment and shared decision-making. In addition, shared decision-making positively affects the patient's compliance with the treatment. The effect of the patient-physician relationship on compliance with treatment was strengthened through shared decision-making. DISCUSSION: The results of the study revealed that patient-physician relationship and shared decision-making are two important factors in patients' compliance with the treatment. Accordingly, the stronger the patient-physician relationship and the more patients participate in their treatment decisions, the higher their compliance with the treatment.

The role of the human factor in occupational safety and health performance.

Objectives. The purpose of this study is to determine the effect of managers' commitment to occupational safety and health (OSH) on employees' safety awareness and competency, employees' involvement, reporting culture and OSH performance; the effect of employees' involvement in OSH on safety awareness and competency, reporting culture and OSH performance; and the mediating role of employees' involvement in the effect of managers' commitment to OSH on OSH performance. Methods. The study population consisted of 600 people working in a private company and the sample consisted of 533 employees agreeing to participate in the survey. Data were analyzed using structural equation modeling. Results. The analysis results showed that managers' commitment to OSH had no significant effect on OSH performance but a significant positive effect on employees' safety awareness and competency, employees' involvement in OSH and reporting culture. Although managers' commitment to OSH alone had no significant effect on OSH performance, it had a significant effect on OSH performance when employees' involvement was used as a mediating variable. Conclusion. OSH should not be considered only as a technical matter. It is recommended that arrangements should be made to improve OSH considering the human factors involved in OSH.

During COVID-19, which is more effective in work accident prevention behavior of healthcare professionals: Safety awareness or fatalism perception?

BACKGROUND: As the pandemic process, COVID-19 has a serious occupational safety risk for healthcare professionals. Therefore, determining their health and safety perceptions and attitudes in the pandemic process is very important. This study aims to determine which is more effective in work accident prevention behavior: safety awareness and competencies of healthcare professionals or perception of fatalism. METHOD: For this purpose, a questionnaire was applied to 326 healthcare professionals. The questionnaire consists of four parts: (1) demographic information of the employees, (2) scale of preventing occupational accidents, (3) fatalism perception scale in occupational health and safety, and (4) security awareness and competency scale. Descriptive statistical methods, multiple regression and correlation analysis were used in the analysis of the data. RESULTS: It was determined that the participants' safety awareness and competencies were at the high level and their fatalism perceptions were at the low level. The average of the responses given by the participants to the scale of preventing work accidents was above the middle level. According to the study, the safety awareness and competencies of health workers were found to be about three times more effective on the behavior of preventing work accidents than the perception of fatalism. CONCLUSION: In conclusion, it is important to recommend managers to take the step to increase the safety awareness and competencies of those working in their institutions.

The mediating role of work alienation in the effect of workplace loneliness on nurses' performance.

AIM: The purpose of this study was to determine the mediating role that work alienation has in the effect of loneliness at the workplace on nurses' job performance. BACKGROUND: The literature includes no research on the relationship between nurses' workplace loneliness, work alienation and job performance. The study used work alienation as a mediating variable, which adds to the originality of the study. This study was carried out to contribute to relevant field research. METHODS: The study used a cross-sectional research design and surveyed 138 nurses working in a public hospital in Turkey. The data were analysed using descriptive statistical methods, Pearson correlation analysis and the PROCESS macro Model 4 in the regression analysis. RESULTS: Workplace loneliness has a negative effect on job performance. This negative effect is magnified when work alienation is used as a mediating variable. CONCLUSION: Nurses' loneliness at the workplace and work alienation leads to a decline in their job performance. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should take into consideration that nurses' feelings of workplace loneliness and alienation can reduce the nurses' job performance. When managers create formal and informal support networks, it can reduce nurses' negative feelings of loneliness and alienation. Thus, helping nurses to perform better at work.

The influence of patient-physician communication on physician loyalty and hospital loyalty of the patient.

OBJECTIVE: Patient-physician communication is important for an effective healthcare service and for the patient's development of loyalty to the hospital. In this regard, this study aimed to determine whether there is a relationship between the patient-physician communication, the loyalty of the patient to the physician and to the hospital. Also study aimed to determine whether there is a mediating role of the physician loyalty on the patient-physician communication effect on to the hospital loyalty. METHOD: Five hundred ten questionnaires were distributed to regular public patients of the government hospitals, clinics, and private clinic patients in Sakarya using a simple random sampling method. Data were analysed using descriptive statistics and Structural Equation Modelling (SEM). RESULTS: According to the findings, there was a significant relationship between patient-physician communication and loyalty to physician and to hospital. Patient-physician communication has a significant effect on loyalty to physician and hospital. In addition, patient loyalty has a mediating role on the patient-physician communication effect on the hospital loyalty. CONCLUSION: According to the result of the study, physician-patient communication could be used as an important tool in creating physician loyalty and hospital loyalty. This study helps physicians and health service providers to formulate strategies and tactics that will effectively develop the loyalty of patients.