Nursing

Cengiz, A., Yoder, L.H. and Danesh, V. (2021). “A concept analysis of role ambiguity experienced by hospital nurses providing bedside nursing care.” Nurs Health Sci 23(4): 807-817.

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The concept of role ambiguity, despite its wide application in nursing research, lacks a clear definition and conceptualization, resulting in inconsistencies about how it is defined, operationalized, and applied in research. The purpose of this paper was to analyze and define the concept of role ambiguity among hospital nurses providing nursing care, using the concept analysis method developed by Walker and Avant. The three defining attributes of role ambiguity were lack of information (information deficiency), lack of clarity, and unpredictability. Antecedents included lack of clear role definitions, lack of education/training, communication problems, supervisory behaviors and support, organizational culture, practice environment conditions, experience, group cohesiveness, and preferred work setting. The consequences of role ambiguity included increased stress, lack of organizational commitment, job dissatisfaction, burnout, and increased intent to leave. This concept analysis provides a clear conceptual definition to better understand role ambiguity among hospital nurses along with implications for nurse leaders, educators, clinicians, and researchers to support nurses and guide future research. This paper further emphasizes the importance of nurse-manager relationships in reducing the experience of role ambiguity among hospital nurses.

Cengiz, A., L. H. Yoder and V. Danesh (2021). “A Concept Analysis of Role Ambiguity Experienced by Hospital Nurses Providing Bedside Nursing Care.” Nurs Health Sci Oct 24. [Epub ahead of print].

Full text of this article.

The concept of role ambiguity, despite its wide application in nursing research, lacks a clear definition and conceptualization, resulting in inconsistencies about how it is defined, operationalized, and applied in research. The purpose of this paper was to analyze and define the concept of role ambiguity among hospital nurses providing nursing care using the concept analysis method developed by Walker and Avant. The three defining attributes of role ambiguity were lack of information (information deficiency), lack of clarity, and unpredictability. Antecedents included lack of clear role definitions, lack of education/training, communication problems, supervisory behaviors and support, organizational culture, practice environment conditions, experience, group cohesiveness, and preferred work setting. The consequences of role ambiguity included increased stress, lack of organizational commitment, job dissatisfaction, burnout, and increased intent to leave. This concept analysis provides a clear conceptual definition to better understand role ambiguity among hospital nurses along with implications for nurse leaders, educators, clinicians, and researchers to support nurses and guide future research. This paper further emphasizes the importance of nurse-manager relationships in reducing experience of role ambiguity among nurses in hospitals.

Danesh, V., Hecht, J., Hao, R., Boehm, L., Jimenez, E.J., Arroliga, A.C., Sanghi, S. and Stevens, A. (2021). “Peer Support for Post Intensive Care Syndrome Self-Management (PS-PICS): Study protocol for peer mentor training.” J Adv Nurs Jan 11. [Epub ahead of print].

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AIMS: The primary aim of the Peer Support for Post Intensive Care Syndrome Self-Management (PS-PICS) peer mentor training trial is to determine the feasibility for peer mentor training to connect new ICU survivors with survivors who have made successful recoveries. Secondary aims are to also examine peer mentor eligibility, recruitment and retention rates and assess changes in participant knowledge of Post Intensive Care Syndrome (PICS), reported symptoms and health-related quality of life. DESIGN: Prospective clinical feasibility trial. METHODS: This study received funding from the National Institutes of Health funded P30 Center for Excellence (2014-2020). Up to 20 adult patients who have had an ICU stay of 3 days or longer more than 3 months ago will be enrolled into the study. Participants will undergo a 6-week peer mentor training program to learn how to promote healthy self-management behaviours, social connections, and well-being using motivational interviewing (MI). Participants will complete surveys about their recovery at 3 points during the study: prior to training, 6 weeks post-training and 3 months post-training. Survey questions will be used to assess trends in participant social isolation, depression, functional status, and self-management behaviours. DISCUSSION: Enrollment closes by December 2020. As a feasibility trial, power sufficient for hypothesis testing will not be available. However, study operations and intervention fidelity contribute to future research knowledge and participant characteristics and longitudinal outcomes will yield data on intervention feasibility. This study is the first use of embedding peer-led motivational interviewing training into a peer support intervention for ICU survivors. IMPACT: Current self-management interventions are limited for ICU survivors and do not sufficiently address barriers to promoting self-management behaviours or improving their health status, well-being and cost of health. This study will provide data to develop and implement interventions for the self-management of PICS-related symptoms and sequelae.

Watson, J. (2020). “Advocacy and Collaboration: Advancing Cancer Prevention and Screening.” Clin J Oncol Nurs 24(5): 39-44.

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BACKGROUND: Cancer prevention and screening is a significant part of the cancer care continuum. Nurses are trusted professionals who can bring stakeholders together and serve diverse groups. OBJECTIVES: This article describes how nurses can advance cancer prevention and screening initiatives in industry, education, legislative advocacy, research, survivorship, and program development and support. METHODS: An online search and collaborative knowledge revealed examples of nurses leading the way in cancer prevention and screening efforts. FINDINGS: Nurse-driven cancer prevention and screening collaborations advance care farther and faster. By creating maximum impact and mobilizing individual passion for a project, any nurse can find collaborative niche opportunities in clinical practice.

Huddleston, P. (2020). “Measuring Unlicensed Assistive Personnel Perceptions of a Healthy Work Environment in Acute Care Settings, Part 4.” J Nurs Adm Sep 1. [Epub ahead of print.].

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BACKGROUND: Survey items on the Healthy Work Environment Scale (HWES) for Unlicensed Assistive Personnel (UAP) were developed using statements from a qualitative research study conducted in a large urban healthcare system. PURPOSE: The purposes of this research study were to develop items on the HWES for UAP, to assess the validity and reliability of this tool, and to describe the UAP perceptions of a healthy work environment (HWE) using a nonexperimental descriptive design. METHODS: This research study has 2 separate phases. In phase 1, the UAP assigned each item to 1 of the 8 characteristics of an HWE to assess face validity. The 2nd step in this phase was to have the 10 content experts rate each survey item based on its relevancy to measuring an HWE using a 4-point Likert scale ranging from “not relevant” to “very relevant” to determine content validity by calculating a scale content validity and item content validity indices. Based on the results, there were no items deleted from the survey. In phase 2, principal component analysis assessed the validity of the tool, a Cronbach’s α served as the test for reliability, and the UAP perceptions of an HWE were measured. RESULTS: Samples included 45 content experts for phase 1 and 406 for phase 2. Principal component analysis revealed 49 items comprising 6 components. Internal consistency was 0.976 for all items. Based on the findings, the HWES for UAP demonstrated strong psychometric properties to measure an HWE in acute care settings.