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AimTo evaluate the psychometric properties of the Arabic language person-centred climate questionnairestaff version. BackgroundThere have been increasing calls for a person-centred rather than a disease-centred approach to health care. A limited number of tools measure the extent to which care is delivered in a person-centred manner, and none of these tools have been validated for us in Arab settings. MethodThe validated form of the person-centred climate questionnairestaff version was translated into Arabic and distributed to 152 health care staff in teaching and non-teaching hospitals in Saudi Arabia. Statistical estimates of validity and reliability were used for psychometric evaluation. ResultsItems on the Arabic form of the person-centred climate questionnairestaff version had high reliability (Cronbach's alpha .98). Cronbach's alpha values for the three sub-scales (safety, everydayness and community), were .96, .97 and .95 respectively. Internal consistency was also high and measures of validity were very good. ConclusionArabic form of the person-centred climate questionnairestaff version provides a valid and reliable way to measure the degree of perceived person-centredness. Implications for nursing managementThe tool can be used for comparing levels of person-centredness between wards, units, and public and private hospitals. The tool can also be used to measure the extent of person-centredness in health care settings in other Arab countries.

Aim: To explore the association between leadership behaviours among managers in aged care, and person‐centredness of care and the psychosocial climate.

Background: Theory suggests that leadership is important for improving person‐centredness in aged care, however, empirical evidence is lacking.

Methods: A cross‐sectional design was used to collect data from Swedish aged care staff (n = 3661). Valid and reliable questionnaires assessing leadership behaviours, person‐centeredness of care and the psychosocial climate were used. Data were analysed using multiple linear regression including interaction terms.

Results: Leadership behaviours were significantly related to the person‐centredness of care and the psychosocial climate. The level of person‐centredness of care moderated the impact of leadership on the psychosocial climate.

Conclusions and implications for nursing management: The leadership behaviour of managers significantly impacts person‐centred care practice and contributes to the psychosocial climate for both staff and residents in aged care. This study is the first empirically to confirm that middle managers have a central leadership role in developing and supporting person‐centred care practice, thereby creating a positive psychosocial climate and high quality care.

The 14-item questionnaire showed high reliability as Cronbach's alpha was satisfactory for the total scale (0.89), and for the four subscales: 0.87, 0.79, 0.82 and 0.69. Test-retest reliability were evaluated in a subsample of 40 staff and resulted in P-values >0.05 between mean scores of the PCQ-S at test and retest, r-values between 0.6 and 0.9, and a two-way mixed effects model, single measures intra-class correlations of 0.75 with a confidence interval of 0.58-0.86. Validity of the scale needs further evaluation.

CONCLUSIONS AND IMPLICATIONS FOR NURSING MANAGEMENT: The English PCQ-S makes possible studies of associations between person-centredness and different organizational systems, environments, staff characteristics and health and managerial styles. However, scale validity needs further evaluation.

Aim: To construct and evaluate psychometric properties of the person-centred care of older people with cognitive impairment in acute care settings (POPAC) scale.

Background: Older people with cognitive impairment are admitted frequently to acute care, with needs not always met through standard practice. Best practice models have been suggested, but few assessment scales exist.

Methods: Psychometric evaluation using statistical estimates of validity and reliability based on an Australian sample of acute care nursing staff (n = 212).

Results: The final 15-item questionnaire consists of three subscales, using cognitive assessments and care interventions, using evidence and cognitive expertise and individualizing care. Estimates of validity and reliability were highly satisfactory.

Conclusion: The POPAC scale makes a valuable contribution by providing valid and reliable measures of the extent to which acute nursing staff report using best practice care processes to identify and consider cognitive impairment and to employ nursing interventions to meet the needs associated with old age and cognitive impairment.

Implications for nursing management: The POPAC scale is short, easy to administer and not time consuming to complete, but still provides clinically relevant information. It can be used as a conceptual fundament in developing best practice nursing care in the acute clinical setting, as well as for nursing research.

AIM: To identify predictors of job strain in residential nursing care staff working with people with dementia. BACKGROUND: It is well known that nursing staff experience high levels of stress, but less is known about how to predict job strain. METHODS: The job strain of nursing care staff (n = 344) within residential dementia care settings was assessed. Standard linear regression analysis was used to explore predictors of job strain. RESULT: Data from the study shows that nursing staff in residential dementia care have a demanding job and experience high levels of strain. The linear regression model with four predictor variables explained 19% of the variability in job strain scores. Perceived caring climate of the unit, staff education level, possibilities to have discussions of difficulties and ethics at work and staff age, had a statistically significant association with job strain. CONCLUSIONS: The caring climate, staff education, reflective practice and staff age can be used as screening variables when predicting job strain. IMPLICATIONS FOR NURSING MANAGEMENT: These predictors can assist managers and directors to identify targeted strategies for supervision and support of nursing staff to secure their well-being, and by that securing the quality of care provided to residents.

AIM: The aim of the study was to construct and evaluate psychometric properties of the Swedish language Person-centred Climate Questionnaire - staff version. BACKGROUND: Person-centred care is often quoted but ill defined, and the literature warrants the development of valid and reliable measurement tools. METHODS: During 2006, a questionnaire was constructed and distributed to a sample of Swedish hospital staff (n = 600). Questionnaire data was subjected to item analysis and reduction. Psychometrical properties of the questionnaire were evaluated. RESULTS: The 14-item Person-centred Climate Questionnaire showed satisfactory psychometric properties. Measures of validity were good, internal consistency was high, Cronbach's alpha was satisfactory for the total scale (0.88) and test-retest reliability was adequate. CONCLUSION: The results indicate that the staff Person-centred Climate Questionnaire is a valid and reliable tool for assessing staff perceptions of the person centredness of hospital environments. IMPLICATIONS FOR NURSING MANAGEMENT: This instrument makes it possible to study the degree of person-centredness in relation to different organizational systems, environments, staff groups and managerial styles. In addition, staff variables such as turnover rates, health outcomes and efficacy can be related to staff perceived person centredness of the organization.

AimThis study aimed to establish reliability and cut-off scores for the person-centred climate questionnaire - staff version (PCQ-S) in residential aged care. BackgroundA number of tools have emerged recently to measure person-centredness, and these need psychometric evaluation and cut-off scores to enhance utilisation and interpretation. MethodA cross-sectional survey design was employed in a Swedish sample of residential aged care staff (n=1237). Psychometric evaluation using Cronbach's alpha and item-total correlation was used, together with establishing cut-off scores based on quartile scores. ResultThe PCQ-S had satisfactory psychometric properties and the following total scale cut-off scores for unit person-centredness were suggested: 49 (well below average'), 50-56 (below average'), 57-62 (above average') and 63 (well above average'). These cut-off scores were clinically meaningful as they separated the sample into four groups in which staff in more person-centred units reported significantly higher work satisfaction, social support and less stress of conscience. ConclusionThe PCQ-S has reliability in residential aged care samples, and cut-off scores are provided that provide important fundaments for comparative studies and aggregation of data to explore person-centredness care further. Implications for nursing managementThe study enables managers with ways to measure, interpret and compare levels of person-centredness between units and facilities for research, practice development and/or benchmarking purposes.

To illuminate meanings of being a supervisor for care providers suffering from burnout: from initial signs to recuperation.

Background

Supervisors in health care, i.e. supervisors with first-line responsibilities for a work unit, are exposed to heavy demands, especially in times of downsizing and restructuring of the healthcare system. When care providers show signs of developing burnout, these demands are even greater. Methods Interviews with 12 supervisors in health care were interpreted using a phenomenological-hermeneutic method.

Results

Being a supervisor when someone in the work team shows signs of burnout means struggling to help them to continue working. In this predicament and being responsible for the unit, the supervisors are torn between focusing on relations and on production. When the care provider reports sick, they are left with feelings of hopelessness and self-blame.

Conclusions and implications for nursing management Supervisors face almost unmanageable strain, caught between conflicting demands. It seems important that supervisors are offered opportunities to share their feelings about this predicament as well as gaining increased knowledge about burnout. This is important if the supervisors are to give proper support, but it will also help to turn supervisory failure into development and to protect the health of the supervisors.

Aim: To test the reliability and validity of the Person-centred care of Older People with cognitive impairment in Acute Care scale to determine nurses’ perceptions of person-centred care.

Background: One-third of older adults admitted to hospital are at risk of serious hospital-acquired complications such as falls, infections and pressure injuries because of cognitive impairment. These risks can be reduced through person-centred practices. The Person-centred care of Older People with cognitiveimpairment in Acute Care scale is a self-report staff instrument to explore the extent to which person-centred practices are undertaken; however psychometric testing is limited.

Methods: A cross-sectional sample of acute care nurses (n = 240) in Queensland, Australia completing self-report questionnaires. Psychometric analyses of item performance, reliability and validity were conducted.

Results: Item analysis revealed independent items. One item was removed due to negatively associating with the scale, improving total Cronbach’s alpha from 0.76to 0.84. The three original factors were maintained with regrouping of items. Confirmatory factor analysis confirmed the revised model.

Conclusions: The revised Person-centred care of Older People with cognitive impairment in Acute Care scale had satisfactory psychometric properties when used as a total scale.

Implications for nursing management Scale brevity and simplicity together with rigorous development and testing indicates that the revised Person-centred care of Older People with cognitive impairment in Acute Care may be useful for quality improvement programmes into the care of older people in hospitals.

AIM: To explore what situations students focus on during group supervision sessions, and what this supervision meant to nursing students during their clinical placements.

BACKGROUND: Knowledge about clinical supervision of nursing students in groups is scarce concerning what situations the students bring to the sessions.

METHOD: Open-ended questionnaires were filled out by students after each session. Qualitative content analysis was performed.

RESULTS: The content evolved as: being a nursing student, encountering demanding situations and becoming a nurse. The meaning of group supervision was captured in the categories: 'satisfaction of being together in the supervision group', 'new understanding and insights' and 'hesitation and discomfort'. A change of pattern was found over time showing a development among the students from a self-centred focus to a profession-centred focus.

CONCLUSION: The value of group supervision as a tool to support nursing students' personal and professional development was emphasized. The students' great need for and lack of support in 'bed-side nursing' was obvious.

IMPLICATIONS FOR NURSING MANAGEMENT: Our findings would be valuable for nurse managers when striving for a good learning environment in clinical placements, as well as for nursing teachers, in their supportive role to both students and preceptors.

The influence of a person-centred psychosocial unit climate on satisfaction with care and work Aim To describe nurses satisfaction with care and work and to explore the extent to which a person-centred unit climate influenced this satisfaction. Background Although the concept of person-centred care is used to describe high-quality care, there is a shortage of studies exploring the relationship between person-centredness and nurses satisfaction with care and work in acute care settings. Methods Registered nurses within a university hospital in Sweden (n = 206) completed the Satisfaction with Nursing Care and Work Assessment Scale and the Person-centred Climate Questionnaire. The data collected was analysed using descriptive and analytical statistics. Design Cross-sectional explorative study. Results The majority of respondents were satisfied with the care and work situation. Nurses with more than 9 years of work experience were more satisfied with care and work, and there were a significant association between a person-centred psychosocial climate of units and nurses satisfaction with care and work. Conclusions This study provided evidence for a significant association between person-centredness and the satisfaction with care and work of nurses in acute care environments. Implications for nursing management Promoting and implementing a person-centred philosophy of care can be one way to improve nurses satisfaction with care and work.

Aim To explore the attitudes held by staff working in acute care units towards patients aged 70 years or older with cognitive impairment, and to explore factors associated with negative attitudes.

Background Hospital staff attitudes towards older patients with cognitive impairment are of concern as older people are the main hospital users, and because staff attitudes influence care quality and uptake of evidence-based care.

Method A cross-sectional survey design was used to collect data from staff (n = 391). Results  Staff attitudes were not explicitly negative. However, higher perceived strain in caring for older patients with cognitive impairment, higher perceived prevalence of these patients in the ward, being younger and working as an assistant nurse were associated with negative attitudes. A majority of staff reported that these patients received the best possible care, but few reported formally assessing cognitive status or working with evidence-based care protocols.

Conclusion Staff characteristics associated with negative attitudes were described and staff perception that patients received best hospital care, despite limited cognitive assessments and care guidelines, indicate areas for improvement. Implications for nursing management Supporting young staff and assistant nurses, and implementing cognitive assessments and evidence-based guidelines can promote positive attitudes and best practice.

Aim: To test the psychometric properties of the Slovenian version of the Person-centred Climate Questionnaire - staff version. Background: Person-centredness can be a quality care indicator, but there are no valid and reliable instruments in the Slovene language aimed at exploring the person-centred care climate from a nursing staff perspective. Methods: Content validity based on expert agreement was evaluated by calculating content validity indices. A cross-sectional survey design using a convenience sample of 790 nurses and nursing assistants from medical and surgical wards in 11 hospitals was used to test the construct validity and internal consistency reliability. Results: The average content validity index for the scale was 0.97, all items had content validity indices higher than 0.78, showing satisfactory content validity. Three components, climate of safety, community and everydayness explained 71.22% of the variance in the data and thus confirmed scale dimensionality. Cronbach's was acceptable for whole scale (0.90) and for subscales (0.89, 0.89 and 0.86). Conclusion: The Slovene version of the Person-centred Climate Questionnaire - staff version is valid and reliable and can be further used in surgical and medical wards in hospital settings. Implication for nursing management: The instrument enables further exploration of the relationships between perceived person-centredness and organisational outcomes.