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Objectives: This study aimed to identify the factors influencing nurses’ posttraumatic growth (PTG) during the early stages of the coronavirus disease 2019 (COVID-19) pandemic.Methods: A literature search was conducted in February 2023 across databases, including Medline, CINAHL, APA PsycINFO, Web of Science, and Google Scholar, for articles published between January 2020 and February 2023 related to PTG in nurses during the COVID-19 pandemic. Inclusion criteria were English-language articles, original research on nurses’ PTG, and studies conducted after January 2020. Of 1089 identified articles, 142 were screened, and 27 were selected for final analysis. Data extracted from the articles included the author(s) name(s), the study’s geographic location, publication year, study purpose, study design, participants, methods, measurement scales, results, and notes. PTG factors were extracted and grouped into 4 broad categories: COVID-related factors, nursing-related factors, factors in Tedeschi’s PTG conceptual model, and other factors. Smaller categories were then created by inductively categorizing the factors based on similarities and differences.Results: As factors of nurses’ PTG during the early stage of the COVID-19 pandemic, 16 subcategories were organized under 4 categories. In addition to all factors from Tedeschi’s PTG model, some COVID-related factors (eg, care context, organizational training), and some nursing-related factors (eg, work environment) were shown to be related to PTG. No significant relationships were found between almost all of the other factors, including sociodemographic attributes, and PTG.Conclusions: Factors found in this study can help identify nurses’ PTG facilitators and guide the development of interventions for future crises.

The nursing practice environment is essential for improving the quality of nursing practice and patient service. Performing secondary analysis of data from the work environment for hospital nurses in Japan (WENS-J) study, this research investigated whether an improved, healthier work environment could enhance nurses’ psychological empowerment. Self-administered questionnaire responses of 2,438 participants from 23 participating general hospitals with over 200 beds in municipalities with a population of 200,000 or more were analyzed. The questionnaire recorded participating nurses’ demographic characteristics and utilized two scales: the Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Psychological Empowerment Instrument (PEI), which identified adequate work environments and measured the internalization of organizational goals and objectives, respectively. Most participants (93.7%) were female nurses with a mean age of 33.7 years. Multilevel analysis (hierarchical linear models) revealed that the total PEI score was significantly related to the PES-NWI composite score and all subscales after adjusting for nurses’ demographic characteristics, such as age (coefficient 0.33–0.72, all p  < .001). The results suggest that a work environment such as that presented in the PES-NWI may contribute to nurses’ psychological empowerment. These findings could provide insight for creating healthier work environments.

Aim To clarify the concept of psychological safety in a healthcare context and to provide the first theoretical framework for improving interpersonal relationships in the workplace to better patient care. Design A Rodgers’ concept analysis. Methods The concept analysis was conducted using a systematic search strategy on PubMed, CINAHL, PsycINFO and Ichushi‐Web. Results An analysis of 88 articles studying psychological safety in health care identified five attributes: perceptions of the consequences of taking interpersonal risks, strong interpersonal relationships, group‐level phenomenon, safe work environment for taking interpersonal risks and non‐punitive culture. The antecedents included structure/system factors, interpersonal factors and individual factors. The four consequences included performance outcomes, organizational culture outcomes, and psychological and behavioural outcomes.

To investigate whether dementia is associated with incidence of adverse events and longer hospital stays in older adults who underwent hip surgery, after adjusting for individual social and nursing care environment. Retrospective observational study using the linked data between the Japanese Diagnosis Procedure Combination database and the reports of the medical functions of hospital beds database in Japan (April 2016-March 2017). A total of 48,797 individuals aged 65 and older who underwent hip surgery and were discharged during the study period. Outcomes included in-hospital death, in-hospital pneumonia, in-hospital fracture, and longer hospital stay. We performed two-level, multilevel models adjusting for individual and hospital characteristics. Among all participants, 20,638 individuals (42.3%) had dementia. The incidence of adverse events for those with and without dementia included in-hospital death: 2.11% and 1.11%, in-hospital pneumonia: 0.15% and 0.07%, and in-hospital fracture: 3.76% and 3.05%, respectively. The median (inter quartile range) length of hospital stay for those with and without dementia were 26 (19-39) and 25 (19-37) days, respectively. Overall, the odds ratios (95% confidence interval (CI)) of dementia for in-hospital death, in-hospital pneumonia, and in-hospital fracture were 1.12 (0.95-1.33), 0.95 (0.51-1.80), and 1.08 (0.92-1.25), respectively. Dementia was not associated with the length of hospital stay (% change) (-0.7%, 95% CI -1.6-0.3%). Admission from home, discharge to home, and lower nurse staffing were associated with prolonged hospital stays. Although adverse events are more likely to occur in older adults with dementia than in those without dementia after hip surgery, we found no evidence of an association between dementia and adverse events or the length of hospital stay after adjusting for individual social and nursing care environment.

Background Advocates for victims of sexual assault are exposed to the traumatic events of victims, which can lead to occupational stress. Occupational stress specific to advocates who support victims can cause compassion fatigue and burnout, which can worsen their mental health. Furthermore, such exposure could lead to compassion satisfaction, which, in turn, may buffer compassion fatigue and burnout. To improve the mental health of advocates for victims of sexual assault in Japan, this study aimed to evaluate a hypothesized model explaining the effect of occupational stress on their mental health. Methods This cross-sectional study was conducted using a self-administered questionnaire via mail. The sample comprised 560 advocates from one-stop support centers for victims of sexual assault. Questionnaires comprising the components of the hypothesized model, namely, compassion fatigue, burnout, compassion satisfaction, traumatic stress symptoms, and psychological distress, were mailed. After using descriptive statistics, a path analysis was conducted to test the hypotheses and the fitness of the model. Results Data from 250 participants were analyzed. The prevalence rates of compassion fatigue, burnout, and compassion satisfaction were 30%, 65%, and 4%, respectively. The hypothesized model demonstrated a good fit. Compassion fatigue exerted a significant positive effect on traumatic stress symptoms and psychological distress. Burnout also demonstrated a significant positive effect on psychological distress. However, its association with traumatic stress symptoms was not significant. Compassion satisfaction exerted a significant negative effect on compassion fatigue and burnout. Conclusions Improving the mental health of advocates, particularly for traumatic stress symptoms, requires not only intervening in burnout but also improving compassion fatigue. Increasing compassion satisfaction contributes to the improvement of compassion fatigue and burnout. Therefore, creating a supportive environment that considered these would help improve the mental health of the advocates.

Background A training opportunity in which ongoing education is encouraged is one of the determinants in recruiting and retaining nurses in home-visit nursing care agencies. We investigated the association between ensuring training opportunities through scheduled training programs and the change in the number of nurses in home-visit nursing agencies using nationwide panel data at the agency level. Methods We used nationwide registry panel data of home-visit nursing agencies from 2012 to 2015 in Japan. To investigate the association between planning training programs and the change in the number of nurses in the following year, we conducted fixed-effect panel data regression analysis. Results We identified 4760, 5160 and 5025 agencies in 2012, 2013, and 2014, respectively. Approximately 60–80% of the agencies planned training programs for all staff, both new and former, during the study period. The means and standard deviations of the percentage change in the number of full time equivalent (FTE) nurses in the following year were 4.2 (19.8), 5.7 (23.5), and 5.8 (25.1), respectively. Overall, we found no statistically significant association between scheduled training programs and the change in the number of FTE nurses in the following year. However, the associations varied by agency size. Results of analysis stratified by agency size suggested that the first and second quartile sized agencies (2.5–4.0 FTE nurses) with scheduled training programs for all employees were more likely to see a 9.0% (95% confidence interval [CI]: 4.5, 13.5) and 8.5% (95% CI: 2.4, 14.5) increase in the number of FTE nurses in the following year, respectively. Similarly, the first and second quartile sized agencies with scheduled training programs for new employees were more likely to see a 4.7% (95% CI: 2.1, 7.2) and 3.3% (95% CI: 0.4, 6.2) increase in the number of FTE nurses in the following year, respectively. Conclusions Ensuring training opportunities through scheduled training programs for all staff, both new and former, in relatively small-sized home-visit nursing agencies might contribute to an increase in the number of nurses at each agency.

Little is known about whether and how local-level resources regarding home care are associated with the prevalence of home deaths. We aimed to investigate whether geographic patterns of the resources for home care were associated with the prevalence of home deaths, taking spatial variation into consideration. We conducted an ecological cross-sectional study in Japan using nationwide data in 2014. The areal unit was the municipality, the smallest administrative unit in Japan. We investigated the association between the percentage of home deaths and the resources of home care support clinics with available 24-hour-a-day functions, considering the geographic effect of neighboring municipalities by applying a geographically weighted regression model. The mean and standard deviation of the percentages of home deaths were 11.4% (5.0%), and those of the number of home care support clinics per 10,000 elderly population were 3.4 (3.7). The percentages of home deaths in neighboring municipalities tended to be significantly correlated (Moran's I 0.34, p<0.001). Adjusting for the number of hospital beds, total population, and the socio-economic status of municipality, the results of an ordinary least squares regression model showed a positive correlation between the percentage of home deaths and the local resources for home care support clinics per 10,000 elderly population (regression coefficient 0.15, 95% confidence interval 0.07, 0.22), while the existence of spatial autocorrelation of the residual was suggested (Moran's I of the residual 0.227, p<0.001). The geographically weighted regression model showed local regression coefficients varying across municipalities with a better model fit over the analogous ordinary least squares model (adjusted R2 0.414 vs. 0.131). Home deaths were more prevalent in municipalities with greater home care resources. This association was geographically varied and further strengthened in some areas.

Background Educational support quality is an essential factor in determining the education of novice home healthcare nurses. This study developed a scale to assess the educational support provided by home healthcare agencies among novice home healthcare nurses. Methods Hypothetical components were derived from a literature review, including experiential learning theory. Expert panels evaluated the initial scale items, and the scale was tested with 3000 agencies from April to June 2022. A total of 627 valid responses were analyzed. Results Exploratory factor analysis produced a four-subscale structure consisting of 34 items that supported the hypothesized components. Cronbach’s alphas ranged 0.889 to 0.961, and the intraclass correlation coefficients ranged 0.703 to 0.905 in the test-retest survey. Conclusions The educational support assessment scale developed for novice home healthcare nurses is valid and reliable. Managers in home healthcare agencies should apply the results of assessments using the scale to improve their human resource development.

Objective A reliable and valid tool is required to assess home healthcare nurses’ job satisfaction for evaluating and improving the work environment and clinical practice of home healthcare. This study aimed to develop and examine the Japanese version of the Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS-J). The Home Healthcare Nurses’ Job Satisfaction Scale (HHNJS) was translated into Japanese; a backward translation was performed until equivalence between the original and the backward-translated HHNJS was confirmed. Subsequently, a mail survey was conducted among 409 home healthcare nurses from 154 home healthcare agencies in Japan. We evaluated construct validity through Confirmatory Factor Analysis (CFA), and criterion-related validity and internal consistency were also tested. Results The CFA revealed a second-order seven-factor structure and adequate internal consistency, although, the fit of the data to the factor structure was moderate. As per the goodness-of-fit indices of the final model of the CFA, the comparative fit index was 0.89 and root mean square error of approximation was 0.06. This newly translated scale can be used to assess the job satisfaction of home healthcare nurses within Japan. The HHNJS-J evaluated acceptable reliability and validity among Japanese home healthcare nurses and had application in clinical practice in Japan.

Background/Objectives: High nurse turnover has economic implications for healthcare organizations and impacts the quality of care. Individual, job-related, and organizational factors determine nurse turnover. This study, thus, aimed to investigate the impact of nurses’ resilience and the quality of the relationship between staff nurses and nurse managers, defined as leader–member exchange (LMX), on actual nurse turnover. Methods: A prospective study was conducted from June to July 2022, targeting nurses from three advanced treatment hospitals in Japan. Data were collected through a self-administered questionnaire investigating the participants’ actual turnover in April 2023. The data of 1130 nurses were analyzed in this study. A binary logistic regression analysis was performed using actual turnover as the dependent variable and nurse resilience and LMX as independent variables. Results: The results revealed that while LMX influenced actual turnover, nurse resilience had no statistically significant relationship with turnover. Conclusions: The findings show that LMX needs to be improved if actual turnover is to be curbed.