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Objectives: The overall purpose of this study was to evaluate the validity and reliability of the Caring Assessment Tool-Administration survey. Three specific aims were to (1) evaluate construct validity of the Caring Assessment Tool-Administration survey by testing the hypothesized eight-factor structure of staff nurses’ perceptions of nurse manager caring behaviors, (2) estimate the internal consistency, and (3) conduct item reduction analysis. Methods: A 94-item Caring Assessment Tool-Administration designed to assess nurse manager caring behaviors appeared in the literature but lacked robust psychometric testing. Using a foundational theory and a cross-sectional descriptive design, the Caring Assessment Tool-Administration was evaluated for reliability and construct validity. Using convenience sampling, 1143 registered nurses were recruited from acute care hospitals in three states located in the Midwestern, Mid-Atlantic, and Southern Regions of the United States. Results: Psychometric testing of the Caring Assessment Tool-Administration was conducted using confirmatory analysis to determine the dimensionality of the construct, nurse manager caring behavior. The null hypothesis was an eight-factor solution fitting the theoretical model being tested. The null hypothesis was rejected because none of the measures examined for goodness of fit indicated the model fit the data. Confirmatory factor analysis did not support the hypothesized structure; however, exploratory factor analysis supported a one-factor solution that was conceptually labeled caring behaviors. To decrease subject burden, the 94-item survey was reduced to 25 items using item reduction analysis including assessing minimum factor loadings of ≥0.60 and evaluating survey item-total correlation and alpha. The Cronbach’s alpha of the new 25-item survey was 0.98. Conclusion: The new 25-item Caring Assessment Tool-Administration survey provides hospital administrators, nurse managers, and researchers with a sound, less burdensome instrument to collect valuable information about nurse manager caring behaviors.

Background The nursing workforce comprises multiple generations, each with unique values, beliefs, and expectations that can influence communication, work ethic, and professional relationships. In Qatar, the generational gap between nurses and nurse managers poses challenges to effective communication and teamwork, impacting job satisfaction and patient outcomes. Aim This study investigates the generational gap between nurses and nurse managers in Qatar, aiming to identify strategies to enhance collaboration and create a positive work environment. Methods A qualitative research design was used, involving semi-structured interviews with 20 participants, including frontline nurses and senior nurse managers. Participants were purposively sampled to represent different generations. Data were collected through face-to-face and virtual interviews, then transcribed and thematically analyzed. Findings Four key themes emerged: Optimizing the Work Environment : Older generations preferred transformational and situational leadership, while younger nurses valued respect, teamwork, accountability, and professionalism. Strengthening Work Atmosphere through Communication and values : Older nurses favored face-to-face communication, while younger nurses preferred digital tools. Cultivating Respect and Empathy : Younger nurses emphasized fairness in assignments and promotions, while older nurses focused on empathy and understanding. Dynamic Enhancement of Healthcare Systems : Younger nurses were more adaptable to technology and professional development, while older nurses prioritized clinical care and patient outcomes. Conclusion The study reveals significant generational differences in leadership preferences, communication styles, and adaptability to technology. Addressing these gaps through effective leadership, ongoing education, and open communication can improve job satisfaction and patient care.

The introduction of health information technology (HIT) has drastically changed health care organizations and the way health care professionals work. Some health care professionals have trouble coping efficiently with the demands of HIT and the personal and professional changes it requires. Lagging in digital knowledge and skills hampers health care professionals from adhering to professional standards regarding the use of HIT and may cause professional performance problems, especially in the older professional population. It is important to gain more insight into the reasons and motivations behind the technology issues experienced by these professionals, as well as to explore what could be done to solve them. Our primary research objective was to identify factors that influence the adoption of HIT in a sample of nurses who describe themselves as digitally lagging behind the majority of their colleagues in their workplaces. Furthermore, we aimed to formulate recommendations for practice and leadership on how to help and guide these nurses through ongoing digital transformations in their health care work settings. In a Dutch university medical center, 10 face-to-face semi-structured interviews were performed with registered nurses (RN). Ammenwerth's FITT-framework (fit between the Individual, Task, and Technology) was used to guide the interview topic list and to formulate themes to explore. Thematic analysis was used to analyze the interview data. The FITT-framework was also used to further interpret and clarify the interview findings. Analyses of the interview data uncovered 5 main categories and 12 subthemes. The main categories were: (1) experience with digital working, (2) perception and meaning, (3) barriers, (4) facilitators, and (5) future perspectives. All participants used electronic devices and digital systems, including the electronic health record. The latter was experienced by some as user-unfriendly, time-consuming, and not supportive in daily professional practice. Most of the interviewees described digital working as \"no fun at all,\" \"working in a fake world,\" \"stressful,\" and \"annoying.\" There was a lack of general digital knowledge and little or no formal basic digital training or education. A negative attitude toward computer use and a lack of digital skills contributed to feelings of increased incompetency and postponement or avoidance of the use of HIT, both privately and professionally. Learning conditions of digital training and education did not meet personal learning needs and learning styles. A positive impact was seen in the work environment when colleagues and nurse managers were aware and sensitive to the difficulties participants experienced in developing digital skills, and when there was continuous training on the job and peer support from digitally savvy colleagues. The availability of a digital play environment combined with learning on the job and support of knowledgeable peers was experienced as helpful and motivating by participants. Nurses who are digitally lagging often have had insufficient and ineffective digital education. This leads to stress, frustration, feelings of incompetency, and postponement or avoidance of HIT use. A digital training approach tailored to the learning needs and styles of these nurses is needed, as well as an on-the-job training structure and adequate peer support. Hospital management and nurse leadership should be informed about the importance of the fit between technology, task, and the individual for adequate adoption of HIT.

Background: Occupational stress refers to the psychological pressure from work‐related factors. Stress overload is a key contributor to the global nursing shortage. Excessive workloads and psychological pressure further exacerbate stress among healthcare professionals. Aims: This study aims to examine the impact of psychological counseling (PC), job characteristics, and perceived respect on occupational stress among Pakistani nurses. Methods: This cross‐sectional study was carried out by nurses from Pakistan, using a random sampling method. Data were collected between April 1 and May 31, 2024. We have access to the nurses’ work‐related stress, respect, and PC through an online questionnaire. A total of 292 nurses took part in the study. Results: Out of 292 participants, 276 completed the survey, with 71.38% male and 28.62% female. The main causes of occupational stress were low income (95.56%), high workload (80.80%), occupational injury (65.95%), family factors (64.50%), strict leadership (60.50%), and physical problems (56.16%). Additionally, 36.23% of nurses had limited faith in the effectiveness of PC, followed by a moderate belief. According to multiple logistic regression analyses, a correlation between a PC high work‐related stress significantly affects nurses’ mental health, increasing the need for PC ( p = 0.0979). Stress relief methods like reading, music, or outdoor sports reduce the stress (OR 2.298–11.031, p < 0.001). At the same time, factors like nurse–patient relationships and strict leadership contribute to high‐stress levels ( p = 0.417, p = 0.682), with reducing work intensity showing minimal impact ( p = 0.993). Conclusion: Our study indicated that low salaries, a high workload, and low respect could cause occupational stress among nurses who need high PC. Implications for Nursing Management: These findings can guide hospital administrators and nurse managers in enhancing rewards, reducing work hours, and improving job satisfaction. Additionally, better working conditions and training programs can help mitigate occupational stress and support nurses’ mental health.

Purpose This study aimed to determine the relationships among the unit‐level nursing work environment and individual‐level health‐promoting behaviors of hospital nurses in South Korea and their perceived nursing performance quality. Methods This study used a cross‐sectional design. Data were collected using self‐reported questionnaires from 432 nurses in 57 units at five hospitals in South Korea. Nursing performance quality, nursing work environment, and health‐promoting behaviors were measured using the Six Dimension Scale of Nursing Performance, Practice Environment Scale of the Nursing Work Index, and Health Promoting Lifestyle Profile‐II, respectively. Results Nurses working in units with nurse managers who were characterized by better ability and by quality leadership, and who provided more support to nurses exhibited significantly greater health responsibility and physical activity. Nurses working with sufficient staffing and resources reported better stress management. Positive collegial nurse–physician relationships in units were significantly associated with more healthy eating among nurses. Nurses working in units with sufficient staffing and resources, and who had a higher level of spiritual growth and health responsibility, were more likely to perceive their nursing performance quality as being higher. Conclusions To improve the quality of nursing practice, hospitals should focus on helping nurses maintain healthy lifestyles, as well as improving their working conditions in South Korea. Organizational support for adequate human resources and materials, mutual cooperation among nurses and physicians, and workplace health‐promotion interventions for spiritual growth and health responsibility are needed. Clinical Relevance Organizational efforts to provide sufficient staffing and resources, boost the development of personal resources among nurses, and promote nurses’ responsibility for their own health could be effective strategies for improving nursing performance quality and patient outcomes.

Objective. This study aimed to evaluate the current status and related factors of practice environments of nurse managers in China. Background. Insufficient nurse staffing and poor working environment directly increase the burnout and turnover of nurse leaders. Nurse managers play a pivotal role in healthcare organizations, and their performance has been inextricably linked to achieving optimal patient, staff, and healthcare organizational outcomes. However, there are few studies exploring the influencing factors of nurse manager practice environment. Methods. A cross-sectional study was undertaken to examine a sample of 405 nursing managers who were selected from 10 hospitals located across three provinces in China. The general characteristics questionnaire, the Nurse Manager Practice Environment Scale, the Perceived Stress Scale, and the Career Growth Scale were used. Data were analyzed by descriptive statistics, univariate analysis, and multiple stepwise linear regression. Results. The total scores of the nurse manager practice environments were 236.71 ± 27.635 (with 270 being the highest possible score), which was at a generally high level. The three lowest scores were adequate budgeted resources, fair and manageable workload, and nurse manager-physician relationships. Nurse manager practice environment was predicted by hospital geographic location, having (or not) training experience in higher ranked hospitals, levels of perceived stress, and career growth scores. Conclusion. Chinese nursing managers reported a relatively favorable nursing practice environment. Policymakers should pay more attention to the practice environment of nursing managers in small city hospitals, and they could regularly evaluate, monitor, and promote practice environment determinants that are sensitive to disparities between different hospitals. In addition, hospital managers can take action by implementing diversity training programs, developing stress-reduction initiatives, and creating robust career development programs for nurse managers to support nurse managers better. Implications for nursing management: a better understanding of the current practice environment of nursing managers is beneficial for improving nursing managers’ work environment, which in turn will promote the quality of care delivered and nursing management work. For nurse managers, the characteristics of the management and work environment of the small city hospitals should be benchmarked and learned against the district capital hospitals. Also, hospital administrators were required to adopt strategies to foster psychological support of nurse managers and create pathways and opportunities for professional growth to create a supportive working environment.

Aims. To identify nurses’ professionalism, work environment, and communication with healthcare professionals as factors influencing clinical nurses’ perception of patient safety culture. Background. Patient safety is a representative indicator of the quality of nursing care. A multidisciplinary approach, including individual and organizational components, is needed to improve patient safety culture. Methods. A cross-sectional study was conducted in January 2021 involving a total of 271 nurses in six tertiary hospitals. Data were collected from participants on nurse professionalism, work environment, communication, and patient safety culture. A multiple regression model was used to analyze variables influencing patient safety culture. Results. Factors affecting patient safety culture were nursing foundations for quality of care (β = 0.230, p<0.001), nurse manager ability, leadership, support of nurses (β = 0.294, p<0.001), and collegial nurse-physician relations (β = −0.138, p=0.026) in the nursing work environment. Accuracy (β = 0.117, p=0.007), shift communication (β = 0.128, p=0.026), satisfaction (β = 0.283, p=0.001), and timeliness (β = 0.239, p<0.001) of communication between healthcare professionals and nurses have a significant impact on patient safety culture. All these predictors accounted for 59% (R2) of patient safety culture awareness (p<0.001). Conclusions. Enhancing patient safety culture requires a systematic and organizational approach that considers individual characteristics. Nurse managers play a crucial role in promoting patient safety by employing various communication channels and leading team education and training initiatives to foster collaboration among healthcare professionals. Implications for Nursing Management. The provision of patient safety education directly influences patient safety culture, and continuous education enables nurses to grow within the institution. To ensure effective communication in healthcare settings, nurse managers should prioritize shift communication, evaluate the accuracy of information exchange, and establish diverse communication channels, including social media platforms or business messengers, for internal hospital communication.

Background Work-related health problems, such as work stress, fatigue, and burnout constitute a global challenge within the nursing profession. Work-related health among nurses is not yet a prioritized phenomenon in Nepal. Health-promoting approaches to maintaining and sustaining nurses’ health are therefore essential. The aim of this study was to explore and thereby gain a deeper understanding of how nurses in Nepal’s hospitals experience their everyday work, with a focus on promoting and sustaining their work-related health. Methods A qualitative design with semi-structured individual interviews were used. Nineteen registered nurses working at hospitals in Kathmandu Valley, Nepal, were individually interviewed between October 6 and December 5, 2018. Transcribed interviews were analyzed through thematic analysis. Results Four main themes with belonging eight subthemes were constructed from the analysis: (1) “Sense of meaningfulness and belongingness in work culture” with subthemes; “Open environment” and “Sharing attitude and cooperating for the entire team” (2) “Support and rewards from the management team” with subthemes; “Lacking managerial support” and “Fair evaluation and job promotion opportunities”(3) “Workload and protection against work-related hazards” with subthemes; “Stressful and multitasking in workload” and “Lacking equipment for own health and caring”, and (4) “Motivation through opportunities and activities” with subthemes; “Employment benefits that motivate work”, and “Activities outside of work needed to recover”. These main themes and subthemes described nurses’ facilitators for and barriers to their work environment and health. Conclusion Our study highlighted nurses’ experiences with facilitators and barriers to their work-related health. Nurses’ work-related health was positively affected by support from colleagues, managers, and the organization. Conversely, less support from managers, lack of equipment, and unfair judgment were barriers to nurses’ work-related health. This study adds new knowledge about nurses’ work-related health from the context of Nepal. Hospital organizations and nursing managers in similar cultural and healthcare settings can apply the results of our study to develop strategies to promote and sustain nurses’ health and prevent work-related illness.

Purpose To explore the ethical experiences of new nurse managers when working at their units and propose response strategies accordingly. Design and methods A qualitative approach was taken at a Grade 3A hospital in Shandong, China. Data were collected via semi‐structured long interviews and analyzed using interpretative phenomenological analysis. A total of 19 new frontline nurse managers participated in the study. Findings The sample consisted of 17 females and two males, with an age range of 40.11 ± 2.71 years and each worked in a variety of units. Trust crisis, tests on capability, and conflicts with the administration were the main ethical issues of new nurse managers, and trust crisis was the most common, especially with nurses in the unit. Eleven subthemes were also involved in these three themes. Conclusions New nurse managers encountered a variety of ethical conflicts and dilemmas in their first year. They should enhance their leadership to cope with the issues, and policy support at the hospital level is also needed. Clinical relevance Senior hospital managers could use these findings to design interventions that might solve new frontline nurse managers’ ethical issues. And medical staff might understand the ethical experiences of new nurse managers and support them in the most critical period of role transition. Findings are conducted in the hope of facilitating new nurse managers to quickly settle into the new position, establishing a good relationship with physicians and patients and improving the quality of nursing services.

This study was performed to measure the effect of a cultural sensitivity education program in increasing Turkish nurses’ intercultural sensitivity and compassion levels. Intercultural care encompasses compassion, an indispensable value of nursing care. The primary purpose of compassion is to ensure the well-being and welfare of the individuals. A parallel group randomized controlled trial. The study was completed by 64 nurses, 32 in the intervention and 32 in the control groups. A Cultural Sensitivity Education Program was presented to the intervention group. Instruments were given to both groups before the intervention (pre-test), one week after the intervention (post-test) and three months later (follow-up test). Chi-square, and two-way mixed-design variance analysis with Bonferroni Multiple Comparison Test were used to analyze the data. The post-test and follow-up test mean scores of intercultural sensitivity and compassion of the intervention group after the intervention increased significantly compared to the control group. The intervention had a large effect size. The study showed that the cultural sensitivity education program effectively increased the nurses’ intercultural sensitivity and compassion levels. Nurse managers could integrate education programs into the in-service education programs to improve the intercultural sensitivity and compassion levels of nurses.