Nursing leadership: Key element of professional development

Trends in recent years have emphasized the importance of nursing leadership in China and globally.In 2020,theWorld Health Organization released State of the world’s nursing 2020:investing in education,jobs and leadership[1],specifically proposing that nursing leadership should be strengthened to enable nurses to become current and future leaders in healthcare.This report is based on the development of healthcare across the world under a comprehensive view of the overall level of human health.As the nursing profession evolves and expands,nurses play an increas-ingly essential role in promoting global human health.Nursing leadership is crucial for professional development.

Relationship between clinical belonging,professional identity,and nursing information ability among nursing interns:Model construction

BACKGROUND Clinical belonging refers to the feeling that clinical medical staff feel recognized and accepted by others or groups.The level of clinical belonging of nursing interns affects students’learning motivation and confidence,which in turn affects their clinical practice behavior.AIM To explore the effects of professional identity and nursing information ability on clinical belonging among nursing interns and establish a relationship model for these factors.METHODS The researchers used the convenience sampling method to select 682 nursing interns from China.The survey was conducted using a general information questionnaire,clinical sense of belonging scale,nursing information ability self-assessment scale,and a nursing student professional identity questionnaire.The mediating effect of nursing information ability between their professional identity and clinical sense of belonging was analyzed using SPSS 21.0 and the path analysis in structural equation modeling.RESULTS The total scores of clinical belonging,professional identity,and nursing information ability of nursing interns were(104.29±13.11)points,(57.89±7.16)points,and(70.29±6.20)points,respectively.Nursing information ability had a direct effect on the clinical sense of belonging(effect value=0.46,P<0.05).Occupational identity had a direct effect(effect value=0.52,P<0.05)and an indirect effect(effect value=0.21,P<0.05)on clinical belonging.CONCLUSION Nursing administrators in nursing colleges and hospitals should take effective measures to improve the professional identity and nursing information ability of nursing interns,as well as the clinical sense of belonging among nursing interns.

Musculoskeletal disorders in nursing staff

Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities.In the current editorial,the duties of nursing staff,the types of musculoskeletal disorders,the predis-posing factors(including factors related to professional tasks/ergonomics and to working schedules,psychological,social and individual factors)and their impact on working ability and quality of life nursing staff are summarized and pre-ventive measures are proposed.

The status of professional identity and professional self-efficacy of nursing students in China and how the medical documentaries affect them: A quasi-randomized controlled trial

Objectives: Professional identity and self-efficacy are important for the education and career develop-ment of students. However, how to improve these factors among Chinese nursing students needs further study. This quasi-randomized control trial was designed to explore the effect of medical documentaries on professional self-efficacy and identity among nursing students in Chinese technical schools. Methods: A total of 277 nursing students were enrolled in this study and divided into an experimental group (n = 135) and a control group (n = 142). The experimental group was invited to watch Chinese medical documentaries, whereas the control group remained on a waiting list. A self-designed general questionnaire, along with professional identity and professional self-efficacy questionnaires, was completed by the nursing students. Results: No significant change in professional self-efficacy was observed (-3.55 ± 14.23, P=0.173) in the experimental group, while professional identity significantly declined (-6.24 ± 12.85, P = 0.002) after the intervention. No significant change was found in the two aspects in the control group. Conclusion: Medical documentaries negatively affect professional identity but do not affect professional self-efficacy. Further researches should be conducted to explore the real reasons.

Associated factors of professional identity among nursing undergraduates during COVID-19:A cross-sectional study

Objectives Professional identity plays an important role in the long-term development of nurses,and it will change when public health emergency occurs.The objective of this study is to investigate the factors associated with the professional identity of nursing undergraduates in the epidemic of COVID-19.Methods A cross-sectional survey design with convenience sampling was used.A total of 3,875 nursing undergraduates were recruited from seven universities across China from March to April 2020.A general information questionnaire was used to collect students’information,and the Professional Identity Questionnaire for Nurse Students was used to survey their professional identity during the early and later stages of the first wave of the COVID-19 epidemic.Results The score of professional identity in the later stage(59.49±12.41)was higher than that in the early stage(56.96±12.61).The stepwise regression indicated that several factors were associated with professional identity,including gender,residential area,major,impact of the epidemic on intention to work after graduation,reasons for choosing nursing major and students’scores of professional identity in early stage.Conclusions Nursing educators can utilize the positive impact of responding to public health emergencies to increase the professional identity of students.Meanwhile,educators should give those students with lower professional identity more targeted education to cultivate their professional identity after the occurrence of public health emergencies.

Resilience as a strategy for struggling against challenges related to the nursing profession

Stressors, such as work overload, role conflicts, lack of time, lack of self-care, poor job-related interpersonal relationships, feeling powerless to provide quality care, struggling with competing demands,death, conflict with doctors, peers and supervisors, and inadequate emotional preparation, can be negative, stressful, traumatic, or difficult situations or episodes of hardship for nurses. Situations or episodes of these types can also cause both physical and mental problems, such as fatigue, irritability,lack of concentration, unhappiness, depressive sensation, depersonalization, and emotional exhaustion.Despite all of these challenges, resilience enables nurses to cope with their work environment and to maintain healthy and stable psychological functioning. The aim of this review is to describe the concept of resilience, explain characteristics with which it is related and outline interventions to increase the resilience of nurses.

Analysis and Synthesis Concept of Caring in Nursing Professional

The purpose of this study was to analyze and synthesize a concept of caring in nursing professionals. The Ethnographic Delphi Future Research （EDFR） contained two phases： Phase 1： The analysis and synthesis of the concept of caring theory in nursing professionals from the literature, research and interviews. The participants were an expert in education, two nurses, two patients and two members of the patients＇ families. The research instrument was a semi-structural questionnaire. The data were analyzed by content analysis and categorized; and Phase 2： The selection of the expressions of caring behavior and guidelines for promotion of caring behavior in new nurses. The participants were two experts in education, eight experts in nursing administration and eight experts in nursing practice. The research instruments were three questionnaires. The data from the first Delphi technique were analyzed by the experts＇ recommendations. The data from the second and third Delphi technique were analyzed by the median and interquartile range of each behavior and consensus. The findings showed the main contents of caring that contained six components as follows： kindness, understanding worth and showing respect, professional relationship, professional competency, professional ethics, and holistic care. The training was a method for promotion of caring behavior. Additionally, in the the first Delphi technique, the experts approved all of the components of caring behavior and the guidelines for promotion of caring behavior as identified in the researchers＇ concepts. However, the researchers＇ concepts were developed 54 caring behaviors while the experts＇ opinion were 50 caring behaviors. In the second and third Delphi technique, all items of caring behaviors get consensus shown by interquartile range not more than 1.5 and the median since 3.5.

Measurement of professional identity in Chinese nursing students

Objectives:Chinese nurses continue to display low professional identity.It is becoming an emergent issue in China how to help nurse students develop their positive professional identity.This paper is to develop the Professional Identity Scale for Nursing Students(PISNS).Methods:Literature review,and interviews with students and experts were adopted to develop initial item.Reliability and validity of the scale were respectively examined by computing internal consistency coefficient alpha and split-half Spearman Brown for equal length,and Exploratory Principle Component Factor Analysis.Results:Five factors with 17-item were obtained explaining 58.9%of the total variance.Cronbach’s alpha,and split-half reliability was 0.83 and 0.84 respectively.Conclusions:Given its high reliability and validity,PISNS could be used as a measurement tool for educators to evaluate the developing level of professional identity in nursing students and assess the effectiveness of corresponding interventions and strategies.

Entrustable professional activities in nursing:A concept analysis

Objective:Entrustable professional activities(EPAs)is a newly emerging concept.This paper aims at analyzing the concept of"EPAs"to clarify the meaning and to identify its components for optimum understanding of the concept for use in nursing education and future research.Method:Three databases-ProQuest,Ovid,and PubMed-were retrieved,and Walker and Avant's concept analysis approach was used to analyze the concept of EPAs.Results:Based on the analysis,three attributes of EPAs were defined,namely (1)EPAs should be restricted to a limited number of tasks;(2)reflect the experience curve;and (3)include acceptance of responsibility and accountability.The antecedent of EPAs is a holistic and integrated assessment approach.This will eventually lead to anticipated consequences such as a mastery of core competencies and an increase in the level of autonomy.Conclusion:The study may contribute to a reduction in the ambiguity of this concept to better apply it in nursing practice.

Factors that Influence Professional Socialization in Nursing Students: A Multigroup Analysis

Background: Nursing professional socialization significantly influences the sustainable development of nursing students’ careers. This study aims to examine the factors that influence professional socialization in nursing students. Methods: This is a quantitative study of a sample of 108 nursing students (80 females and 28 males). The Simulation Learning Effectiveness Scale, Caring Assessment Report Evaluation Q-sort, Self-Reflection and Insight Scale, and Holistic Nursing Competence Scale were used to collect the data on the independent variables. The Team Skills Scale, Nursing Image as a Profession questionnaire, and Nursing Professional Commitment Scale were used to assess the level of students’ nursing professional socialization, which is an outcome construct variable. A multigroup analysis was used to examine the professional socialization research model. Results: The full model findings show that individual learning effectiveness had a significantly positive effect on nursing students’ caring behavior and on self-reflection and insight. In addition, caring behavior and self-reflection and insight had a significantly positive effect on nursing competence. Finally, nursing competence also had a significantly positive effect on nursing professional socialization. Overall, all independent variables were significant predictors of nursing professional socialization, explaining 36.7% of the variance in the integrated model of professional socialization. In addition, a permutation test revealed no differences in the two comparisons’ path coefficient estimates in the model (female vs. male). Conclusion: It is important to further strengthen nursing students’ self-learning effectiveness to promote their self-reflection and caring behavior. Increasing students’ nursing competence is a key factor in improving their professional socialization.

Correlation between self-differentiation and professional adaptability among undergraduate nursing students in China

Purpose:This study aimed to investigate the current status of self-differentiation and professional adaptability among undergraduate nursing students,to analyze the relationship between these two variables,and to provide recommendations for nursing educators.Methods:A total of 341 nursing undergraduate students at the University of South China were investigated using the Differentiation of Self Inventory and the Professional Adaptability Scale for college students.Results:The mean scores of self-differentiation and professional adaptability were 3.70±0.60 and 2.87±0.37,respectively,and the two variables were positively correlated(P<0.01).Conclusion:The level of self-differentiation of undergraduate nursing studentsaffects their professional adaptability.Nursing educators should consider the characteristics of self-differentiation of undergraduate nursing students in developing measures to improve their professional adaptability.

Diversified Teaching Methods in Nursing:Using Animal Experimentation to Promote Core Professional Competencies in Basic Nursing Training

Objective： The aim of this project was to train highly professional and specialized nursing students from medical colleges to adapt to bedside clinical care by exploring and discussing various methods of injection and IV infusion in animal experimentation to hone the core professional nursing competencies. Methods： Two classes from the 2012 senior graduating nursing class were randomly selected by a computer to conduct the diversified practical teaching methods based on animal experimentation. A hospital environment was simulated by requiring students to perform different types of injections and practical IV infusion techniques. A comprehensive evaluation of the core professional competencies, as well as other integrated competencies, was conducted to determine the effectiveness of the teaching methods. Results： Two-sampled, pairwise u-tests were performed between the scores of the experimental （nursing class 2） and control （nursing class 1） groups. These findings showed that the overall test scores were significantly higher in the experimental group compared to the control group and that the average P-values for the competencies in various categories were 〈0.01, which indicated statistically significant results. Conclusions： Based on the data from this project, diversified teaching methods for basic nursing training founded on animal experimentation can help nursing students perfect their core professional competencies and improve their overall professional standing. The introduction of animal experimentation requires further verification, and an increased acknowledgement of its benefits through the widespread dissemination of this information.

Nursing as a profession:Undergraduate female students’perception

Background and Objective: Nursing profession has a robust educational pathway into the practice and acontinuously growing body of knowledge within programs in higher education. This study aimed to investigate andcompare between first and fourth year nursing students’ perception toward their profession. Method: The studywas conducted at one of the biggest female governmental universities in Saudi Arabia in the college of nursing. Thestudy involved a convenient sample of 300 currently enrolled bachelors nursing students from the first and fourthyears in the college of nursing. Self-administered questionnaire was used in this study. Results: The majority ofstudy sample have joined the faculty of nursing due to grades foundation year and 50% of them have also a nursefriend or relative. Fourth year students were more proud than first year students when they are talking aboutnursing, and their image was changed to better after clinical training, majority of the participants have a positiveperception toward nursing, and no significant differences in perception of nursing profession between first andfourth year students. Conclusion: There are many students of first and fourth year who have no plans regardingchanging their profession. This may be an indication for a possible decreasing in the shortage of Saudi nurses. Butthere is still a need to improve the public image of nursing to attract students into nursing programs, and advisingshould be provided for students to develop positive perception towards nursing profession.

Emotional intelligence in professional nursing practice:A concept review using Rodgers's evolutionary analysis approach

Background:Knowledge around emotional intelligence originated in the 1990s from research regarding thoughts,emotions and abilities.The concept of emotional intelligence has evolved over the last 25 years;however,the understanding and use is still unclear.Despite this,emotional intelligence has been a widely-considered concept within professions such as business,management,education,and within the last 10 years has gained traction within nursing practice.Aims and objectives:The aim of this concept review is to clarify the understanding of the concept emotional intelligence,what attributes signify emotional intelligence,what are its antecedents,consequences,related terms and implications to advance nursing practice.Method:A computerized search was guided by Rodger's evolutional concept analysis.Data courses included:CINAHL,PyschINFO,Scopus,EMBASE and ProQuest,focusing on articles published in Canada and the United Stated during 1990e2017.Results:A total of 23 articles from various bodies of disciplines were included in this integrative concept review.The analysis reveals that there are many inconsistencies regarding the description of emotional intelligence,however,four common attributes were discovered:self-awareness,self-management,social awareness and social/relationship management.These attributes facilitate the emotional well-being among advance practice nurses and enhances the ability to practice in a way that will benefit patients,families,colleagues and advance practice nurses as working professionals and as individuals.Conclusion:The integration of emotional intelligence is supported within several disciplines as there is consensus on the impact that emotional intelligence has on job satisfaction,stress level,burnout and helps to facilitate a positive environment.Explicit to advance practice nursing,emotional intelligence is a concept that may be central to nursing practice as it has the potential to impact the quality of patient care and outcomes,decision-making,critical thinking and overall the well-being of practicing nurses.

Letter to the Editor: Evidence-based practice for nursing profession: Barriers and teaching strategies solutions

Dear Editor,We have read the article entitled"Improve nursing in evidencebased practice:How Chinese nurses'read and comprehend scientific literature"by Huang et al.[1]published in the International Journal of Nursing Sciences.We would like to appreciate and strongly support the authors'efforts in pointing out the importance of Evidence-Based Practice(EBP)in nursing.Nurses are required to adhere to accepted standards of practice and professional performance.As a professional,nurses need to use evidence-based intervention and the integration of research findings into practice[2,3].EBP is an approach to nursing care that is very important for improving patient outcomes[4],however,the previous studies have been suggested that health professional does not always use the evidence to guide their practice[1,5-7].Huang et al.state that only 3.5%of nurses read literature regularly on a daily,9.8%on a weekly,9.3%on a monthly and 66%only read when needed[1].Further,O'lynn et al.also state that"in terms of actual use of research findings in practice,small range of nurses(27.1%)reported using research"often"or"very often"in the past year;whereas 30.0%reported using research"rarely"or"never"in the past year"[6].

Predictors of critical care nurses’ intention to leave the unit, the hospital, and the nursing profession

Nursing turnover and shortage are acknowledged as worldwide issues: understanding the factors that foster nurses’ intention to leave (ITL) is essential in retaining them. The present study aims at providing insight into the factors influencing critical care and intensive care nurses’ ITL the unit, the hospital, and the nursing profession. The study was conducted in two hospitals, by a questionnaire administered to all nurses employed in critical and intensive care units. 512 questionnaires (89.4%) were returned. Results revealed that a low job satisfaction (JS) for interaction with physicians and nurses, seniority ≥20 years, and working in Emergency are related to higher ITL the unit. Low JS for work organization policies, seniority ≥11 years, working in a private hospital, and higher educational level are related to higher levels of ITL the hospital. Low JS for professional status, for pay, and for work organization policies, age ≥40 years, part-time schedule are related to higher ITL the nursing profession. The research permitted detection of various predictors of different kinds of ITL, enhancing the importance of regular monitoring of ITL. In order to limit ITL, it would be important to work on the relationship with physicians and colleagues, work demands, organizational policies, and acknowledgement of competence.

Correlation among academic self-efficacy,professional identity,and professional attitude of higher vocational nursing students

Objective:To analyze the influence of professional identity and academic efficacy on the professional attitude of higher vocational nursing students.Methods:A total of 656 higher vocational nursing students were investigated with general information questionnaire,academic self-efficacy scale,professional identity scale,and professional attitude scale of nursing students.Results:The score of professional attitude of higher vocational nursing students was(106.34±9.86),which is found to be in the upper middle level.The professional attitude of higher vocational nursing students is positively correlated with academic self-efficacy(P<0.05),and with learning ability self-efficacy(P<0.01).Professional cognition,professional will,and professional values have a positive predictive effect on the professional attitude of higher vocational nursing students(P<0.05).Conclusions:Academic self-efficacy and professional identity are important predictors of professional attitude.Learning behavior self-efficacy,professional cognition,professional will,and professional values have a significant impact on the establishment of positive professional attitude.

Literature Review of Nursing Education Promoting Professional Socialization among Nursing Students

The aim of this review was to clarify the elements that promote socialization of nursing professionals from the findings of previous studies, with keywords related to socialization among undergraduate nursing students, and obtain indicators for promoting professional socialization in nursing students in the current nursing education. The literature review was conducted using a qualitative analysis of the promotion of professional socialization among nursing students. The results were reported according to the reporting checklist of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The authors conducted a literature search using electronic databases in July 2021, such as CINAHL (EBSCOhost), MEDLINE (EBSCOhost) for English articles, and Ichushi for Japanese articles. Included studies were from 1985 to 2021. Previous studies were integrated to current studies. A total of 23 articles in English and 34 articles in Japanese were analyzed. The methods for promoting professional socialization in nursing students include self-learning, online media, extracurricular elements, and clinical practice. Socialization process differed for each school year;the first-year students tend to have ideological answers, while the fourth-year students tend to have practical answers as a result of education. The process needs supports from instructors and mentors. Nursing education promoting professional socialization in nursing students has developed diverse modeling, positive effects for improving social skills, and impact of self-efficacy and self-esteem and has fostered professional commitment and professional identity. However, loss of idealism of professional identity after graduation should be considered with supports from instructors and mentors. To establish nursing professional identity smoothly, nursing instructors supporting skills should be developed by understanding students’ stage of professional socialization.

Talking about Giving Up a Child for Adoption with Nursing Professionals

The subject of adoption is well-studied worldwide. In contrast, when it comes to women who give up their children for adoption, studies are far fewer. The present research aims to investigate how the myth of motherly love affects the ideas and conceptions concerning giving up a child for adoption from the perspective of the nursing professionals directly involved with these women. Also, the aim here is to interfere preventively with these professionals, raising awareness of the conceptions and prejudices related to giving up a child for adoption. Methodologically speaking, the research is designed as a qualitative research, based on the clinical method. The procedure was undertaken using group dynamics carried out with 19 professionals （nurses and nursing technicians）. PaJcticipants performed a free association activity and continued with two fictional stories on giving up a child for adoption. The results indicate that the ideas derived from the myth of motherly love are indeed present in the professionals＇ subjectivity and influence their behavior and attitude towards these women. Additionally, financial difficulties and other factors external to these women are provided as the main reasons for giving a child for adoption. Additionally, the intention is also to minimize the negative effects on the psychic life of these women who give their children up for adoption as well as to provide these children with a more sustainable life project.

A study on the correlation between function motivation and professional identity among nursing volunteers

Objective:The objective of this study is to understand the status quo of function motivation and professional identity among nursing volunteers and explore the correlation between the two.Materials and Methods:A total of 3375 nursing volunteers from Nightingale Volunteer Service Group in Shanxi Province were investigated by using Occupational Identity Scale and Volunteer Functional Motivation Scale.Results:A total of 3375 questionnaires were issued and 3330 were recovered,among which 3324 were valid,with an effective recovery rate of 99.82%(3324/3330).The overall score of professional identity of nurses was 110.31±18.71,and the score of each dimension was 32.17±6.62 for professional cognitive evaluation dimension,22.77±3.74 for professional social support,21.31±4.09 for professional social skills,22.78±3.79 for professional frustration coping,and 11.32±2.03 for professional self-reflection.The total score of function motivation was 157.12±29.92.The above five dimensions of nurse’s professional identity scale were positively correlated with the total score of function motivation of nursing volunteers(r=0.044,0.035,0.034,0.035,and 0.042,respectively,all P<0.05).Conclusion:The functional motivation and professional identity of nursing volunteers in Shanxi Province are in the middle level in China.Therefore,it is necessary for the hospital to stimulate nursing staff’s enthusiasm about participation by carrying out multi-channel and multi-form volunteer service projects,enhance their professional identity,and make them better give back nursing professional skills to the society.