Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Effects of comprehensive nursing with cognitive behavioral therapy in orthodontic osteodilated arch treatment

BACKGROUND This work explored the effects of cognitive behavior therapy(CBT)-based comprehensive nursing intervention(CNI)mode in arch expansion to treat patients with orthodontic osteodilated arch(OOA).AIM To explore the application effect of CBT-based CNI model in orthodontic expansion arch treatment.METHODS Using convenient sampling method,81 patients with OOA were selected and rolled into a control group(Ctrl group,40 cases)and an observation group(Obs group,41 cases).During the treatment,patients in the Ctrl group received routine nursing intervention mode,and the those in the Obs group received CBT mode on the basis of this.Before and after intervention,the incidence of oral mucositis,the mastery rate of correct arch expansion method,self-rating anxiety scale score,soft scale index,and plaque index were compared for patients in different groups.In addition,satisfaction and complications were comparatively analyzed.RESULTS Incidence of oral mucositis in the Obs group was lower(14.6%vs 38.5%),and the mastery rate of correct arch expansion method was obviously higher(90.2%vs 55.0%)was obviously higher(all P<0.05).Meanwhile,the soft scale index and plaque index in the Obs group were much lower(P<0.05).The compliance(90.24%)and satisfaction(95.12%)in the Obs group were greatly higher(P<0.05).CONCLUSION The CBT-based CNI mode greatly improved the mastery rate of correct arch expansion method during arch expansion in treating patients with OOA and enhanced the therapeutic effect of arch expansion and the oral health of patients,improving the patient compliance.

Effect of cognitive behavior therapy training and psychological nursing on the midwifery process in the delivery room

BACKGROUND The severe physical and psychological impact of pain on the physical and mental health of women during labor leads to increased risks and complications during childbirth,presenting a major public health concern.Some studies have shown that cognitive behavioral therapy(CBT)has a positive effect on maternal psychology during delivery,reducing stress and shortening labor time.Thus,CBT training for mothers and delivery room staff may be beneficial in minimizing complications and adverse effects during natural birth.AIM To investigate the clinical effects of CBT training and psychological care during delivery,and their therapeutic effects on women in labor.METHODS This study used a retrospective analysis and included 140 mothers admitted to the maternity ward between January 2021 and January 2023.The study subjects were randomized into two groups:control(n=70)and observation(n=70).Routine care,CBT training,and psychological care were provided to mothers in both groups.Psychological status scores,delivery time,and satisfaction with care pre-and post-delivery were compared,and the incidence of complications after receiving care was analyzed between the two groups.RESULTS Although the psychological state of both groups improved significantly in the late stages of labor,the psychological state scores of the mothers in the observation group were significantly lower than those of the mothers in the control group(P<0.05).The duration of labor and incidence of complications in the observation group were significantly lower than those in the control group(P<0.05).The mothers in the observation group were significantly more satisfied with nursing care during the course of labor than those in the control group(P<0.05).CONCLUSION CBT training and psychological care for mothers in the midwifery process can effectively improve anxiety and depression,shorten labor duration,reduce postnatal complications,and improve nursing satisfaction and nurse-patient relationships.Its clinical application is effective and has popularization value,providing a new way to protect maternal mental health.

Rational-emotive behavioral intervention helped patients with cancer and their caregivers to manage psychological distress and anxiety symptoms

There is a dearth of evidence-based data on how psychological distress and death anxiety symptoms experienced by cancer patients and caregivers are treated in developing regions. This article sheds light on the report of the findings from a 2016 study that revealed a rational-emotive behavioral intervention helped a select group of cancer patients and their family caregivers to manage problematic assumptions, psychological distress, and death anxiety symptoms in Nigeria.Based on my experience as a co-investigator and corresponding author of this previous study, I addressed the challenges of conducting such a study and the implications for future research in this article. This article encourages future researchers to replicate the study and endeavor to overcome the limitations of the previous study. Funders were also encouraged to ensure increased access to funds for conducting similar studies with cancer patients and their family caregivers in developing countries and other parts of the world.

The effect of self-employment on health, access to care, and health behavior

The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions;access-to-care measures such as a barrier to obtaining necessary health care;and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.

Research on the Mechanism of Retail Strategy Influencing Consumer Behavior Intention——Based on Empirical Analysis of Domestic Luxury Cosmetics Brands

This is a research on the mechanism of retail strategy mix and consumer behavior intention,and psychological impact on consumer attitude, consumer purchase decision-making model and its components are conducted firstly. Next, retail strategy, merchandise strategy, and store strategy, contained in the retail management theory, are adopted as other important variables to measure the impact on consumer attitudes. And then, the key factors of retail strategy mix are identified by means of Focus Group (FG). In addition, the hypothetical model of retail strategy mix and consumer behavior intention for domestic luxury cosmetic brands is established to understand the relationship between the two factors. Finally, empirical researches are conducted on consumers and retailers of luxury cosmetics brands. And some advice are given on retail strategy mix's influence on the consumer behavior intentions, aiming to enlighten domestic luxury cosmetic enterprises to improve performance by the integrated use of retail strategy mix.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Predictive Modeling of Sedentary Behavior Patterns in Adults Using Stacked LSTM

A new health concern in recent periods has seen the evolution of uncertain sedentary behavior.Remaining sedentary for extended durations is regarded as a notable hazard across various adult age brackets,especially the excessive dependence on automobiles for transportation.Throughout the active period,monitoring seating habits has been made easier by sensors.Nevertheless,there exists a disagreement among professionals regarding the most suitable quantifiable criteria for encompassing the comprehensive data on sedentary behavior throughout the day.Owing to variations in measurement methodologies,data analysis approaches,and the lack of essential outcome indicators such as the total sedentary duration,the assessment of sedentary patterns in numerous research investigations was considered unfeasible.The research suggested fleeting granularity distinguish occurrences of regular human activities.Sophisticated units(essential cells) acquire multivariate transitory information.Frequent Behavior Patterns(FBPs) can be identified with a estimation of timeframe using our proposed scalable algorithms that employ collected widespread multivariate data(fleeting granularity).The research outcome,supported by rigorous analyses on two validated datasets,mark a significant progression.In the final stages of the study,a stacked Long Short-Term Memory(LSTM) model was utilized to replicate and forecast repetitive sedentary behavior patterns,leveraging data from the preceding six-hour window blocks of sedentary activity.The model effectively replicated state traits,previous action sequences,and duration,attaining an impressive 99% accuracy level as assessed through RMSE,MSE,MAPE,and r-correlation metrics.

Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Relationship between nutritional therapy and beneficial bacteria ratio in severe disease

Objective:To evaluate relationship between changes in the beneficial bacteria in intensive care unit(ICU)patients and nutritional therapy type.Methods:Ten patients aged≥18 years admitted to the ICU between January and December 2020,were included.Good enteral nutrition was defined as early achievement of target calorie intake through enteral feeding.The ratio of beneficial bacteria at the first and second bowel movements after each patient’s admission was calculated and the patients were classified into the increase or decrease group.Among all patients,five each were in the increase and decrease groups.We investigated patient background,changes in sequential organ failure assessment(SOFA)and acute physiology and chronic health evaluation(APACHE)Ⅱscores,nutritional doses or methods,and clinical outcomes.Results:No relationship was found between changes in the ratio of beneficial bacteria and changes in SOFA/APACHEⅡscores at the time of admission.The rate of good enteral nutrition was significantly higher in the increase group than in the decrease group(4/5 vs.0/5,P=0.01).Conclusions:An increase in beneficial bacteria may be significantly related to the early establishment of enteral nutrition.In the future,accumulating cases may make it possible to establish a new nutritional strategy for critically ill patients from an intestinal microbiota perspective.

Rehabilitative Outcomes after Hip Fracture in a Special Care Unit for Persons with Dementia and Behavioral and Psychotic Symptoms

Aim: Hip fracture implies severe problems to older people;special concerns regard persons with dementia, due either to cognitive impairment, or to behavioral and psychic symptoms. This study illustrates rehabilitative outcomes of these patients discharged by a special care unit ruled by “GentleCare” principles. Method: 54 patients [89% females, aged 82.3 years (range 66 - 94)] followed a post-surgery rehabilitative program carried out by a physiotherapist and an occupational therapist, supported by a psychologist. The multidimensional assessment consisted of cognition evaluation (Mini Mental State Examination, Clinical Dementia Rating, Global Deterioration Scale), functional evaluation (Barthel Index, Tinetti Gait and Balance, Bedford Alzheimer Nursing Severity scale), behavioral evaluation (UCLA Neuropsychiatric Inventory) and comorbidity evaluation (Cumulative Illness Rating Scale). Results: All parameters improved, including the 5 most frequent behavioral and psychic symptoms that usually preclude admission in ordinary rehabilitation units. 24% of improvement in Barthel Index total score was explained by agitation and apathy at discharge, in a multiple linear regression model: better functional levels corresponded to smoother behavioral problems. Most patients improved;70.5% of them were discharged to home. Conclusion: A prosthetic approach enables valuable results in the rehabilitation of severely demented patients with hip fracture also in presence of behavioral symptoms.

Perception of caring behavior and associated factors among nurses and midwives working in public hospitals in Southern Ethiopia

Objective:This study aimed to assess the perception of caring behaviors and associated factors among nurses and midwives who provided maternal health care services at Sidama region public hospitals,Hawassa,Ethiopia.Methods:An institutional-based cross-sectional study design was used on a sample of 269 nurses and midwives working in maternity wards in Sidama region public hospitals.A self-administered questionnaire was used to collect data.Bivariate and multivariable logistic regression analysis was used to identify factors associated with nurses’and midwives’perceptions of caring behaviors.Results:Totally 261 nurses and midwives participated the survey.Based on the mean score,participants’perception of caring behavior was classified as higher and lower.According to this study,75.1%(196/261)of nurses and midwives demonstrated a higher perception of caring behavior.Respondents’age,professional satisfaction,personal satisfaction,midwife/nurse-doctor relationship and workload were significantly associated with their perception of caring behavior.Conclusions:Assessing the nurses’and midwives’perception of caring behavior and related factors is crucial for providing high-quality nursing and midwifery interventions.It is suggested to create a positive and conducive caring behavior in the organization by reducing excessive workload of nurses and midwives,as well as enhancing nurse/midwife-doctor relationship,and increasing their job satisfaction by providing recognition and reward will improve nurses’and midwives’caring behavior.

A Mindfulness-Based Cognitive Therapy (MBCT) Intervention to Improve Resilience and Mitigate Symptoms of Burnout Syndrome in Critical Care Nurses: Results of a Randomized Trial

Objective: Critical care nurses work in a challenging intensive care (ICU) environment that results in work-related psychological distress. Our objective was to pilot an in-person or virtual mindfulness-based cognitive therapy (MBCT) program enhanced resilience and a similarly designed attention control group. Methods: We randomized ICU nurses with symptoms of burnout syndrome and decreased resilience to an MBCT program or a similarly formatted book club control. Our primary outcome was change in resilience as measured by the Connor-Davidson Resilience Scale (CD-RISC). Results: One-hundred one nurses completed study-related procedures. Overall, 70% had baseline symptoms of anxiety and 26% had symptoms of depression. For the in-person cohorts, there was no statistical difference between intervention and control groups regarding the total number of sessions attended (3.85 days ± 1.4 versus 3.75 days ± 0.15;p = 0.64). Using the Client/Patient Satisfaction Questionnaire-8 (CSQ-8), satisfaction scores were higher in the intervention group for weeks two through four of the program: p = 0.03, 0.0003, 0.007 respectively. There was no difference in the change in CD-RISC scores between the two groups (mean difference: treatment = 5.0, control = 7.0;p = 0.30). The online intervention cohort had greater improvements in the change of their median emotional exhaustion burnout scores when compared to the in-person intervention cohorts (-5 [-8 to -1.5] vs. 2 [-5 to 8], p = 0.049). Conclusions: We developed a feasible and acceptable in-person and online MBCT-ICU intervention that did not increase resilience scores in ICU nurses when compared to an attention control group. These results could help guide the proper design of larger trials to determine the efficacy of other resilience interventions.

Development and psychometric evaluation of the nurse behavior toward confirmed and suspected HIV/AIDS patients (NB-CSHAP) scale

There is a scarcity of literature discussing nurses’ behaviors toward caring for suspected or confirmed human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. The development of a scale specific to measure nurses’ behaviors will allow health institutions to assess the disposition of their nurses in terms of HIV care. This study aims to present the rigors of developing and validating a reliable instrument to contextualize these nurses’ behaviors. This study utilized a sequential exploratory mixed method design to develop the NB-CSHAP scale. Thematic analysis was done on the qualitative data from the interviews with persons living with HIV/AIDS (PLHA) from which items were selected to be included in the scale. Exploratory factor analysis was utilized to extract the factors and Cronbach’s alpha was used to assess the reliability of the instrument. Four factors were extracted and are categorized as either caring or discriminatory behaviors. These include: (1) service-oriented, (2) openhanded, (3) perceptive, and (4) discriminatory. The scale has an internal consistency of 0.73. The scale shows acceptable psychometric properties, hence can be used to assess the nurses’ behaviors in caring for confirmed or suspected HIV clients. The scale may be used by health institutions to determine the quality of the patient care provided by their nurses to clients with confirmed or suspected HIV .

Behavioral Aspects in Obligatory Reports of Public Hospitals in Poland

The health care sector is the most difficult one to manage and control. Special units in this field are public hospitals which are required to prepare a lot of reports to various institutions, including the ownership body. The paper focuses on two issues. The first is the presence of behavioral factors in the reporting of public hospitals in Poland to the ownership bodies. This article aims to indicate the thematic areas of specific reports, most affected by behavioral factors and explain the causes and consequences of their occurrence. The second issue is the analysis of the legal status of obligatory reporting of public hospitals. Participants of the conducted research, due to their specific ownership and political and social position, were public hospitals in Poland. The paper uses the research methods of the meta-analysis of the literature, legal acts in Poland and empirical materials, and also the methods of synthesis, observation, and deduction. Data analysis focused on specific sample of reports issued by Polish public hospitals for their ownership body. The research shows that hospitals draw up a tremendous number of often thematically overlapping and redundant reports addressed to different institutions in different time periods. It is a consequence of legal regulations failing to streamline the reporting of the health care sector institutions, in particular public hospitals. The paper points to the large number of legal instruments that contain imprecise requirements resulting from the complex and obscure forms of control of public funds allocation in this sector. There are many behavioral factors that shape some fields of public hospitals＇ reports, for example, interpersonal relationships, egoism, private financial interests, strengthening of the employment status and professional position, and professional competences. There is considerable freedom in the reporting process fulfilled by public hospitals in Poland for their ownership body. It causes strong consequences, like poor-quality data, duplication of information, and its chaos, as well as high costs of obtaining information. Reporting system of financial and non-financial data of public hospitals in Poland is dysfunctional.

Characteristics of Patients with Decreased Cognitive Function Undergoing Treatment for Acute Exacerbation of Chronic Heart Failure—Basic Survey for Standardization of Nursing to Prevent Discontinuation of Treatment

The purpose of this study is to clarify the characteristics of patients with decreased cognitive function undergoing treatment for acute exacerbation phase of chronic heart failure as a basic survey with a view to the standardization of nursing to prevent discontinuation of treatment of patients with declining cognitive function in the acute exacerbation phase of chronic heart failure. As the first stage of the research, using the interview guide created based on the background of discontinuation of treatment and symptomatic monitoring from 33 target literature sources, seven certified chronic heart failure nurses and 15 certified dementia nurses were given semi-structured interviews. Data obtained from the interviews was analyzed by qualitative induction. As a result, we obtained opinions/views on 8 situations namely, “cognitive function at hospitalization”, “characteristics at hospitalization, “characteristics when receiving examinations, procedures or treatment”, “characteristics of course of treatment”, “characteristics related to difficulties in grasping the symptoms of chronic heart failure and indices of deterioration”, “characteristics when using diuretics”, “characteristics concerning compliance with dietary restrictions” and “support required for discharge from hospital” concerning patients with declining cognitive function. In the future, it is necessary to prepare nursing protocols incorporating these contents for standardization of nursing.

Self-care practices and health-seeking behavior among older persons in a developing country:Theories-based research

Purpose:The aim of this study was to examine the self-care practices and health-seeking behaviours of older adults in urban Indonesia.Methods:The cross-sectional study was performed from January to March 2014 in the Tammua sub-district of Indonesia.At the time of the study,273 older adults resided in Tammua,and half of them(51.2%)participated in this study.Data collection was carried out including self-care practices,health literacy,self-efficacy and basic conditioning factors.Results:It was found that most respondents(124;88.6%)always ate various protein sources daily.However,many participants never limited consumption of sugar(55;39.3%)or salt(40;28.6%),and more than half of respondents(96;68.6%)did not regularly visit MHCs.Health status(p<0.05),health maintenance(p<0.01)and salt limitation(p<0.05)were all significantly associated with salt limitation.It was found that respondents with higher selfefficacy,those who did not want to get information,and those of younger ages are less likely to visit MHCs regularly.Conclusion:An understanding of self-care practices and self-efficacy is needed to improve health care in developing countries.High self-efficacy should be promoted along with adequate health literacy.Older persons should learn the importance of regular health examinations to promote health,prevent diseases,and slow the progress of chronic diseases.The number of respondents who never limit their sugar and salt intake was especially surprising.An intervention program should be developed to limit salt and sugar intake of Indonesian elderly and to motivate older persons to use primary health services.

Information seeking and anxiety among colonoscopy-na?ve adults: direct-to-colonoscopy vs traditional consult-first pathways

AIM To investigate the effects of direct to colonoscopy pathways on information seeking behaviors and anxiety among colonoscopy-na?ve patients.METHODS Colonoscopy-na?ve patients at two tertiary care hospitals completed a survey immediately prior to their scheduled outpatient procedure and before receiving sedation.Survey items included clinical pathway(direct or consult),procedure indication(cancer screening or symptom investigation),telephone and written contact from the physician endoscopist office,information sources,and pre-procedure anxiety.Participants reported pre-procedure anxiety using a 10 point scale anchored by "very relaxed"(1) and "very nervous"(10).At least three months following the procedure,patient medical records were reviewed to determine sedative dose,procedure indications and any adverse events.The primary comparison was between the direct and consult pathways.Given the very different implications,a secondary analysis considering the patient-reported indication for the procedure(symptoms or screening).Effects of pathway(direct vs consult) were compared both within and between the screening and symptom subgroups.RESULTS Of 409 patients who completed the survey,34% followed a direct pathway.Indications for colonoscopy were similar in each group.The majority of the participants were women(58%),married(61%),and internet users(81%).The most important information source was family physicians(Direct) and specialist physicians(Consult).Use of other information sources,including the internet(20% vs 18%) and Direct family and friends(64% vs 53%),was similar in the Direct and Consult groups,respectively.Only 31% of the 81% who were internet users accessed internet health information.Most sought fundamental information such as what a colonoscopy is or why it is done.Pre-procedure anxiety did not differ between care pathways.Those undergoing colonoscopy for symptoms reported greater anxiety [mean 5.3,95%CI: 5.0-5.7(10 point Likert scale)] than those for screening colonoscopy(4.3,95%CI: 3.9-4.7).CONCLUSION Procedure indication(cancer screening or symptom investigation) was more closely associated with information seeking behaviors and pre-procedure anxiety than care pathway.

Clinical leadership behaviors among critical care nurses in private and governmental hospital:A cross-sectional survey

Objectives This study aimed to investigate clinical leadership behaviors among critical care nurses and compare the differences between nurses in private and public hospitals.Methods A cross-sectional survey including 365 critical care nurses with a bachelor’s degree in nursing science were recruited in two Egyptian hospitals(a government teaching hospital and one private hospital from January to March 2019.A socio-demographic characteristics form and the Clinical Leadership Behaviors Questionnaire(CLB-Q)were used to collect data.For comparison and analysis,the mean score was calculated and converted to a percentage value.Results Results showed that the overall mean score of nurses’clinical leadership behaviors was 77.11±11.87,the level was higher,and the highest score of the communication dimension was 91.84±7.38.The mean score of nurses at a private hospital(90.48±5.53)was higher than that at a government teaching hospital(68.29±4.21)(P<0.001).On nursing experience,nurses with 5–10 years had higher mean score in self-awareness,advocacy and empowerment,decision making,quality and safety,teamwork,and clinical excellence dimension of clinical leadership behavior than those who worked less than 5 years or more than 10 years(P<0.01).Single nurses had higher mean score in advocacy and empowerment,decision making,quality and safety,and clinical excellence dimension of clinical leadership behavior than those who married(P<0.01).Conclusions Nurse managers should foster clinical leadership by enabling critical care nurses to practice clinical excellence and encouraging their attendance in training programs on quality and safety.Nurses in government hospitals need improvement in clinical leadership behaviors regarding all dimensions.

The relationships among critical thinking disposition, caring behavior, and learning styles in student nurses

The purpose of this study was to identify the relationships among disposition toward critical thinking, learning styles, and caring behaviors in student nurses enrolled in three 5-year junior nursing colleges in Southern Taiwan. Methods: This cross-sectional study used a convenience sample that comprised 777 nursing students from two cities. The data were obtained through the Critical Thinking Disposition Inventory, Chinese Version (CTDI-CV), Index of Learning Styles (ILS), and the Caring Behavior Scale (CBS). The sample ranged in age from 16 to 22 years (M = 18.21). Results: Students scored highest on the inquisitiveness subscale and lowest on the truth-seeking subscale. Additionally, some dimensions of disposition toward critical thinking differed significantly by learning style. There was a positive relationship between overall critical thinking dispositions and caring behaviors (r = 0.23, p < 0.01). Finally, dimensions of caring behavior, with the exception of the maturity dimension, were significantly positively related to most dimensions of the disposition toward critical thinking (p < 0.05). Conclusion: The findings indicate that not only is learning style related to critical thinking disposition but also to caring behaviors. However, the cause of these relationships warrants further study.