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  • Article: Crucial information needs of ICU charge nurses in Finland and Greece.
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    ABSTRACT: To describe crucial information needs of ICU charge nurses, and to compare these needs in two countries in Europe. ICU charge nurses are on the front line for ensuring that the activities of their units are running smoothly. They are accountable for making sure that the right tasks are performed under the right circumstances, with the right people, at the right time. An online survey based on a previous observation study regarding the ad hoc decision-making of ICU shift leaders. A total of 257 Finnish and 50 Greek ICU charge nurses participated in this study, from 17 Finnish and 16 Greece ICUs for adults. Our survey incorporated 122 statements divided into six dimensions (patient admission, organization and management of work, allocation of staff, allocation of material, special treatments and patient discharge) with a rating scale from 0 to 10. Analysis involved descriptive statistics. Mann-Whitney U and Kruskal-Wallis tests were used to compare the answers of the two countries. Validity was verified with confirmatory factor analysis and the reliability was tested with Cronbach's α values. The most crucial information needs of ICU charge nurses concerned the overall organization and management of work. Both staff-related and individual patient-related information was needed. Information needs of Finnish and Greek charge nurses concerned similar kinds of situations in ICUs. However, there were some differences that might depend on the cultural differences between the countries. Accurate and real-time information is a prerequisite for ICU charge nurses' ad hoc decision-making during daily care management. Identification of the most crucial information is needed when tools for information management are developed. Relevance to clinical practice: The results of this study indicated that a major portion of immediate information needs of ICU charge nurses are internationally common in similar settings.
    Nursing in Critical Care 05/2013; 18(3):142-53. · 1.08 Impact Factor
  • Article: Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy.
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    ABSTRACT: AIM: To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses. BACKGROUND: Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions. METHODS: A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses. RESULTS: The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P < 0.001); and (2) intention to resign (r = 0.244, P < 0.0001). The frequency of occurrence of moral distress was associated with the intention of nurses to resign (r = -0. 209, P < 0.0001). CONCLUSION: Moral distress seems to be associated with the intention to resign, whereas poor nurse-physician collaboration appears to be a pivotal factor accounting for nurses' moral distress. IMPLICATIONS FOR NURSING MANAGEMENT: Enhancement of nurse-physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession.
    Journal of Nursing Management 03/2013; · 1.18 Impact Factor
  • Article: Cross-cultural validity of the Individualised Care Scale - a Rasch model analysis.
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    ABSTRACT: Aims and objectives.  The aim of this study was to investigate, using Rasch model analysis, the measurement invariance of the item ratings of the Individualised Care Scale. Background.  Evidence of reliability is needed in cross-cultural comparative studies. To be used in different cultures and languages, the items must function the same way. Design.  A methodological and comparative design. Methods.  Secondary analysis of data, gathered in 2005-2006 from a cross-cultural survey using the Individualised Care Scale from Finnish, Greek, Swedish and English predischarge hospitalised orthopaedic and trauma patients (n = 1093), was used. The Rasch model, which produces calibrations (item locations and rank) and item fit statistics, was computed using the Winstep program. Results.  The rank of average Individualised Care Scale item calibrations (-2·26-1·52) followed a generally similar trend (Infit ≤ 1·3), but slight differences in the item rank by country were found and some item misfit was identified within the same items. There was some variation in the order and location of some Individualised Care Scale items for individual countries, but the overall pattern of item calibration was generally corresponding. Conclusions.  The Rasch model provided information about the appropriateness, sensitivity and item function in different cultures providing more in-depth information about the psychometric properties of the Individualised Care Scale instrument. Comparison of the four versions of the Individualised Care Scale - patient revealed general correspondence in the item calibration patterns although slight differences in the rank order of the items were found. Some items showed also a slight misfit. Based on these results, the phrasing and targeting of some items should be considered. Relevance to clinical practice.  The Individualised Care Scale - Patient version can be used in cross-cultural studies for the measurement of patients' perceptions of individualised care. Information obtained with the use of the Individualised Care Scale in clinical nursing practice is important, and valid measures are needed in evaluating patients' assessment of individualised care, one indicator of care quality.
    Journal of Clinical Nursing 08/2012; · 1.12 Impact Factor
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    Article: Nurses' sociodemographic background and assessments of individualized care.
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    ABSTRACT: The aim of this study was to explore the association between nurses' characteristics (educational level, country, work title, gender, type of work, age, and length of working experience) and their assessments of individualized care. A cross-sectional comparative survey using questionnaires was employed to sample nurses from seven countries. Data were collected from orthopedic and trauma nurses from Cyprus, Finland, Greece, Portugal, Sweden, Turkey, and the United States (N= 1,163, response rate 70%) using the Individualized Care Scale-Nurse (ICS-Nurse) and a sociodemographic questionnaire in 2008. Data were analyzed using descriptive statistics and general linear models. When compared with practical nurses, registered nurses, length of working experience, and the country of the nurses were associated with assessments of the support of patient individuality in specific nursing activities (ICS-A-Nurse) and country assessments of individuality in the care provided (ICS-B-Nurse). The background and experience within nursing teams together with the country affect the delivery of individualized care. Overall, our findings suggest that nurses' personal attributes have important effects on their assessments of individualized nursing care that will be useful when making context-dependent recruitment decisions. The characteristics of nurses contribute to the care delivered in healthcare organizations. Recognition of these nurse-related factors may help nurse leaders in the development and management of clinical practice.
    Journal of Nursing Scholarship 08/2012; 44(3):284-93. · 1.49 Impact Factor
  • Article: How Greek healthcare services are affected by the Euro crisis.
    Maria Kalafati
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    ABSTRACT: Greece's economic crisis is having a detrimental effect on the country's health service. Government cutbacks have forced hospitals to merge, reduced nurse-to-patient ratios and have led to pay cuts and poorer conditions for staff. Emergency nurses must work longer hours with fewer resources for less money, when emergency admissions in the public sector are rising as a result of the economic pressures on Greek society.
    Emergency nurse: the journal of the RCN Accident and Emergency Nursing Association 06/2012; 20(3):26-7.

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