Self-efficacy and organizational commitment among Spanish nurses: the role of work engagement

Aim: The objective of this study was to verify the mediating role of work engagement between self-efficacy and affective organizational commitment on the basis of the Job Demands-Resources Model in a sample of Spanish nursing staff. Background: Affective organizational commitment is a key element, both for the permanence of nursing staff and for the provision of an excellent quality of care of health organizations. However, the relationships between self-efficacy, work engagement and affective commitment to the organization have been little explored within the nursing context. Methods: A total of 527 nursing professionals from Spanish public hospitals in Andalusia were surveyed, obtaining a convenience sample of 324 participants (52.96% nurses, 47.04% nursing assistants). The mediating role of work engagement was examined using structural equation modelling and the bootstrapping method. Results: The results showed that affective organizational commitment was positively predicted by self-efficacy and work engagement. Work engagement had a direct effect on affective organizational commitment, while the effect of self-efficacy on affective commitment was totally mediated by work engagement. Conclusions: The results give empirical support to the Job Demands-Resources Model, which raises the mediating role of work engagement between self-efficacy (personal resource) and affective organizational commitment (organizational result). Implications for nursing practice: Health organizations should be aware that a greater perception of efficacy beliefs and work engagement strengthens the affective bond with the organization, thus improving the corporate image of the health institution. Implications for nursing policy: Policy changes are necessary to create work environments that enhance the self-efficacy of nursing staff and generate high levels of work engagement, such as flexible training plans and informal support groups

(E)motion and creativity: Hacking the function of motor expressions in emotion regulation to augment creativity

Positive emotion can help augment human creativity. To utilize this potential in an interactive system, we propose that such a system should be designed to regulate the emotions that are caused by a creative task. We argue that this can be done by hacking the function of motor expressions in emotion regulation. To this end, we have conceived and made an interactive system that is designed to regulate positive emotion during an idea generation and an insight problem solving task. The system regulates emotion by letting users interact using arm gestures that are designed based on motor expressions, choreographed in a way that enables emotion regulation. Using this interactive system we experimentally test the hypotheses that positive approaching, rather than negative avoiding arm gestures, used to interact with a system, can heighten positive emotion, and augment creativity. The findings demonstrate that an interactive system can be designed to use the function of motor expressions in emotion regulation to help people perform better on certain creative tasks

Mindfulness, self-stigma and social functioning in first episode psychosis: a brief report

This study aimed to test the hypothesis that people with first-episode psychosis who are more mindful will have lower self-stigma, and hence better social functioning. Thirty-four participants experiencing first-episode psychosis completed self-report questionnaires, in a cross-sectional design. Consistent with the hypothesis, higher levels of mindfulness predicted lower self-stigma and better social functioning, and self-stigma statistically mediated the mindfulness → social functioning relationship. However, contrary to expectations, when symptom severity was included as a covariate, evidence of mediation was lost. Limitations and implications of these findings are discussed

The dynamics of internalised and extrinsic motivation in the ethical decision making of small business owners

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.We investigate the ethical behaviour of small business owners by focusing on individuals’ motivations to comply with tax obligations. In a study of 330 small business owners, we assess the role of internalised motivation to pay taxes versus extrinsic motivation in driving tax compliance. First, we find that internalised and extrinsic motivation have distinct predictors. Internalised motivation is related to strong personal moral norms to comply and a sense that the fiscal system is fair. Extrinsic motivation is related to perceptions that penalties are severe, that checks are likely, and is associated with a perceived lack of tax knowledge. Second, we find that, when considered together, internalised motivation but not extrinsic motivation predicts self-reported tax compliance. Third, we test the undermining hypothesis by which the presence of extrinsic motivation may crowd out the positive effect of internalised motivation. We find evidence of a motivation crowding effect only at very high levels of extrinsic motivation. We discuss avenues for further integration of motivation theory in research on tax compliance behaviour, and more generally the study of regulatory compliance and ethical behaviour in business settings.This work was conducted in the Tax Administration Research Centre at the University of Exeter, jointly funded by the Economic and Social Research Council, HM Revenue & Customs and HM Treasury (grant no. ES/K005944/1); we are very grateful to our funders for their support

Integrating access to care and tumor patterns by race and age in the Carolina Breast Cancer Study, 2008–2013

Purpose: Understanding breast cancer mortality disparities by race and age is complex due to disease heterogeneity, comorbid disease, and the range of factors influencing access to care. It is important to understand how these factors group together within patients. Methods: We compared socioeconomic status (SES) and comorbidity factors in the Carolina Breast Cancer Study Phase 3 (CBCS3, 2008–2013) to those for North Carolina using the 2010 Behavioral Risk Factor Surveillance Study. In addition, we used latent class analysis of CBCS3 data to identify covariate patterns by SES/comorbidities, barriers to care, and tumor characteristics and examined their associations with race and age using multinomial logistic regression. Results: Major SES and comorbidity patterns in CBCS3 participants were generally similar to patterns in the state. Latent classes were identified for SES/comorbidities, barriers to care, and tumor characteristics that varied by race and age. Compared to white women, black women had lower SES (odds ratio (OR) 6.3, 95% confidence interval (CI) 5.2, 7.8), more barriers to care (OR 5.6, 95% CI 3.9, 8.1) and several aggregated tumor aggressiveness features. Compared to older women, younger women had higher SES (OR 0.5, 95% CI 0.4, 0.6), more barriers to care (OR 2.1, 95% CI 1.6, 2.9) and aggregated tumor aggressiveness features. Conclusions: CBCS3 is representative of North Carolina on comparable factors. Patterns of access to care and tumor characteristics are intertwined with race and age, suggesting that interventions to address disparities will need to target both access and biology

Mood and anxiety disorders in very preterm/very low-birth weight individuals from 6 to 26 years

Background Very preterm (<32 weeks’ gestational age; VP) or very low–birth weight (<1,500 g; VLBW) birth has been associated with increased risk for anxiety and mood disorders and less partnering in adulthood. The aim was to test whether (a) VP/VLBW are at increased risk of any anxiety or mood disorders from 6 to 26 years compared with term-born individuals; (b) social support from romantic partners is associated with protection from anxiety and mood disorders; and (c) VP/VLBW adults’ lower social support mediates their risk for any anxiety and mood disorders. Methods Data are from a prospective geographically defined longitudinal whole-population study in South Bavaria (Germany). Two hundred VP/VLBW and 197 term individuals were studied from birth to adulthood. Anxiety and mood disorders were assessed at 6, 8, and 26 years with standardized diagnostic interviews and social support via self-report at age 26. Results At age 6, VP/VLBW children were not at increased risk of any anxiety or mood disorder. At age 8, VP/VLBW more often had any anxiety disorder than term comparisons (11.8% vs. 6.6%, OR = 2.10, 95% CI [1.08–4.10]). VP/VLBW adults had an increased risk for any mood (27.5% vs. 18.8%, OR = 1.65 [1.02–2.67]) but not for any anxiety disorder (33.0% vs. 28.4%, OR = 1.27 [0.82–1.96]). None of the significant differences survived correction for multiple testing. Social support was associated with a lower risk of anxiety or mood disorders in both groups (OR = 0.81 [0.68–0.96]) and mediated the association of VP/VLBW birth with any anxiety or any mood disorders at age 26. Conclusions This study does not show a persistently increased risk for any anxiety or mood disorder after VP/VLBW birth. Low social support from a romantic partner mediates the risk for anxiety or mood disorders after VP/VLBW birth

Investigating associations between health-related quality of life and endocrine therapy underuse in women with early-stage breast cancer

Purpose Endocrine therapy (ET) underuse puts women at increased risk for breast cancer (BC) recurrence. Our objective was to determine if health-related quality of life (HRQOL) subgroups were associated with underuse. Methods Data came from the third phase of the Carolina Breast Cancer Study. We included 1,599 women with hormone receptor-positiveBCage 20 to 74 years.HRQOLwas measured, on average,5months postdiagnosis. Subgroups were derived using latent profile (LP) analysis. Underuse was defined as not initiating or adhering to ET by 36 months postdiagnosis. Multivariable logistic regression models estimated adjusted odds ratios (ORs) between HRQOL LPs and underuse. The best HRQOL LP was the reference. Chemotherapy- and race-stratified models were estimated, separately. Results Initiation analyses included 953womenwhohad not begun ET by their 5-month survey. Of these, 154 never initiated ET. Adherence analyses included 1,114 ET initiators, of whom 211 were nonadherent.HRQOLwas not significantly associated with noninitiation, except among nonchemotherapy users, with membership in the poorest LP associated with increased odds of noninitiation (adjusted OR, 5.5; 95% CI, 1.7 to 17.4). Membership in the poorest LPs was associated with nonadherence (LP1: adjusted OR, 2.2; 95% CI, 1.2 to 4.0 and LP2: adjusted OR,1.9;95%CI, 1.1 to 3.6). Membershipin the poorestLPwasassociated with nonadherence among nonchemotherapy users (adjusted OR, 2.1; 95% CI, 1.2 to 5.1). Conclusion Ourresults suggestwomenwith poorHRQOLduring active treatmentmaybe at increased risk for ET underuse. Focusing on HRQOL, a modifiable factor, may improve targeting of future interventions early in theBCcontinuum to improve ET initiation and adherence and prevent BC recurrence

Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality

Purpose: To examine trends in the surgical treatment of breast cancer by age, rurality, and among Black women in a populous, racially diverse, state in the Southeastern United States of America. Methods: We identified women diagnosed with localized or regional breast cancer between 2003 and 2016 in the North Carolina Central Cancer Registry (n = 86,776). Using Joinpoint regression we evaluated the average annual percentage change in proportion of women treated with mastectomy versus breast-conserving surgery overall, by age group, among Black women, and for women residing in rural areas. Results: Overall, the rate of mastectomy usage in the population declined 2.5% per year between 2003 and 2016 (95% CI − 3.2, − 1.7). Over this same time interval, breast-conserving surgery increased by 1.6% per year (95% CI 0.9, 2.2). These temporal trends in surgery were also observed among Black women and rural residing women. Trends in surgery type varied by age group: mastectomy declined over time among women > 50 years, but not among women aged 18–49 at diagnosis. Discussion: In contrast to national studies that reported increasing use of mastectomy, we found declining mastectomy rates in the early 2000s in a Southern US state with a racially and geographically diverse population. These decreasing trends were consistent among key subgroups affected by cancer inequities, including Black and White rural women

Financial impact of breast cancer in black versus white women

Purpose Racial variation in the financial impact of cancer may contribute to observed differences in the use of guideline-recommended treatments. We describe racial differences with regard to the financial impact of breast cancer in a large population-based prospective cohort study. Methods The Carolina Breast Cancer Study oversampled black women and women younger than age 50 years with incident breast cancer in North Carolina from 2008 to 2013. Participants provided medical records and data regarding demographics, socioeconomic status, and financial impact of cancer at 5 and 25 months postdiagnosis. We report unadjusted and adjusted financial impact at 25 months postdiagnosis by race. Results The sample included 2,494 women who completed follow-up surveys (49% black, 51% white). Since diagnosis, 58% of black women reported any adverse financial impact of cancer (v 39% of white women; P, .001). In models adjusted for age, stage at diagnosis, and treatment received, black women were more likely to report adverse financial impact attributable to cancer (adjusted risk difference [aRD], +14 percentage points; P, .001), including income loss (aRD, +10 percentage points; P, .001), health care–related financial barriers (aRD, +10 percentage points; P, .001), health care–related transportation barriers (aRD, +10 percentage points; P, .001), job loss (aRD, 6 percentage points; P, .001), and loss of health insurance (aRD, +3 percentage points; P, .001). The effect of race was attenuated when socioeconomic factors were included but remained significant for job loss, transportation barriers, income loss, and overall financial impact. Conclusion Compared with white women, black women with breast cancer experience a significantly worse financial impact. Disproportionate financial strain may contribute to higher stress, lower treatment compliance, and worse outcomes by race. Policies that help to limit the effect of cancer-related financial strain are needed