Occurrence of workplace violence and the psychological consequences of it among nurses working in psychiatric outpatient settings

Abstract Introduction: There is a scarcity of studies concerning violence and its consequences in psychiatric outpatient setting. Aim: This study aimed to explore the occurrence of workplace violence and the psychological consequences of exposure to violence among nurses working in psychiatric outpatient settings. Method: Research followed a cross‐sectional survey design. Data were collected with the VIA‐Q instrument. Results: During the 12 months prior to the study, nurses (n = 181) had most often experienced psychological violence, with fatigue being the most common consequence. Harassment most often caused feelings of violated integrity, whereas physical violence most often caused insomnia. Significant relationships between exposure to violence and psychological consequences were identified. Discussion: Workplace violence can manifest in a broad array of psychological symptoms and be harmful for nurses in psychiatric outpatient settings. It is important to discuss the subject of workplace violence and its place in the nursing curriculum and to reflect on how nurses are educated and trained to face violence in psychiatric nursing. Implications for Practice: De‐escalation interventions should be implemented in psychiatric outpatient settings. Organizations should take steps to abolish internal violence. Nurses need appropriate education in order to prepare them to manage workplace violence

Background characteristics and exposure to violence predict well-being at work among psychiatric outpatient nurses

Abstract Aims: To investigate the well-being at work and analyze relevant predictors of it among nurses working in psychiatric outpatient settings including following specific objectives 1) describe the current state of well-being at work among psychiatric nurses; and 2) examine how background characteristics and exposure to violence predict well-being at work. Design: A cross-sectional survey design. Methods: Two-staged sampling was used to select participants from psychiatric outpatient units. Data were collected with printed Nordic Questionnaire for Monitoring the Age Diverse Workforce (QPSNordic-ADW) and Violence Incidence Assessment (VIA-Q) questionnaire from January 2019 to June 2019. Descriptive statistics were performed to summarize the collected data and binary logistic regression was used to identify predictors related to the well-being at work. Results: The respondents (n = 181) generally evaluated well-being at work quite positively but were more critical towards interaction with their immediate superior, organizational culture, interaction between work and private life, and organizational commitment. Working experience in psychiatric nursing and experiences of harassment were identified as strong predictors of well-being at work. Conclusions: The management of healthcare organizations should discuss nursing ethics and morale more, as well as pay attention to the ethical environment to prevent moral distress among nurses. Several weaknesses seem to exist especially in the management of psychiatric outpatient units which influence nurses’ well-being at work. Identification of these can help organizations to develop management and implement interventions to increase nurses’ well-being at work. Conversations about the managerial culture and collegial climate should also arise at the organizational and unit levels

Näyttöön perustuvan toiminnan johtamistehtävien jakaantuminen sairaalaorganisaatiossa hoitotyön lähi- ja keskijohdon arvioimana

Tiivistelmä Tutkimuksen tarkoitus: Kuvata näyttöön perustuvan toiminnan johtamistehtävien jakaantumista erikoissairaanhoidossa sairaalaorganisaation eri tasoilla toimivien hoitotyön johtajien ja eri asiantuntijoiden kesken hoitotyön lähi- ja keskijohdon arvioimana. Aineisto ja menetelmät: Aineisto kerättiin kyselylomakkeella maaliskuussa 2019 kahdesta sairaalasta Pohjois-Suomessa. Aineisto muodostui 64 johtajan vastauksesta, ja se analysoitiin kuvailevilla tilastomenetelmillä. Tulokset: Johtajat arvioivat näyttöön perustuvan tiedon levittämiseen liittyvien johtamistehtävien kuuluvan useimmiten lähi- ja keskijohdolle, ja vain vähemmistön mielestä ne kuuluivat hoitotyön asiantuntijoille. Näyttöön perustuvan toiminnan muutoksen tukemisessa johtamistehtävät jakaantuivat kaikille johtamistasoille. Näyttöön perustuvan toiminnan seurantaan ja arviointiin liittyvät johtamistehtävät kuuluivat vastaajien mielestä lähi- ja keskijohdolle. Johtamistehtävien vastuunjako toteutui harvoin resurssien varmistamisessa, seurannassa ja arvioinnissa sekä organisaatiokulttuurin muutoksen tukemisessa. Päätelmät: Näyttöön perustuvan toiminnan johtamistehtävät jakaantuvat sairaalaorganisaation eri tasoilla toimivien hoitotyön johtajien ja eri asiantuntijoiden kesken, mutta vastuunjako ei ole selkeä. Tehtävänkuvia on tärkeää selkeyttää.Abstract The division of leadership tasks for evidence-based practice in hospital organization as evaluated by front-line and middlemanagement nurse leaders Aim: To describe the division of leadership tasks for evidence-based practice in the specialized health care between nurse leaders at different levels of the hospital organization and various professionals as evaluated by frontline and middle-management nurse leaders. Data and methods: The data was collected with a questionnaire from two hospitals in northern Finland in March 2019. Date consisted of the responses of 64 leaders, and it was analysed with descriptive statistical methods. Results: Leaders evaluated that leadership tasks related to the dissemination of evidence-based information belong to frontline and middle-management leaders, and only minority evaluated that these belong to nursing professionals. In supporting the change of evidence-based practice, leadership tasks were distributed across all management levels. According to the respondents, the leadership tasks related to the monitoring and evaluation of evidence-based practice belonged to the frontline and middle-management leaders. The division of leadership responsibilities rarely took place in securing resources, monitoring and evaluation and supporting change in organizational culture. Conclusions: The leadership tasks for evidence-based practice divided between nurse leaders and various professionals at different levels of the hospital organization, but the division of responsibilities is not clear. It is important to clarify the job description

An adventurous learning journey:physiotherapists’ conceptions of learning and integrating cognitive functional therapy into clinical practice

Abstract Background: Recent low back pain guidelines recommend a BPS approach to the management of disabling low back pain. However, the most effective way of teaching physiotherapists to implement these approaches remains unknown. The present qualitative study aimed to explore physiotherapists’ conceptions of learning and integrating Cognitive Functional Therapy (CFT) into clinical practice in Finnish primary health care. Methods: We interviewed 22 physiotherapists, who participated in four to six days of CFT workshops. A phenomenographic approach was used to explore the variation in the physiotherapists’ conceptions of this process. Results: Four themes emerged from the data: 1) membership of work community; 2) learning journey; 3) transition to new working methods; and 4) professional role as a physiotherapist. These themes varied in four categories of description: recognizing difference of the new approach, toward integrating the new approach, waking up to explore, commitment to new approach and expanding application of new approach. The critical aspects between the categories that enabled the integration of CFT into clinical practice were ability to overcome resistance and to change views, being shaken and ability to critically reflect on one’s work, support from the work community and becoming convinced, creativity, multidisciplinary collaboration and continuous learning. Conclusion: The participants’ responses to the training varied greatly, suggesting that for some, the training was insufficient to support adequate changes in their practice behavior; whereas for others, the training was a life changing experience

Advanced practice nurses’ experiences of evidence-based practice:a qualitative study

Abstract Evidence-based practice (EBP) has been shown to improve patient safety as well as quality of care. Advanced practice nurses (APNs) have a vital role in the implementation of EBP. This study aimed to describe APNs’ experiences of EBP implementation. The study was a descriptive qualitative study and data were collected between May and August 2019 through interviews with APNs (n = 12). The data were analyzed using inductive content analysis. The study was reported according to COREQ guidelines. The responses were divided into four main categories: EBP in clinical nursing; EBP leadership; implementation of supporting structures for EBP; and EBP in APNs’ work. APNs experienced: that the realization of EBP varied in clinical nursing, that there was a need for development in the leadership of EBP, variation in nurse leaders’ competence in EBP leadership, and a lack of resources for EBP

Social, health and rehabilitation sector educators’ competence in evidence-based practice:a cross-sectional study

Abstract Aim: The purpose of the study was to identify and describe the characteristic profiles of evidence-based practice competence of educators in the social, health and rehabilitation sectors and to establish relevant background factors. Design: This study was carried out as a descriptive cross-sectional study. Methods: Data were collected from social, health and rehabilitation sector educators working in the 21 Finnish universities of applied sciences and seven vocational colleges (n = 422; N = 2,330). A self-assessment instrument measuring evidence-based practice competence was used. Competence profiles were formed using a K-cluster grouping analysis. Results: Three distinct competence profiles were identified and delineated. Most educators feel that they can guide students' critical thinking and are able to seek and produce scientific knowledge. Evidence-based practice competence was explained by background factors such as year of graduation (for higher degree), level of education, job title, current employer and current field of work

Transcultural adaption and preliminary evaluation of “understanding low back pain” patient education booklet

Abstract Background: Low back pain (LBP) is the number one cause of disability globally. LBP is a symptom associated with biological, psychological and social factors, and serious causes for pain are very rare. Unhelpful beliefs about LBP and inappropriate imaging are common. Practitioners report pressure from patients to provide inappropriate imaging. A recently developed patient education and management booklet, ‘Understanding low back pain’, was designed to target previously identified barriers for reducing inappropriate imaging. The booklet includes evidence-based information on LBP and supports communication between patients and practitioners. Our aim was to 1) describe the translation process into Finnish and 2) study patients’ and practitioners’ attitudes to the booklet and to evaluate if it improved patients’ understanding of LBP and practitioners’ ability to follow imaging guidelines. Methods: We translated the booklet from English to Finnish. Preliminary evaluation of the booklet was obtained from LBP patients (n = 136) and practitioners (n = 32) using web-based questionnaires. Open-ended questions were analysed using thematic analysis. Results: Approximately half of the patients reported that reading the booklet helped them to understand LBP, while a third thought it encouraged them to perform physical activity and decreased LBP-related fear. Eighty percent of practitioners reported that the booklet helped them to follow imaging guidelines. In addition, practitioners reported that they found the booklet helpful and that it decreased the need for imaging. Conclusions: The booklet seemed to be helpful in LBP management and in decreasing the need for LBP imaging according to patients and practitioners. Further research on the clinical effectiveness of the booklet in controlled study settings is needed