A modest start, but a steady rise in research use: a longitudinal study of nurses during the first five years in professional life

<p>Abstract</p> <p>Background</p> <p>Newly graduated nurses are faced with a challenging work environment that may impede their ability to provide evidence-based practice. However, little is known about the trajectory of registered nurses' use of research during the first years of professional life. Thus, the aim of the current study was to prospectively examine the extent of nurses' use of research during the first five years after undergraduate education and specifically assess changes over time.</p> <p>Method</p> <p>Survey data from a prospective cohort of 1,501 Swedish newly graduated nurses within the national LANE study (Longitudinal Analyses of Nursing Education and Entry in Worklife) were used to investigate perceived use of research over the first five years as a nurse. The dependent variables consisted of three single items assessing instrumental, conceptual, and persuasive research use, where the nurses rated their use on a five-point scale, from 'never' (1) to 'on almost every shift' (5). These data were collected annually and analyzed both descriptively and by longitudinal growth curve analysis.</p> <p>Results</p> <p>Instrumental use of research was most frequently reported, closely followed by conceptual use, with persuasive use occurring to a considerably lower extent. The development over time showed a substantial general upward trend, which was most apparent for conceptual use, increasing from a mean of 2.6 at year one to 3.6 at year five (unstandardized slope +0.25). However, the descriptive findings indicated that the increase started only after the second year. Instrumental use had a year one mean of 2.8 and a year five mean of 3.5 (unstandardized slope +0.19), and persuasive use showed a year one mean of 1.7 and a year five mean of 2.0 (unstandardized slope +0.09).</p> <p>Conclusion</p> <p>There was a clear trend of increasing research use by nurses during their first five years of practice. The level of the initial ratings also indicated the level of research use in subsequent years. However, it took more than two years of professional development before this increase 'kicked in.' These findings support previous research claiming that newly graduated nurses go through a 'transition shock,' reducing their ability to use research findings in clinical work.</p

Declining Sleep Quality among Nurses: A Population-Based Four-Year Longitudinal Study on the Transition from Nursing Education to Working Life

Background: Several studies have established impaired sleep is a common problem among nurses. Overworked, fatigued and stressed nurses are at a higher risk of making mistakes that threaten patient safety as well as their own health. The aim of the present study was to longitudinally monitor the development of sleep quality in nurses, starting from the last semester at the university, with three subsequent annual follow-ups once the nurses had entered working life. Methodology/Principal Findings: Nationwide, longitudinal questionnaire study of nursing students and newly qualified nurses in Sweden. The results imply a continuous decline in sleep quality among nurses during the three years of follow-up, starting from their last semester of nursing education and continuing for three years into their working life. The most pronounced short-term decline in sleep quality seems to occur in the transition between student life and working life. Conclusion/Significance: This finding is important since it may affect the quality of care and the health of nurses negatively

Monitoring the newly qualified nurses in Sweden: the Longitudinal Analysis of Nursing Education (LANE) study

BACKGROUND: The Longitudinal Analysis of Nursing Education (LANE) study was initiated in 2002, with the aim of longitudinally examining a wide variety of individual and work-related variables related to psychological and physical health, as well as rates of employee and occupational turnover, and professional development among nursing students in the process of becoming registered nurses and entering working life. The aim of this paper is to present the LANE study, to estimate representativeness and analyse response rates over time, and also to describe common career pathways and life transitions during the first years of working life. METHODS: Three Swedish national cohorts of nursing students on university degree programmes were recruited to constitute the cohorts. Of 6138 students who were eligible for participation, a total of 4316 consented to participate and responded at baseline (response rate 70%). The cohorts will be followed prospectively for at least three years of their working life. RESULTS: Sociodemographic data in the cohorts were found to be close to population data, as point estimates only differed by 0-3% from population values. Response rates were found to decline somewhat across time, and this decrease was present in all analysed subgroups. During the first year after graduation, nearly all participants had qualified as nurses and had later also held nursing positions. The most common reason for not working was due to maternity leave. About 10% of the cohorts who graduated in 2002 and 2004 intended to leave the profession one year after graduating, and among those who graduated in 2006 the figure was almost twice as high. Intention to leave the profession was more common among young nurses. In the cohort who graduated in 2002, nearly every fifth registered nurse continued to further higher educational training within the health professions. Moreover, in this cohort, about 2% of the participants had left the nursing profession five years after graduating. CONCLUSION: Both high response rates and professional retention imply a potential for a thorough analysis of professional practice and occupational health

A systematic review of the psychometric properties of self-report research utilization measures used in healthcare

<p>Abstract</p> <p>Background</p> <p>In healthcare, a gap exists between what is known from research and what is practiced. Understanding this gap depends upon our ability to robustly measure research utilization.</p> <p>Objectives</p> <p>The objectives of this systematic review were: to identify self-report measures of research utilization used in healthcare, and to assess the psychometric properties (acceptability, reliability, and validity) of these measures.</p> <p>Methods</p> <p>We conducted a systematic review of literature reporting use or development of self-report research utilization measures. Our search included: multiple databases, ancestry searches, and a hand search. Acceptability was assessed by examining time to complete the measure and missing data rates. Our approach to reliability and validity assessment followed that outlined in the <it>Standards for Educational and Psychological Testing</it>.</p> <p>Results</p> <p>Of 42,770 titles screened, 97 original studies (108 articles) were included in this review. The 97 studies reported on the use or development of 60 unique self-report research utilization measures. Seven of the measures were assessed in more than one study. Study samples consisted of healthcare providers (92 studies) and healthcare decision makers (5 studies). No studies reported data on acceptability of the measures. Reliability was reported in 32 (33%) of the studies, representing 13 of the 60 measures. Internal consistency (Cronbach's Alpha) reliability was reported in 31 studies; values exceeded 0.70 in 29 studies. Test-retest reliability was reported in 3 studies with Pearson's <it>r </it>coefficients > 0.80. No validity information was reported for 12 of the 60 measures. The remaining 48 measures were classified into a three-level validity hierarchy according to the number of validity sources reported in 50% or more of the studies using the measure. Level one measures (n = 6) reported evidence from any three (out of four possible) <it>Standards </it>validity sources (which, in the case of single item measures, was all applicable validity sources). Level two measures (n = 16) had evidence from any two validity sources, and level three measures (n = 26) from only one validity source.</p> <p>Conclusions</p> <p>This review reveals significant underdevelopment in the measurement of research utilization. Substantial methodological advances with respect to construct clarity, use of research utilization and related theory, use of measurement theory, and psychometric assessment are required. Also needed are improved reporting practices and the adoption of a more contemporary view of validity (<it>i.e.</it>, the <it>Standards</it>) in future research utilization measurement studies.</p

Stability and validity of self-reported personality traits

Background: People differ, and these differences are often attributed to individual differences in certain personality traits assumed to have 'more than nominal value' and to 'exist within' the individual. The aim of the present study was to evaluate some properties of a trait assessment instrument, the Karolinska Scales of Personality (KSP). More specifically, the purpose was to study the stability of the KSP scales, as well as to evaluate various aspects of validity by using prospective designs and clinical and biological correlates. Results: Are some KSP scales more stable than others, i.e., is there a hierarchy of rank order stability coefficients for the KSP scales? In general, Socialization, Somatic and Psychic Anxiety, Muscular Tension and Inhibition of Aggression, and the scales derived from the Sjöbring model (Impulsiveness, Monotony Avoidance, Detachment and Psychasthenia), have higher stability than the Social Desirability scale and the five aggression-related scales (Indirect and Verbal Aggression, Irritability, Suspicion and Guilt). Stability would be of little interest if the scales did not also possess an ability to predict trait relevant outcomes. The ability of preoperative personality traits to predict postsurgical quality of life, was tested and the results indicated that Muscular Tension/Somatic Anxiety and poor Socialization independently predicted postoperative quality of life. Moreover, subjects who volumteered for a psychobiological study, which included a potentially painful procedure, were compared with those who declined participation. Scores on the KSP Impulsiveness scale, about 16-18 months before decision about participation, predicted subsequent volumteering. Behavioral genetic analyses were thought to contribute to the validation of the KSP scales. In general, the most important factor explaining individual differences for all scales was the nonshared environmental component. Furthermore, results showed genetic factors to influence individual differences in scores on the Psychasthenia, Somatic Anxiety, Irritability, Guilt, Impulsiveness, Monotony Avoidance, Detachment and Social Desirability scales. Shared rearing/correlated environmental determinants were important for individual differences in scores on the Muscular Tension, Lack of Assertiveness, Psychic Anxiety, Socialization, Suspicion, Verbal and Indirect Aggression scales. Some markers of dopamine neurotransmission have shown good biometric properties, and therefore would be appropriate targets for studies of biological correlates of the KSP scales. The allelic association previously found between dopamine D4 receptor (DRD4) genotypes and personality traits was not confirmed in this study. However, the Detachment scale showed a high correlation with [llC]raclopride, a measure of D2-receptor density, indicating an association between social withdrawal and low dopamine D2 density. Finally, an evaluation of whether the KSP scales were differently related to objective ratings of type of personality disorder and/or to severity of personality pathology was performed. The KSP Socialization scale was found to be the scale most highly correlated with maladaptivity (severity of personality pathology). Clinical ratings of Cluster B-traits correlated positively with the Impulsiveness, Monotony Avoidance and Verbal Aggression scales and negatively with the Social Desirability scale. Three of the KSP anxiety-proneness scales were correlated with the clinically rated Cluster-C traits. In addition, both the Detachment scale and the Suspicion scale were positively correlated with the cluster C ratings, whereas Verbal Aggression manifested a negative association. Discussion: In the discussion validity arguments are put forward focusing on coherent patterns of findings, viewing the present results in the light of previous KSP results. With the exception of some of the aggression-related scales, it is concluded that the KSP scales demonstrates stability and construct validity. Key words: Karolinska Scales of Personality (KSP), personality traits, stability, outcome behavioral genetics, biological and clinical correlates Stockholm 1997 ISBN 91-628-250

Monitoring the newly qualified nurses in Sweden: the Longitudinal Analysis of Nursing Education (LANE) study

Abstract Background The Longitudinal Analysis of Nursing Education (LANE) study was initiated in 2002, with the aim of longitudinally examining a wide variety of individual and work-related variables related to psychological and physical health, as well as rates of employee and occupational turnover, and professional development among nursing students in the process of becoming registered nurses and entering working life. The aim of this paper is to present the LANE study, to estimate representativeness and analyse response rates over time, and also to describe common career pathways and life transitions during the first years of working life. Methods Three Swedish national cohorts of nursing students on university degree programmes were recruited to constitute the cohorts. Of 6138 students who were eligible for participation, a total of 4316 consented to participate and responded at baseline (response rate 70%). The cohorts will be followed prospectively for at least three years of their working life. Results Sociodemographic data in the cohorts were found to be close to population data, as point estimates only differed by 0-3% from population values. Response rates were found to decline somewhat across time, and this decrease was present in all analysed subgroups. During the first year after graduation, nearly all participants had qualified as nurses and had later also held nursing positions. The most common reason for not working was due to maternity leave. About 10% of the cohorts who graduated in 2002 and 2004 intended to leave the profession one year after graduating, and among those who graduated in 2006 the figure was almost twice as high. Intention to leave the profession was more common among young nurses. In the cohort who graduated in 2002, nearly every fifth registered nurse continued to further higher educational training within the health professions. Moreover, in this cohort, about 2% of the participants had left the nursing profession five years after graduating. Conclusion Both high response rates and professional retention imply a potential for a thorough analysis of professional practice and occupational health.</p