Examination of relationships and mediating effects of self-efficacy, locus of control, coping and the practice environment on caring efficacy and job satisfaction in Australian registered nurses

Background to the Problem: Improving nurses' self-efficacy and job satisfaction may improve the quality of nursing care to patients. Moreover, to work effectively and consistently with professional nursing standards, nurses have to believe they are able to make decisions about their practice. In order to identify what strategies and professional development programmes should be developed and implemented for registered nurses in the Australian context, a comprehensive profile of registered nurses and factors that affect nursing care in Australia needs to be available. However, at present, there is limited information available on a) the perceived caring efficacy and job satisfaction of registered nurses in Australia, and b) the relationships between the demographic variables general self-efficacy, work locus of control, coping styles, the professional nursing practice environment and caring efficacy and job satisfaction of registered nurses in Australia. This is the first study to 1) investigate relationships between caring efficacy and job satisfaction with factors such as general self-efficacy, locus of control and coping, 2) the nursing practice environment in the Australian context and 3) conceptualise a model of caring efficacy and job satisfaction in the Australian context. Research Design and Methods: This study used a two-phase cross-sectional survey design. A pilot study was conducted in order to determine the validity and reliability of the survey instruments and to assess the effectiveness of the participant recruitment process. The second study of the research involved investigating the relationships between the socio-demographic, dependent and independent variables. Socio-demographic variables included age, gender, level of education, years of experience, years in current job, employment status, geographical location, specialty area, health sector, state and marital status. Other independent variables in this study included general self-efficacy, work locus of control, coping styles and the professional nursing practice environment. The dependent variables were job satisfaction and caring efficacy. Results: A confirmatory factor analysis of the Brisbane Practice Environment Measure (B-PEM) was conducted. A five-factor structure of the B-PEM was confirmed. Relationships between socio-demographic variables, caring efficacy and job satisfaction, were identified at the bivariate and multivariable levels. Further, examination using structural equation modelling revealed general self-efficacy, work locus of control, coping style and the professional nursing practice environment contributed to caring efficacy and job satisfaction of registered nurses in Australia. Conclusion: This research contributes to the literature on how socio-demographic, personal and environmental variables (work locus of control, general self-efficacy and the nursing practice environment) influence caring efficacy and job satisfaction in registered nurses in Australia. Caring efficacy and job satisfaction may be improved if general self-efficacy is high in those that have an internal work locus of control. The study has also shown that practice environments that provide the necessary resources improve job satisfaction in nurses. The results have identified that the development and implementation of strategies for professional development and orientation programmes that enhance self-efficacy and work locus of control may contribute to better quality nursing practice and job satisfaction. This may further assist registered nurses towards focusing on improving their practice abilities. These strategies along with practice environments that provide the necessary resources for nurses to practice effectively may lead to better job satisfaction. This information is important for nursing leaders, healthcare organisations and policymakers, as the development and implementation of these strategies may lead to better recruitment and retention of nurses. The study results will contribute to the national and international literature on self-efficacy, job satisfaction and nursing practice.

Trends in nurse-administered procedural sedation and analgesia across cardiac catheterisation laboratories in Australia and New Zealand : results of an electronic survey

Background Knowledge of current trends in nurse-administered procedural sedation and analgesia (PSA) in the cardiac catheterisation laboratory (CCL) may provide important insights into how to improve safety and effectiveness of this practice. Objective To characterise current practice as well as education and competency standards regarding nurse-administered PSA in Australian and New Zealand CCLs. Design A quantitative, cross-sectional, descriptive survey design was used. Methods Data were collected using a web-based questionnaire on practice, educational standards and protocols related to nurse-administered PSA. Descriptive statistics were used to analyse data. Results A sample of 62 nurses, each from a different CCL, completed a questionnaire that focused on PSA practice. Over half of the estimated total number of CCLs in Australia and New Zealand was represented. Nurse-administered PSA was used in 94% (n = 58) of respondents CCLs. All respondents indicated that benzodiazepines, opioids or a combination of both is used for PSA (n = 58). One respondent indicated that propofol was also used. 20% (n = 12) indicated that deep sedation is purposefully induced for defibrillation threshold testing and cardioversion without a second medical practitioner present. Sedation monitoring practices vary considerably between institutions. 31% (n = 18) indicated that comprehensive education about PSA is provided. 45% (n = 26) indicated that nurses who administer PSA should undergo competency assessment. Conclusion By characterising nurse-administered PSA in Australian and New Zealand CCLs, a baseline for future studies has been established. Areas of particular importance to improve include protocols for patient monitoring and comprehensive PSA education for CCL nurses in Australia and New Zealand.

Influences on compliance with standard precautions among operating room nurses

Background Occupational exposures of health care workers occur because of inconsistent compliance with standard precautions. The purpose of this study was to develop national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses (specifically, scrub nurses) in Australia and to assess variables that influence compliance. Methods A descriptive correlation design was used to investigate relationships between variables and compliance, using a theoretical framework, the Health Belief Model, to give meaning to the variables. Data collection was done through mail-out surveys to members of the Australian College of Operating Room Nurses. Results This article reports the results of compliance with the following 2 specific self-protective behaviors: double-gloving and wearing adequate eye protection. Mean compliance rates were 55.6% with always double-gloving during surgical procedures and 92% with always wearing adequate eye protection. In addition, the variable that had the most influence on compliance was the perception of barriers to compliance, specifically, that adhering to standard precautions interfered with duties. Conclusion These results have implications for the development of multifaceted perioperative infection control programs, including strategies for prevention, education, and policy development, to improve practices aimed at reducing occupational exposures among this high-risk group.

A comparative study of early childhood curriculum documents focused on education for sustainability in South Korea and Australia

This thesis is about a comparative study of early childhood education (ECE) curriculum documents focused on education for sustainability (EfS) in South Korea and Australia. It examined how the national ECE curriculum documents in two culturally different contexts align with contemporary concepts of sustainability and activist early childhood education for sustainability (ECEfS) principles. Drawing on systems theory, Korean and Australian ECE curriculum documents were used as the primary sources for this study within the framework of critical document analysis (CDA). This study offers a step forward in developing culturally inclusive/holistic understandings of sustainability and more contextualised/localised approaches to ECEfS.

Diet and physical activity behaviour in nurses: A qualitative study

Issue addressed: Previous research has shown that approximately 60% of nurses in Australia are overweight or obese, insufficiently active and have an unhealthy diet. The aim of this study was to gain an understanding of nurses’ determinants contributing to these behaviours. This will inform a needs assessment for a future workplace health promotion program (WHPP) in this group. Methods: Four focus group discussions (n = 17) were conducted with a convenience sample of nurses aged 25–59 years from three hospitals in the Brisbane metropolitan area. Questions addressed barriers and motivation towards diet and physical activity (PA), and suggestions for future WHPP. Data were analysed with Nvivo10 following a thematic analysis with a realistic approach using Self-determination theory as a framework. Results: Work environment was the main barrier for healthy diet behaviours. Long working hours and lack of breaks challenged nurses’ self-control and self-regulation when making dietary choices. Fatigue was the main barrier for PA. However, relaxation, feeling energised before work and better sleep after working night shifts motivated nurses to do PA. Social environment at work seemed to be an effective external motivation to encourage healthy diet and regular PA. Goal-setting, self-monitoring and social support at work were identified as potential WHHP strategies. Conclusion: The workplace and job demands negatively impacts nurses’ lifestyle behaviours. Future interventions should include social support from colleagues, which could motivate nurses to make healthier food choices at work and be more active outside work.

Participation of registered nurses in continuing education

This correlational study investigated the psychological types, learning style preferences, readiness for self-directed learning, demographic and continuing education participation data of 154 registered nurses at two different Southern Ontario hospitals. One hospital was a large tertiary care university-affiliated teaching centre (Cityview) and the other was a smaller secondary care community hospital (Waterview). The instruments used in the study were the PET Type Check, Kolb's Learning Style Inventory, the Self-Directed Readiness Scale (SDLRS), and a Nursing Survey developed by the researcher. Descriptive statistics, crosstabulations and correlational analyses were calculated. The most common psychological types identified among this sample of nurses were extraverted thinking, introverted intuitive and extraverted intuitive. There were no significant differences between the two hospitals. The accommodator learning style was preferred overall, with more nurses at Waterview Hospital preferring the diverger learning style, and more nurses at Cityview Hospital preferring the accommodator learning style. The majority of nurses scored in the average and above average categories on the SDLRS, indicating that they perceive themselves as ready to engage in self-directed learning. At Cityview Hospital there were more nurses in the average and high readiness categories, whereas at Waterview Hospital more nurses scored in the below average category. No significant correlations were found for learning style with psychological type, or for learning style with SDLRS scores. A positive correlation was found to exist between SDLRS scores and each of the psychological types extraverted feelings, extraverted thinking, and introverted intuitive.The only significant correlation for psychological type and continuing education activity was a positive correlation between extraverted thinking types and participation in informal discussion or study groups. Positive correlations were found for SDLRS scores with each of the following continuing education activities; number of hours per month spent reading journals; journal reading; attendance at credit courses; watching videos; using reference texts. Further details of the results are included as well as a discussion of the findings and implications for future research.

Perceptions of acculturation and social identity construction among three Taiwanese/Chinese migrants in Australia

In recent years, increasing numbers of Chinese migrants have come to Australia to study or to live. In doing so, they have entered a new cultural space. They are faced with many challenges, not only to do with study experience, workplace experience and life-style practices, but also to do with language, communication, culture and identity. Such new challenges can feel dangerous, unstable and uncomfortable as they require moves out of the safety zone of primary cultural experience. This qualitative research study investigates the perceptions and narratives of three Taiwanese-Australian migrants in terms of their experience of this process of acculturation and social identity construction as migrant tertiary students in the new Australian context and of their subsequent experience professionally. Their accounts of where they see themselves to have 'landed' in terms of their acculturation process and identity construction might provide relevant insights to the experience of hybridity which is intercultural Australia.

Paving pathways : shaping the public health workforce through tertiary education

Public health educational pathways in Australia have traditionally been the province of Universities, with the Master of Public Health (MPH) recognised as the flagship professional entry program. Public health education also occurs within the fellowship training of the Faculty of Public Health Medicine, but within Australia this remains confined to medical graduates. In recent years, however, we have seen a proliferation of undergraduate degrees as well as an increasing public health presence in the Vocational Education and Training (VET) sector. ----- Following the 2007 Australian Federal election, the new Labour government brought with it a refreshing commitment to a more inclusive and strategic style of government. An important example of this was the 2020 visioning process that identified key issues of public health concern, including an acknowledgment that it was unacceptable to allocate less than 2% of the health budget towards disease prevention. This led to the recommendation for the establishment of a national preventive health agency (Australia: the healthiest country by 2020 National Preventative Health Strategy, Prepared by the Preventative Health Taskforce 2009). ----- The focus on disease prevention places a spotlight on the workforce that will be required to deliver the new investment in health prevention, and also on the role of public health education in developing and upskilling the workforce. It is therefore timely to reflect on trends, challenges and opportunities from a tertiary sector perspective. Is it more desirable to focus education efforts on selected lead issues such as the “obesity epidemic”, climate change, Indigenous health and so on, or on the underlying theory and skills that build a flexible workforce capable of responding to a range of health challenges? Or should we aspire to both? ----- This paper presents some of the key discussion points from 2008 – 2009 of the Public Health Educational Pathways workshops and working group of the Australian Network of Public Health Institutions. We highlight some of the competing tensions in public health tertiary education, their impact on public health training programs, and the educational pathways that are needed to grow, shape and prepare the public health workforce for future challenges.

Factors influencing oncology nurses' approaches to accommodating cultural needs in palliative care

Aims and objectives: The purpose of this study is to explore the social construction of cultural issues in palliative care amongst oncology nurses. ---------- Background: Australia is a nation composed of people from different cultural origins with diverse linguistic, spiritual, religious and social backgrounds. The challenge of working with an increasingly culturally diverse population is a common theme expressed by many healthcare professionals from a variety of countries. ---------- Design: Grounded theory was used to investigate the processes by which nurses provide nursing care to cancer patients from diverse cultural backgrounds. ---------- Methods: Semi-structured interviews with seven Australian oncology nurses provided the data for the study; the data was analysed using grounded theory data analysis techniques. ---------- Results: The core category emerging from the study was that of accommodating cultural needs. This paper focuses on describing the series of subcategories that were identified as factors which could influence the process by which nurses would accommodate cultural needs. These factors included nurses' views and understandings of culture and cultural mores, their philosophy of cultural care, nurses' previous experiences with people from other cultures and organisational approaches to culture and cultural care. ---------- Conclusions: This study demonstrated that previous experiences with people from other cultures and organisational approaches to culture and cultural care often influenced nurses' views and understandings of culture and cultural mores and their beliefs, attitudes and behaviours in providing cultural care. ---------- Relevance to clinical practice: It is imperative to appreciate how nurses' experiences with people from other cultures can be recognised and built upon or, if necessary, challenged. Furthermore, nurses' cultural competence and experiences with people from other cultures need to be further investigated in clinical practice.

Collaboration : developing integration in multi-purpose services in rural New South Wales, Australia

Introduction: The Multi-purpose Service (MPS) Program was introduced to rural Australia in 1991 as a solution to poor health outcomes in rural compared with metropolitan populations, difficulty in attracting healthcare staff and a lack of viability and range of health services in rural areas. The aim of this study was to describe the main concerns of participants involved in the development of multi-purpose services in rural New South Wales (NSW). This article is abstracted from a larger study and discusses the extent to which collaboration occurred within the new multi-purpose service. Methods: A constructivist grounded theory methodology was used. Participants were from 13 multi-purpose services in rural NSW and 30 in-depth interviews were conducted with 6 community members, 11 managers and 13 staff members who had been involved in the process of developing a multi-purpose service. Results: The main concern of all participants was their anticipation of risk. This anticipation of risk manifested itself in either trust or suspicion and explained their progression through a phase of collaborating. Participants who had trust in other stakeholders were more likely to embrace an integrated health service identity. Those participants, who were suspicious that they would lose status or power, maintained that the previous hospital services provided a better health service and described a coexistence of services within the multi-purpose service. Conclusions: This study provided an insight into the perceptions of community members, staff members and managers involved in the process of developing a multi-purpose service. It revealed that the anticipation of risk was intrinsic to a process of changing from a traditional hospital service to collaborating in a new model of health care provided at a multi-purpose service.

Introductory Indigenous Studies in Education : Reflection and the Importance of Knowing

Although the demand for pre-service teachers to be better informed about Indigenous issues in Australia has been broadly articulated, it is reasonably new for universities to make Indigenous studies a compulsory area of study, or to define what is meant by 'Indigenous education'. This book was motivated by the growing necessity for an approach to Indigenous education that would include more than just a summarising of Indigenous history and traditional culture. It is useful for anyone with an interest in challenging their ideas about culture, identity and history in Australia.