Objective This study aims to determine the mediating effects of psychological empowerment on abusive supervision and turnover intention as perceived by nurses to provide information to change the status of nurse turnover. Methods A cross-sectional survey (a questionnaire examining perceptions of abusive supervision, measurement of psychological empowerment, and questionnaire for turnover intention) was used to collect data. A total of 1127 clinical nurses, who were recruited through convenience sampling, participated in the survey. Results Nurses’ average perceived abusive supervision, psychological empowerment, and turnover intention scores were 1.62 ± 0.95, 3.24 ± 0.83, and 14.17 ± 3.78, respectively. Psychological empowerment was found to mediate the relationship between abusive supervision and turnover intention ( P < 0.01). Turnover intention tends to be stronger and psychological empowerment reduced when nurse managers adopt an abusive leadership style. Conclusions Nurses' psychological empowerment is an intermediary variable that predicts the relationship between abusive supervision and turnover intention. Nurse managers should manage abusive supervision to increase nurses’ psychological empowerment and decrease turnover intention.
Aim This study aimed to develop a patient classification system that stratifies patients admitted to the intensive care unit based on their disease severity and care needs. Background Classifying patients into homogenous groups based on clinical characteristics can optimize nursing care. However, an objective method for determining such groups remains unclear. Methods Predictors representing disease severity and nursing workload were considered. Patients were clustered into subgroups with different characteristics based on the results of a clustering algorithm. A patient classification system was developed using a partial least squares regression model. Results Data of 300 patients were analysed. Cluster analysis identified three subgroups of critically patients with different levels of clinical trajectories. Except for blood potassium levels (p = .29), the subgroups were significantly different according to disease severity and nursing workload. The predicted value ranges of the regression model for Classes A, B and C were <1.44, 1.44–2.03 and >2.03. The model was shown to have good fit and satisfactory prediction efficiency using 200 permutation tests. Conclusions Classifying patients based on disease severity and care needs enables the development of tailored nursing management for each subgroup. Implications for Nursing Management The patient classification system can help nurse managers identify homogeneous patient groups and further improve the management of critically ill patients.
Background Poor physical functioning (PF) is a common issue among critically ill patients. It was suggested that reasonable nutrition accelerates PF recovery. However, the details and types of nutritional interventions on the PF of different intensive care unit (ICU) patients at present have not been well analyzed yet. This study aimed to systematically synthesize nutritional interventions on PF in different ICU populations. Methods Whittemore and Knafl’s framework was employed. PubMed, EMBASE, Web of Science, CINAHL Plus with Full Text, and Cochrane Library were searched to obtain studies from January 2010 to September 2020, with a manual search of the included studies’ references. Record screening, data extraction, and quality appraisal were conducted independently by each reviewer before reaching an agreement after discussion. Results Twelve studies were included reporting the effects of early parenteral nutrition, early enteral nutrition, early goal-directed nutrition, early adequate nutrition, higher protein delivery, higher energy delivery, low energy delivery, energy and protein delivery, intermittent enteral feeding on PF like muscle mass, muscle strength, and function. Function was the most common outcome but showed little improvements. Muscle strength outcomes improved the most. The mechanically ventilated were the most popular target ICU population. The commenced time of the interventions is usually within 24 to 48 hours after ICU admission. Conclusion Research on nutritional interventions on critically ill patients’ PF is limited, but most are of a high level of evidence. Few intervention studies specified their evidence basis. Qualitative studies investigating timeframe of initiating feeding, perspectives of the patients’ perspectives and caregivers are warranted to advance research and further discuss this topic.
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