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Nursing

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24

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    Improving person-centred leadership: A qualitative study of ward managers' experiences during the COVID-19 crisis
    (Dove Press, 2021-04-07) Hølge-Hazelton, Bibi; Kjerholt, Mette; Rosted, Elizabeth; Thestrup Hansen, Stine; Zacho Borre, Line; McCormack, Brendan
    In order to provide guidance and prepare ward managers for future crisis situations similar to the COVID-19 pandemic, the aim of this study was to reflect and learn how person-centred nursing leadership may be strengthened in such situations. The pandemic has forced nurse leaders to face new challenges. Knowledge about their experiences may contribute to advancing leadership practices in times of future crises. A qualitative directed content analysis was chosen. The theoretical perspective was person-centred leadership. Thirteen ward managers from a Danish university hospital were included and interviewed using telephone interviews three months after the first national COVID-19 case was confirmed. The main findings of the study revealed that the ward managers often experienced a lack of timely, relevant information, involvement in decision-making and acknowledgement from the head nurse of department and the executive management. This was caused by the existing organizational cultures and the traditional hierarchy of communication. This meant that the ward managers' sense of own competences and leadership values and beliefs came under high pressure when they had to balance different stakeholders' needs. When the experience of ward managers results in them being unable to lead authentically and competently in a crisis like the COVID-19 pandemic, lack of engagement can occur, with serious consequences for patients, staff and the ward managers themselves. Traditional organizational cultures that are hierarchical and controlling needs to be challenged and reoriented towards collaborative, inclusive and participative practices of engagement and involvement. Leadership development must be an established and integrated component of organizations, so that ward managers are able to sustain person-centred ways of being and doing in times of crisis.
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    Danish translation and adaptation of the Context Assessment Index (CAI) with implications for evidence-based practice
    (Wiley, 2019-01-28) Hølge-Hazelton, Bibi; Bucknall, Tracey; Bruun, Line Zacho; Slater, Paul F.; McCormack, Brendan; Klausen, Susanne Hwiid; Thomsen, Thora Skodshøj
    Background: Healthcare contexts are rapidly changing with growing demand for health services to accommodate an ageing population and financial pressures. Assessment of context in healthcare set-tings has been the subject of increasing debate. The Context Assessment Index (CAI) examines three interconnected contextual elements derived from the PARIHS-Framework with the purpose of providing practitioners with an understanding of the context in which they work. Aims: 1: To describe the translation of the CAI into Danish and adapt the instrument for use in Danish hospitals. 2: To evaluate the psychometric properties of the Danish version of the CAI. Methods: Translation and adaption included an expert panel and a translation/back-translation pro-cess. The CAI was then sent to 4416 nurses in the Region Zealand, Denmark. There are two alternative measurement models to explain the factor structure of the CAI, the five-factor model and the three-factor model. In order to provide the best explanation for the data both measurement models were examined using confirmatory factor analysis. Results: The CAI was translated and modified based on expert review and usability testing. 2261 nurses completed the CAI. For both models, factor loadings and fit statistics were acceptable, appropriate and statistically significant, and the measurement models were confirmed (5-factor model RMSEA 0.07, CFI=0.923; 3-factor model RMSEA 0.07, CFI=0.924). Cronbach alpha scores showed the models to have broadly acceptable scores (5-factor 0.64 – 0.89; 3-factor model 0.72 – 0.89). Linking Evidence to Action: The three-factor model can advantageously be used when the PARIHS framework is part of the project. In a translation process, differences in cultural specificity, language, and working environment have to be considered. By understanding the context of practice, nurses may enable person-centered care and improve patient outcomes.