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Formal managerial authority is the right to make managerial decisions for a delimited part of an organization and its employees. Based on the literature, this article develops a measure of formal managerial authority that is used to examine the distribution of formal managerial authority. Results from a survey of 181 managing physicians and 451 managing nurses show that formal managerial authority varies significantly across types of managerial decisions and professional groups. An exploratory cross-sectional analysis shows that formal managerial authority is positively associated with self-reported visionary leadership and the perception of being able to complete leadership tasks within the allotted time. We find no association with self-reported use of verbal recognition or the perception of having the necessary leadership skills.

Cover -- Title -- Copyright -- Contents -- Preface -- Acknowledgments -- Part I: Overview of Hospice -- Chapter 1: An Introduction to Hospice and Palliative Care -- Chapter Objectives -- Hospice Care -- Characteristics of Hospice Care -- Bereavement Care -- Palliative Care -- The Palliative Care Nurse -- Provision of Palliative Care Services -- Conclusion -- References -- Chapter 2: History and Evolution of Hospice in the United States -- Chapter Objectives -- Hospice in the United States -- Conclusion -- References -- Chapter 3: Hospice Philosophy and the Role of the Nurse -- Chapter Objectives -- Nursing and the Relief of Human Suffering -- Hospice Nursing as a Specialty Area -- Standards of Practice -- Conclusion -- References -- Chapter 4: The Hospice Interdisciplinary Team -- Chapter Objectives -- Who's on the Team? -- The RN on the Hospice Interdisciplinary Team -- Interdisciplinary Communication -- Communicating During Patient Transitions -- Managing Conflict Within the Interdisciplinary Team -- Conclusion -- References -- Part II: Essentials of Hospice Nursing -- Chapter 5: The Hospice Nurse as Case Manager -- Chapter Objectives -- The Case Management Model -- The Hospice RN as Case Manager -- The Nursing Process and Case Management -- Conclusion -- References -- Chapter 6: Goals of Care Conversations -- Chapter Objectives -- Establishing and Reestablishing Goals of Care -- Having Difficult Conversations -- Facilitating Family Conversations -- Family Meetings -- Diffusing Family Conflict -- Conclusion -- References -- Chapter 7: Establishing Hospice Eligibility -- Chapter Objectives -- Guidelines and Assessment Tools -- Documenting the Patient's Baseline and Declining Clinical Status -- Evidence of Meeting Disease-Specific Guidelines for Hospice Care -- Conclusion -- References -- Chapter 8: Hospice Admission and Levels of Care.

Abstract Background Accessing cancer treatment requires First Nation peoples living in rural and remote communities to either commute to care, or to relocate to an urban centre for the length or part of the treatment. While Canadians living in rural and remote communities must often make difficult decisions following a cancer diagnosis, such decisions are further complicated by the unique policy and socio-historical contexts affecting many First Nation peoples in Canada. These contexts often intersect with negative healthcare experiences which can be related to jurisdictional confusion encountered when seeking care. Given the rising incidence of cancer within First Nation populations, there is a growing potential for negative health outcomes. Methods The analysis presented in this paper focuses on the experience of First Nation peoples' access to cancer care in the province of Manitoba. We analyzed policy documents and government websites; interviewed individuals who have experienced relocation ( N = 5), family members ( N = 8), healthcare providers and administrators ( N = 15). Results Although the healthcare providers (social workers, physicians, nurses, patient navigators, and administrators) we interviewed wanted to assist patients and their families, the focus of care remained informed by patients' clinical reality, without recognition of the context which impacts and constrains access to cancer care services. Contrasting and converging narratives identify barriers to early diagnosis, poor coordination of care across jurisdictions and logistic complexities that result in fatigue and undermine adherence. Providers and decision-makers who were aware of this broader context were not empowered to address system's limitations. Conclusions We argue that a whole system's approach is required in order to address these limitations.

Abstract Background Accessing cancer treatment requires First Nation peoples living in rural and remote communities to either commute to care, or to relocate to an urban centre for the length or part of the treatment. While Canadians living in rural and remote communities must often make difficult decisions following a cancer diagnosis, such decisions are further complicated by the unique policy and socio-historical contexts affecting many First Nation peoples in Canada. These contexts often intersect with negative healthcare experiences which can be related to jurisdictional confusion encountered when seeking care. Given the rising incidence of cancer within First Nation populations, there is a growing potential for negative health outcomes. Methods The analysis presented in this paper focuses on the experience of First Nation peoples' access to cancer care in the province of Manitoba. We analyzed policy documents and government websites; interviewed individuals who have experienced relocation (N = 5), family members (N = 8), healthcare providers and administrators (N = 15). Results Although the healthcare providers (social workers, physicians, nurses, patient navigators, and administrators) we interviewed wanted to assist patients and their families, the focus of care remained informed by patients' clinical reality, without recognition of the context which impacts and constrains access to cancer care services. Contrasting and converging narratives identify barriers to early diagnosis, poor coordination of care across jurisdictions and logistic complexities that result in fatigue and undermine adherence. Providers and decision-makers who were aware of this broader context were not empowered to address system's limitations. Conclusions We argue that a whole system's approach is required in order to address these limitations.

Background: Accessing cancer treatment requires First Nation peoples living in rural and remote communities to either commute to care, or to relocate to an urban centre for the length or part of the treatment. While Canadians living in rural and remote communities must often make difficult decisions following a cancer diagnosis, such decisions are further complicated by the unique policy and socio-historical contexts affecting many First Nation peoples in Canada. These contexts often intersect with negative healthcare experiences which can be related to jurisdictional confusion encountered when seeking care. Given the rising incidence of cancer within First Nation populations, there is a growing potential for negative health outcomes. Methods The analysis presented in this paper focuses on the experience of First Nation peoples' access to cancer care in the province of Manitoba. We analyzed policy documents and government websites; interviewed individuals who have experienced relocation (N = 5), family members (N = 8), healthcare providers and administrators (N = 15). Results Although the healthcare providers (social workers, physicians, nurses, patient navigators, and administrators) we interviewed wanted to assist patients and their families, the focus of care remained informed by patients' clinical reality, without recognition of the context which impacts and constrains access to cancer care services. Contrasting and converging narratives identify barriers to early diagnosis, poor coordination of care across jurisdictions and logistic complexities that result in fatigue and undermine adherence. Providers and decision-makers who were aware of this broader context were not empowered to address system's limitations. Conclusions We argue that a whole system's approach is required in order to address these limitations. ; Applied Science, Faculty of ; Non UBC ; Nursing, School of ; Reviewed ; Faculty

Abstract Background To identify barriers to participation in a primary oral health care programme aimed at preventing early childhood caries, as perceived by nurses. Methods Of a total of 140 randomly selected nurses employed in 40 government health centres in Lima, 123 completed a pre-tested questionnaire. Background variables were districts' 'socio-economic status' (SES) and 'years of experience'. Factor analysis was performed. ANOVA was applied for testing the influence of the background variables on the barrier factors. Chi-square test was applied to test for differences between single item barriers and the background variables. The Likert-scale (1–4) was used. Results There was no statistical significant effect of 'SES' or of 'years of experience' of nurses on any of the 7 barrier factors, nor on the 11 single item barrier factors. The highest mean score (3.81) was obtained for the barrier factor ' importance of oral health' , followed by 'perceived responsibility' (3.44). The lowest mean score was (1.70) for 'knowledge on caries prevention' . Conclusions Nurses consider oral health very important and are willing to participate actively in programmes aimed at reducing Early Childhood Caries, provided that they will be trained well and that the director and dentists of the health centre give their consent.

Nurses' knowledge regarding advance directives may affect their administration and completion in end‐of‐life care. Confidence among nurses is a barrier to the provision of quality end‐of‐life care. This study investigated nurses' knowledge of advance directives and perceived confidence in end‐of‐life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross‐sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients' symptoms at end‐of‐life and more comfortable stopping preventive medications at end‐of‐life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end‐of‐life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end‐of‐life care.

Black family caregivers of persons with dementia experience high levels of stress that can negatively affect caregiver health outcomes and reduce caregiving capacity. However, Black caregivers tend to report low levels depressive symptoms or other negative health effects. This qualitative descriptive study aimed to identify factors that contribute to resilience among Black family caregivers. Using the rigorous and accelerated data reduction (RADaR) technique to complete thematic analysis, a team of five coders examined transcript data from three focus groups of Black current and former family caregivers ( n = 17) of persons with dementia. We identified three primary factors that contributed to caregiver resilience including access to supportive environments, adaptability, and planning skills. Caregiver resistance to reporting depressive symptoms may be attributed to the strong Black woman schema. Findings from this study may be used to develop future culturally responsive interventions that support caregivers and promote family health.

Stress experienced by nurses affects personal life, physical and mental health, and work efficiency. The long – term and constant stress experienced at work can escalate into burnout. And some stress management strategies can be effective in managing and reducing the stress experienced. The aim of this research –to analyze the stress management of nurses serving in the primary military health care centers. Research methodology.Quantitative research has been fullfiled with the questionnaire used as a research instrument. The Perceived Stress Scale – 10 (PSS – 10) and the Four – Factor Stress Management Methodology have been applied. 79 respondents have been included into the research sample. The research has been accomplished in compliance with ethical principles. SPSS 15.0 for Windows software package has been used for the analysis of data. Research results. The level of subjectively perceived stress among nurses serving in primary military health care centers was found to be low. However, two – thirds of nursing staff at the site at least sometimes feel covered in stress and excitement. And a third feel that sometimes or more often thet do not cope with their responsibilities and the tasks they receive. One in five nurses feel they can almost never or never manage their annoyance. It turned out that nurses serving in primary military health care centers mostly use problem – solving and social support stress – coping strategies. The least used – emotional discharges. Nurses serving primary military health care centers using active stress management strategies experience lower level of stress. No statistically significant relationship was found betweed the age, length of service, length of service in civilian health care institutions and subjectively perceived stress levels of nurses serving in primary military health care centers. Conclusion. Nurses serving in primary military health care centers using active stress management strategies experience lower levels of stress.

Stress experienced by nurses affects personal life, physical and mental health, and work efficiency. The long – term and constant stress experienced at work can escalate into burnout. And some stress management strategies can be effective in managing and reducing the stress experienced. The aim of this research –to analyze the stress management of nurses serving in the primary military health care centers. Research methodology.Quantitative research has been fullfiled with the questionnaire used as a research instrument. The Perceived Stress Scale – 10 (PSS – 10) and the Four – Factor Stress Management Methodology have been applied. 79 respondents have been included into the research sample. The research has been accomplished in compliance with ethical principles. SPSS 15.0 for Windows software package has been used for the analysis of data. Research results. The level of subjectively perceived stress among nurses serving in primary military health care centers was found to be low. However, two – thirds of nursing staff at the site at least sometimes feel covered in stress and excitement. And a third feel that sometimes or more often thet do not cope with their responsibilities and the tasks they receive. One in five nurses feel they can almost never or never manage their annoyance. It turned out that nurses serving in primary military health care centers mostly use problem – solving and social support stress – coping strategies. The least used – emotional discharges. Nurses serving primary military health care centers using active stress management strategies experience lower level of stress. No statistically significant relationship was found betweed the age, length of service, length of service in civilian health care institutions and subjectively perceived stress levels of nurses serving in primary military health care centers. Conclusion. Nurses serving in primary military health care centers using active stress management strategies experience lower levels of stress.

The views of a sample of Xhosa-speaking psychiatric nurses on traditional healing and its role in mental health care in South Africa are examined. We explore how the nurses manage apparent incompatibilities between their practice of Western psychiatry and the use of traditional healing services. Under normal circumstances this incongruity appears unproblematic for the respondents; these systems co-exist pluralistically in their experience. However, when questioned about the possible cooperation of these systems, respondents give views inconsistent with their pluralistic world-view and promote psychiatry's hegemony. Implications for healthcare planning are discussed.

The drive to reform the public health care system became a common feature of Australia's political and economic landscape from the early 1980s. Health care reform in Australia has been underpinned by New Public Management (NPM) which was promoted as providing more transparent policy and empowering managers to manage service delivery. However, these claims are a fallacy and nursing and nursing care have been affected adversely and severely. General (generic) management structures have replaced established nursing management structures and the distance between politics (politicians) and health service managers has narrowed to the extent that there is now an unprecedented level of political interference in the daily management of health services, in direct contrast to the tenets of NPM. This article reports on the 'reformed' health care environment as experienced by nurse managers. They reported that their ability to manage nursing services and provide professional and clinical leadership has been seriously diminished, as has their work satisfaction, motivation and commitment. They also report uncertainty about their future as well as the future of nursing itself.

Oral health is not an isolated aspect of well-being but an essential component of overall health. A growing body of evidence highlights the significant impact of oral diseases, particularly periodontal infections, on systemic conditions such as cardiovascular disease, diabetes, respiratory illnesses, and neurodegenerative disorders. The "oral-systemic link" underscores the need for a multidisciplinary approach in identifying, managing, and preventing diseases that originate in the oral cavity but influence the entire body. General dentists, laboratory technicians, nursing technicians, and phlebotomists each play a distinct yet interconnected role in tackling these oral-systemic disease mysteries. Dentists serve as the frontline professionals in diagnosing and treating conditions like periodontitis, which contribute to systemic inflammation. Laboratory technicians analyze microbial profiles, biochemical markers, and inflammatory mediators to provide diagnostic insights. Nursing technicians assist in patient education, treatment adherence, and post-procedural care, ensuring that patients receive proper oral hygiene guidance to reduce systemic risks. Phlebotomists contribute by collecting and processing blood samples that help track inflammatory markers and correlate oral infections with systemic diseases. This review highlights the collaborative effort among these professionals in advancing research, refining diagnostic methods, and improving patient outcomes. By understanding the complexities of oral-systemic interactions, healthcare providers can develop more comprehensive strategies to prevent and manage diseases that affect both the oral cavity and the entire body.

Background To identify barriers to participation in a primary oral health care programme aimed at preventing early childhood caries, as perceived by nurses. Methods Of a total of 140 randomly selected nurses employed in 40 government health centres in Lima, 123 completed a pre-tested questionnaire. Background variables were districts' 'socio-economic status' (SES) and 'years of experience'. Factor analysis was performed. ANOVA was applied for testing the influence of the background variables on the barrier factors. Chi-square test was applied to test for differences between single item barriers and the background variables. The Likert-scale (1–4) was used. Results There was no statistical significant effect of 'SES' or of 'years of experience' of nurses on any of the 7 barrier factors, nor on the 11 single item barrier factors. The highest mean score (3.81) was obtained for the barrier factor 'importance of oral health', followed by 'perceived responsibility' (3.44). The lowest mean score was (1.70) for 'knowledge on caries prevention'. Conclusions Nurses consider oral health very important and are willing to participate actively in programmes aimed at reducing Early Childhood Caries, provided that they will be trained well and that the director and dentists of the health centre give their consent.

This book is intended to be a tool for personnel working in the field of public nutrition or related areas. Such personnel may be public nutritionists, community dieticians, physicians, nurses, mid-level managers and planners and managers in government and private institutions with responsibility for or interested in public nutrition, and relevant others who are not mentioned here. The personnel of non-governmental and international organisations and university departments concerned with health and nutrition may also find it useful. The book may not be considered as a textbook on basic issues in nutrition or research methodology. It is assumed that the people who will use the book already have fundamental skills in these areas. The approach suggested reflects the author's viewpoint on public nutrition. The editor has drawn for the first publication of the book, and his own experiences, that of other people working in public nutrition, various theories in nutrition and health planning, education, social marketing, business planning and leadership, and managers by objectives. The World Health Organisation should also be thanked for allowing using the second issue of the book, Planning and Managing Community Nutrition Work, as a point of departure for this issue.