Suchergebnisse

Quality service provision depends on the performance of the service providers; therefore, enhancing an empowering work environment is crucial to achieving excellence. This study examined the intercorrelation between structural empowerment, nurses perceived formal and informal power, and their job performance. Nurses perceived only a moderate level of power in their work environment with the highest performance quality in the area of critical care. The model "the three-component feedback system of power, empowerment, and job performance" was tested using the structural equation model. The data from 200 nurses strongly fit with the proposed model. This study proposed that job performance, power, and empowerment are involved in a loop of feedback system in which each variable in the loop affects other variables either directly or through other variables in the loop. Applying staff improvement plans can begin in one component of the system, and the progress will eventually enhance the other components.

Background: Depression is a frequently reported phenomenon that negatively affects selfcare and healthcare provided to older adults with heart failure. However, the literature is contradicting about predictors of depression in older adults with heart failure. Purpose: To examine newly introduced variables derived from the acceptance and commitment therapy model (psychological flexibility, impulsivity, perceived stress and perceived control) and selected demographics as predictors of depression in older adults with heart failure. Methods: This study was conducted using a cross-sectional design. Participants with heartfailure (N = 272) were recruited from major regional hospitals during their regular visits to the heart-failure clinics. The following tools were used to collect the data: The Patient Health Questionnaire–9, the Acceptance and Action Questionnaire, the Perceived Stress Scale-10, the Barratt Impulsiveness Scale, the Atlanta Heart Failure Knowledge Test, the New York Heart Association and the Control Attitudes Scale-Revised. Results: Bivariate analysis shows that all bivariate correlations were significant (r = 0.16 to 0.63, p <0.05), except for the correlation between "age with time since diagnosis" and "time since diagnosis with psychological flexibility". The results showed that time since diagnosis, impulsivity, stress, psychological flexibility and heart-failure knowledge significantly predicted depression in elder adults with heart failure. The model explained 49.5% of the variance in depression. Conclusion: An array of psychological and socio-demographic variables explained approximately a half of the variation in depression in elder adults with heart failure. The acceptance and commitment therapy model has been shown to be beneficial in incorporating new variables contributing to depression in older adults with heart failure. Implications for Nursing: The current study offers preliminary evidence of the potential benefit of the acceptance and commitment therapy model-based interventions. Further research should be conducted to minimize the impact of depression in older adults with heart failure. Keywords: Depression, Stress, Perceived control, Impulsivity, Heart failure, Psychological flexibility.

Background: The Acceptance and Commitment Therapy Model has gained empirical support, with limited evidence on the role of psychological flexibility in persons with heart failure. Objective: To examine the role of psychological flexibility in persons with heart failure. Methods: A total of 172 persons with heart failure from three major referral hospitals participated in the study. A proposed model based on the acceptance and commitment therapy was tested. Results: The results showed that the path between psychological flexibility and emotional outcomes is statistically significant. Psychological flexibility explained 52% of the variance. On the other hand, the path between psychological flexibility and behavioral outcomes was not significant. Conclusions: This study suggests that psychological flexibility plays a significant role in determining emotional outcomes in persons with heart failure. Implications to Nursing: Nurses need to assess persons with compromised psychological flexibility as a predictor of adverse emotional outcomes. Targeting psychological flexibility may improve stress and depression in persons with heart failure. Keywords: Psychological flexibility, Heart failure, Acceptance and commitment therapy, Depression, Stress.