The aim of this study was to develop and psychometrically assess an instrument to measure senior baccalaureate nursing student self-efficacy related to meeting entry level competencies required on acceptance to the nursing profession. The theoretical foundation of this study is social cognitive theory (Bandura, 1986). Social cognitive theory includes the construct of self-efficacy. The foundation of social cognitive theory guides the selection of study variables, the study design and the interpretation of the study findings. The conceptual framework for this study is The Health System and Health Human Resources (HHR) Planning Framework (O’Brien-Pallas & Tomblin Murphy, 2006). The framework links important elements in health human services and workforce planning to the self-efficacy of future registered nurses in relation to meeting expected professional competencies. A twenty-two item, likert type measurement instrument entitled the Nursing Competence Self- Efficacy Scale (NCSES) was developed and validated by experts in nursing research and practice and in consultation with experts in instrument development and psychometric assessment. Nursing experts (n=8) participated in a two-step validation process consisting of two independent reviews of the instrument, before it was administered to senior baccalaureate nursing students (N=253). The NCSES has demonstrated evidence of internal consistency reliability, test-retest stability reliability, content validity, construct validity and contrasting group validity. This is the first study to develop and assess a scale to measure senior baccalaureate nursing students’ self-efficacy for competent nursing practice. It contributes a practical 22 item instrument to evaluate senior baccalaureate nursing students’ self-efficacy for nursing competence.

This research has focused on a detailed exploration of undergraduate nursing students' development for registration and their future employability potential. There has been a particular emphasis on probing whether there is value in being a nursing graduate, within this. In the study employability refers to graduating students' preparedness to contribute to their immediate and longer term working lives, using the combination of operational and academic competence, self-efficacy and potential for further development through reflection and lifelong learning. A review of literature has revealed that there is a general paucity of any type of related published research from the within the UK and elsewhere, especially qualitatively-based research. In particular, no research could be found which has explored in-depth, as its primary aim, what nursing graduateness constitutes at the point of graduation and registration as a nurse and, whether it contributes to the employability potential of graduate nurses for both basic and advanced practice. A qualitative, instrumental case study was applied as the research design to achieve depth of focus for this inquiry, in order to meet the aims of the research. Findings from the study have uncovered a wide range of graduate attributes which were identified within participating students' development and perceived employability potential. From this a model of nursing graduateness has been proposed. Findings also indicated that changing healthcare needs within society coupled with the recent reforms in healthcare, NHS policy and the nursing role have placed greater emphasis than ever before on such graduate attributes within nursing as higher order thinking for effective nursing practice. Recommendations have been put forward for nursing education practice and research.

This study by the human capital point of view, discuss on the nursing professional human capital, and its investment and return as well as nursing competence. Effective samples from 25 different level teaching hospitals amounted to 2,101. In this cross-sectional research, development "nursing competence" scale, by items analysis and explorations as well as confirmed factors analysis, extracted into six factors, named for: integrated care plans, care interventions and communication, self-growth and professional development, management, and coordination and teaching competence, modified to 33 questions items, Cronbach ' s alpha value for 0.885~0.937. Developed evaluation scale for clinical ladder system by 18 items, including 2 factors, personal and professional growth and organizational resource factors, Cronbach ' s alpha values was .875 and .967. Use statistical software Spss 14 and Mplus to test of multivariate and cross-level analysis. The result was that "nursing clinical level" is a very good indicator to the human capital, will affect the "clinical ladder investment evaluation" and "competence"; " Clinical ladder system "will affect the" nursing competence ". Regulation effect of organizational factors, "resource from organization" may affect the relationship of "nursing clinical ladder systems evaluation and nursing competence ". "Hospital grading" has parts of impact on nursing competence. Nurse is worthy human capital, that individuals and organizations should continue to invest obtain the best value for return.

The study investigated how patients in the general wards of the Avenues Clinic perceive the nursing care they received. The study objectives were to identify how nurses in the general wards of the Avenues Clinic respond to patients' needs and if the nursing care received from the nurses matched patients' expectations. The study further sought to determine if patients would return to use Avenues Clinic nursing services and recommend services to family and friends. Data was drawn from 87 respondents by randomly distributing 100 questionnaires to three thirty-four bedded general wards of the Avenues Clinic. Findings of the study indicated that the majority of patients who received nursing care that was in line with their expectations would also return to use Avenues Clinic nursing services as well as recommend the services to family and friends. The theme "optimal care" was used to consolidate patient satisfiers while "suboptimal care" was used to describe patient dissatisfiers. / Health Studies / (M.A.(Health Studies ))

The study investigated how patients in the general wards of the Avenues Clinic perceive the nursing care they received. The study objectives were to identify how nurses in the general wards of the Avenues Clinic respond to patients' needs and if the nursing care received from the nurses matched patients' expectations. The study further sought to determine if patients would return to use Avenues Clinic nursing services and recommend services to family and friends. Data was drawn from 87 respondents by randomly distributing 100 questionnaires to three thirty-four bedded general wards of the Avenues Clinic. Findings of the study indicated that the majority of patients who received nursing care that was in line with their expectations would also return to use Avenues Clinic nursing services as well as recommend the services to family and friends. The theme "optimal care" was used to consolidate patient satisfiers while "suboptimal care" was used to describe patient dissatisfiers. / Health Studies / (M.A.(Health Studies ))

Abstract The aim of this study is to describe the development of nursing students' decision-making as a part of their professional skills during their nursing education. The population consisted of 32 college nursing students who had started their education in January 1987 or 1988 and 23 polytechnic nursing students who had started their education in 1996. The college students' process of learning decision - making was studied during 1988-1991 by taping clinical lessons about planning patient care (terms IV-VI) and by collecting essays prodeced by the students during the clinical periods (terms III, V and VII). Essays produced by the polytechnic students (terms III and IV) during 1997-1998 were also collected. The data were analyzed by using both quantitatively and qualitatively content analysis (deductive and inductive analysis). The results show that rational decision-making was emphasized both in college and in polytechnic. The care plans made by the students were consistent with the phases of the nursing process. Of the different phases of the nursing process the implementation and the evaluation of nursing care were most important. At the beginning of their practical training college students emphazised nursing methods, while polytechnic students focused on medical methods. In all data sets, most uttrances pertained to the physical aspects in the implementation of nursing, in the definition of nursing problems and in the evaluation of nursing. As learning proceeded from one term to the next no changes were seen. The only exception were the clinical lessons at the beginning of the education and the essays and clinical lessons during the last phases of education in which psychic support and the need to evaluate the patient's psychic condition were emphazised. At the beginning of practical training polytechnic students gave more attention to physic support of the patient than college students. Plenty of knowledge was collected about a patient for purposes of decision-making, but it was only partly utilized as the planning of care proceeded. All data sets clearly reflected the mechanical decision-making model. At the beginning of practical training the next largest category in the college students' data was the patient-centered model which was only rarely seen in the polytechnic data. In all data sets the objectives of nursing were defined in a patient-centered manner. The college data included a small number of features of the model-oriented and creative decision-making model which were not found in the polytechnic data at the beginning of practical training at all. The following features of the creative decision-making model were found setting priorities, giving reasons for choosing the nursing model, nursing problems and methods and producing alternative nursing solutions. In both data sets the students' learning level appeared to be quite low. The findings reflected superficial mechanical learning without reflection and critical thinking.

The overall aim was to study nurses’ and managers’ attitudes towards micro social patient advocacy (I) and factors related to patient advocacy (II, III) with the main focus being on advocacy in the care of older patients in community health care together with psychometric testing of the instrument 'Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy' (IV). Methods: A quantiative cross-sectional study and a qualitative study were carried out. Nurses (n=207) and managers (n=23) in community health care responded to a questionnaire about patient advocacy, nursing competence, personal traits, quality of care and organisational climate (I, II, IV). Nurses' (n=18) perceptions of influencers of patient advocacy was studied in a phenomenographic study (III). The results showed that nurses and managers reported positive attitudes to patient advocacy (I, II), especially for patients unable to speak for themselves (I). Two areas of nursing competence (Performing the nursing process, Supervision and cooperation) and a dimension of quality of care of older patients were positively associated with attitudes towards patient advocacy (II). Two organisational dimensions were, negatively (dynamism) respectively positively (playfulness), associated with attitudes towards patient advocacy. The nurses' perceptions of influencers of patient advocacy consist of three hierarchically related levels: The nurse's character traits, The nurse’s bond with the patient and The organisational conditions (III). The Swedish version of APAS-AMIA consists of 33 items in a four-factor structure (APAS-AMIA/SE): Support patients’ beliefs and decision-making, Safeguard patients' health care, Support patients to communicate their wishes and Respect patients’ wishes not to participate in decisions regarding care (IV). Conclusions: Maintaining the continuing professional competence of nurses is important, and is ensuring the organisational prerequisites to enable nurses' advocacy for patients. / Det övergripande syftet var att studera sjuksköterskors och chefers attityder till mikrosocialt företrädarskap för patienter (I), faktorer relaterade med företrädarskap (II, III) med huvudsakligt fokus på företrädarskap för äldre patienter inom kommunal hälso- och sjukvård samt psykometriskt testa instrumentet Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy (IV). Metod: En kvantitativ tvärsnittstudie och en kvalitativ studie genomfördes. Sjuksköterskor och chefer (n=230) i kommunal hälso-och sjukvård besvarade frågor om företrädarskap, yrkeskompetens, personlighet, vårdkvalitet och organisationsklimat (I, II, III). Sjuksköterskors (n=18) uppfattningar av vad som påverkar företrädarskap studerades i en fenomenografisk studie (III). Resultat: Sjuksköterskor och chefer rapporterade positiva attityder till företrädarskap (I, II), framför allt för oförmögna patienter (I). Två områden av yrkeskompetens (Att utföra omvårdnadsprocessen, Arbetsledning och samarbete) liksom en dimension av kvalitet i vården av äldre var positivt associerade med attityder till företrädarskap (II). Två organisatoriska dimensioner var negativt (livfullhet) respektive positivt (lekfullhet) associerade med attityder till företrädarskap. Sjuksköterskors uppfattningar av vad som påverkar företrädarskap omfattar tre hierarkiskt relaterade nivåer: Sjuksköterskans karaktärsdrag, Sjuksköterskans förhållande till patienten och Arbetsplatsens beskaffenhet (III). Den svenska versionen av APAS-AMIA omfattar 33 påståenden i en fyrfaktorstruktur (APAS-AMIA/SE): Stödja patienternas önskemål och beslutsfattande, Värna om patienternas vård, Stödja patienterna att kommunicera sina önskemål och Respektera patienternas önskemål om att inte delta i beslut (IV). Konklusioner: Sjuksköterskors yrkeskompetens bör upprätthållas för att de ska ha förutsättningar att företräda patienter. Det är viktigt att skapa organisatoriska förutsättningar för att sjuksköterskor ska kunna etablera en relation till patienten som underlag till företrädarskap.