Psychometric Testing of the Technological Competency as Caring in Nursing Instrument – Revised (English Version Including a Practice Dimension)

Background: The middle range theory Technological Competency as Caring in Nursing (TCCN) guides nursing practices. The TCCN Instrument (TCCNI) measures perception dimension of the theory and has been revised and translated into the Japanese language (TCCNI-R). Testing the translated version of the TCCNI-R to English language with the inclusion of a practice dimension is warranted.Purpose: This study aims to determine the psychometric properties of the TCCNI-Revised English version with Practice dimension (TCCNI-RePract).Methods: A web-based cross-sectional study was conducted with data from 202 valid questionnaire copies from professional nurses in selected hospitals and nurse educators in universities. Results: The suitability for factor analysis was determined using Kaiser-Meyer-Olkin index (0.93), Bartlett's sphericity test of 3256.93, p<0.001, the anti-image correlations ranged between 0.87 and 0.96, and an average value of communalities of 0.66. In the four rotations conducted with the maximum likelihood method with a Harris-Kaiser Orthoblique rotation, four items were excluded with factor loadings less than 0.40. These results determined the final scale with 21 items and four subscales, namely: (1) Knowing the person (8 items); (2) Technological competency as Caring (6 items); (3) Technology and caring (4 items); and (4) Expression of nursing as Caring (3 items). Cronbach’s alpha coefficient for the total scale was 0.94. With two dimensions of the TCCNI-RePract, the perception dimension had significantly higher scores than the practice dimension. When comparing mean factor point among the dimensions, the perception scores were significantly higher for Factor 1 and Factor 3.Conclusion:The TCCNI-RePract is an acceptable tool that can reliably measure nurses’ perception and practice of TCCN. It is affirmed that with this tool, measuring perception and practice status of TCCN theory is possible. It is considered that the evaluation results can be used to plan in-hospital education.

Empirical Indicators: Conceptual and Theoretical Origins

This paper discusses the connections between nursing conceptual model concepts, middle-range theory, and situation-specific theory concepts, as well as between the theory concepts and how they are measured, that is, empirical indicators. Three types of empirical indicators are described—instruments, assessment tools, and interventions—and an example of each type is given. The paper’s central thesis is that a conceptual model concept is —or should be— the starting point for selecting or constructing an empirical indicator.

Self-care Behaviours and Technology utilised during COVID-19:Systematic Review (Preprint)

BACKGROUND Self-care behaviours are essential for people living with chronic conditions. However, the outbreak of the COVID-19 pandemic has imposed additional complications into their daily routines. Few studies have analysed how self-care behaviours have changed during COVID-19 and the role of digital technology, especially amongst people with chronic conditions. OBJECTIVE This study aimed to review how self-care behaviours have changed for people with chronic conditions during the COVID-19 pandemic, and what technology they have adopted to manage their conditions during that period. METHODS A systematic review was conducted using narrative synthesis. Data were extracted from PubMed, MEDLINE, Excerpta Medica database (EMBASE), PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Google Scholar, included studies from December 2019 onwards. Eligible studies focused on adults diagnosed with chronic conditions undertaking any self-care tasks in line with the middle-range theory of self-care of chronic illness (i.e. self-care maintenance, monitoring, and management). Methodological quality of included articles were assessed with a modified version of McMaster Critical Review Forms for Quantitative or Qualitative studies. RESULTS In total, 36 primary research articles were included. Changes to self-care behaviours during COVID-19 amongst people with chronic conditions were organised according to middle-range theory of self-care of chronic illness focusing on self-care maintenance (i.e. medication adherence, physical activity, diet control), self-care monitoring (i.e. monitoring signs and symptoms), and self-care management (i.e. consultations with health care providers). Positive self-care behaviours observed include: individuals trying to maintain good glycaemic control during COVID increased their medication adherence in 27% of studies, and diet control improved in 50% of studies. Negative self-care behaviours observed include: decline in physical activities and increased sedentariness observed in 65% of studies; poor diet control in 57% of studies, and self-monitoring of health status dropped in 43% of studies. Use of technology to support self-care of chronic conditions during COVID were reported in 26 studies. Actual utilisation of telehealth in place of physical consultations during COVID was observed in 50% of studies and other digital technology (e.g. social media apps, smartphone apps, online platforms, web browsing )were used in 50% of studies. Telehealth was discussed and recommended as the default technology in delivering future health care services during COVID-19 and beyond in 77% of studies. CONCLUSIONS The review highlighted the necessity to re-think how models of self-care should continue to address the demands of chronic conditions while being responsive to the imminent threats of infectious diseases. Perhaps the silver lining of COVID-19 is that adoption of digital technology (especially telehealth) amongst a vast cross-section of people with chronic conditions is possible. Future research should investigate effective ways to incorporate evidence-based digital health tools into these new models of self-care that address the challenges of chronic and infectious conditions.

A Theory of Balanced Leadership

This chapter describes balanced leadership theory. It starts by discussing the need for theories for good practical work. A positioning follows, which locates balanced leadership as a middle-range theory between substantive and grand theories. The chapter continues with some of the required information to make sense of the theory. This includes the philosophical stance, which is critical realism, and the theoretical lens, which is realist social theory and its morphogenetic cycle. A detailed description of the theory follows. This description addresses the theory’s constituting variables (the what), the macro- and micro-processes that explain the flow of activities (the how), the internal functioning and its relation to contingency theory (the why), and finally, the limitations and areas of application where the theory holds (the where/when/who). Various cross-references are made to the subsequent chapters in this book.

Unfinished Paths—From Blockchain to Sustainability in Supply Chains

Blockchain technology has been promised as a solution to social and environmental issues in supply chains. The potential includes reduction of vulnerable party exploitation and avoiding environmentally harmful practices. Yet, it remains unclear how these potential improvements are created and whether blockchain can truly contribute. Therefore, this field study explores and identifies the mechanisms for blockchain technology to facilitate positive social and environmental impacts in supply chains. We applied an explorative qualitative research approach and interviewed blockchain technology implementers and practitioners that allowed a detailed analysis of this problem despite the scarcity of practice data. The results include the development of a middle-range theory that shows barriers and drivers of blockchain-based technologies in supply chains, introduces the concept of blockchain-enabled system, and outlines expected outcomes and impacts. We further identify four impact pathways that describe how blockchain-enabled system create positive impact: (voluntary) market mechanisms, plausibility checks, smart contracts and tokenisation, and peer-to-peer trust. The study contributes by providing insights into “how” blockchain-based technologies in supply chains can lead to social and environmental impacts. The study also furthers the discussion on blockchain technology’s role in supply chain implementation and addresses the yet unresolved problem of measuring the impact of such blockchain-enabled systems.

Developing a Taxonomy of Informal Learning Space

The move from traditional teaching-centred approach to student-centred approach has resulted in more student collaboration outside classroom, contributing to the growing importance of information learning space (ILS). Review of recent literature suggests the ILS research agenda is at an initial stage of development, without convergence in research methods and lacks theoretical underpinning. Research studies were conducted on a piece meal basis, lacking comparability and generalization. Using a mixed-method approach, this study contributes to ILS knowledge by introducing a qualitative methodology based on concept mapping and sorting for idea generation; to develop a taxonomy of four user-generated ILS types from a portfolio of 38 ILS sites on campus. This is followed by quantitative validation using seven ILS sites to evaluate satisfaction and usage behaviour. Drawing from middle range theory and the ILS taxonomy, practical design principles are proposed based on functionalities and features for the four ILS types. The learnings can be shared with designers, policy makers and different institutions to facilitate knowledge transfer, which contributes to generalization of learnings and theory building.

Elastic Scattering of Slow Electrons by Noble Gases—The Effective Range Theory and the Rigid Sphere Model

We report on an extensive semi-empirical analysis of scattering cross-sections for electron elastic collision with noble gases via the Markov Chain Monte Carlo-Modified Effective Range Theory (MCMC−MERT). In this approach, the contribution of the long-range polarization potential (∼r−4) to the scattering phase shifts is precisely expressed, while the effect of the complex short-range interaction is modeled by simple quadratic expression (the so-called effective range expansion with several adjustable parameters). Additionally, we test a simple potential model of a rigid sphere combined with r−4 interaction. Both models, the MERT and the rigid sphere are based on the analytical properties of Mathieu functions, i.e., the solutions of radial Schrödinger equation with pure polarization potential. However, in contrast to MERT, the rigid sphere model depends entirely upon one adjustable parameter—the radius of a hard-core. The model’s validity is assessed by a comparative study against numerous experimental cross-sections and theoretical phase shifts. We show that this simple approach can successfully describe the electron elastic collisions with helium and neon for energies below 1 eV. The purpose of the present analysis is to give insight into the relations between the parameters of both models (that translate into the cross-sections in the very low energy range) and some “macroscopic” features of atoms such as the polarizability and atomic “radii”.

Introduction to Rivera’s Gender Affirming Nursing Care Model: A Middle-Range Theory

Purpose: Currently, standards for transgender care guide surgical, hormonal, cosmetic and psychological care, yet do not include the domain of nursing care and nursing sensitive care outcomes. In response, the purpose of this project was to create a middle-range nursing theory to guide transgender nursing care. Methods: Rivera’s Gender Affirming Nursing Care (GANC) Model was developed using a community informed iterative process, combining and modifying two existing theories. Each theory was evaluated, construct templates were created, modified, and expanded to create the proposed gender transcendent model. Face validity was established through expert and community review. Findings: Concepts identified include: Relationship (Join With), Knowledge (Learn With) and Engagement (Partner With). Action within the model is propelled by drivers, including ongoing learning, ongoing research, ongoing self-assessment, and leadership. The model operates within the recognized domains of nursing, to support gender affirming nursing care. Conclusions: The middle-range theory was tested and found to stimulate gender neutral thinking; however, the model would benefit from additional testing to determine impact on nursing and patient outcomes. The model allows the nurse, through self-reflection and other internal growth mechanisms, to identify personal implicit and explicit bias. It is through these actions and shifting paradigms that nurses develop a personal gender affirming nursing practice.

Coalition-making under conditions of ideological mismatch: The populist solution

This article problematizes how non-spatial factors facilitate the formation of extraordinary ideologically mismatched government coalitions. An intensive case study analysis of the SYRIZA–ANEL governments in Greece (2015–2019) suggests that a shared symbolic discourse directed against mainstream contenders allowed elite actors with widely disparate programmatic commitments to circumvent rigid constraints imposed by minimal range theory. Under conditions of acute polarization and socioeconomic upheaval owing to the Greek sovereign debt crisis, a strategic use of populist anti-bailout discourse upset the usual order of party competition along spatial dimensions, fostering cross-ideological cohabitation at the executive level between the radical-left SYRIZA and the radical-right ANEL for a total of four years. However, an office-seeking approach based on a populist symbolic framework to represent salient grievances cannot fully eliminate policy dissension. Once core ideological commitments become explicitly challenged, inelastic policy-oriented factions and voting blocs may ultimately precipitate the expiration of the populist coalition.