Lina Daouk-Öyry

The JOINT model of nurse absenteeism and turnover: A systematic review

BACKGROUNDnAbsenteeism and turnover among healthcare workers have a significant impact on overall healthcare system performance. The literature captures variables from different levels of measurement and analysis as being associated with attendance behavior among nurses. Yet, it remains unclear how variables from different contextual levels interact to impact nurses attendance behaviors.nnnOBJECTIVESnThe purpose of this review is to develop an integrative multilevel framework that optimizes our understanding of absenteeism and turnover among nurses in hospital settings.nnnMETHODSnWe therefore systematically examine English-only studies retrieved from two major databases, PubMed and CINAHL Plus and published between January, 2007 and January, 2013 (inclusive).nnnFINDINGSnOur review led to the identification of 7619 articles out of which 41 matched the inclusion criteria. The analysis yielded a total of 91 antecedent variables and 12 outcome variables for turnover, and 29 antecedent variables and 9 outcome variables for absenteeism. The various manifested variables were analyzed using content analysis and grouped into 11 categories, and further into five main factors: Job, Organization, Individual, National and inTerpersonal (JOINT). Thus, we propose the JOINT multilevel conceptual model for investigating absenteeism and turnover among nurses.nnnCONCLUSIONSnThe JOINT model can be adapted by researchers for fitting their hypothesized multilevel relationships. It can also be used by nursing managers as a lens for holistically managing nurses attendance behaviors.

Using cognitive interviewing for the semantic enhancement of multilingual versions of personality questionnaires

We discuss the use of cognitive interviewing with bilinguals as an integral part of cross-cultural adaptation of personality questionnaires. The aim is to maximize semantic equivalence to increase the likelihood of items maintaining the intended structure and meaning in the target language. We refer to this part of adaptation as semantic enhancement, and integrate cognitive interviewing within it as a tool for scrutinizing translations, the connotative meaning, and the psychological impact of items across languages. During the adaptation of a work-based personality questionnaire from English to Arabic, Chinese (Mandarin), and Spanish, we cognitively interviewed 12 bilingual participants about 136 items in different languages (17% of all items), of which 67 were changed. A content analysis categorizing the reasons for amending items elicited 11 errors that affect 2 identified forms of semantic equivalence. We provide the resultant coding scheme as a framework for designing cognitive interviewing protocols and propose a procedure for implementing them. We discuss implications for theory and practice.

What do nurse managers say about nurses’ sickness absenteeism? A new perspective

AIMnTo explore nurses sickness absenteeism from the perspective of nurse managers.nnnBACKGROUNDnSickness absenteeism among health-care providers, especially nurses, remains a significant problem in an era of challenges to provide high quality care with the required skill mix. This in turn compromises the quality of care and adds to the costs of an organisation.nnnMETHODSnA qualitative descriptive design was used. Data were collected from a governmental academic hospital in Lebanon. In-depth tape-recorded interviews were conducted with a total of 20 nurse managers. Data were analysed through a content analysis approach.nnnRESULTSnData analysis yielded three domains as follows: work-related, individual and organisational factors that lead to nurses sickness absenteeism.nnnCONCLUSIONnThis study conceptualised nurses absenteeism from the nurse managers perspective, and it revealed absence antecedents that are rarely reported elsewhere in the literature.nnnIMPLICATIONS FOR NURSING MANAGEMENTnThe findings from this study can be utilised to design reform initiatives concerned with nurses absenteeism and to decrease its negative consequences in terms of quality and cost.

Developing a competency framework for academic physicians

Abstract Background: There is a mismatch between the requirements of the multifaceted role of academic physicians and their education. Medical institutions use faculty development initiatives to support their junior academic physicians, however, these rarely revolve around academic physician competencies. The aim of this study was to identify these academic physician competencies and develop a competency framework customized to an organizational context. Methods: The authors conducted semi-structured interviews and Critical Incident Technique with 25 academic physicians at a teaching medical center in the Middle East region inquiring about the behaviors of academic physicians in teaching, clinical, research, and administrative roles. Results: Using content analysis, the authors identified 16 competencies: five “Supporting Competencies”, common to all four roles of academic physicians, and 11 “Function-Specific Competencies”, specific to the role being fulfilled. The developed framework shared similarities with frameworks reported in the literature but also had some distinctions. Conclusions: The framework developed represents a step towards closing the gap between the skills medical students are taught and the skills required of academic physicians. The model was customized to the context of the current organization and included a future orientation and addressed the literature calling for increasing focus on the administrative skills of academic physicians.

A mixed-methods study of personality conceptions in the Levant: Jordan, Lebanon, Syria, and the West Bank

Personality taxonomies are investigated using either etic-style studies that test whether Western-developed models fit in a new culture, or emic-style studies that derive personality dimensions from a local culture, using a psycholexical approach. Recent studies have incorporated strengths from both approaches. We combine the 2 approaches in the first study of personality descriptors in spoken Arabic. In Study 1, we collected 17,283 responses from a sample of adults in Lebanon, Syria, Jordan, and the West Bank (N = 545). Qualitative analysis revealed 9 personality dimensions: Soft-Heartedness, Positive Social Relatedness, Integrity, Humility versus Dominance, Conscientiousness, Extraversion, Emotional Stability, Intellect, and Openness. In Study 2, we converted the qualitative model into an indigenous personality inventory and obtained self-ratings of a sample of adults in the same region (N = 395). We also simultaneously obtained self-ratings on an adapted etic inventory that measures the lexical Big Five (N = 325). Psychometric and conceptual considerations yielded a robust 7-factor indigenous model: Agreeableness/Soft Heartedness, Honesty/Integrity, Unconventionality, Emotional Stability, Conscientiousness, Extraversion/Positive Social Relatedness, and Intellect. Initial validation evidence shows that 5 of the 7 factors overlapped with the Big Five, whereas Honesty/Integrity and Unconventionality did not overlap. Also, scores on the indigenous tools were better predicted by relevant demographic variables than scores on the etic tool. Our study demonstrated the viability of combining etic and emic approaches as key to the understanding of personality in its cultural context.

The catalytic role of Mystery Patient tools in shaping patient experience: A method to facilitate value co-creation using action research

Improving patients’ experience in hospitals necessitates the improvement of service quality. Using mystery patients as a tool for assessing and improving patients’ experience is praised for its comprehensiveness. However, such programs are costly, difficult to design and may cause unintended negative consequences if poorly implemented. Following an Action Research theoretical framework, the aim of this study is to utilize the Mystery Patient (MP) for engaging the patient in co-creating valuable non-clinical services and producing guidance about future managerial interventions. This was operationalized at the Outpatient Clinics at a large Academic Hospital in the Middle East region whereby 18 Mystery Patients conducted 66 visits to clinics and filled out 159 questionnaires. The results indicated higher scores on hard criteria or skills (technical), such as personal image and professionalism, and lower scores on soft criteria (interpersonal), including “compassion” and “courtesy”. The data also demonstrated how the MP tool could provide targeted information that can point to future interventions at any one of the patient experience core pillars, namely: process, setting, and employees. This paves the way for another cycle of spiral learning, and consequently, a continuous process of organizational learning and development around service provision. The MP tool can play the role of the catalyst that accelerates the value co-creation process of patient experience by directing management to necessary interventions at the three pillars of patient experience: employees, processes, and setting.

Arab-Levantine Personality Structure: A Psycholexical Study of Modern Standard Arabic in Lebanon, Syria, Jordan, and the West Bank

OBJECTIVEnThe debate of whether personality traits are universal or culture-specific has been informed by psycholexical (or lexical) studies conducted in tens of languages and cultures. We contribute to this debate through a series of studies in which we investigated personality descriptors in Modern Standard Arabic, the variety of Arabic that is presumably common to about 26 countries and native to more than 200 million people.nnnMETHODnWe identified an appropriate source of personality descriptors, extracted them, and systematically reduced them to 167 personality traits that are common, are not redundant with each other, and are familiar and commonly understood in Lebanon, Syria, Jordan, and the West Bank (Palestinian territories).nnnRESULTSnWe then analyzed self- and peer ratings (Nu2009=u2009806) and identified a six-factor solution comprising Morality (I), Conscientiousness (II), Positive Emotionality (III), Dominance (IV), Agreeableness/Righteousness (V), and Emotional Stability (VI) without replicating an Openness factor.nnnCONCLUSIONSnThe factors were narrower or broader variants of factors found in the Big Five and HEXACO models. Conceptual and methodological considerations may have impacted the factor structure.

Nurse-Led Competency Model for Emergency Physicians: A Qualitative Study

Study objective: To develop a competency model for emergency physicians from the perspective of nurses, juxtapose this model with the widely adopted Accreditation Council for Graduate Medical Education (ACGME) model, and identify competencies that might be unique to the nurses perspective. Methods: The study relied on secondary data originally collected as part of nurses assessment of emergency physicians nonclinical skills in the emergency department (ED) of an academic medical center in the Middle East. Participants were 36 registered nurses who had worked in the ED for at least 2 years and had worked for at least 2 shifts per month with the physician being evaluated. Results: Through content analysis, a nurse‐led competency model was identified, including 8 core competencies encompassing 33 subcompetencies. The 8 core competencies were emotional intelligence; problem‐solving and decisionmaking skills; operations management; patient focus; patient care, procedural skills, and medical knowledge; professionalism; communication skills; and team leadership and management. When the developed model was compared with the ACGME model, the 2 models diverged more than they converged. Conclusion: The nurses perspective offered distinctive insight into the competencies needed for physicians in an emergency medicine environment, indicating the value of nurses perspective and shedding light on the need for more systematic and more methodologically sound studies to examine the issue further. The differences between the models highlighted the competencies that were unique to the nurse perspective, and the similarities were indicative of the influence of different perspectives and organizational context on how competencies manifest.