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Advanced practice role delineation within Hong Kong: A cross-sectional study.

ABSTRACT: A career ladder for nurses, including several levels of nursing practice and specific roles for advanced practice nurses, was introduced in Hong Kong around the start of the 21st century. To date no studies have distinguished the practices of advanced practice nurses in Hong Kong. This cross-sectional study, conducted between November 2020 and March 2021, aims to identify and differentiate the practice patterns of advanced practice nurses by utilizing the Advanced Practice Role Delineation tool. A total of 191 responses were obtained. Three roles were identified: nurse consultant, advanced practice nurse, and advanced practice nurse in management. Among the five advanced practice nursing domains, nurses were most frequently involved in Education and in Direct Comprehensive Care activities, while least active in Research and in Publication and Professional Leadership. Identifying activities in various nursing roles helps to differentiate their responsibilities and provides new insights for role utilization and support. Although the role characteristics are shaped by country contexts, research evidence on practice patterns may be used to support international discussion and efforts to promote role clarity and effective role introduction and optimization.

SUBMITTER: Jokiniemi K

PROVIDER: S-EPMC9545430 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Advanced practice role delineation within Hong Kong: A cross-sectional study.

Jokiniemi Krista K Chair Sek Ying SY Wong Frances Kam Yuet FKY Bryant-Lukosius Denise D

Nursing & health sciences 20220708 3

A career ladder for nurses, including several levels of nursing practice and specific roles for advanced practice nurses, was introduced in Hong Kong around the start of the 21st century. To date no studies have distinguished the practices of advanced practice nurses in Hong Kong. This cross-sectional study, conducted between November 2020 and March 2021, aims to identify and differentiate the practice patterns of advanced practice nurses by utilizing the Advanced Practice Role Delineation tool. ...[more]

PMID: 35699666

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Project description:ObjectiveThere were studies evaluating advanced nursing practice independently in the mainland and Hong Kong Special Administrative Region of China, but there was no attempt to make a comparison of practice between them. This study employed a case study method to examine and compare advanced nursing practice in Hong Kong and Guangzhou.MethodPurposive sampling method was used to recruit 24 advanced practice nurses (APN) who came from the specialty of medical, surgical and pediatric in Hong Kong and Guangzhou. A questionnaire survey and semi-structured interview were conducted to solicit quantitative and qualitative data for exploring the structure-process-outcome of advanced nursing practice. The structure component explored the factors influencing advanced nursing practice. The process part examined APN role components and illustrations of exemplary advanced nursing practice. The outcomes described outcome indicators that best reflected advanced nursing practice.FindingsFindings revealed that in the structure domain, APN education and career development, team approach in healthcare, and support from management, physicians and professional associations were important contextual factors for APN development in both cities. For the process domain, participants had at least 80% of their time practicing independently/interdependently and were engaged in APN activities including direct/indirect patient care, research/project work, initiation of staff and patient protocols. All participants demonstrated competencies with impacts on patient, service and profession in their description of exemplary practice. Participants from both cities ranked patient-related outcomes as top indicators for their advanced nursing practice.ConclusionThis study has revealed that APNs in Guangzhou and Hong Kong shared similar work involvement and impacts and their demonstrated competencies were on par with international counterparts. Continued efforts need to be put in establishing formal APN education, clear clinical career pathway and title protection to empower nurses to provide optimal care to the fullest extent that they are prepared for.

Project description:ObjectivesStudies of violence towards nursing students (NSs) have been scattered mainly in the West and Middle East, but to date there have been no studies in Eastern countries. Differences in nursing education systems and cultures might have contributed to variations in incidences of clinical violence. The purpose of this study was to investigate the prevalence, associated factors and impact of clinical violence to NSs.MethodsThis was a cross-sectional survey study. Convenience sampling was used to recruit university NSs from March to June 2012 in classroom settings in Hong Kong. A valid and reliable questionnaire was used to collect the data. 1297 questionnaires were distributed and 1017 NSs completed questionnaires, with a response rate of 78.41%.ResultsOf the 1017 NSs, 37.3% (n=379) reported having experienced clinical violence during their nursing studies. The prevalence of verbal abuse (30.6%) was significantly greater than that of physical violence (16.5%). The perpetrators of verbal abuse were predominantly patients (66.8%), hospital staff (29.7%), university supervisors (13.4%) and patients' relatives (13.2%). Patients (91.0%) were the greatest source of physically violent assaults. Compared with those who had experienced physical violence, the NSs who had experienced verbal abuse were more likely not to take action, and not to stop or report the incident, but were also more likely to tell their friends/families. Although the negative effects on emotions, clinical performance and the extent to which they were disturbed by the violence were significantly greater for verbal abuse than that for physical violence, their intention to leave the nursing profession after experiencing either verbal or physical violence was significantly higher after than before the experience (p<0.001).ConclusionsOur results found a moderately high prevalence of clinical violence among NSs. Provision and/or reinforcement of appropriate training about clinical violence in the nursing curricula is necessary.

Project description:ObjectiveColorectal cancer (CRC) ranked second in terms of cancer mortality worldwide. It is associated with a substantial global disease burden. We aimed to examine whether the theory of planned behaviour (TPB) could predict the uptake of faecal immunochemical test to inform novel strategies for enhancing CRC screening participation in population-based programmes.DesignCross-sectional study.SettingsA Hong Kong-based and territory-wide telephone survey was conducted during the study period from October 2017 to November 2018.Participants4800 asymptomatic individuals aged 61-70 years who can communicate in Cantonese were recruited during the survey period. Those who had a history of CRC, chronic bowel inflammation, two or more first-degree relatives with CRC, and received colonoscopy in the past 10 years or faecal occult blood test in the past 5 years were excluded.Outcome measuresThe association between CRC screening uptake and the factors pertinent to TPB was analysed by univariable and multivariable regression models and the mediating effect of intention. We adjusted for age, gender, educational level, marital and working status, as well as household income.ResultsMultivariable regression analysis showed that high perceived behavioural control (adjusted OR (AOR)=12.35, 95% CI 8.21 to 18.60, p<0.001), high intention for CRC screening (AOR=7.86, 95% CI 6.60 to 9.36, p<0.001) and positive attitude towards CRC screening (accuracy and effectiveness: AOR=1.19, 95% CI 1.03 to 1.38, p<0.05; embarrassment and apprehension: AOR=4.27, 95% CI 3.13 to 5.82, p<0.001) were significantly associated with CRC screening uptake. Mediation analysis found that the effect of social norms on screening behaviour was primarily mediated by intention (83.2%), and this indirect, mediated effect accounted for 21.7% to 24.1% of total effects of other constructs in TPB on screening behaviour.ConclusionsThe variables pertinent to TPB could successfully predict CRC screening uptake. Promotion of CRC screening based on interventions that increase perceived behavioural control and behavioural intention could potentially enhance screening uptake. Further studies are needed to establish the cause and effect relationship among these variables and screening uptake, as well as to evaluate the cost-effectiveness of such interventions.

Dataset Information

Advanced practice role delineation within Hong Kong: A cross-sectional study.

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Advanced practice role delineation within Hong Kong: A cross-sectional study.

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