Interpersonal sensitivity of clinical nurses and related factors/Klinik hemsirelerinin kisiler arasi duyarliliklari ile iliskili faktorler.
Nursing is a profession that necessitates the use of therapeutic communication skills to generate healthy relationships with individuals and increase patient satisfaction.  Appropriate and effective use of these communication skills prevents problems and also shows directions in problem solving. [5,6] Interpersonal sensitivity, which is characterized by increased vigilance, can be one of the factors causing nurses to have interpersonal problems with patients and members of the health care team. These problems can decrease the quality of care; negatively affect nurses, health care organizations, and patients; and cause stress and discomfort in health care environments. [4,5] Defining variables related to high interpersonal sensitivity will provide valuable information for the improvement of quality of care by guiding us to the nursing groups which needs preventive support and which needs to be better understood regarding to interpersonal sensitivity. No study has explored these factors among clinical nurses so far; for this reason, we aimed to identify the factors associated with interpersonal sensitivity among clinical nurses in this study.
Literature Review Interpersonal Sensitivity
Interpersonal sensitivity, which is defined as undue and excessive awareness of and sensitivity to the behavior and feelings of others, can negatively affect emotional state. Studies have found a correlation between interpersonal sensitivity and depression, bulimic symptomatology, anxiety, stress, mental workload, problematic Facebook use, patient-physician communication, social isolation, and self-treatment with alcohol and medication. [7-13] A study showed that low levels of interpersonal sensitivity in some individuals improved their relationships and increased their self-confidence; on the other hand, high levels caused recurrence of depression and anxiety episodes in people with a depression history and posed an increased risk of depression in people without a history.  When interpersonal sensitivity is high, self-direction decreases and avoidance behavior increases in negative situations.  Interpersonal sensitivity is also related to the concept of ego, which constitutes one's own identity, and the existence of the individual; additionally, it affects the person's way of thinking, understanding, interpreting, and evaluating incidents. [1,8] Low self-respect might lead to serious physiological and psychological conditions, avoidance of disputes, social anxiety, and increased interpersonal sensitivity.  A study by Garaigordobil, et al.  found an inverse relationship between interpersonal sensitivity and self-respect.
Interpersonal sensitivity comprises five main components including interpersonal awareness, need for approval, separation anxiety, timidity, and fragile inner-self.  Interpersonal awareness, which is significantly related to low self-esteem and mood and anxiety disorders, can be defined as sensitivity towards interpersonal interactions and the individual's effect on others.  It is represented by statements such as "I care about what others feel about me" and "I am concerned about what others think about me." Another component of interpersonal sensitivity, need for approval, reflects elements such as being flexible to ensure agreement in relationships, satisfying others, and realizing and not refusing others' requests.  Statements such as "I feel secure when I'm in a close relationship" and "After a fight with a friend, I feel uncomfortable until I have made peace" are examples of need for approval. Separation anxiety is an important dimension of interpersonal sensitivity. According to Bowlby, if a person is not able to ensure safe separation in childhood, he/she is challenged in adulthood; this feeling is called separation anxiety. [18, p. 324] Separation anxiety, which can increase the risk of depression in individuals, is represented by statements such as "I feel anxious when I say goodbye to people" and "I can never be really sure if someone is pleased with me." Timidity, a behavioral dimension of interpersonal sensitivity, is the inability to exhibit precipitous behavior in interpersonal interactions.  Statements such as "I worry about hurting the feelings of other people" and "I am always aware of how other people feel" are examples of timidity. Fragile inner-self indicates a hated aspect of ego, which can be hidden from others.  It is represented by statements such as "If other people knew what I am really like, they would think less of me" and "My value as a person depends enormously on what others think of me."
We aimed to identify the factors related to interpersonal sensitivity among clinical nurses, and looked for answers to the following questions:
* What are the levels of interpersonal sensitivity among clinical nurses?
* How are nurses' interpersonal sensitivity levels distributed according to factors such as age and professional variables?
Design and Sample
We conducted a cross-sectional descriptive study. Our sampling aimed to represent clinical nurses working in hospitals located within the borders of the Metropolitan Municipality of Ankara city (capital of Turkey) with a minimum capacity of 100 beds. Therefore, the research population comprised 8565 clinical nurses working at 33 hospitals (6 private, 7 university, and 20 state hospitals), and the research sample was determined as 400 nurses with 95% reliability (Table 1). The only inclusion criteria for the participants was being able to speak and write Turkish. The clinical nurses included in the study sample were chosen using random sampling at each hospital.
The majority of nurses in the study were female (95.2%); 23% were [greater than or equal to] 39 years old and the mean age ((M [+ or -] SD) was 33.48 [+ or -] 7.35 years; 67.8% were married; 58.5% had children; and 60.3% were university graduates. More than half (61.2%) were working in state hospitals, 19.5% of nurses had been working for 5-10 years and similarly 19.5% of them had been working for more than 20 years, 29.8% of the nurses were working in internal diseases units. This study was conducted between 29 December 2012 and 15 March 2013.
Data Collection Tools
The Nurse Data Form and the Interpersonal Sensitivity Scale were used for data collection. The Nurse Data Form was developed by the researchers to collect demographic and professional information including age, level of professional education, type of hospital and unit where the nurses worked, and years of experience in nursing. The Interpersonal Sensitivity Scale (IPSS) was developed by Boyce and Parker to determine interpersonal sensitivity levels of individuals based on their experiences with other individuals. It consists of 36 items to be answered on a 4-point Likert scale. The IPSS provides a total interpersonal sensitivity score and five subscale scores (interpersonal awareness, need for approval, separation anxiety, timidity, and fragile inner-self). The adaptation of the scale into Turkish was completed by Erozkan, from whom permission was obtained to use the adapted scale in our study. In Erozkan's study; the general reliability coefficient of the scale was .84, and the reliability coefficients of the sub-dimensions were .73 for interpersonal awareness, .77 for need for approval, .75 for separation anxiety, 76 for timidity, .77 for fragile inner self.  In our study, general reliability coefficient of the scale was .87 and the reliability coefficients of the sub-dimensions were .43 for interpersonal awareness, .60 for need for approval, .61 for separation anxiety, .70 for timidity, .75 for fragile inner self. The scale does not include any reverse scoring items or cut-off scores. The range of total interpersonal sensitivity score is 36-144 points. The subscale score ranges are 7-28 for interpersonal awareness, 8-32 for need for approval, 7-28 for separation anxiety, 8-32 for timidity, and 6-24 for fragile inner-self. A higher score on a subscale means a more frequent exhibition of the particular sub-dimension.
Written permission was obtained from the hospitals before initiating the study. Thereafter, permission was obtained from the Hacettepe University Ethical Board for Scientific Research (approval no: LUT 12/168). After the nurses were provided with information about the study, they gave their verbal and written consent to be voluntarily involved, and subsequently received the questionnaires.
Data Collection Procedure
Firstly, we determined the most suitable shifts and times for the nurses to complete the questionnaires and then proceeded to collect the data. The duration of data collection was approximately 10 min per nurse. The questionnaires were disseminated and gathered by the research team members.
Statistical analysis of the study data was performed using SPSS 20.0 software. As the sample had a normal distribution, the test for significance of the difference between two means (t-test) and one-way analysis of variance (ANOVA) among the parametric tests were utilized. After determining statistically significant multiple group variables through ANOVA, we used the Tukey HSD test to determine the significant differences in pair-wise comparisons. For statistical significance, p value less than 0.05 (p<0.05) was determined as statistically significant.
In our study, conducted with 400 clinical nurses from 33 hospitals, the nurses' total interpersonal sensitivity mean score (M [+ or -] SD) was 81.43 [+ or -] 13.54 (range=36-144). Mean scores of the IPSS sub-dimensions were 15.01 [+ or -] 2.74 (range=7-28) for interpersonal awareness, 16.72 [+ or -] 3.60 (range=8-32) for need for approval, 15.64 [+ or -] 3.25 (range=7-28) for separation anxiety, 19.76 [+ or -] 4.22 (range=8-32) for timidity, and 14.30 [+ or -] 3.73 (range=6-24) for fragile inner-self (Table 2).
Based on the age groups, a statistically significant difference was only found between the mean scores on the interpersonal awareness subscale of the IPSS. The Tukey HSD test showed that the mean score for interpersonal awareness in the 31-34 age group was lower than in the age groups 26 and under (Tukey HSD, p=.047) and 35-38 (Tukey HSD, p=.021) (Table 3).
In relation to the hospital types, there was a significant difference in the nurses' timidity mean scores. Nurses working in state hospitals (20.12 [+ or -] 4.39) had higher timidity scores than those working in private hospitals (17.91 [+ or -] 3.85) (Tukey HSD, p=.043).
Years of experience as a nurse were another variable showing a statistically significant difference between the mean scores on total interpersonal sensitivity, interpersonal awareness, and timidity. The total interpersonal sensitivity and timidity scores of nurses with 15-20 years of experience (total 85.68 [+ or -] 12.86, timidity 20.71 [+ or -] 4.10) were higher than those of nurses with 10-15 years of experience (total 78.48 [+ or -] 15.10, timidity 18.60 [+ or -] 4.56) (Tukey HSD, p=.024). On the interpersonal awareness subscale, the scores of participants who had 10-15 years of experience were lower than the scores of those who had 2 years or less, and 15-20 years of experience.
According to the analysis based on the type of units where the nurses worked, the total interpersonal sensitivity mean score of nurses working at polyclinics (86.29 [+ or -] 13.62) was higher than that of those working in intensive care (78.30 [+ or -] 13.66) (Tukey HSD, p=.006) and other units (76.84 [+ or -] 13.05) (Tukey HSD, p=.013). The interpersonal awareness mean score was higher for nurses working in polyclinics (15.87 [+ or -] 2.55) than for those working in intensive care units (14.39 [+ or -] 3.00) (Tukey HSD, p=.017). On the timidity subscale, the mean score for nurses employed at polyclinics was higher than for those working in internal diseases units, intensive care departments, and other units. On the fragile inner-self subscale, the mean score for nurses working in polyclinics (15.47 [+ or -] 4.12) was higher than for those working in intensive care clinics (13.43 [+ or -] 3.72).
According to the results of our study, nurses in the 31-34 age group had lower interpersonal awareness scores than nurses who were 26 and under, and 35-38 years of age. Boyce and Parker described interpersonal awareness as a negative kind of awareness and sensitivity towards interpersonal interactions and the individual's effect on others. In the 31-34 age group, nurses may have become more experienced in the profession and more mature in life. Lower interpersonal awareness in the 31-34 age group might be related to the increased maturity and self-confidence acquired with professional and life experiences. Although using a different study sample, in contrast with our results, Erozkan did not find a statistically significant difference in interpersonal sensitivity according to age in university students. In health care environments, age is an important factor for nurses as it affects the generations of nurses that work together but have different competencies, values, and motivations for work.  In Turkey, 31-34 age group nurses are young and excited and they have handled the problem of professional inexperience to an extent, they start to have valuable experiences regarding to relations and culture of work environment, they use the wisdom coming from these experiences during service provision. However, 26-year-old or younger nurses have excitement for nursing but they lack experiences while 35-38 age group may have a kind of burnout arising from efforts for quality of care which had not been awarded and disappointing clinical experiences with other team members and hospital managements. Our result showing a decreased interpersonal awareness in 31-34 age group may be due to these characteristics of nursing profession in Turkey.
In our study, nurses working in state hospitals had higher timidity scores than those working in private hospitals. In Turkey, there are differences between state and private hospitals in terms of nurse selection and our findings may be related to this issue. Turkish state hospitals accept nurses who exceed a number of points in a central, nationwide examination aiming to choose civil servants, and cannot interview nurses before they start working. On the other hand, private hospitals do a written exam to test the academic knowledge of nurses, after which successful nurses are accepted for an interview to test their interpersonal skills and attitudes towards given cases. After these steps, the nurses who are found qualified in terms of their professional knowledge base and interpersonal skills are accepted to work in private hospitals. Additionally, the working environments provided by state and private hospitals are very different in their nature. While private hospitals care about the opinions of nurses in order to improve the quality of services, and make efforts to improve the working conditions of their staff, state hospitals have a more traditional and physician-focused culture that does not pay much attention to nurses' opinions. These differences in the culture of the working environments may have also caused clinical nurses in state hospitals to be more timid than those in private hospitals. Similarly, Tyson and Pongruengphant found that nurses working in state hospitals experienced more stress than those in private hospitals and were also more often misunderstood, causing them to be more withdrawn. In their study, Mrayyan, et al.  and Hamid, et al.  reported that private hospitals were more ready for change and provided opportunities for their staff to contribute to improvements than state hospitals. In other studies, nurses working in private hospitals experienced more satisfaction and intent to stay than nurses working in state hospitals. [25,26] In light of these findings, private hospitals might be less stressful and more encouraging for clinical nurses by providing a healthier working environment.
As another interesting finding of our study, total interpersonal sensitivity, timidity and interpersonal awareness scores were higher in nurses who had 15-20 years of experience compared with those with less experience. These findings indicate that increased working time increases interpersonal sensitivity and timidity. However Ozgur, et al.  in contrary to our study, reported that nurses who had been working in this profession for 12 years and longer had lower interpersonal sensitivity compared to those who had been working for a shorter time Although we expected that experience would develop self-esteem, assertiveness, and interpersonal skills in nurses, our study showed the opposite. This result may be due to the culture and environment of state and university hospitals, where the vast majority of nurses for our study sample were recruited. In Turkish state and university hospitals, health services have conventional and physician-centered characteristics, as previously mentioned. Besides, the nursing profession internationally has a high demand and low decision latitude character.  Therefore, although in their early years of professional life nurses may have tried to be more assertive and change these working environments, they may have faced obstacles in bringing about such changes, and their experiences with physicians and hospital managements may have repressed their positive efforts and increased their interpersonal sensitivity, awareness, and timidity.
In our study, the nurses working in polyclinics had higher levels of interpersonal sensitivity, interpersonal awareness, and fragile inner-self than nurses working in intensive care units. One of the factors underlying this result may be the difference in working conditions between policlinics and intensive care units. Working conditions in policlinics are based on daily work, provides very short time for nurse-patient interaction while working conditions in intensive care units are more complex as it includes care provided 7 days a week 24 hours a day.  In intensive care units, nurses are expected to present professional competencies with holistic approach as well as technical skills.  These characteristic of working in intensive care units provide opportunity to use professional competencies that have the potential to increase job satisfaction and decrease interpersonal sensitivity. According to Unal and Seren, nurses working in polyclinics are not able to provide the care that forms the basis of nursing or fulfil other duties which are unrelated to their profession. On the other hand, more experienced and older nurses who are generally medical vocational high-school graduates and educated in a physician-oriented and dependent culture are generally placed in polyclinics in Turkey. These factors may be influencing each other, and a physician-oriented polyclinic practice may be the cause of feelings such as dependency and insufficiency, which may result in higher interpersonal sensitivity levels in polyclinic nurses.
In our study, age and particular professional variables were related to interpersonal sensitivity among Turkish clinical nurses. As a sub-dimension of interpersonal sensitivity, interpersonal awareness was lower in the 31-34 age group than in other age groups. Timidity was higher in state hospital nurses than private hospital nurses. Total interpersonal sensitivity, interpersonal awareness, and timidity were higher in nurses who had 15-20 years of experience. Nurses working in polyclinics had higher levels of interpersonal sensitivity, interpersonal awareness, and fragile inner-self than those working in intensive care units. Our study results provide an important insight for clinical nurses and nursing administrations regarding the nurses' characteristics that might need improvement. Based on these results, self-improvement programs for determined clinical nursing groups can be organized to help them reach optimum interpersonal sensitivity levels. Additionally, the underlying reasons for increased interpersonal sensitivity, timidity, and interpersonal awareness levels in more experienced nurses should be determined with quantitative and qualitative studies. As the interpersonal sensitivity and timidity scores of state hospital nurses are higher, research is needed to determine the causes of this situation. Furthermore, skill development and practical activities should be provided through counselling programs to reduce the interpersonal sensitivity and timidity of state hospital nurses, as more than half of the nurses in our sample are employed at state hospitals. Lastly, qualitative studies to determine the reasons for higher interpersonal sensitivity, interpersonal awareness, and fragile inner-self levels in nurses working in polyclinics should also be conducted.
Implications for nursing practice
Nursing care is naturally based on the relationship and the interaction between the nurse and the patient. Nurses can experience certain challenges in establishing, maintaining, and terminating interpersonal relationships. Interpersonal sensitivity and its negative outcomes, which may affect the nurse, the institution and the person receiving care, are among these challenging factors. By causing problems during interactions, oversensitivity and conflicts can damage the patient-nurse relationship and cause various difficulties in nursing. This affects the patient and the patient's relatives directly, and can decrease the quality of care offered by nurses. Therefore, this study provides important information for research and clinical practice by revealing the factors related to interpersonal sensitivity among clinical nurses. Moreover, it draws attention to the necessity to support nurses working in state hospitals and polyclinics in terms of interpersonal sensitivity, and provides important data for nurse managers about possible support areas.
[1.] Dogan T, Sapmaz S. Psychometric analysis of the Interpersonal Sensitivity Measure (IPSM) among Turkish undergraduate students. Journal of Theoretical Educational Science. 2012; 5(2):143-55. http:// www.keg.aku.edu.tr/arsiv/c5s2/c5s2m1.pdf
[2.] Marin TJ, Miller GE. The interpersonally sensitive disposition and health: an integrative review. Psychological Bulletin. 2013; 139(5):941. doi.org/10.1037/a0030800
[3.] Boyce P, Parker G. Development of a scale to measure interpersonal sensitivity. Australian and New Zealand Journal of Psychiatry. 1989; 23:341-51. doi.org/10.3109/00048678909068291
[4.] Smith BW, Zautra, AJ. Interpersonal sensitivity and reactivity to spousal conflict in healthy older women. Personality and Individual Differences. 2001; 31:915-23. doi.org/10.1016/S0191-8869(00)00193-8
[5.] Boggs, K. Resolving conflict between nurse and client. In: Arnold E, Boggs K, eds. Interpersonal Relationships: Professional Communication Skills for Nurses. 6th ed. USA: Elsevier Saunders; 2011:272-89.
[6.] Laursen B, Hafen CA. Future directions in the study of close relationships: conflict is bad (except when it's not). Social Development. 2010; 19(4):858-72. doi.org/10.1111/j.1467-9507.2009.00546.x
[7.] Vidyanidhi K, Sudhir PM. Interpersonal sensitivity and dysfunctional cognitions in social anxiety and depression. Asian Journal of Psychiatry. 2009; 2:25-8. doi.org/10.1016/j.ajp.2008.12.001
[8.] Erozkan A. Investigation of social anxiety with regards to anxiety sensitivity, self esteem, and interpersonal sensitivity. Elementary Education Online. 2011; 10(1):338-47. http://ilkogretim-online.org.tr/ vol10say1/v10s1m27.pdf
[9.] Hamann DM, Wonderlich-Tierney AL, Vander Wal JS. Interpersonal sensitivity predicts bulimic symptomatology cross-sectionally and longitudinally. Eating Behaviors. 2009; 10:125-27. doi.org/10.1016/j. eatbeh.2009.01.001
[10.] Ozkan A, Ozdevecioglu M, Kaya Y, Koc FO. Effects of mental workloads on depression- anger symptoms and interpersonal sensitivities of accounting professionals. Revista De Contabilidad- Spanish Accounting Review. 2015; 18(2):194-9. doi.org/10.1016/j.rcsar.2014.06.005
[11.] Eraslan Capan B. Interpersonal sensitivity and problematic facebook use in Turkish university students. Anthropologist. 2009; 21(3):395-403. http://krepublishers.com/02-Journals/T-Anth/Anth-21-0-000-15-Web/ Anth-21-3-000-15-Abst-PDF/T-ANTH-21-3-395-15-1461-EraslanCapan-B/T-ANTH-21-3-395-15-1461-Eraslan-Capan-B-Tx.pdf
[12.] Siegel SD, Molton I, Penedo FJ, et al. Interpersonal sensitivity, partner support, patient-physician communication, and sexual functioning in men recovering from prostate carcinoma. Journal of Personality Assessment. 2007; 89(3):303-9. doi.org/10.1080/00223890701629847
[13.] Masillo A, Day F, Laing J, et al. Interpersonal sensitivity in the at-risk mental state for psychosis. Psychological Medicine. 2012; 42:1835-45. doi.org/10.1017/S0033291711002996
[14.] Wilhelm K, Boyce P, Brownhill S. The relationship between interpersonal sensitivity, anxiety disorders and major depression. Journal of Affective Disorders. 2004; 79:33-41. doi.org/10.1016/S0165-0327(02)00069-1
[15.] Otani K, Suzuki A, Ishii G, Matsumoto Y, Kamata M. Relationship of interpersonal sensitivity with dimensions of the temperament and character inventory in health subjects. Comprehensive Psychiatry. 2008; 49:184-7. doi.org/10.1016/j.comppsych.2007.09.004
[16.] O'Connor LE, Berry JW, Weiss J, Gilbert, P. Guilt, fear, submission, and empathy in depression. Journal of Affective Disorders. 2002; 71:19-27. doi.org/10.1016/S0165-0327(01)00408-6
[17.] Garaigordobil M, Perez J, Mozaz M. Self-concept, self-esteem and psychopathological symptoms. Psicothema. 2008; 20:114-23. http:// www.psicothema.com/pdf/3436.pdf
[18.] Bowlby J. Attachment and Loss (Vol. 1). London, England: Hogarth Press; 1969.
[19.] Erozkan A. The analysis of university student's interpersonal sensitiveness and rejection sensitiveness. Journal of Gazi University Kirsehir Faculty of Education. 2004; 5(2):85-98. http://kefad.ahievran. edu.tr/archieve/pdfler/Cilt5Sayi2/JKEF_5_2_2004_85_98.pdf
[20.] Erozkan A. Interpersonal sensitivity and depression levels of university students. Journal of Social Sciences and Humanities Researches Mugla University. 2005; 14(1):129-55. http://www.infolla.com/dosyalar/artic leextension7635841427813258961_151-211-1-PB.pdf
[21.] Lammintakanen J, Kivinen T. Continuing professional development in nursing: does age matter? Journal of Workplace Learning. 2012; 24(1):34-47. http://www.emeraldinsight.com/doi/pdfplu s/10.1108/13665621211191096
[22.] Hamid S, Malik A, Kamran I, Ramzan M. Job satisfaction among nurses working in the private and public sectors: a qualitative study in tertiary care hospitals in Pakistan. J Multidiscip Healthc. 2014; 7:25. https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC3887073/
[23.] Tyson D, Pongruengphant R. Five-year follow-up study of stress among nurses in public and private hospitals in Thailand. International Journal of Nursing Studies. 2004; 41:247-54. doi.org/10.1016/S0020-7489(03)00134-2
[24.] Mrayyan MT, Modallal R, Awamreh K, et al. Readiness of organizations for change, motivation and conflict-handling intentions: senior nursing students' perceptions. Nurse Education in Practice. 2008; 8(2):120-8. doi.org/10.1016/j.nepr.2007.04.001
[25.] Pillay R. Work satisfaction of professional nurses in South Africa: a comparative analysis of the public and private sectors. Human Resources for Health. 2009; 7(15):1-10. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC2650673/
[26.] Abualrub RF, Omari FH, Al-Zaru IM. Support, satisfaction and retention among Jordanian nurses in private and public hospitals. International Nursing Review. 2009; 56:326-32. doi. org/10.1111/j.1466-7657.2009.00718.x. http://onlinelibrary.wiley. com/doi/10.1111/j.1466-7657.2009.00718.x/epd
[27.] Ozgur G, Yildirim S, Aktas N. Determination of operating room and intensive care nurse's mental health in the University hospital. Journal of Cumhuriyet University School of Nursing. 2008; 12(2): 21-30. http:// eskidergi.cumhuriyet.edu.tr/dergi.php?name1=hemsirelikyo&yil=200 8&cilt=12&sayi=2
[28.] Zhang Y, Punnett L, Mawn B, Gore R. Working conditions and mental health of nursing staff in nursing homes. Issues in Mental Health Nursing. 2016; 37(7):485-92. doi.or g/10.3109/01612840.2016.1162884
[29.] Gershengorn HB, Garland A. Who should be at the bedside 24/7: doctors, families, nurses? Seminars in Respiratory and Critical Care Medicine. 2016; 37(1):107-18. https://www.thieme-connect.com/ products/ejournals/html/10.1055/s-0035-1570350
[30.] Urden LD. Critical care nursing practice. In: Urden LD, Stacy K, Lough M, eds. Critical Care Nursing: Diagnosis and Management. 7th ed. USA: Mosby; 2014:1-13.
[31.] Stalperss D, Van der Linden D, Kaljouw MJ, Schuurmans MJ. Nurse perceived quality of care in intensive care units and associations with work environment characteristics: a multicentre survey study. Journal of Advanced Nursing. 2017; 73(6):1482-1490. doi.org/10.1111/ jan.13242.
[32.] Unal A, Seren S. Employment of nurses in non-nursing departments and evaluation of causes. Journal of Electronic Dokuz Eylul University School of Nursing. 2010; 3(1):23-29. http://acikerisim.deu.edu.tr/ xmlui/bitstream/handle/12345/4545/2329_pdf. pdf?sequence=1&isAllowed=y
ADEVIYE AYDIN *
DUYGU HICDURMAZ *
Bu calisma yuksek lisans tezinden uretilmis olup, 2014 yilinda Malta'da duzenlenmis olan "3rd HORATIO European Festival of Psychiatric Nursing" isimli kongrede sozel bildiri olarak sunulmustur.
* A Aydin, Ars.Gor., Dr.; D Hicdurmaz, Yrd. Doc. Dr.
Hacettepe Universitesi Hemsirelik Fakultesi Psikiyatri Hemsireligi Anabilim Dali, Ankara
Yazisma Adresi / Address for Correspondence:
Adeviye Aydin, Ars. Gor., Dr., Hacettepe Universitesi Hemsirelik Fakultesi, Adnan Saygun Caddesi D Bloklari 1. Kat
Samanpazari / Ankara
Tel.: 0 312 324 20 13 Faks: 0 312 312 70 85
Gelis Tarihi: 25.10.2016, Kabul Tarihi: 25.05.2017
Table 1. Number of nurses included in the sample at hospitals with a minimum capacity of 100 beds and located within the borders of metropolitan municipality in Ankara HOSPITALS RESEARCH SAMPLE PERCENTAGE POPULATION (%%) State hospitals Hospital site 1 108 5 1.25 Hospital site 2 55 2 0.50 Hospital site 3 159 14 3.50 Hospital site 4 292 15 3.75 Hospital site 5 90 5 1.25 Hospital site 6 694 30 7.50 Hospital site 7 551 24 6.00 Hospital site 8 439 22 5.50 Hospital site 9 442 20 5.00 Hospital site 10 466 20 5.00 Hospital site 11 118 8 2.00 Hospital site 12 266 12 3.00 Hospital site 13 91 5 1.25 Hospital site 14 255 11 2.75 Hospital site 15 84 5 1.25 Hospital site 16 61 3 0.75 Hospital site 17 237 10 2.50 Hospital site 18 396 22 5.50 Hospital site 19 228 10 2.50 Hospital site 20 58 2 0.50 University hospitals Hospital site 21 702 32 8.00 Hospital site 22 512 22 5.50 Hospital site 23 533 14 3.50 Hospital site 24 137 9 2.25 Hospital site 25 229 12 3.00 Hospital site 26 653 37 9.25 Hospital site 27 140 6 1.50 Private hospitals Hospital site 28 90 4 1.00 Hospital site 29 115 5 1.25 Hospital site 30 125 5 1.25 Hospital site 31 150 6 1.50 Hospital site 32 34 1 0.25 Hospital site 33 55 2 0.50 Total 8565 400 100.00 Table 2. Mean scores of interpersonal sensitivity of the nurses (n=400). INTERPERSONAL SENSITIVITY M [+ or -] SD EXPECTED RANGES ACCORDING TO SCALE Total interpersonal 81.43 [+ or -] 13.54 36-144 sensitivity Interpersonal awareness 15.01 [+ or -] 2.74 7-28 Need for approval 16.72 [+ or -] 3.60 8-32 Separation anxiety 15.64 [+ or -] 3.25 7-28 Timidity 19.76 [+ or -] 4.22 8-32 Fragile inner-self 14.30 [+ or -] 3.73 6-24 Table 3. Mean scores of interpersonal sensitivity according to nurses' characteristics INTERPERSONAL SENSITIVITY Total Interpersonal Sensitivity M [+ or -] SD 26 years and less (a) 83.47 [+ or -] 10.90 (n=78) 27-30 years (b) (n=76) 80.27 [+ or -] 12.88 31-34 years (c) (n=83) 78.21 [+ or -] 15.94 AGE 35-38 years (d) (n=71) 83.30 [+ or -] 12.40 39 years and more (e) 82.20 [+ or -] 14.16 (n=92) Statistical analysis * F=2.18 p=.070 * Tukey HSD test State hospital (a) 82.59 [+ or -] 14.14 (n=245) University hospital (b) 80.14 [+ or -] 12.21 HOSPITALS (n=132) Private hospital (c) 76.52 [+ or -] 13.03 (n=23) Statistical analysis * F=3.05 p=. 050 * Tukey HSD test Less than 2 years (a) 84.25 [+ or -] 11.30 (n=51) 2 -5 years (b) 79.91 [+ or -] 11.79 YEARS OF (n=58) EXPERIENCE 5 -10 years (c) 79.76 [+ or -] 13.93 AS NURSE (n=78) 10 -15 years (d) 78.48 [+ or -] 15.10 (n=73) 15-20 years (e) 85.68 [+ or -] 12.86 (n=62) 20 years' more than 81.78 [+ or -] 13.88 (n=78) Statistical analysis * F=2.81 p=. 016 * Tukey HSD test d<e Internal diseases units (a) 82.35 [+ or -] 13.30 (n=119) Surgical units (b) 81.58 [+ or -] 13.09 (n=115) UNITS Intensive care units (c) 78.30 [+ or -] 13.66 (n=79) Polyclinics (d) (n=79) 86.29 [+ or -] 13.62 Other units (e) (n=32) 76.84 [+ or -] 13.05 Statistical analysis * F=4.00 p=.003 * Tukey HSD test c<d, e<d INTERPERSONAL SENSITIVITY Interpersonal Awareness M [+ or -] SD 26 years and less (a) 15.42 [+ or -] 2.45 (n=78) 27-30 years (b) (n=76) 14.90 [+ or -] 2.50 31-34 years (c) (n=83) 14.23 [+ or -] 3.04 AGE 35-38 years (d) (n=71) 15.56 [+ or -] 2.93 39 years and more (e) 15.05 [+ or -] 2.62 (n=92) Statistical analysis * F= 2.93 p=.021 * Tukey HSD test a>c, c<d State hospital (a) 15.18 [+ or -] 2.84 (n=245) University hospital (b) 14.82 [+ or -] 2.57 HOSPITALS (n=132) Private hospital (c) 14.35 [+ or -] 2.59 (n=23) Statistical analysis * F=1.47 p=. 232 * Tukey HSD test Less than 2 years (a) 15.88 [+ or -] 2.41 (n=51) 2 -5 years (b) 14.79 [+ or -] 2.25 YEARS OF (n=58) EXPERIENCE 5 -10 years (c) 14.53 [+ or -] 2.81 AS NURSE (n=78) 10 -15 years (d) 14.30 [+ or -] 2.90 (n=73) 15-20 years (e) 16.00 [+ or -] 3.08 (n=62) 20 years' more than 14.97 [+ or -] 2.46 (n=78) Statistical analysis * F=4.36 p=.001 * Tukey HSD test a>d, d<e Internal diseases units (a) 15.23 [+ or -] 2.80 (n=119) Surgical units (b) 15.03 [+ or -] 2.54 (n=115) UNITS Intensive care units (c) 14.39 [+ or -] 3.00 (n=79) Polyclinics (d) (n=79) 15.87 [+ or -] 2.55 Other units (e) (n=32) 14.25 [+ or -] 2.50 Statistical analysis * F=3.22 p=.013 * Tukey HSD test c<d INTERPERSONAL SENSITIVITY Need for approval M [+ or -] SD 26 years and less (a) 17.38 [+ or -] 3.03 (n=78) 27-30 years (b) (n=76) 16.69 [+ or -] 3.31 31-34 years (c) (n=83) 16.10 [+ or -] 3.96 AGE 35-38 years (d) (n=71) 17.23 [+ or -] 3.78 39 years and more (e) 16.72 [+ or -] 3.60 (n=92) Statistical analysis * F=1.85 * Tukey HSD test p=.119 State hospital (a) 16.88 [+ or -] 3.83 (n=245) University hospital (b) 16.61 [+ or -] 3.23 HOSPITALS (n=132) Private hospital (c) 15.65 [+ or -] 2.96 (n=23) Statistical analysis * F=1.33 p=. 266 * Tukey HSD test Less than 2 years (a) 17.39 [+ or -] 3.07 (n=51) 2 -5 years (b) 16.22 [+ or -] 3.16 YEARS OF (n=58) EXPERIENCE 5 -10 years (c) 16.79 [+ or -] 3.42 AS NURSE (n=78) 10 -15 years (d) 16.49 [+ or -] 4.02 (n=73) 15-20 years (e) 17.47 [+ or -] 3.68 (n=62) 20 years' more than 16.19 [+ or -] 3.84 (n=78) Statistical analysis * F=1.52 p=.182 * Tukey HSD test Internal diseases units (a) 17.08 [+ or -] 3.80 (n=119) Surgical units (b) 16.51 [+ or -] 3.10 (n=115) UNITS Intensive care units (c) 16.30 [+ or -] 3.40 (n=79) Polyclinics (d) (n=79) 17.30 [+ or -] 4.20 Other units (e) (n=32) 16.13 [+ or -] 3.81 Statistical analysis * F=1.25 p=. 288 * Tukey HSD test INTERPERSONAL SENSITIVITY Separation Anxiety M [+ or -] SD 26 years and less (a) 16.22 [+ or -] 2.87 (n=78) 27-30 years (b) (n=76) 15.42 [+ or -] 3.21 31-34 years (c) (n=83) 15.04 [+ or -] 3.64 AGE 35-38 years (d) (n=71) 15.87 [+ or -] 2.86 39 years and more (e) 15.72 [+ or -] 3.44 (n=92) Statistical analysis * F=1.53 * Tukey HSD test p=.192 State hospital (a) 15.78 [+ or -] 3.40 (n=245) University hospital (b) 15.45 [+ or -] 2.88 HOSPITALS (n=132) Private hospital (c) 15.30 [+ or -] 3.60 (n=23) Statistical analysis * F=0.55 p=. 577 * Tukey HSD test Less than 2 years (a) 16.25 [+ or -] 3.19 (n=51) 2 -5 years (b) 15.45 [+ or -] 3.20 YEARS OF (n=58) EXPERIENCE 5 -10 years (c) 15.46 [+ or -] 3.11 AS NURSE (n=78) 10 -15 years (d) 15.16 [+ or -] 3.49 (n=73) 15-20 years (e) 16.27 [+ or -] 2.95 (n=62) 20 years' more than 15.51 [+ or -] 3.41 (n=78) Statistical analysis * F=1.27 p=. 277 * Tukey HSD test Internal diseases units (a) 16.09 [+ or -] 3.29 (n=119) Surgical units (b) 15.63 [+ or -] 3.28 (n=115) UNITS Intensive care units (c) 15.05 [+ or -] 3.11 (n=79) Polyclinics (d) (n=79) 16.07 [+ or -] 3.29 Other units (e) (n=32) 14.72 [+ or -] 2.96 Statistical analysis * F=2.14 p=.075 * Tukey HSD test INTERPERSONAL SENSITIVITY Timidity M [+ or -] SD 26 years and less (a) 20.13 [+ or -] 3.49 (n=78) 27-30 years (b) (n=76) 19.27 [+ or -] 3.84 31-34 years (c) (n=83) 18.90 [+ or -] 4.45 AGE 35-38 years (d) (n=71) 20.06 [+ or -] 4.43 39 years and more (e) 20.41 [+ or -] 4.60 (n=92) Statistical analysis * F=1.94 * Tukey HSD test p=.102 State hospital (a) 20.12 [+ or -] 4.39 (n=245) University hospital (b) 19.4l [+ or -] 3.87 HOSPITALS (n=132) Private hospital (c) 17.9l [+ or -] 3.85 (n=23) Statistical analysis * F=3.59 p=. 029 * Tukey HSD test a>c Less than 2 years (a) 20.27 [+ or -] 3.78 (n=51) 2 -5 years (b) 20.14 [+ or -] 3.52 YEARS OF (n=58) EXPERIENCE 5 -10 years (c) 18.73 [+ or -] 3.99 AS NURSE (n=78) 10 -15 years (d) 18.60 [+ or -] 4.56 (n=73) 15-20 years (e) 20.71 [+ or -] 4.10 (n=62) 20 years' more than 20.49 [+ or -] 4.62 (n=78) Statistical analysis * F=3.46 p=. 004 * Tukey HSD test d<e Internal diseases units (a) 19.66 [+ or -] 4.42 (n=119) Surgical units (b) 19.83 [+ or -] 4.07 (n=115) UNITS Intensive care units (c) 19.13 [+ or -] 4.20 (n=79) Polyclinics (d) (n=79) 21.56 [+ or -] 3.96 Other units (e) (n=32) 18.31 [+ or -] 3.62 Statistical analysis * F=4.04 p=. 003 * Tukey HSD test a<d, c<d, d<e INTERPERSONAL SENSITIVITY Fragile inner-self M [+ or -] SD 26 years and less (a) 14.32 [+ or -] 3.03 (n=78) 27-30 years (b) (n=76) 13.99 [+ or -] 3.71 31-34 years (c) (n=83) 13.96 [+ or -] 4.39 AGE 35-38 years (d) (n=71) 14.58 [+ or -] 3.27 39 years and more (e) 14.64 [+ or -] 3.98 (n=92) Statistical analysis * F=0.60 * Tukey HSD test p=.666 State hospital (a) 14.64 [+ or -] 3.79 (n=245) University hospital (b) 13.85 [+ or -] 3.39 HOSPITALS (n=132) Private hospital (c) 13.30 [+ or -] 4.59 (n=23) Statistical analysis * F=2.81 p=. 061 * Tukey HSD test Less than 2 years (a) 14.45 [+ or -] 3.16 (n=51) 2 -5 years (b) 13.31 [+ or -] 3.10 YEARS OF (n=58) EXPERIENCE 5 -10 years (c) 14.24 [+ or -] 4.12 AS NURSE (n=78) 10 -15 years (d) 13.92 [+ or -] 3.80 (n=73) 15-20 years (e) 15.23 [+ or -] 3.65 (n=62) 20 years' more than 14.62 [+ or -] 3.97 (n=78) Statistical analysis * F=1.89 p=. 095 * Tukey HSD test Internal diseases units (a) 14.30 [+ or -] 3.50 (n=119) Surgical units (b) 14.57 [+ or -] 3.66 (n=115) UNITS Intensive care units (c) 13.43 [+ or -] 3.72 (n=79) Polyclinics (d) (n=79) 15.47 [+ or -] 4.12 Other units (e) (n=32) 13.44 [+ or -] 3.62 Statistical analysis * F=3.08 p=.016 * Tukey HSD test c<d
|Printer friendly Cite/link Email Feedback|
|Author:||Aydin, Adeviye; Hicdurmaz, Duygu|
|Publication:||Journal of Education and Research in Nursing|
|Date:||May 1, 2017|
|Previous Article:||Investigating the reasons of nurses' requests for leaving their institution in an education and research hospital/Bir egitim arastirma hastanesinde...|
|Next Article:||The views of nurses on nutritional assessment and nutritional support of hospitalized patients/ Yatan hastalarin nutrisyonel degerlendirme ve...|