Aim: To clarify the concept of psychological safety in a healthcare context and to provide the first theoretical framework for improving interpersonal relationships in the workplace to better patient care.Design: A Rodgers’ concept analysis.Methods: The concept analysis was conducted using a systematic search strategy on PubMed, CINAHL, PsycINFO and Ichushi‐Web.Results: An analysis of 88 articles studying psychological safety in health care identified five attributes: perceptions of the consequences of taking interpersonal risks, strong interpersonal relationships, group‐level phenomenon, safe work environment for taking interpersonal risks and non‐punitive culture. The antecedents included structure/system factors, interpersonal factors and individual factors. The four consequences included performance outcomes, organizational culture outcomes, and psychological and behavioural outcomes.

Aims: The aim of this study was to examine the reliability and validity of the Practice Environment Scale of the Nursing Work Index (PES‐NWI) for hospital nurses in Japan.Design: A cross‐sectional mail survey.Methods: Participants in this study were 1,219 full‐time ward nurses from 27 hospitals in Japan, using 31 items of the Japanese version of the PES‐NWI questionnaire, from December 2008‐March 2009. Construct validity, criterion‐related validity and internal consistency of the PES‐NWI were tested.Results: The PES‐NWI showed reliable internal consistency. The five‐factor structure was supported by confirmatory factor analysis. The PES‐NWI correlated significantly with job satisfaction, burnout and the nurses’ intention to stay on the job, supporting criterion‐related validity.

Little is known about whether and how local-level resources regarding home care are associated with the prevalence of home deaths. We aimed to investigate whether geographic patterns of the resources for home care were associated with the prevalence of home deaths, taking spatial variation into consideration. We conducted an ecological cross-sectional study in Japan using nationwide data in 2014. The areal unit was the municipality, the smallest administrative unit in Japan. We investigated the association between the percentage of home deaths and the resources of home care support clinics with available 24-hour-a-day functions, considering the geographic effect of neighboring municipalities by applying a geographically weighted regression model. The mean and standard deviation of the percentages of home deaths were 11.4% (5.0%), and those of the number of home care support clinics per 10,000 elderly population were 3.4 (3.7). The percentages of home deaths in neighboring municipalities tended to be significantly correlated (Moran’s I 0.34, p<0.001). Adjusting for the number of hospital beds, total population, and the socio-economic status of municipality, the results of an ordinary least squares regression model showed a positive correlation between the percentage of home deaths and the local resources for home care support clinics per 10,000 elderly population (regression coefficient 0.15, 95% confidence interval 0.07, 0.22), while the existence of spatial autocorrelation of the residual was suggested (Moran’s I of the residual 0.227, p<0.001). The geographically weighted regression model showed local regression coefficients varying across municipalities with a better model fit over the analogous ordinary least squares model (adjusted R² 0.414 vs. 0.131). Home deaths were more prevalent in municipalities with greater home care resources. This association was geographically varied and further strengthened in some areas.

Despite societal efforts to alleviate the challenges, caregiving seems to constitute a substantial burden and source of stress for many families of older adults in Japan. However, precise information on the physical health of caregivers, based on objective data, is not available. The purpose of this study was to improve the understanding of the physical health of Japanese family caregivers using objective indicators and a comparative research design. A cross-sectional, comparative study was conducted among family caregivers and their non-caregiver counterparts. Surveyors visited caregivers in their homes to administer a questionnaire survey, measure their blood pressure, and collect blood samples using a kit. Blood samples were tested for LDL-Cholesterol, HDL-Cholesterol, AST, ALT, γ-GTP, uric acid, creatinine and HbA1c. Non-caregiver data were collected at a university-based health checkup center. We compared 149 caregivers with 149 sex- and age-matched non-caregivers using conditional logistic regression analyses to examine the impact of caregiving, adjusting for multiple control variables. Analyses were conducted separately for men and female. The prevalence of high blood pressure was significantly higher among caregivers than non-caregivers (male: 72.7% among caregivers vs. 40.9% among non-caregivers, female: 57.1% vs. 27.6%, respectively). After adjusting for related sociodemographic and health factors, high blood pressure remained significantly more prevalent among caregivers than non-caregivers, only among female (adjusted OR=2.16, 95% CI [1.14, 4.08]). Female caregivers showed lower eGFR than their non-caregiver counterparts (adjusted OR=6.54, 95% CI [2.38, 17.91]). No significant differences were observed between the two groups on any other indicators. Results suggest that female caregivers are at a higher risk of conditions such as cerebral, cardiovascular or kidney diseases than non-caregivers. Steps must be taken to identify caregivers with high blood pressure and lowered eGFR and provide them with the support they need before these risk factors develop into serious diseases.

Aim his study aimed to identify the effects of authentic leadership, structural empowerment, and forms of communication as antecedent factors of workplace social capital in nursing. Background Enhancing workplace social capital for nurses by management requires identifying antecedent factors of workplace social capital focusing on work environment and relationships between members. Methods In 2019, self‐administered questionnaires were sent to all nurses working on the general wards of two university hospitals in Japan. A multilevel analysis was conducted to evaluate the relationships between perceived workplace social capital—the dependent variable—and authentic leadership, structural empowerment, and forms of communication—the individual‐ and ward‐level independent variables. Results Data from 463 nurses and 28 nurse managers were analyzed (valid response rates = 38.0% and 58.3%, respectively). Their average age was 28.64 years (Standard deviation: 7.00), and 93.5% were female. Ward‐level authentic leadership and semi‐formal communication were found to be significantly related to workplace social capital. Conclusion More authentic leadership and communication to promote mutual understanding between members can foster workplace social capital among hospital nurses. These findings can help inform effective workplace training in hospitals. Implications for Nursing Management Workplace social capital can be produced by improved management, environment, and communication opportunities.

Nursing shortage is a global and priority issue. Affective commitment has been identified as a key to retention in the workplace. Exploring the way to promote the nurse's affective commitment is necessary to maintain the nursing workforce and care quality. The staff nurse's organizational justice (procedural and interactional justice) and the manager's condition of mental health have the potential to be related to the staff nurse's affective commitment. To explore the impact on the nurse's affective commitment from procedural and interactional justices at individual and unit levels and the manager's mental health. A multi-site longitudinal design. Nine Japanese hospitals with more than 200 beds and located in an area with more than 150,000 people. 385 staff nurses and their 42 nurse managers who completed both surveys in 2016 and 2017. We analyzed the data from a two-year national survey of the Work Environment for hospital Nurses in Japan part II. Nurse staff and their managers completed the surveys. This multilevel analysis performed four random intercept models on affective commitment and entered the variables of procedural and interactional justices and manager mental health into the models. The staff nurse's affective commitment was positively associated with procedural justice climate (unit level), interactional justice climate (unit-level), and the perception of interactional justice (individual justice). The manager's mental health (psychological distress) had a negative relationship with affective commitment. The climates of procedural and interactional justice, the individual perception of interactional justice, and the manager's mental health impacted the nurses’ affective commitment as a predictor of retention. Moreover, the perception of interactional justice and the organizational contexts (organizational justice climates and managers’ psychological distress) were mediated by affective commitment. Thus, support to maintain the manager's mental health is required to promote staff's affective commitment related to retention. None. Nurse staff's affective commitment was stimulated by interactional justice, two types of organizational justice climate, and the manager's mental health.