The article is entitled “Predictors of Professional Nursing Practice Behaviors in Hospital Settings” and the title clearly reflects the background and purpose of the study. In particular, considering the objective of the article, which is exploring the personal and environmental factors, which affect the behaviors related to professional nursing, one can assume that the title fully correlates with the direction of the study. The keywords of the title are “predictors”, “nursing behaviors” and “hospital”, and they clearly show that the researchers have examined the effect of a variety of factors, both internal and external on the extent to which hospital nurses use their professional skills. The title is a successful generalization of the study and the discussion, and each of the words describes a certain global aspect of the study (object, goals, and scope), so there are no distracting or redundant words.
Although the author does not use abstract in its classical form, she actually puts a well-structured summary of the article in its beginning. This outline contains such points as purpose, methods, results, and well many other elements. In the Methods and Results sections, the variables are delineated only generally, i.e. the independent ones include environmental and personal factors, which are not specified, whereas the dependent variables refer to the professional behaviors, mentioned without additional details. The abstract does not fully address all the major findings, as it does not include the results about the influence of education on the specified behaviors. However, the abstract is clear and comprehensive enough to give the reader the idea of the study due to the fact that the background information and conclusions of the discussion are included along with the key sections, so it is quite easy to evaluate the usefulness of the article after reading its abstract.
The research problem is not defined clearly in the introduction, so the reader must carefully examine the first paragraphs in order to come to the major problem, as the author starts with the shortage of nursing and further discusses several elements of the problem in three separate paragraphs. However, it needs to be noted that the problem is quite serious, as the author believes the lack of empowerment does not allow consistent self-realization of the nurses and might contribute to the shortage of nursing personnel. The theoretical rationale for the study is provided as the description of the model of magnet hospital, which elucidates why exactly such hospitals are characterized by the favorable atmosphere for the nurse’s professional development and, accordingly, identifies the common gaps in the functioning of the regular hospital. The author provides a theoretical framework, which introduces the environmental and personal factors (e.g. structural empowerment), their relationships with self-efficacy, but does not specify the exact empirical indicators of the construct of “nursing professional behavior”, so it does not fully correlate with the statement of the research problem. The hypotheses are not stated clearly, instead, the author briefly notes that she intends to test the conceptual framework. Contrarily, the research questions are provided in a separate section and stated in a clear and directional way, i.e. they follow the statement of the aims and each of them implies a certain direction, e.g. establishing a relationship between self-efficacy and structural empowerment. The literature review comprehensively covers the nature of the influence of various factors on professional nursing behaviors, but the author fails to conceptualize and operationalize the latter construct, so the reader has no idea of empirical indicators through which the author will measure these professional behaviors.
The description of the sample is sufficient, as the author mentions the size, important characteristics of the subjects (e.g. nurses’ narrow specialties), and the ways of selection. However, no principles like voluntariness or confidentiality are not mentioned so it is not clear how exactly the subject was convinced to participate. As the author describes the instruments she used (organization of questionnaires), one can evaluate their appropriateness and it needs to be noted that all of them are close-knit to the variable; e.g. self-efficacy is explored through “Opportunity, Information, Support, and Resources”, earlier presented as its components. All the instruments employed for measuring the interdependence between the variables are “time-honored”, i.e. tested in the earlier relevant investigations, so their validity was proven, but there is no information about their reliability. The actual materials needed for data collection are not mentioned, yet the author implies that the subjects were surveyed and mentions the number of items in each questionnaire. The article does not contain the schedule of all scientific procedures which comprise the study. The intended design is defined in detail: “This descriptive study used a comparative survey design” (Manojlovich, 2005, p.43). In light of the research problem, questions, and literature review, the other types of design and procedures would not allow answering the numerous questions the author poses, and descriptive design is justified by the fact that the question of nurses’ motivation was answered in the earlier studies and the use of survey is necessary due to the large size of questionnaires and sample which both exclude the opportunity of the interview or document analysis. Overall, the method section is organized logically and covers even the secondary details like the introduction of control variable and instrumental variable, so it allows repeating this research.
The results section is not organized into subsections, but its structure is consistent with the sequence of model testing. Due to the fact that the author uses formal questionnaires for quantitative studies with already established and tested coding patterns, one can assume that data coding does not distort the constructs intended for measurement and the “codes” thus reflect certain parts of the research goal. Data analysis procedures are fully related to the statement of the study questions and aims (e.g. the author questions the existence of a relationship and thus uses correlation as its statistical representation). As it has been noted above, the author states no hypotheses, but the key results are associated with the model she proposes for testing, i.e. they reveal how structural empowerment and self-efficacy reinforce one another and affect professional behavior. All schemes, tables, and other visual materials are clearly labeled and not fully repeated in the text. As for the organization, the indicators and coefficients presented in the tables are rated by significance (left to the right or top to the bottom).
As the author has a critical approach to her study, she clearly identifies the limitations: for instance, occurrences and processes, which can be measured with maximal exactness in a longitudinal study, was evaluated with a single assessment; the sample was selected from the single professional association, the MNA. By its content and context, the discussion section is connected with the introduction and statement of the problem, theoretical framework. In particular, the discussion section presents the reviewed theoretical model, corrected in accordance with the recent findings. The implications for both further research and clinical practice are addressed: in particular, the author notes the necessity of using long-term study for measuring continuous processes, associated with nursing practice behavior and the importance of using structural empowerment as a tool of improving the performance of the nursing staff.
As the conclusions logically derive from the salient findings, as the author extrapolates the priorities, suggested by the results to the field of clinical practice: “Work effectiveness may be viewed as a positive contributor to professional behaviors, whereas control over nursing practice is one of the characteristics of professional practice behaviors” (Manojlovich, 2005, p.46).
More than half of the references are recent in relation to the given study, which was conducted in 2005, i.e. the main part of the information comes from the papers published after the year 2000. The life of references demonstrates the breadth of information the author is using: several articles are dedicated to researching the causes of the recent shortage of nurses, other papers focus on the instruments of measuring nurses’ self-efficacy, whereas certain works provide merely theoretical models which Manojlovich employs. Bibliographic citations in the text comply with APA standards, i.e. each idea from the literature review is referenced and direct quotations are followed by page numbers.
As one can conclude, the article is organized in an optimal way, i.e. the author includes formal sections like introduction, methods, and results as well as the subheadings, needed to underline or separately discuss certain elements or issues. The study addresses the performance of professional nurses and the way of encouraging or empowering them in the hospital settings, so disabled individuals who receive nurses’ care might benefit from the application of the findings in practice. However, the study is not fully focused specifically on the provision of nursing services to individuals with certain impairments. The most important knowledge gained from the article refers to the finding that empowerment and positive external incentives are not sufficient for raising a nurse’s commitment, instead, it is necessary to work in the systemic and organized way on raising the specialist’s self-efficacy, as in this case, the extrinsic incentive turns into the intrinsic thus becoming more stable and producing positive results in the long-term perspective. The first strength of the given study is the development of the specific model or structured framework for improving nursing practice in hospitals and raising their commitment to and sense of responsibility for the strategy of the institution rather than realization of the specific daily duties. The second is the multifaceted apparatus of measuring the necessary relationships, as the researcher makes use of several questionnaires to address each aspect of the variable. However, the article would be more effective and understandable if hypotheses were identified in the text rather than in the scheme and nursing practice behaviors were conceptualized early in the introduction.
References
Manojlovich, M. (2005). Predictors of Professional Nursing Practice Behaviors in Hospital Settings. Nursing Research, 54(1), 41-47.