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Middle Nurse Managers (MNMs) play a pivotal role in translating organizational strategy into operational practice, ensuring care quality, and fostering team performance. Despite their importance, limited research has examined the factors influencing MNMs' competencies, particularly the interplay between individual and organizational determinants.
To examine the direct and moderating effects of self-efficacy and other organizational and individual factors on MNMs' competence knowledge and competence application across Italy.
A cross-sectional, multicenter study was conducted between September 2022 and December 2023 with the participation of 382 MNMs from public and private healthcare organizations. Data were collected using validated instruments, including the Chase Nurse Manager Competencies Scale, the Questionnaire on Experience and Work Evaluation (QEEW 2.0), and the Leadership Self-Efficacy Scale. Structural equation modeling (SEM) tested direct effects of educational appropriateness, leadership training intentions, autonomy, role clarity, and work complexity, and the moderating role of self-efficacy.
Educational appropriateness, autonomy, and role clarity were significantly associated with competence knowledge, while educational appropriateness and autonomy were associated with competence application. Self-efficacy was directly associated with both competence outcomes and significantly moderated the relationship between educational appropriateness and autonomy with each competence dimension, with positive associations observed among individuals with higher self-efficacy (β = −0.456 for knowledge; β = −0.459 for application, p < 0.001).
Self-efficacy was associated with competence outcomes and moderated the associations between organizational factors and competence. High self-efficacy may reduce reliance on perceived educational appropriateness, whereas lower self-efficacy increases its importance.
To describe the latest information on types of psychosocial interventions and their effectiveness on loneliness reduction among older adults in community and residential care settings, and the experience with these interventions.
Umbrella review.
The Joanna Briggs Institute methodology for umbrella reviews.
Cochrane Database of Systematic Reviews; Cumulative Index of Nursing and Allied Health Literature; Medline; Embase; Emcare; PsycINFO; ProQuest Dissertation & Thesis Global; Ovid Nursing Database; MedRxvi.
Twenty-two reviews were included. Seven major types of psychosocial intervention were identified: (1) social facilitation interventions, (2) psychological therapies, (3) health and social care provision, (4) animal-assisted interventions, (5) befriending interventions, (6) leisure and skill development, and (7) other interventions. Social facilitation interventions that provide synchronised interaction, psychological therapies, health and social care provision, and animal (−assisted) interventions demonstrated positive effects while leisure/skill development and befriending interventions warrant more rigorous evidence. Group settings, synchronised interaction and purpose-driven are identified as facilitators, whereas technological issues and safety issues are barriers to participation.
Seven types of psychosocial interventions are currently available for loneliness among community-dwelling older adults, and a positive effect in reducing loneliness was demonstrated in some types. Facilitators and barriers to their participation were synthesised. Two future research directions are suggested: (1) reviews on meaning-centred interventions to provide a comprehensive understanding and (2) implementation studies employing community-based paraprofessionals to promote programme scalability and accessibility.
Health and social care practitioners (e.g., nurses), researchers and policymakers are recommended to employ social facilitation interventions with synchronised interaction, psychological therapies, health and social care provision and animal-assisted interventions to address loneliness among community-dwelling older adults.
This review provided empirical information on available effective interventions to address loneliness among community-dwelling older adults. It also provided information for nurses to implement psychosocial interventions in the community.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
This study did not include patient or public involvement in its design, conduct or reporting.
PROSPERO CRD 42023482852, registered 25/11/2023
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