Aurelija Blaževičienė

Background/Objectives: The postpartum period is important for mother–infant bonding and breastfeeding self-efficacy. This study compared these outcomes between women receiving midwife-led and obstetrician-led intrapartum care. Methods: A prospective longitudinal observational study was conducted in two Lithuanian hospitals between September 2022 and July 2024. Women with low-risk births (n = 349) were assessed at 1–3 days and 6–8 weeks postpartum using the MIBS and BSES-SF. Results: In unadjusted comparisons, total MIBS scores showed a more stable pattern in the MW-led group (between-group difference in change, p = 0.004), and total BSES-SF scores increased within the MW-led group (p < 0.001). In adjusted analyses, the care setting was not independently associated with change in total MIBS or total BSES-SF scores. At 6–8 weeks postpartum, care setting (p = 0.041) and parity (p = 0.017) were associated with total BSES-SF scores. Conclusions: Selected unadjusted outcomes showed more favourable patterns in the MW-led setting, but adjusted analyses did not support an independent association between care setting and change in either principal outcome. Since each model was represented by a different hospital, observed associations cannot be attributed specifically to the professional care model.

Background: Adverse event reporting is a critical component of patient safety systems; however, nurses’ engagement in reporting is influenced not only by reporting procedures but also by broader organizational characteristics of the nursing practice environment. Although previous studies have examined reporting behaviors in various healthcare settings, limited evidence is available regarding how organizational factors influence nurses’ perceptions of adverse event reporting in post-Soviet primary healthcare systems. Objective: To examine the relationship between the nursing practice environment and nurses’ perceived benefits of adverse event reporting in primary healthcare settings in Kazakhstan and to explore the underlying factor structure of the nursing practice environment within this context. Methods: A cross-sectional survey was conducted among 468 primary healthcare nurses from six major cities in Kazakhstan. Participants were recruited through professional and educational networks using a targeted convenience sampling strategy. The nursing practice environment was assessed using the Revised Professional Practice Environment (RPPE) scale, while attitudes toward adverse event reporting were measured using the Reporting of Clinical Adverse Events Scale (RoCAES), focusing on the perceived benefits of reporting dimension. Exploratory factor analysis was performed to identify the underlying structure of the RPPE scale. Associations between EFA-derived factors and perceived benefits of adverse event reporting were examined using Spearman correlation analysis and multivariable logistic regression with adjustment for age, gender, city, and professional position. Results: Exploratory factor analysis identified three dimensions of the nursing practice environment: Professional Motivation and Teamwork, Interprofessional Conflict and Workplace Relationships, and Staffing Adequacy. Spearman correlation analysis demonstrated significant associations between all three factors and perceived benefits of adverse event reporting. Factor 1 (Professional Motivation and Teamwork) showed the strongest negative correlation with the outcome (r = −0.562, p < 0.001), followed by Factor 3 (Staffing Adequacy) (r = −0.434, p < 0.001), whereas Factor 2 (Interprofessional Conflict and Workplace Relationships) demonstrated a positive correlation (r = 0.227, p < 0.001). In the multivariable logistic regression model adjusted for age, gender, city, and professional position, Factor 1 was negatively associated with favorable perceptions of adverse event reporting (OR = 0.389, p < 0.001), whereas Factor 2 demonstrated a positive association (OR = 1.763, p = 0.002). Factor 3 and demographic variables were not statistically significant. Conclusions: The findings suggest that nurses’ perceptions of the benefits of adverse event reporting are influenced by multiple dimensions of the nursing practice environment. Exploratory factor analysis identified three organizational dimensions—Professional Motivation and Teamwork, Interprofessional Conflict and Workplace Relationships, and Staffing Adequacy—that were associated with reporting perceptions. After adjustment for demographic characteristics, Professional Motivation and Teamwork and Interprofessional Conflict and Workplace Relationships remained independently associated with perceived benefits of adverse event reporting, whereas demographic factors did not demonstrate significant associations. These findings highlight the importance of organizational conditions, communication processes, and professional engagement in shaping nurses’ attitudes toward adverse event reporting. Efforts to strengthen patient safety reporting systems should therefore extend beyond reporting procedures alone and include broader organizational strategies aimed at improving communication, teamwork, and supportive work environments within primary healthcare settings.

Background: Adverse event reporting is a critical component of patient safety systems; however, nurses’ engagement in reporting is influenced not only by reporting procedures but also by broader organizational characteristics of the nursing practice environment. Understanding how these organizational factors shape nurses’ perceptions of reporting systems remains insufficiently explored, particularly in post-Soviet healthcare contexts. Objective: This study aimed to examine how characteristics of the nursing professional practice environment are associated with nurses’ perceptions of the benefits of adverse event reporting in healthcare institutions in Kazakhstan. Methods: A cross-sectional survey was conducted among 468 nurses working in healthcare organizations across six major cities in Kazakhstan. The professional practice environment was assessed using the Revised Professional Practice Environment (RPPE) scale, while attitudes toward adverse event reporting were measured using the Reporting of Clinical Adverse Events Scale (ROCAES), specifically the “perceived benefits of reporting” dimension. Exploratory factor analysis, Spearman correlation analysis, and binary logistic regression were applied. Results: Exploratory factor analysis identified three key dimensions of the professional practice environment: professional motivation and teamwork, interprofessional conflict and communication, and staffing adequacy. Correlation analysis showed that several dimensions of the practice environment were negatively associated with perceived benefits of reporting. However, multivariable regression analysis revealed that cultural sensitivity, internal work motivation, and control over practice were positive predictors of perceived reporting benefits. This contrast between negative bivariate correlations and positive multivariable predictors highlights the complex organizational dynamics underlying nurses’ reporting attitudes. Conclusions: The findings indicate that nurses’ perceptions of adverse event reporting are embedded within a broader organizational ecology of nursing practice. Strengthening supportive professional environments—particularly those promoting motivation, autonomy, and culturally responsive care—may enhance nurses’ engagement in patient safety activities and improve the effectiveness of reporting systems.

Introduction: Childbirth is a transformative experience with lasting psychological and emotional effects. Evidence shows that birth experience influences maternal outcomes such as breastfeeding self-efficacy, mother–infant bonding, and postpartum depression, yet these associations in low-risk...

Introduction: A woman’s health and her child’s development are greatly affected by the responsiveness and support of the health system throughout the postpartum period. While various scholars have analysed the qualities of continuity of care and their effects during that phase, this article aims to reveal women’s experiences of postpartum care by analysing the impact of continuity of care through home visiting (HVCoC) versus standard care. Methods: Semi-structured interviews have been conducted in a qualitative study with 19 mothers of children under 1 year of age, who meet at least one criterion, such as living in poverty, being under 18 while giving birth, lacking permanent housing, residing in crisis centres due to domestic violence, or giving birth for the first time. All participants of the study have received either standard care or continuity of care through home visiting within the HVCoC model project. Results: The study has shown that women’s postpartum care experiences depend on the service delivery model. The standard care model, compared with the HVCoC model, has led to negative experiences for women across three dimensions: Relational, informational, and management continuity of care. Conclusions: While existing research has concluded that adequate postpartum support is related to the continuity of care model, this study’s findings reveal how different care organisation models affect the value women receive from their healthcare. Decision makers should develop postnatal care services that ensure continuity of care throughout pregnancy and the postpartum period by providing access to the same healthcare specialist for ongoing care.

Aim: To synthesize the contributions of this special issue examining how workplace culture, spirituality, religiosity, and mentorship shape positive clinical work environments and inform contemporary nursing management. Background: Amid workforce shortages, rising clinical complexity, and escalating moral demands, nursing management is often evaluated through operational metrics that fail to capture the ethical and relational foundations of sustainable practice. Growing evidence highlights the importance of organizational culture, meaning‐making, and inclusive leadership in supporting nurse retention and well‐being. Design: Editorial synthesis of contributions within the special issue. Results: The papers demonstrate that workplace culture is enacted through everyday leadership practices, ethical clarity, and relational consistency, directly influencing psychological safety and professional commitment. Spirituality is framed as a professional resource supporting meaning‐making and resilience when reflection and dialog are enabled. Religiosity and cultural diversity require culturally responsive leadership to foster trust and inclusion. Mentorship emerges as a strategic leadership function that strengthens confidence, moral coherence, and retention. Collectively, the contributions shift attention from individual resilience to organizational stewardship of ethical and relational infrastructure. Conclusions: Positive work environments are intentionally shaped through leadership that governs culture, inclusion, and mentorship alongside operational performance. Implications for Nursing Management: Nurse managers must extend their focus beyond operational performance to stewardship of culture and ethical climate. Workplace culture, spirituality, religiosity, and mentorship are structural drivers of psychological safety, retention, and professional commitment. Leaders should foster inclusive, respectful environments that support ethical dialog and cultural humility and formalize mentorship as a strategic workforce priority. Embedding values‐based and relational leadership within governance frameworks is essential for sustaining workforce resilience.

Background/Objectives: The implementation of advanced practice nursing in Kazakhstan is aimed at improving the accessibility and quality of primary healthcare. One of the key indicators of the effectiveness of this model is patient satisfaction, which reflects the perceived quality of care and directly influences treatment adherence. The aim of the study was to assess patient satisfaction with nurse-led consultations in primary healthcare institutions in Kazakhstan. Methods: A cross-sectional study was conducted using a questionnaire developed on the basis of Karin Bergman’s instrument and adapted to the Kazakhstani context. A total of 621 patients who attended independent nursing consultations in polyclinics in Aktobe, Almaty, Astana, and the village of Merke participated in the survey. Descriptive statistics and Pearson’s χ² test were applied, with statistical significance set at p < 0.05. Results: The majority of respondents were women, with a median age of 61 years. Awareness of independent consultations was higher among patients who regularly visited nurses (97.1% vs. 86.9%; p < 0.006). High satisfaction levels were associated with service accessibility, quality of examination, and clarity of recommendations. Among regular visitors, 99.2% reported satisfaction with the nurse’s work, and 76.6% rated the service as “excellent”. In contrast, patients with irregular visits more often reported dissatisfaction due to insufficient attention and limited knowledge of nurses. Conclusions: The findings confirm a high level of patient satisfaction with advanced practice nursing services and highlight the importance of this model in strengthening primary healthcare in Kazakhstan.

Aim: To describe the self‐reported mental health of nurses from 35 countries who worked during the COVID‐19 pandemic.Background: There is little occupationally specific data about nurses' mental health worldwide. Studies have documented the impact on nurses’ mental health of the COVID‐19 pandemic, but few have baseline referents.Methods: A descriptive, cross‐sectional design structured the study. Data reflect a convenience sample of 9,387 participants who completed the opt‐in survey between July 31, 2022, and October 31, 2023. Descriptive statistics were run to analyze the following variables associated with mental health: Self‐reports of mental health symptoms, burnout, personal losses during the pandemic, access to mental health services, and self‐care practices used to cope with pandemic‐related stressors. Reporting of this study was steered by the STROBE guideline for quantitative studies.Results: Anxiety or depression occurred at rates ranging from 23%–61%, with country‐specific trends in reporting observed. Approximately 18% of the sample reported experiencing some symptoms of burnout. The majority of nurses’ employers did not provide mental health support in the workplace. Most reported more frequently engaging with self‐care practices compared with before the pandemic. Notably, 20% of nurses suffered the loss of a family member, 35% lost a friend, and 34% a coworker due to COVID‐19. Nearly half (48%) reported experiencing public aggression due to their identity as a nurse.Conclusions: The data obtained establish a basis for understanding the specific mental health needs of the nursing workforce globally, highlighting key areas for service development.Implications for nursing policy: Healthcare organizations and governmental bodies need to develop targeted mental health support programs that are readily accessible to nurses to foster a resilient nursing workforce.