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Table 4 Themes and sub-themes of factors affecting nurses participate in health policy making

From: Factors influencing nurses participation in the health policy-making process: a systematic review

Main themes

Sub-themes

Factors

Nursing related factors

Nurses’ viewpoints on policy making

• Lack of priority of health policy for nurses (1)

• Not knowing the process of health policy as part of the tasks (1)

• The existence of psychological issues in active participation (2)

• Disapproval of nurses’ involvement in policymaking by others (2)

Lack of proper reaction by nurses

• Fear of facing different perspectives (1)

• Fear of confrontation with administration (1)

• Feeling powerless (2)

• Fear of facing new challenges (2)

Gaining experience and skills

• Lack of skills to engage in process of health polices (5)

• Building experience in the nursing (2)

• Limited skills in public relations (3)

• Improvement of their political skills (4)

• Lack of research skills (4)

Education and research system

• Lack of knowledge and education about the policy-making process (4)

• Lack of understanding of a complex political process (4)

• Lack of public understanding (3)

• Lack of access to research resources (3)

• Personal interest in political knowledge and information (3)

• Integrating Political education in the design nursing curriculum (3)

• Undertaking research in health policy (3)

• General deficiencies in nursing education (2)

• Inability of nurses to bring forward research evidence to inform policy formulation (1)

• Clarity in research directions (1)

• Building of supportive research environments (2)

• Strengthening nurses’ research capacity (2)

• Promotion of evidence based decision making in nursing practice (1)

• Providing International training opportunities for research and policy formulation (1)

Management and organizational factors

Creating communication networks

• Lack of communication from the top down (4)

• Lack of communication networks and bonding (2)

• Lack of sense of teamwork and collegiality (3)

• Lack of involvement with nursing organizations (1)

• Lack of national nursing association (1)

• Lack of professional interest groups (1)

• Use of technology and informatics (2)

• Lack of collective action amongst different nursing stakeholders (2)

• Existence of unity (2)

Gaining and sharing knowledge and information

• Lack of access to information (2)

• Lack of university nursing academics (2)

• Lack of college nursing educators (1)

• Lack of information sharing (2)

• Lack of sharing of policies (1)

• Getting new ideas from nursing literature (1)

• Utilizing evidence based information (2)

Providing specialized and motivated human resources

• Lack of access to key individuals (2)

• Increasing number of PhD nurses (1)

• Having an organizational commitment (1)

• Nurses motivation (1)

• Shortage of nursing (2)

Providing non-human resource

• Lack of time (5)

• Lack of money and other resources (8)

Establish effective leadership styles

• Combination of proactive leadership (1)

• Leadership development among nurses (1)

Establishment of incentive organizational structure

• Follow Health policy of top-down approach (2)

• Lack of enabling structures (5)

• Sufficient authority (1)

• The existence of a hierarchical system (2)

• Bottom-up approach (2)

• Clinical governance (1)

• Determining where the power lies in organizations (2)

Membership in advisory and policy making committees

• Lack of nurses’ membership in the Policy development committee (1)

• Membership in professional and or advocacy organizations (1)

Health policy outcomes and impact

• Correct role playing of policy making by nurses (1)

• Lack of health policy capacity (1)

• Dispersion in making policies (1)

• Different attitudes of health policy makers (2)

• Failure to make a difference by political activities (2)

Work environment

Environmental elements

• Existence of mental health issues among nurses (2)

• The negative image of nursing by others professions (3)

• Creation of an enabling environment (2)

• Creating more opportunities for participation of nurses (2)

External support

• Lack of support from political sector (2)

• Lack of support from government officials (1)

• Lack of support from professional organizations (1)

• Strong support from the national nursing association (1)

• Non-academic view of some physicians on the field of nursing (2)

Establishing fair and right work rules

• Heavy workload (2)

• Career development of nurses (1)

• Sex issues (2)

• Restrictions of Nursing recruitment (1)