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Accessible summary: What is known on the subject?: Nursing observations at night are conducted on psychiatric wards to ensure the safety and well‐being of patients as well as to reduce the risk of suicide or severe harm.To our knowledge, no studies have examined the lived experience of the psychiatric ward environment and of nursing observations at night. What does the paper add to existing knowledge?: The main complaint from patients was the constant interruption of their sleep, as most of the patients in this study were observed 2–4 times an hour. Their sleep was interrupted by (a) the light from torches shone into their faces by staff checking on their safety, (b) the noises produced by the opening and closing of bedroom/ward doors, and/or (c) staff talking to each other during the observation. Patients also reported that they found having somebody enter the room in the middle of the night intimidating and unsettling. What are the implications for practice?: Poor sleep has been associated with an increase in suicide risk and mental health problems.Identifying practices that promote sleep hygiene is vital.The study could be used to develop a Quality Improvement Project to improve patients' sleep and perhaps reduce duration of stay. Introduction: A fundamental component of nursing care is observations at night to ensure the well‐being of patients. However, there is no literature on the lived experience by inpatients of such observations or of the general environment of a psychiatric ward at night. Aim/Question: This study aims (a) to understand the lived experience of being an inpatient on a psychiatric ward at night with a focus on intermittent observations and (b) contribute to developing a tool to monitor the psychiatric ward environment for use in quality improvement projects. Method: Semi‐structured interviews were conducted with twelve inpatients from five psychiatric wards who had experienced intermittent observations at night. These interviews were subsequently transcribed and analysed using content analysis. Results: Environmental disturbances including light and noise, invasion of privacy and safety considerations on the ward all contributed to sleep disturbance. The unintended consequences of disturbances caused by intermittent night observations, and by staff in general and other patients formed the core of the inpatients' experience. We developed a clinical tool that could be used to identify the factors that are relevant on an individual ward. Discussion: Participants interviewed unanimously agreed that poor sleep quality had a significant negative impact on their psychological and social well‐being. These were discussed in relation to the environment and the experience of observations at night. Implications for nursing practice: Deprivation of inpatients' sleep is currently under‐reported, and the usefulness of intermittent observations at night in psychiatric wards is questioned. Much could be done to adjust the environment at night to support quality sleep and improve psychiatric symptoms. This paper aims to highlight the lived experience of patients to help bring improvements. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to report the findings of a qualitative case study that investigated abused women's experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care. Background Domestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England. Design Qualitative study with a case study design. Methods In line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016. Findings Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health. Conclusion Nurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important. [ABSTRACT FROM AUTHOR]

Tame S.L. (2013) The effect of continuing professional education on perioperative nurses' relationships with medical staff: findings from a qualitative study. Journal of Advanced Nursing 69(4), 817-827. doi: 10.1111/j.1365-2648.2012.06065.x Abstract Aims. To report perceived changes to UK perioperative nurses' relationships with medical staff following periods of formal, university-based study. Background. Continuing professional development is considered important for nursing internationally; however, practice changes may not result following formal study. The literature did not describe perioperative nurses' experiences of formal study, and it was believed differences may exist due to hierarchical interprofessional relationships in the operating theatre. Design. Descriptive, qualitative. Methods. Unstructured interviews ( N = 23) were conducted between 2006-2007 with a purposive sample of perioperative nurses who had recent experience of continuing professional education. All participants were employed by one National Health Service Trust in the North of England, UK. Audio-taped interviews were transcribed fully into the ethnograph computer-assisted qualitative data analysis programme and data coded and analysed to identify themes. Findings. The findings indicated that whilst continuing professional education did not have a direct impact on practice, development of increased knowledge and confidence facilitated participants' collaboration with and questioning of medical colleagues. Such increased interprofessional collaboration was attributed to indirectly enhancing patient care. Conclusion. Continuing professional education appeared to lead to intrinsic changes to practitioners rather than direct behavioural change. Nurses' increased knowledge and confidence affected the balance of power in the doctor-nurse relationship in British perioperative environments. This paper is of significance to perioperative nursing and may be transferable to other areas of care. [ABSTRACT FROM AUTHOR]

Aim This paper is a report of a qualitative study conducted as part of a randomized controlled trial comparing a lay-facilitated angina management programme with usual care. Its aim was to explore participants' beliefs, experiences, and attitudes to the care they had received during the trial, particularly those who had received the angina management intervention. Background Angina affects over 50 million people worldwide. Over half of these people have symptoms that restrict their daily life and would benefit from knowing how to manage their condition. Design A nested qualitative study within a randomized controlled trial of lay-facilitated angina management. Method We conducted four participant focus groups during 2008; three were with people randomized to the intervention and one with those randomized to control. We recruited a total of 14 participants to the focus groups, 10 intervention, and 4 control. Findings Although recruitment to the focus groups was relatively low by comparison to conventional standards, each generated lively discussions and a rich data set. Data analysis demonstrated both similarities and differences between control and intervention groups. Similarities included low levels of prior knowledge about angina, whereas differences included a perception among intervention participants that lifestyle changes were more easily facilitated with the help and support of a lay-worker. Conclusion Lay facilitation with the Angina Plan is perceived by the participants to be beneficial in supporting self-management. However, clinical expertise is still required to meet the more complex information and care needs of people with stable angina. [ABSTRACT FROM AUTHOR]

gibson j. & watkins c. (2011) People's experiences of the impact of transient ischaemic attack and its consequences: qualitative study. Journal of Advanced Nursing 68(6), 1707-1715. Abstract Aim. This paper is a report of a study of how people's experiences of transient ischaemic attack affect their perception of their health and their uptake of health maintenance measures. Background. Transient ischaemic attack is a well-recognized warning sign of subsequent stroke, but early diagnosis and management of risk factors can substantially reduce this risk. Even though the physical effects of a transient ischaemic attack are transient, it is known to negatively affect quality of life. However, no qualitative studies have explored the impact of transient ischaemic attack on people's everyday lives. Methods. Sixteen participants were recruited from a vascular surgery clinic in a district general hospital in North West England. All had a recent transient ischaemic attack. A qualitative grounded theory study using detailed interviews ( n = 21) was conducted. Findings. Participants experienced conflict between acknowledgement of the transient ischaemic attack as a significant illness episode with implications for their long-term health, and denial of its seriousness. Although they often ignored the initial signs, participants also experienced fear due to increased awareness of their risk of stroke. Often, they believed that they were having a permanent stroke. Many participants were prompted to seek medical advice by a family member or acquaintance. Having a transient ischaemic attack negatively changed their perception of their health and their quality of life, but some also viewed it as a positive event that had warned of their stroke risk and enabled them to take up health maintenance measures. Conclusions. Having a transient ischaemic attack permanently changes people's quality of life and their perception of their health, despite the transience of the symptoms. The ability of people to make positive health changes after a transient ischaemic attack to some extent ameliorates the negative effects of being aware of their heightened stroke risk. Their appreciation of their quality of life may also be enhanced. The transience of the symptoms and lack of knowledge of transient ischaemic attacks lead to delays in seeking medical advice. [ABSTRACT FROM AUTHOR]

hughes c., knibb w. & allan h. (2010) Laparoscopic surgery for endometrial cancer: a phenomenological study. Journal of Advanced Nursing 66(11), 2500-2509. Aim. This paper is a report of a study of women's perspectives on the experience of laparoscopic surgery for endometrial cancer. Background. Laparoscopic surgery is increasingly used to treat early endometrial cancer. It is associated with low levels of morbidity and is considered safe as cancer surgery, but research on quality of life and women's experiences is limited. Method. Heideggerian hermeneutic phenomenology was used to explore the experiences of 14 women who had undergone the procedure in two English cancer centres between February 2008 and July 2009. In-depth interviews were taped, transcribed and analysed using Colaizzi's framework. Findings. A phenomenological description was produced from five identified themes: having cancer, transfer of responsibility to the surgeon, information and support, independence, and normality. The experience of laparoscopic surgery was overshadowed by the presence of cancer. Fear and lack of knowledge played an important role in entrusting the surgeon with the responsibility for decision-making. Individual, unmet information needs focused on the practicalities of treatment and being in an unfamiliar situation and environment. Loss of control and vulnerability were associated with illness and surgery, but early postoperative mobility and reduced pain, facilitated rapid return to independence and maintained a sense of normality. Conclusion. Healthcare professionals should deliver care in early endometrial cancer in a way that recognizes the significance of the cancer diagnosis, the role of the surgeon in decision-making and the need for practical information. Women with endometrial cancer should have access to treatments that reduce dependency and maintain normality. [ABSTRACT FROM AUTHOR]

nicholson j., slade p. & fletcher j. (2010) Termination of pregnancy services: experiences of gynaecological nurses. Journal of Advanced Nursing 66(10), 2245–2256. Aim. This paper is a report of a study to identify the experience of gynaecological nurses involved with termination of pregnancy. Background. Staff involved with termination of pregnancy have been found to experience both positive and negative views. Varying processes and experiences for staff have been identified, from termination of pregnancy work being emotionally draining and stressful to there being a process of care that evolves with greater experience. Methods. A purposive sample of seven gynaecological nurses currently working in a termination of pregnancy service was recruited. Data were collected between October 2007 and January 2008 using interviews and standardized questionnaires. Transcripts of the interviews were analysed using Interpretive Phenomenological Analysis. Results. Eight superordinate themes emerged from the analysis: (1) Unconditional acceptance and understanding of termination of pregnancy, (2) Strategies for managing the demands and challenges, (3) What we do for patients and job satisfaction, (4) Challenges to unconditional acceptance, (5) Juggling the contrasting needs and demands of patients, (6) The most demanding aspects of the role, (7) The significance of personal experience and (8) The service context. Some of the experiences were interpreted as ways in which nurses justified their role. The themes were understood in terms of a balance between strains, coping and contextual influences. Conclusion. Providing a recognized supportive supervisory environment might allow for the acknowledgement of the unique challenges staff in termination of pregnancy services face, and might enhance a sense of validation within the organization and hence staff wellbeing. [ABSTRACT FROM AUTHOR]

Aim: To understand how advanced nurse practitioners use knowledge to inform their discharge decision‐making in the emergency department. Background: Advanced nurse practitioner roles have developed globally in a wide range of healthcare settings, including the emergency department, over the past few years. The scope of practice and training vary widely between countries. Little is known about how they use clinical knowledge in the emergency department. Design: An ethnographic study was undertaken in an emergency department in the North of England. Method: Data were collected by observation (n = 5) and semi‐structured interviews (n = 13) between September 2016 and June 2017. Interview transcripts and field notes were coded using Quirkos software. Thematic analysis was used to identify key themes. Findings: In boundary blurring with medicine, advanced nurse practitioners in the emergency department need to make timely, autonomous discharge decisions. Knowledge mobilization is messy and complex; however, shortcuts facilitate autonomous discharge decision‐making. More experienced advanced nurse practitioners rely less on shortcuts as they draw on experiential knowledge. Discussion: Boundary blurring in the advanced nurse practitioner role in the emergency department, requires reliable knowledge shortcuts. Support from senior colleagues and accessible smartphone apps enable advanced nurse practitioners to efficiently make discharge decisions. This study adds to previous research on how knowledge is managed in boundary blurring. Conclusion: Advanced nurse practitioners in the emergency department require timely access to relevant, up to date knowledge. This study has highlighted their preferred knowledge sources to inform discharge decision‐making. In boundary blurring, shortcuts enable ANPs to use knowledge efficiently to inform patient care in the emergency department. Impact: The findings increase our understanding of how to equip advanced nurse practitioners with knowledge to facilitate clinical decision‐making. Clinical managers should provide mentorship and relevant up to date knowledge shortcuts to ensure efficient, evidence‐based discharge decision‐making. [ABSTRACT FROM AUTHOR]

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Aims and objectives: To explore nurses' perceptions of the impact of a programme designed to train them to teach end‐of‐life care. Background: Central to national and international policies are the need for generalist healthcare staff to have education in end‐of‐life care. Much end‐of‐life care education is provided by specialist nurses who often have no specific education development to prepare them to teach. To address this gap, an Education Development Programme (EDP) was developed and delivered to specialist nurses. We report on the evaluation of the programme. Design: A qualitative programme evaluation methodology was adopted. Methods: Data were collected through focus groups, at three hospice education centres in North West England, with a total of 20 participants. Nurses who had completed the EDP were purposively sampled. Data were digitally audio‐recorded and subjected to thematic analysis to organise, reduce and refine the data. Ethical approval was obtained. COREQ guidelines have been adhered to in the reporting of this study. Results: Two main themes were identified; learning to teach and building skills to change teaching practice. Participants felt more confident and better prepared to teach. Conclusions: It cannot be assumed that specialist staff, with teaching in their role, have the skills to facilitate learning. This programme offers a potential method of improving facilitation skills for nurses who have an education element to their role. Relevance to clinical practice: Quality end‐of‐life care is only possible with a skilled workforce, confident and able to apply the principles of compassionate end‐of‐life care to everyday practice. Appropriately trained, specialist staff are better able to teach others how to deliver good quality end‐of‐life care. Specialist staff with teaching responsibilities should be provided with, or engage in, continuous professional development to develop their skills and improve their efficacy when teaching. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore why adherence to vital sign observations scheduled by an early warning score protocol reduces at night. Background: Regular vital sign observations can reduce avoidable deterioration in hospital. early warning score protocols set the frequency of these observations by the severity of a patient's condition. Vital sign observations are taken less frequently at night, even with an early warning score in place, but no literature has explored why. Design: A qualitative interpretative design informed this study. Methods: Seventeen semi‐structured interviews with nursing staff working on wards with varying levels of adherence to scheduled vital sign observations. A thematic analysis approach was used. Results: At night, nursing teams found it difficult to balance the competing care goals of supporting sleep with taking vital sign observations. The night‐time frequency of these observations was determined by clinical judgement, ward‐level expectations of observation timing and the risk of disturbing other patients. Patients with COPD or dementia could be under‐monitored, while patients nearing the end of life could be over‐monitored. Conclusion: In this study, we found an early warning score algorithm focused on deterioration prevention did not account for long‐term management or palliative care trajectories. Nurses were therefore less inclined to wake such patients to take vital sign observations at night. However, the perception of widespread exceptions and lack of evidence regarding optimum frequency risks delegitimising the early warning score approach. This may pose a risk to patient safety, particularly patients with dementia or chronic conditions. Relevance to clinical practice: Nurses should document exceptions and discuss these with the wider team. Hospitals should monitor why vital sign observations are missed at night, identify which groups are under‐monitored and provide guidance on prioritising competing expectations. early warning score protocols should take account of different care trajectories. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To investigate how mentors form judgements and reach summative assessment decisions regarding student competence in practice. Background: Competence assessment is a significant component of pre‐registration nursing programmes in the United Kingdom. Concerns exist that assessments are subjective, lack consistency and that mentors fail to judge student performance as unsatisfactory. Design: A two‐stage sequential embedded mixed‐methods design. Data collected 2012–2013. Methods: This study involved a whole student cohort completing a UK undergraduate adult nursing programme (N = 41). Stage 1: quantitative data on mentor conduct of assessment interviews and the final decision recorded (N = 330 from 270 mentors) were extracted from student Practice Assessment Documents (PADs). Stage 2: mentor feedback in student PADs was used in Stimulated Recall interviews with a purposive sample of final placement mentors (N = 17). These were thematically analysed. Findings were integrated to develop a theoretically driven model of mentor decision‐making. Results: Course assessment strategies and documentation had limited effect in framing mentor judgements and decisions. Rather, mentors amassed impressions, moderated by expectations of an “idealized student” by practice area and programme stage that influenced their management and outcome of the assessment process. These impressions were accumulated and combined into judgements that informed the final decision. This process can best be understood and conceptualized through the Brunswik's lens model of social judgement. Conclusion: Mentor decisions were reasoned and there was a shared understanding of judgement criteria and their importance. This impression‐based nature of mentor decision‐making questions the reliability and validity of competency‐based assessments used in nursing pre‐registration programmes. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the experiences of patients who have failed to maintain weight loss following the insertion of a laparoscopic adjustable gastric band (LAGB) for the treatment of morbid obesity. Background: Obesity is a global health problem resulting in physical, psychological and economic problems and presenting challenges for health services. Surgical intervention is an increasingly common approach to treatment; however, some patients do not sustain their weight loss following bariatric surgery and little is known about people’s longer-term experiences following LAGB insertion. Design: A narrative-based qualitative interview study. Methods: A purposive sample of ten participants who had undergone LAGB insertion for morbid obesity was recruited. Semistructured interviews were conducted in 2014. Thematic analysis identified codes and emerging themes common to the participants’ experiences. Findings: Three major themes emerged: living with the side effects, regret and lack of support. These reflect the difficulties participants experienced and provide new insights on why weight loss is not sustained after 2 years following surgery. Conclusion: Participants reported that the surgery had a detrimental effect on their lives and some regretted having the band inserted. These findings identify areas of care that need to be addressed if patients undergoing LAGB are to experience its potential benefits and indicate that further research is needed into the long-term effects of gastric band insertion. Patients need to be better informed about the consequences of bariatric surgery if it is to have a lasting impact on their weight reduction. Relevance to clinical practice: Patients require comprehensive information and support before and after LAGB insertion to develop strategies which will help them lose weight and sustain it over the longer term. Clinicians need to be sensitive to patients’ needs when weight loss plateaus or weight is regained and intensify support during these periods. [ABSTRACT FROM AUTHOR]

Abstract: Aims: The aim of this study was to explore the experiences of Clinical Research Nurses, with an emphasis on factors that may have an impact on successful study delivery. Background: The Clinical Research Nurse workforce is pivotal to improving health outcomes through supporting research‐active health economies. Investment in research infrastructure has led to nurses and midwives increasingly undertaking extended roles to deliver clinical research. Despite such opportunities, the recruitment of sufficient participants into research studies remains problematic. A growing body of literature is exploring barriers to successful study delivery, indicating the emergence of a caring‐recruiting dichotomy in clinical research staff. Design: This qualitative study investigates the experiences of Clinical Research Nurses delivering research in the United Kingdom National Health Service. Methods: Four Focus groups (total 19 participants) were conducted in a large North East National Health Service Foundation Trust from November 2015 ‐ February 2016. Findings: Thematic analysis identified perceptions of the role in the wider context of professional identity. Role transition, altered relationships and workload complexity, affected participants’ practice, leading to inconsistency between core clinical values and perceived identities as research delivery staff. A duty of care as patient advocates contrasted elements of the work reflecting that of salespeople. The emotional labour of approaching patients and unease regarding peer perceptions of the Clinical Research Nurse role, affected the positive aspects of research delivery. Conclusion: Professional‐identity and self‐concept appear to have an impact on practice in a research delivery role. Further research should explore these issues further, to enlighten the basis on which such feelings are positioned and to work towards practical solutions. [ABSTRACT FROM AUTHOR]

Aim This article is a report of a study protocol designed to examine patients' and families' knowledge and experiences of peritoneal dialysis-associated peritonitis. Background Peritonitis is a considerable problem for people using peritoneal dialysis, leading to antibiotics, hospitalization and decreased quality of life. For some patients, peritonitis requires changing renal replacement therapy and can be fatal. Peritonitis is distressing and some patients are unfamiliar with the signs and symptoms. Patients with better knowledge of peritonitis and adherence to peritoneal dialysis procedures have lower rates of peritonitis. Little is known about patients' and families' knowledge and experience of peritoneal dialysis-associated peritonitis in the United Kingdom. Design Ethical approval was gained in March 2017. To meet the study aim, a two-phase sequential explanatory mixed methods study is proposed. Methods Phase One: An author-developed questionnaire will be sent to patients using peritoneal dialysis at five sites in England and Wales. Patients will be asked to consider inviting a relative to participate. The questionnaire will assess peritonitis knowledge and experience. Data will be analysed statistically. Phase Two: Semi-structured interviews will be conducted with a purposive sample of Phase One participants ( n = 30) to explore their experiences of peritonitis in further depth. The data will be analysed thematically using Wolcott's (1994) approach. Discussion Data from the two phases will be synthesized to identify patients' and families' peritonitis information needs, to ensure they are appropriately supported to prevent, monitor, identify and report peritonitis. [ABSTRACT FROM AUTHOR]

Aims To examine frontline staff acceptance of telehealth and identify barriers to and enablers of successful adoption of remote monitoring for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure. Background The use of telehealth in the UK has not developed at the pace and scale anticipated by policy. Many existing studies report frontline staff acceptance as a key barrier, however data are limited and there is little evidence of the adoption of telehealth in routine practice. Design Case studies of four community health services in England that use telehealth to monitor patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure. Methods Thematic analysis of qualitative interviews with 84 nursing and other frontline staff; and 21 managers and key stakeholders; data collected May 2012-June 2013. Findings Staff attitudes ranged from resistance to enthusiasm, with varied opinions about the motives for investing in telehealth and the potential impact on nursing roles. Having reliable and flexible technology and dedicated resources for telehealth work were identified as essential in helping to overcome early barriers to acceptance, along with appropriate staff training and a partnership approach to implementation. Early successes were also important, encouraging staff to use telehealth and facilitating clinical learning and increased adoption. Conclusions The mainstreaming of telehealth hinges on clinical 'buy-in'. Where barriers to successful implementation exist, clinicians can lose faith in using technology to perform tasks traditionally delivered in person. Addressing barriers is therefore crucial if clinicians are to adopt telehealth into routine practice. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate the extent to which the Davies and Oberle (1990) model of supportive nursing has currency across specialist and specialised care settings in England. Background The model describes attributes of palliative nursing for practice and associated educational curricula. It is influential but predates introduction of specialist/specialised care. Its applicability in contemporary care settings has not been evaluated. Design Evaluation was undertaken using sequential mixed methods, predominantly qualitative. Data collected during 2008-2009. Methods Four stages: (1) focus groups involving hospital and community palliative clinical nurse specialists and nurses from three hospice settings (total = 25) to identify setting-specific characteristics, (2) survey of nurses ( n = 48 respondents/31%) with follow-up interviews ( n = 25) to identify congruence with the model, (3) interviews with patients ( n = 6) and carers ( n = 13) for practice evidence and (4) reconvened focus groups ( n = 19 nurses) for confirmation. Results All major dimensions were evidenced. ' Connecting' had reduced emphasis in the hospital setting where specialist nurses spend limited time with patients, but diminishing time to 'connect' with patients and carers as service develops could potentially become problematic across all settings. Two new dimensions (' Displaying expertise' and 'Influencing other professionals') with subdimensions (e.g. ' Advanced communication skills') are proposed as additions to reflect advanced practice. Further new subdimensions (' Making the assessment', ' Prioritising', 'Agreeing the plan') are suggested to be best aligned with the existing dimension ' Connecting'. Conclusions A revised model of supportive care incorporating dimensions of advanced nursing has currency in contemporary specialist/specialised care settings, although evaluation is required as to the actual impact of the model on care outcomes. ' Connecting' is currently being affected by pace of work and lateness of referrals. Implications for practice 'Spending time' is increasingly difficult to sustain so challenging nurses as to how they may continue to 'connect' with patients as service delivery continues to change. [ABSTRACT FROM AUTHOR]

Background Children's emergency hospital use is of concern internationally, but there has been little examination of home care by nurses. Aims To examine the care provided by community children's nurses during acute illness. Design Triangulation of findings from case studies of three Community Children's Nursing Teams. Methods Parents or carers ( n = 763) completed questionnaires between 2008-2010 about their contacts with nurses and satisfaction with aspects and overall assessment of nursing care provided. Eighty-one individuals participated in semi-structured interviews: 29 parents/carers described their experiences and explained their questionnaire responses in more detail; 13 children talked about their care both in hospital and at home; and 39 nurses and other healthcare providers explained how nurses supported care of children at home. Questionnaire data were analysed descriptively and interview data qualitatively. The findings were integrated by triangulation of methods (questionnaires and interviews) and of data from different informants (children, parents, healthcare providers). Results Nursing care most frequently took the form of advice and education by either home visits or telephone contact. Parents and children were reassured by access to nurses and it gave them confidence to care at home. Most respondents thought that it reduced the time their children spent in hospital. Conclusions Nurses can make an important contribution to supporting parents to care confidently for their children at home to reduce or even to avoid hospitalization for acute conditions and give them confidence to manage future episodes of illness. [ABSTRACT FROM AUTHOR]

tutton e., seers k., langstaff d. & westwood m. (2012) Staff and patient views of the concept of hope on a stroke unit: a qualitative study. Journal of Advanced Nursing 68(9), 2061-2069. Abstract Aim. This study explores the experience of hope for patients and staff in the context of a British stroke unit. Background. Hope is identified as a useful concept for exploring how people find meaning in recovery from illness. Uncovering the experience of hope in acute stroke care has provided evidence that can be used to facilitate rehabilitation. Methods. The methodology drew on the principles of ethnography, undertaking unstructured qualitative interviews with ten patients, ten multidisciplinary staff and 21 hours of participant observation including informal discussions with staff and patients. Data collection took place between November 2007 and November 2008. Findings. Four themes were identified: suffering, struggling with no hope and despair, hope for recovery and realistic hopefulness. Hope was experienced in the context of suffering a stroke demonstrated as loss of function, loss of mental capacity and dependency. Patients struggled to maintain a sense of hopefulness while feeling close to a slippery slope towards despair and death. Hope was expressed as a strong desire to recover, get back to normal and a time to reflect on their lives so far. Staff identified realistic hopefulness as focused on keeping things real while balancing giving hope and avoiding false hope. Conclusion. Hope is placed within the emotional challenges of suffering and struggle inherent in recovery from stroke. The staff work with patients' hopes but offer realistic hopefulness as a practical strategy for recovery. Further interventions are required for working with feelings of despair or no hope. [ABSTRACT FROM AUTHOR]

Aim. To explore the perceptions and work experiences of internationally recruited neonatal nurses. Background. Neonatal nursing and health care are global issues facing developing and developed countries. In the UK, the recruitment of international nurses to address the labour shortage is not a new phenomenon. Methods. A purposeful sample was drawn from internationally recruited neonatal nurses, working at two teaching hospitals in London. Husserl's phenomenological approach underpins this study. Thirteen nurses, (all female) participated in the study and semi-structured face-to-face interviews were conducted to capture the unique perceptions and experiences of neonatal nurses at two hospital sites. A qualitative approach was adopted and this study used Colaizzi's analytical framework to analyse the data. Results. The analysis of the data resulted in four themes namely the support mechanisms, unfamiliarity with family centred care, feelings of being treated like a child and coping strategies. Conclusion. It can be concluded that in recruiting internationally recruited neonatal nurses to work in the NHS, there is a need to support them, encourage them to become familiar with family centred care and they should be treated as qualified nurses. Therefore, there is a need to consider these findings in any recruitment process involving neonatal nurses. Relevance to clinical practice. Internationally recruited neonatal nurses play an important role in caring for neonates in the NHS in the UK however meeting their needs have not always been addressed in the health care setting. [ABSTRACT FROM AUTHOR]