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Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

Little is known about the lived experience of the dyad following a fetal death and the impact on relationships. The purpose of this paper is to explore the dyadic relationship between partners, with health care providers, and with the baby's memory after birth. This qualitative study utilized hermeneutic phenomenology. The sample included 10 heterosexual dyads from the United States and Canada. All experienced a fetal death between 6 months and 7 years prior to their interviews. The data revealed three themes: (a) The Dyad Relationship: Moving Through the Experience Together; (b) Keeping the Memory Alive: Memorializing the Baby; and (c) Relationships With Health Care Providers: A Spectrum of Caring. The findings from this study provide the beginning knowledge needed to improve the care of dyads who have experienced a fetal death and for future studies to improve care delivery for dyads as their relationships change after fetal death. [ABSTRACT FROM AUTHOR]

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource. [ABSTRACT FROM AUTHOR]

The internationalization of universities and the aging of the global population are two current issues that converge and challenge undergraduate gerontology curriculum development in Canada. One response to this challenge is to envision an intercultural gerontology curriculum. What might this curriculum encompass? How might it be taught? An exploratory study was undertaken to address these two questions. This paper presents findings from this study based primarily on interviews with university-based stakeholders from Canada, the United States, and Europe. Thematic analysis of the interviews resulted in five themes: multiple perspectives on cultural diversity; the dynamic nature of cultural diversity and aging; flow of an intercultural curriculum; institutional culture and intercultural curricula; and principles and practice for intercultural gerontology. Framed by principles of gerontology theory and educational approaches, this paper focuses on the principles and practice suggested by study participants. Scaffolding learning, active learning strategies, experiential learning opportunities, teacher modelling, and internet-based learning are discussed as key to intercultural learning. An appendix includes a list of resources that may be useful to developing an intercultural gerontology curriculum. [ABSTRACT FROM AUTHOR]

Research to date on heterosexual couples that have never been able to engage in penile-vaginal intercourse (PVI) has been conducted almost exclusively outside of Canada and the United States and is primarily problem-focused, examining biomedical treatments of sexual dysfunction that cause the inability to have PVI (or unconsummated marriage as it is referred to in the literature). Almost nothing is known about the experience of the individuals affected by this phenomenon. This study used a phenomenological approach to answer the question: what is the lived experience of individuals in heterosexual relationships who have been unable to have penile-vaginal intercourse despite wanting to do so? The focus of this paper is on answering the following questions: (1) what is the meaning of PVI? and (2) what is the impact of the inability to have PVI on the relationship and sex life of individuals in heterosexual relationships who have been unable to have PVI? The study involved semi-structured interviews with 17 individuals residing in Canada and the United States. Study findings indicated that although all of the participants expressed a desire to be able to have PVI, the majority described satisfying relationships and sex lives without PVI. However, even participants who described satisfying sex lives tended to view PVI as having special significance over other sexual activities. Implications for healthcare providers and future research are discussed. [ABSTRACT FROM AUTHOR]

cook c. (2012) Email interviewing: generating data with a vulnerable population. Journal of Advanced Nursing 68(6), 1330-1339. Abstract Aims. This paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. The paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. Background. Online recruitment and in-depth email interviewing have been used by only a small number of nurses internationally. The method enables inclusion of people who might otherwise be excluded from research, for reasons such as geographical distance, incompatible time frames, clinicians''gate-keeping' and participants' desire for anonymity for physical or emotional reasons. Methods. In-depth email interviews were conducted with 26 women in New Zealand, United States of America, Canada and England who had a diagnosis of either human papilloma virus or genital herpes simplex virus. Data were collected during 2007-2008 and analysed using a poststructuralist, feminist thematic analysis. Results. Participant retention was high. Women emphasized satisfaction with the process. Asynchronous interviews allowed for additional reflexivity in the researcher's responses and rich data generation. Conclusion. This method has the potential to enable nurses to include vulnerable and relatively inaccessible participants in 'sensitive' research. In-depth email interviews may generate rich data through a process participants deem to be of personal value. [ABSTRACT FROM AUTHOR]

This article presents emerging findings from the first year of a two-year study, which employed ethnographic methods to explore the culture of interprofessional collaboration (IPC) and family member involvement in eight North American intensive care units (ICUs). The study utilized a comparative ethnographic approach - gathering observation, interview and documentary data relating to the behaviors and attitudes of healthcare providers and family members across several sites. In total, 504 hours of ICU-based observational data were gathered over a 12-month period in four ICUs based in two US cities. In addition, 56 semi-structured interviews were undertaken with a range of ICU staff (e.g. nurses, doctors and pharmacists) and family members. Documentary data (e.g. clinical guidelines and unit policies) were also collected to help develop an insight into how the different sites engaged organizationally with IPC and family member involvement. Directed content analysis enabled the identification and categorization of major themes within the data. An interprofessional conceptual framework was utilized to help frame the coding for the analysis. The preliminary findings presented in this paper illuminate a number of issues related to the nature of IPC and family member involvement within an ICU context. These findings are discussed in relation to the wider interprofessional and health services literature. [ABSTRACT FROM AUTHOR]

Personalisation has now become centre-stage in adult social care and continues to have an enduring level of political commitment and on-going appeal for many disabled people. And yet its roll-out has taken place during a time of austerity where central governments in many neo-liberal countries are re-imagining (read: shrinking) their role in social care provision. This paper reports on findings from an empirical study of relevant government officials from different countries which have advanced personalisation: Canada, England and the US. It reports on their views on personalisation and the remaking of adult social care, and managing expectations for change. Despite the relative success of personalisation, the findings reveal a tempered, cautious account, with respondents aware of the pitfalls and risks inherent in self-led support, government limitations in changing systems and an end to the primary involvement by the state in the creation of a social care market. With this in mind, the study's findings make a strong case for forms of ‘progressive localism’, as imagined by Featherstone et al. (2012), in galvanising local community resources alongside more radical politics in order to make self-led support achieve its desired outcomes on the ground. [ABSTRACT FROM PUBLISHER]

Recent Canada–US ‘Beyond the Border’ negotiations have been accompanied by a highlighting of the issue of unauthorised crossings at the Canada–US border. In this paper, I offer some grounded contextualisation of this current politicisation by drawing upon press reports and interviews to document Canadian border-resident and press constructions of unauthorised crossings in one Canada–US border region in the late 1990s to mid-2000s. The evidence suggests that there is widespread local awareness of these crossings, including the dangers and sometimes death faced by would-be migrants. The analysis explores why this knowledge has not served to challenge still-dominant constructions of a ‘benign’ Canada–US border and/or ongoing projects of border securitisation. [ABSTRACT FROM AUTHOR]

To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. Searches of the electronic databases Cinahl, Medline, Embase and SweMed, the websites Google and Google Scholar and hand searches of reference lists occurred. Eligibility criteria included (A) a focus on patient classification systems measuring nursing intensity and workload in home health care and (B) published in English between January 2007 and March 2019. In level one testing two team members screened titles and abstracts, in level two testing two team members determined which papers should undergo a full text review. Data were extracted using structured extraction by one team member and verified by two other members. Thirteen peer-reviewed articles and grey literature documents were identified, from Canada, Ireland, the UK, the USA, Scotland, Turkey and the Netherlands. Four patient classification systems had been tested for both validity and reliability. Validity was tested through face validity, predictive validity, concurrent validity or content validity index. Reliability was tested through stability, internal consistency, observer agreement or inter rater reliability. One patient classification system had been tested only for reliability, through interrater reliability and observer agreement. Two patient classification systems had been evaluated through summative evaluation; one qualitatively through focus group interviews and one through semi-structured interviews. Only one patient classification system had been validity and reliability tested and evaluated. Overall, the patient classification systems in the included papers (13) were considered to have benefits and to be appropriate for the measurement of patients' needs, workload and allocation of staff, although specific information was not always given. Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care. [ABSTRACT FROM AUTHOR]

Aim: To assess the feasibility of collecting electronic pain data from thalassaemia patients, based on its acceptability and convenience to the participants and study team. Methods: Participants in the Thalassemia Clinical Research Network Assessment of Pain Survey Study completed the Brief Pain Inventory (BPI) quarterly by paper or phone interview. Participants in a substudy completed the BPI Short Form daily over three non-consecutive transfusion cycles through an automated telephone system. Results: The consent rate for the main study was 93%, with 93% retention. The substudy had 75% retention, with more than 75% of scheduled calls completed. Regular monitoring of enrolment, missed calls, data quality, and the performance of the subcontractor for the automated system was crucial to fulfillment of the study goals. Conclusions: Use of electronic data collection for patient-reported outcomes was convenient for both patients and study personnel but required human interactions beyond the automated system to maximise data quantity and quality. [ABSTRACT FROM AUTHOR]

This paper uses qualitative interview analysis conducted online with adults to examine links between self-injury and creative writing. It concentrates on why an individual who self-injures may write creatively and what this could mean for professional practice. The research shows that writing about self-injury and associated trauma can be helpful for controlling 'internal chaos' and allowing the individual to communicate their experiences in different ways, as controlled by the writer. This creates the potential for an escape from their 'encaptive conflict', facilitating a move from pseudo-independence to forming containing relationships with professionals and others. [ABSTRACT FROM AUTHOR]

• Despite consensus on importance of relationships in RCC, theorisation is limited. • Relational practice most prominently identified as threshold in transatlantic study. • All 5 characteristics of threshold concepts were reflected across interview data. • There was an emphasis on the troublesome nature of relationship boundaries. • The relational nature of teaching and learning relational practice was identified. Despite growing international consensus around the complex and demanding nature of residential child care for children and young people, consensus is lacking around how to develop a workforce equal to the task. Similarly, there is near unanimity about the essential nature of relationships, particularly the relationship between practitioner and child, for good residential care. At the same time, theorization on how those relationships are enacted and how to support practitioners' related development of practice is underdeveloped or even absent in some contexts. This second of a two-part paper discusses stage two of a two-stage, transatlantic study aimed at identifying and exploring threshold concepts in residential child care. Threshold concepts are central concepts in a given discipline which are transformative but troublesome for many. They are important to their given discipline because they shape thinking and practice, but they are often difficult to master. In stage one, relational practice was the most prominently discussed potential threshold concept in focus groups comprised of educators and practitioners who had studied, practiced and/or taught in the UK, Canada and/or the US. In stage two, in-depth individual interviews were carried out with practitioners around their threshold experiences of relational practice. Analysis found all five characteristics of threshold concepts reflected in the data, with a particular emphasis on the troublesome nature of relationship boundaries. A further theme around the relational nature of teaching and learning relational practice was identified, raising important parallels between the relational experiences practitioners have as part of their training, and their relational practice in the field. Implications are discussed, including the misfit between the demarcation of professional boundaries as applied by cognate fields and the actual requirements of ameliorative relationships in residential child care. [ABSTRACT FROM AUTHOR]

• Threshold concepts are core concepts in a given field that are transformative. • They are important because they shape thinking and practice. • A transatlantic study was carried out to identify them in residential child care. • Relational Practice and Use of Self were prominently identified. • They have explanatory power in guiding workforce development. Despite growing international consensus around the complex and demanding nature of residential child care for children and young people, consensus is lacking around how to develop a workforce equal to the task. Threshold concept theory casts a light on related issues of training and education, and offers direction in addressing them. Threshold concepts are central concepts in a given discipline which are transformative but troublesome for many. They are important to their given discipline because they shape thinking and practice, but they are often difficult to master. This first of a two-part paper discusses the first of a two-stage, transatlantic study aimed at identifying and exploring threshold concepts in residential child care. Using focus groups and individual interviews with participants who had studied, practiced and/or taught in the UK, Canada or the US, it explored the views and experiences of educators who have contributed to knowledge production in the field, as well as front-line practitioners who have completed a dedicated course in child and youth care, residential child care or therapeutic child care. Findings included unanimous agreement about the relevance of threshold concept theory to their experiences, and strong support for its utility in considering how curricula should be taught. There was a greater degree of commonality than divergence between educator and practitioner views about what might be threshold, with relational practice the most prominently discussed. A theme around the self of the learner was identified in discussions of threshold concept theory more generally, particularly across the educator focus groups. Implications for pedagogical practice are discussed, including the concept of praxis which provides a useful counterpoint for conceptualising the relationship between threshold concept theory and the use of self in practice, especially in fields where the self is a primary instrument of the work. [ABSTRACT FROM AUTHOR]