Search

This paper is a discussion of the possible ethical dilemmas that may arise in both qualitative and quantitative research despite stringent methodological protocols. Three categories of ethical issues will be elaborated on, namely, researcher-participant relations, informed consent and confidentiality and privacy. These are of note because ethical dilemmas most often arise in these areas. Both qualitative and quantitative research types may thus present with problems associated with any, or a combination, of these categories. Methodological rigour will also be discussed as a vital component of any research study. Critics of the qualitative approach have often suggested that the innate lack of methodological rigour has resulted in the preponderance of ethical issues in qualitative studies. Qualitative studies, similar to quantitative studies, have mechanisms that guarantee rigour, quality and trustworthiness. These checks are at par with those of quantitative research but based on different criteria. Both types of research, then, can be considered equal in terms of methodological rigour, regardless of the nature. As no research approach can be perfectly free from threats of ethical issues, it is the researcher's responsibility to address these in ways that will be less harmful to the participants, bearing in mind ethical problems can arise at any time during the research endeavour. [ABSTRACT FROM AUTHOR]

Aim: Expanding and sustaining student nurse placements outside of the acute sector is a universal challenge. This paper aims to evaluate the Care Home Education Facilitator Role introduced in one area of Wales, United Kingdom, and to report on the outcomes achieved from this novel role. Methods: Semi‐structured interviews were undertaken with key stakeholders including the Care Home Education Facilitator postholder leading the pilot, care home managers, higher education institutions' placement managers/coordinators, student nurses and national health service staff. Results: Five key areas were identified, which included timing of introducing the post and establishing a clear rationale and understanding of the intention of the role. The benefits, challenges and suggested improvements to the Care Home Education Facilitator initiative are provided. Conclusion: Introducing the role of the Care Home Education Facilitator to work closely with key stakeholders resulted in increased placements for student nurses, but investing time in developing relationships with these stakeholders was critical to the success of the role. Summary statement: What is already known about this topic? There is a universal shortage of clinical placements for nursing students, particularly within a care home setting.The number of studies exploring how we might grow the number of nurses needed in this setting is limited. What this paper adds? This study evaluated a novel initiative introduced in South Wales, United Kingdom, that focuses on the development of nursing placements in the care home setting.Engaging with stakeholders involved in the development and implementation of the Care Home Education Facilitator initiative, a roadmap was provided to illustrate the stepped approach required to support an active care home placement including key governance arrangements. The implications of this paper: For those involved in identifying and developing student placements, this study provides valuable insight to a role that can help increase student numbers in a care setting often overlooked.It identifies viable career options for nurses at the point of registration.The role assists with widening networks for the care homes across health and social care sectors. [ABSTRACT FROM AUTHOR]

Aims: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. Methods: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi‐structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. Results: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub‐themes. Conclusions: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management. Summary Statement: What is already known about this topic? Violence is most commonly reported as experienced by nurses in the emergency department.Violence affects nurses deeply and causes negative effects in daily life. What this paper adds: Nurses described the violence perpetrated by patients or by patients' relatives as a situation that causes negative feelings such as anger, worthlessness, and injustice.Nurses emphasized that violence affects their clinical environment and their daily lives. The implications of this paper: The multidimensional and destructive effects of violence on nurses have shown that it is important to make the necessary arrangements quickly to reduce violence in the emergency departmentThe study provides information about the experiences of nurses who have been exposed to violence by patients or their relatives in the emergency department. [ABSTRACT FROM AUTHOR]

Background: Cultural competence is considered one of the criteria for high‐quality nursing care. Aim: This study aimed to analyse cultural competence in nursing. Methods: This study was performed using the hybrid concept analysis approach in three phases. In the theoretical phase, literature was reviewed by searching Persian and English language databases, and 94 articles were included. In the second or fieldwork phase, 11 semi‐structured interviews were conducted with purposefully selected nurses. The results of both theoretical and fieldwork phases were analysed using conventional content analysis, and in the final analysis phase, the results of the previous phases were triangulated. Results: The attributes of cultural competence were obtained in the theoretical phase in six and the fieldwork phase in three categories. In the final phase, the categories obtained in both previous phases were triangulated: cultural competence in nursing is a continuous, developmental, flexible, extensive and complex process that is patient‐ and justice‐oriented and emerges through learning and skills acquisition, including cultural knowledge, attitudes and practices. Conclusion: Managers and planners of nursing education can use the results of this study to educate nursing students and nurses and evaluate outcomes as one of the criteria for quality care. Summary statement: What is already known about this topic? There is a concern in nursing that the profession needs a unified definition of cultural competence.What this paper adds? This study showed that cultural competence in nursing is a continuous, developmental, complex, and extensive process that is patient‐ and justice‐orientated and emerges through learning and skills acquisition, including cultural knowledge, attitudes, and practices.The implications of this paper: The findings help identify and present the definition of cultural competence in nursing and be used in the training of nursing students and the continuous education of nurses. [ABSTRACT FROM AUTHOR]

Aim: Studies of the effects of COVID‐19, especially post‐acute COVID‐19 syndrome, on psychological health in non‐severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality‐of‐life in three groups of outpatients, hospitalized and intensive care patients. Methods: A total 276 patients, previously confirmed with SARS‐CoV‐2 infection, attending the COVID‐19 follow‐up outpatient clinic from December 2020 to July 2021 were interviewed face‐to‐face. In this cross‐sectional, retrospective study, all participants were asked our self‐designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL‐BREF survey to evaluate quality of life. Results: In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post‐traumatic stress disorder symptoms at a rate of 28.6% and obsessive‐compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID‐19 infection had a higher risk of developing psychological symptoms and decreased quality of life. Conclusion: COVID‐19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness. Summary statement: What is already known about this topic? Post‐intensive care syndrome affects physical, cognitive and psychological health.It is associated with symptoms such as generalized weakness, memory disturbances, cognitive function impairment, depression, anxiety and post‐traumatic stress disorder.Some physical and psychological symptoms persist for over 12 weeks in some patients and have been classified as 'Post‐acute COVID‐19 Condition or Syndrome' (PCS). What this paper adds? At the post‐acute‐COVID‐19 period, a considerable number of outpatients with COVID‐19 infection were at higher risk for psychological distress symptoms than those who had been treated in the hospital or intensive care unit.Depression, anxiety, panic disorder and PTSD symptoms were found to be higher in outpatients and those with these symptoms were also shown to have a lower quality of life.Our findings highlight the significant psychological impact of COVID‐19 on patients, even after their reported recovery from the acute manifestations of this disease. The implications of this paper: Ongoing psychological symptoms in the post‐COVID period are not associated with the severity of the disease in the acute phase.It is important that healthcare professionals are equally concerned not only with physical condition of post‐COVID‐19 patients but also with their psychological state and the patient's psychology‐related quality of life. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to explore the influence of Chinese culture and customs on the beliefs and health‐related behaviours of Chinese women with gestational diabetes mellitus (GDM). Methods: This descriptive qualitative study conducted semi‐structured interviews with 15 Chinese women between November 2022 and January 2023. The interview data were analysed using thematic analysis. Results: Three major themes are found: (1) beliefs in health, (2) beliefs in illness and GDM and (3) beliefs in health‐related behaviours. They worried about the negative effects of GDM on the infant and family, so they actively sought medical advice to maintain health. However, it is challenging for them to balance adhering to healthcare professionals' advice and avoiding practical difficulties in the impact of the Chinese sociocultural context. Conclusion: This study emphasizes the influence of Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM. Healthcare providers should recognize the influence of Chinese culture, customs and beliefs on women with GDM and their families, in order to provide individualized education to help them maintain health‐related behaviours. Summary statement: What is already known about this topic? The prevalence of gestational diabetes mellitus (GDM) is increasing in China and affects 14.8% of pregnant women.Some personal beliefs about illness and health can lead to inadequate self‐care behaviours and thus failure to achieve optimal self‐management and health goals.Factors of Chinese sociocultural content and Chinese traditional culture and customs may have different influences on Chinese married women's beliefs in health, illness and health‐related behaviours. What this paper adds? Influenced by Chinese culture and customs, Chinese women's perspectives on gestational diabetes are bidirectional. They fear the negative effects of the disease on infants' and families' health and actively seek help, while some try to balance following professional advice and practical difficulties, such as diet control and self‐glucose monitoring.The low‐risk self‐management awareness, lack of adequate healthcare knowledge, and self‐care practice in Chinese women with GDM are one of the factors that lead to practical difficulties in GDM management.Understanding the impact of traditional Chinese culture and customs on the beliefs and health‐related behaviours of women with GDM, well‐trained healthcare professionals can disseminate personalized health education to individuals, families and communities to improve GDM management in these women. The implications of this paper: Health providers need to constantly update the GDM guidelines with Chinese cultural characteristics based on the cultural acceptance and customs of Chinese women with GDM in order to offer them individualized care and scientific advice.The findings of this study could act as a clinical resource for health professionals to investigate the impact of differences in culture and customs across countries or regions on individual beliefs and health‐related behaviours in different populations. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the impact of bronchial asthma‐related factors on the emotional well‐being of adolescents with bronchial asthma and their primary caregivers. Background: Bronchial asthma is a common chronic disease in childhood and adolescence that can have a psychological impact on both patients and their primary caregivers. Methods: The study used a cross‐sectional design and included 150 patient–caregiver dyads diagnosed with bronchial asthma, aged between 12 and 16 years and collected between 2018 and 2020. It assessed the emotional adjustment of both patients and caregivers and recorded variables related to the disease. Qualitative and quantitative analyses were conducted to perform statistical analyses. Results: Caregivers had higher anxiety and depression scores than patients. Good adherence to treatment was necessary for the emotional adjustment of the dyad. Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. Conclusions: The study highlights the importance of assessing anxiety and depression levels in both patients and caregivers because the presence of these symptoms can lead to the misuse of medication, inadequate inhalation techniques, the omission of medication and reduced confidence in controlling asthma symptoms. Summary statement: What is already known about this topic? Certain variables related to asthma, such as its degree of control, severity, duration of diagnosis and adherence, have been linked to adjustment to the disease by the adolescent–caregiver dyad. What this paper adds? Caregivers had higher anxiety and depression scores than patients.Good adherence to treatment was necessary for the emotional adjustment of the dyad.Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. The implications of this paper: The study evaluated the variables in combination to identify risk and healthier profiles in the dyad's emotional adjustment and identified variables related to the disease most associated with emotional adjustment to the disease in the dyad.Identifying the risk and health profiles in emotional adjustment in both the adolescent and his or her caregiver may be used to mitigate future consequences related to poor adjustment to asthma.Knowledge of these variables allows health professionals to design psychoeducational programmes to ensure better adaptation to the disease. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to develop a model to help parents cope with decisional conflict. Background: Parents of children with congenital heart defect experience decisional conflict when they are uncertain about treatment decisions for their child, which may lead to delay in seeking care or distress over the decision made. Design: Correlational design with model building and data triangulation was used. Methods: Data were collected through surveys and interviews with a consecutive sample of 221 parent respondents from June to December 2018. Structural equation modelling and qualitative data analysis were used. Results: Lower decisional conflict was seen in parents with higher income, more nurse support and physician risk communication. Time delay for surgery was correlated with the child's age, social service coverage, and social support. Decisional conflict mediated the influence of income, nurse support and physician risk communication on satisfaction with decision. Based on model fit parameters, the emerging model is a good and parsimonious model of decisional conflict. The overall theme, 'Deciding for Surgery: What Matters Most', described the processes parents went through in making treatment decisions. Conclusion: Nurses may help parents feel more certain, less conflicted, and more satisfied with their decision by addressing factors including knowledge gaps, personal values, available support, and resource access. Summary statement: What is already known about this topic? Decisional conflict occurs when parents are uncertain of the best action for their child because treatment options entail risks for undesirable outcomes, value compromise, unclear prognosis, or anticipated regret over the decision.Professional support, information, and communication are vital to parents' decision‐making process.Child, parent, and support factors may influence parent treatment decisions in varied paediatric conditions. What this paper adds? Child's age at the time of decision‐making had an effect on the delay in surgery. However, assisting parents to weigh their options and focus on personal values allowed them to make their treatment decision.Low income, costly health services, and bureaucratic processes impeded the timely availment of surgery. Healthcare reforms that provide a system of government funding, streamlined health structure, and social insurance may be looked into.Family support weighed in on the parents' decision to delay surgery for fear of blame or guilt. Providing relevant information enabled parents to make a choice and stand by their decision regardless of the outcome. The implications of this paper: Modelling provides a framework to identify which factors are more important and how they interact to affect decision‐making. It may be used as an approach to find solutions to clinical problems for groups with different diagnoses.Though nursing support, information, and communication are essential, a more holistic family nursing care approach may be considered to assist parents to make appropriate treatment decisions for their child.Familiarity with the healthcare system may equip nurses to aid parents in processing available healthcare funding and dealing with financial uncertainty affecting decisions for their child's treatment. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences and emotions of individuals with depression and physical comorbidity within the context of psychoeducational group interventions led by primary care nurses in Catalunya (Spain). Method: A psychoeducational group intervention was conducted in the first semester of 2019 with 13 primary care teams (rural/urban) and 95 participants with depression and physical comorbidity. The qualitative research and phenomenological perspective were based on 13 field diaries and 7 semi‐structured interviews carried out with the observer nurses. The interviews were recorded and transcribed. Codes were identified by segmenting the text into citations/verbatim accounts and emerging categories/subcategories by regrouping the codes. The results were triangulated among the researchers to identify and compare similarities and differences. Results: Four major themes were found: (a) gender differences; (b) coping strategies and changes observed during the intervention; (c) functions of the group as a therapeutic element; and (d) the nurses' perceptions of the group experience. Gender differences were identified in relation to experiences and emotions. Conclusions: As some patients acquired skills/behaviours during the intervention that helped them initiate changes and the nurses were satisfied with the intervention, it is important to include this information when planning effective interventions for patients with this profile. Summary statement: What is already known about this topic? There are gender differences in the prevalence of depression. What this paper adds? This study describes the experiences and emotions of women with depression and physical comorbidity within the context of psychoeducational group intervention. The implications of this paper: The study provides information about the experiences and emotions of women with depression. It will be important to include this qualitative information when planning effective interventions directed at patients with this profile. [ABSTRACT FROM AUTHOR]

Aim: This study's aim is to develop and psychometrically assess the Sickness Presenteeism Scale‐Nurse. Background: Evaluation of the effects of sickness presenteeism on nurses' performance and productivity is important for healthcare quality. Design: This was an instrument development and validation study. Methods: Scale items were created based on literature review and qualitative research. Data were collected from 619 nurses between October and December 2021. The factor structure of the scale was determined by explanatory and confirmatory factor analysis performed with different sample groups. Convergent and discriminant validity were investigated, and reliability was evaluated with Cronbach's α values, adjusted item‐total correlation, composite‐reliability and split‐half reliability. Results: Explanatory factor analysis showed that Sickness Presenteeism Scale‐Nurse consisted of four sub‐dimensions and 21 items and explained 57.9% of the total variance. This factor structure was confirmed by confirmatory factor analysis. The convergent and discriminant validity was confirmed. The total Cronbach's α value of the scale was calculated as 0.928, with Cronbach's α values of the sub‐dimensions calculated as 0.815–0.903; composite reliability values were calculated as 0.804–0.903. Conclusions: The Sickness Presenteeism Scale‐Nurse is a valid and reliable measurement instrument that can be used to evaluate the effect of nurses' sickness presenteeism behaviour on job performance. Summary statement: What is already known about this topic? Presenteeism can reduce work performance and productivity.Nursing is one of the occupations where presenteeism is commonly reported, but there is no scale to measure the effect of presenteeism on nurses' work performanceWhat this paper adds? In this study, the Sickness Presenteeism Scale‐Nurse, an instrument that can be used to evaluate the effects of sickness presenteeism on nurses' work performance, was developed.The Sickness Presenteeism Scale‐Nurse consists of four dimensions: general performance, patient safety, relationships within the team and emotion.This study provides evidence of the validity and reliability of the Sickness Presenteeism Scale‐Nurse.The implications of this paper: Effects of presenteeism on the performance and productivity of nurses can be evaluated by using Sickness Presenteeism Scale‐Nurse to provide information to guide policy makers in determining interventions to promote work performance and productivity. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID‐19) has adversely affected intensive care nurses; for instance, they have fought against an unknown disease, and their workload has increased. In addition, the COVID‐19 pandemic has led intensive care nurses to work in new settings and with new teams. Objective: The aim of this study was to explore and describe the caregiving experiences of nurses who were working in a new COVID‐19 intensive care unit in Turkey and providing care for patients infected with SARS‐CoV‐2. Method: In this descriptive qualitative study, semi‐structured interviews were held from 22 July to 31 August 2020 and were recorded and analysed based on thematic analysis. The researchers followed the COREQ checklist in reporting the study. Findings: From interviews held with 11 nurses, four main themes (uncertainty and challenges in the 'danger zone', emotional and psychosocial changes, professional effects of the pandemic and being ready for a future pandemic) were derived from 11 sub‐themes. Conclusions: The new setting and the ever‐changing team make caring for the COVID‐19 patient even more difficult. A good organization, an experienced permanent team, a known setting and good working conditions are essential to be prepared for possible pandemics in the future. Summary statement: What is already known about this topic? Pandemics are emergencies that can lead the health system to collapse.Patient care quality is associated with nurses' knowledge and experience.The COVID‐19 pandemic has led intensive care nurses to work in new settings and with new teams. What this paper adds? Nurses described challenges such as the fear, stress and stigma they experienced in the ICU during the first wave of the pandemic, which negatively affected patient care.The new setting and the ever‐changing team make caring for the COVID‐19 patient even more difficult. The implications of this paper: A good organization and an experienced permanent team should be established in order to ensure patient safety and high‐quality care in ICU settings for COVID‐19 patients.Working conditions of nurses should be improved without changing their setting during the pandemic. [ABSTRACT FROM AUTHOR]

Aim: The aim of this work is to synthesize and interpret qualitative research examining the experiences of nurses providing care for patients with COVID‐19 in acute care settings in the early stages of the pandemic in different countries. Background: The prevalence of disasters, including the pandemic, is increasing globally. It is important to understand nurses' experiences in depth to effectively manage extraordinary events that may occur in the future. Design: This is a thematic meta‐synthesis study. Methods: Electronic databases, including CINAHL, MEDLINE, PubMed, Web of Science, OVID, and Scopus, were searched for publications from December 2019 to October 2020. The search was updated for publications to 30 May 2022. The thematic synthesis method was used to analyse and interpret the data. Findings The experiences of the nurses giving care to patients with COVID‐19 were grouped under four themes: (1) Difficulties encountered in the care of patients with COVID‐19; (2) mixed emotions experienced in the care of patients with COVID‐19; (3) coping strategies that nurses used in the management of the pandemic; (4) the benefits of the COVID‐19 to nurses. Conclusion: Nurses faced many difficulties and experienced mixed emotions while providing care for patients with coronavirus disease. Perceived social support was seen as the most important strategy for coping with these difficult situations. It is important to be aware of the difficulties and emotions experienced by nurses and support them during the COVID‐19 pandemic for the management of future pandemics. Summary statement: What is already known about this topic? During the COVID‐19 pandemic, the health sector was affected most.Nurses were on the front lines and faced many challenges. What this paper adds? Nurses perceived the COVID‐19 pandemic as a unique experience for their professional identity and personal development despite the difficulties they faced.They saw social support, which would make them feel valuable, as the most important coping strategy. The implications of this paper Lessons learned from nurse experiences in the early stages of the pandemic should be taken into account when planning for a pandemic or other disaster situations.Politicians, health‐care organizations, and nurse managers should increase social support to ensure the well‐being of nurses in busy work environments such as pandemics. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to delineate the relationships between actors and contextual factors associated with the development of the advanced practice role in Catalonia. Methods: A complementary data analysis was conducted based on the social network analysis (SNA) method. The primary study design was qualitative, descriptive and explanatory. Participants from diverse perspectives of practice, organization and external environment were engaged to participate in semi‐structured focus groups. Data collection was conducted between March and May 2016 in Catalonia, Spain. Participants were asked to report on various dimensions of the role development context: understanding of the role, felt needs, perceived outcomes, barriers and facilitators. Results: Primary data analysis performed for 44 participants identified 71 related contextual factors associated with role development. Complementary network analysis revealed multiple relationships and agreements among participants and context‐related themes. Professional roles and disciplines clustered around topics show consensus and the significance of topics. Conclusion: Understanding the level of interactions and consensus among participants and contextual factors will ultimately allow better insight into how complex contexts influence the development of advanced practice nursing in healthcare organizations. Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. Summary statement: What is already known about this topic? Comprehensive understanding of context at various levels should generate greater knowledge about what affects advanced practice role development locally and globally.What this paper adds? Findings could help organizations to make sense of the full dimension of context and to predict or act on development of advanced practice nursing roles.The implications of this paper: Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. [ABSTRACT FROM AUTHOR]

Aims: We aimed to investigate the perspective of primary care nurses on their role with patients who have chronic cardiovascular disease and to identify cultural elements shared by nurses caring for people with chronic cardiovascular disease. In primary care, the role of the nurse is essential to promote self‐efficacy in cardiovascular self‐care. Individuals with chronic cardiovascular disease need to integrate the disease into their life, together with the health recommendations for management and follow‐up. Methods: A qualitative, focused ethnographic study was conducted. Purposeful sampling was used to include nurses who were working in primary care during the study. Data collection took place between 20 January and 20 May 2014 and consisted of semi‐structured interviews. A thematic analysis was applied using the data. Results: Eleven participants were included. Cardiovascular care forces nurses to reflect on their identity and role in primary care. The relationship between the nurse and people with chronic cardiovascular disease is a complex process, which may cause nurses to feel a sense of failure and monotony in their work. Conclusions: Our findings may help to understand the role of the nurse and the care provided in patients with chronic cardiovascular disease. Summary statement: What is already known about this topic? Primary care nursing is necessary for the improvement of cardiovascular risk factors.Chronic cardiovascular patients need training in self‐care.The organizational culture confers different forms of care to patients. What this paper adds? The vision of the socio‐cultural role of the family and community nurse is shown regarding cardiovascular prevention.Information is provided on the differentiating approach to chronic cardiovascular patients in primary care.Our study reflects the influence of routine care in nursing consultations, and what it entails to provide improved nursing care in cardiovascular patients. The implications of this paper: These findings can be used to understand the need to change the focus of nursing care in cardiovascular prevention.The implementation of a follow‐up protocol for the care of cardiovascular patients can improve patients' self‐care and reduce monotony in the nursing consultation.Further training and research is necessary regarding comprehensive chronic cardiovascular care within primary care services. [ABSTRACT FROM AUTHOR]

Aim: To examine the relationships between self‐efficacy, uncertainty and anxiety among nursing graduates waiting for a mandatory nursing licensing test that was postponed due to the COVID‐19 pandemic. Methods: A total of 352 graduates of nursing education programs participated in this mixed‐methods study. The data were collected using an online questionnaire in June 2020. Results: The participants demonstrated high uncertainty and anxiety and low self‐efficacy towards the ability to succeed in the licensing exam. Graduates, who started working, reported lower uncertainty. Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of 24% of the variance of the anxiety. The qualitative analysis revealed three themes: (a) emotional distress, cognitive challenge and social implications, (b) consequences for significant others and (c) strengthening of professional values and norms. Conclusions: A significant crisis like a pandemic is accompanied by acute cognitive burden and stressful emotional experiences and creates an unconventional situation that requires unusual solutions. Granting a temporary permit for employment as a nurse following the postponement of a licensing test contributed to the ability of nursing graduates to cope with the situation. Policies to deal with similar situations in the future emergencies should be developed and implemented. Summary statement: What is already known about this topic? The COVID‐19 pandemic changed all the rules when the licensing examination was postponed at relatively short notice.The graduates found themselves without a work permit and also outside the education system.Many graduates reported economic challenges and feelings of uncertainty and fear of the future. What this paper adds? The participants demonstrated high levels of uncertainty and anxiety, with low self‐efficacy.Self‐efficacy, uncertainty, gender and family status contributed significantly to the explanation of the anxietyQualitative analysis supported these findings through examples that paint the whole picture in vivid colours. The implications of this paper: The study emphasizes the importance of providing emotional support and information to the students in times of crisis, while communicating policy decisions.Granting a temporary permit for employment as a registered nurse following the postponement of the licensing test contributed to the ability of nursing graduates to contend with the situation.There is a need to formulate policies to deal with similar situations in the future. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore and understand the barriers perceived by Italian nurses to adopting self‐monitoring for managing oral anticoagulation in real‐life settings. Background: Barriers to self‐monitoring implementation for managing oral anticoagulation have been poorly described. Design: The study had a qualitative descriptive and exploratory design with a hybrid approach. Methods: A literature review was conducted to identify a priori barriers (deductive approach), while a small and semi‐structured focus group discussion was performed to explore the contextual barriers experienced by Italian nurses (inductive approach). A classic content analysis technique was adopted. Data were collected in 2019. Findings Two main categories were identified. Organizational barriers referred to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring. Individual barriers encompassed professional characteristics (e.g. university background, professional knowledge, continuum education and accountability/responsibility) and patient characteristics (e.g. patient health literacy and knowledge, engagement/empowerment and educational programmes). Finally, unwarranted clinical variation in oral anticoagulation management arose as a barrier determined by organizational and individual elements. Conclusions: The results of this study pointed out an urgent public health issue in addressing barriers influencing self‐monitoring practice and in sustaining care models that might enhance the quality improvement of self‐monitoring for managing oral anticoagulation. Summary statement: What is already known about this topic? Anticoagulation therapy is one of the leading chronic treatments worldwide to prevent stroke in atrial fibrillation patients.Self‐monitoring is a valuable option to further improve the quality of anticoagulation surveillance and patient medication adherence compared to standard care models.Thus far, the barriers underpinning self‐monitoring implementation experienced by Italian nurses are mainly unexplored.What does this paper add? This study is the first Italian description regarding the main barriers perceived by Italian nurses to adopting SM in patients treated using oral anticoagulation therapy.Organizational barriers refer to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring.Individual barriers encompass professional characteristics and patient characteristics, and unwarranted clinical variation arose as a barrier determined by both organizational and individual barriers.The implications of this paper Description of the main barriers perceived by Italian nurses to adopt self‐monitoring of oral anticoagulation is required to prioritize policies and system‐level interventions.Health institutions, patient associations and scientific societies should develop policies that enhance the continuum of professional education of nurses regarding self‐monitoring for oral anticoagulation.Integrated care models where nurses have a leadership role in providing self‐monitoring practice are required to implement self‐monitoring widely. [ABSTRACT FROM AUTHOR]

Purpose: To identify the risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease based on Antonovsky's salutogenesis theory. Methods: This study used a qualitative descriptive design. We interviewed adolescents diagnosed with Moyamoya disease and their parents and experts with experience in treating them from 4 July 2019 to 10 October 2019. Data analysis was performed according to the process of deductive content analysis based on Antonovsky's salutogenesis theory. Results: This study identified risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease. Risk factors were closely related to problems with friends, parent relationships and academic work. Protective factors were identified as emotional support through interpersonal relationships, positive attitudes to the disease situation, ability to understand and predict patterns of symptoms, increasing strength to resolve the state of tension and developing available resources. Conclusion: The factors affecting a salutogenic sense of health in adolescents were identified reflecting on the characteristics of the developmental stage of adolescents and the symptoms and situations that are unique to adolescents. It is important for adolescents with Moyamoya disease to recognize available resources and use them appropriately to successfully manage the state of tension caused by stress. Summary statement: What is already known about this topic? Adolescence is an important developmental stage in which individuals experience rapid physical and cognitive changes; these developmental changes can be more stressful for adolescents with Moyamoya disease.Stressful situations increase the frequency and worsen the symptoms of transient cerebral ischaemic attacks, and these negative experiences lead to depression, anxiety, low self‐esteem, negative self‐concept formation and social maladjustment, which persist until adulthood. What this paper adds? The risk factors affecting the salutogenic sense of health in adolescents with Moyamoya disease were related to problems with interpersonal relationships and academic work.The families of adolescents with Moyamoya disease play a pivotal role in increasing their strength to resolve their state of tension.It is important for adolescents with Moyamoya disease to identify and understand the resources available to them and use them appropriately to manage the state of tension. The implications of this paper: This study is meaningful in that the factors affecting the salutogenic sense of health were identified by reflecting on the unique characteristics of the developmental stage of adolescents.The results of this study will guide clinical nurse and researchers in developing interventions to maintain and promote the health of adolescents with Moyamoya disease. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this project was to examine the role of cultural differences in shaping the management of diabetes among Ethiopian immigrants living in Israel. Methods: A qualitative, in‐depth study involved semistructured interviews with 16 Ethiopian immigrants with diabetes living in Israel. The interviews were audio‐recorded, transcribed and translated into Hebrew, if necessary. The authors each identified themes in the responses and then through discussion came to a consensus about the most significant ones and how to categorize them. Results: A main theme was revealed structuring the participants' perception of diabetes: an oscillation between a familiar narrative, associated with traditional life in Ethiopia, and a foreign one. Five additional subthemes were also identified as an oscillation about the causes of disease, between collectivism and individualism, between accessible food and a balanced diet, between relying on bodily sensations and prescribed treatment and between culturally oriented and translated knowledge. Conclusion: The participants understood that they could be adversely affected both by the changes in lifestyle following their move and by adhering to the traditional norms. They agreed that professional liaisons and peers who have successfully managed their diabetes could help provide a bridge between the narratives. Summary statement: What is already known about this topic? Diabetes is a worldwide epidemic where immigrant populations are more likely to suffer from it.Language and cultural barriers pose a challenge to immigrants when accessing healthcare.Among immigrants, diabetes‐related distress is often accompanied by distress due to the challenges of immigration and acculturation.What this paper adds? Among Ethiopian immigrants, there exists a division between two main narratives about their illness and the way it is treated: the familiar and the foreign.Ethiopian communities play an important role in the treatment of an individual's illness, for better or worse.Translation alone is not sufficient to make language accessible; it must be combined with a medically‐culturally tailored approach.The implications of this paper: An understanding of the oscillations between narratives that Ethiopian immigrants experience is important for promoting person‐centred care for this population.During individual and group training, nurses should include Ethiopian immigrants who have successfully managed their diabetes.Nurse managers should ensure that their clinic has professional liaisons not only for translation but also for the provision of culture‐based health care. [ABSTRACT FROM AUTHOR]

Background: The first wave of the COVID‐19 pandemic caused a shortage of health care staff, forcing the hiring of senior nursing students. Aims: To describe the psychosocial impact and coping strategies used by nursing students during the first outbreak of the COVID‐19 pandemic and to understand the coping strategies they employed. Method: A qualitative exploratory study was conducted, based on Sandelowski's proposal. Purposive sampling was carried out to recruit 18 students hired during the pandemic. The students were interviewed between 18 March and 15 June 2020. Semi‐structured interviews were conducted using a digital platform. An inductive thematic analysis was performed. Findings The students lived alone and isolated during their contract to protect their cohabitants from possible contagion. The impact of working during the pandemic leads to experiences of stress, insomnia, nightmares and anxiety. Nursing students coped with the emotional burden through mental disconnection and the support of co‐workers and family members. Conclusion: Psychological support and tutoring should be provided by health centres. In addition, in these special circumstances, universities should adapt the training provided. Summary statement: What is already known about this topic? In Spain, as in many other countries, a state of alarm was declared during the first wave of COVID 19. The Ministry of Health established measures to manage the health crisis and contain infections, including the hiring of senior nursing students to work.Working conditions had a high physical and psycho‐emotional impact on health professionals.The lack of prior experience of students in the context of a pandemic and how they enter the workforce could make it difficult to develop adequate coping strategies, enhancing the presence of mental and emotional disorders.What this paper adds? During their work, and in order to avoid contagion, the students lived apart from their families, limited their contacts and were isolated in refuge in rooms or homes. Upon entering the home, they showered, changed clothes and disinfected any surfaces they touched.The students described feeling stressed due to the lack of protective equipment and staff, heavy workloads and lack of knowledge regarding the unit and work protocols. They worried about making mistakes, doing their jobs poorly or being unable to help patients. When they got home, they had episodes of insomnia and anxiety.Faced with this situation, students used mental disconnection or distraction as coping strategies. Others shared their fears and uncertainties with other health care professionals and family members, seeking support and understanding. Other times, they tried to be strong and hide their suffering.The implications of this paper: The incorporation of students as relief for professionals in a situation of extreme need is not exempt from significant psychosocial risks and should include monitoring programs and psychological evaluation.The hospitals should monitor and mentor students to facilitate their adaptation to similar situations in the future.The students required greater support from the administration, including offering them housing where they could live away from family and relatives. [ABSTRACT FROM AUTHOR]

Background: There are controversial results about the effects of cancer and chemotherapy on the perception of distress. Aims: The purpose to the study is to explore the meaning of the distress experienced by patients with cancer and verify whether the cancer diagnosis, stage and receiving chemotherapy influence this experience. Design This is a mixed‐methods study with cancer patients. Methods: Data were collected in 2018 using a phenomenological interview (n = 18) and one suffering inventory (n = 100). Qualitative analysis was performed using the empirical‐comprehensive model and quantitative using statistical tests. The results were triangulated. Results: Distress originated from difficulties faced in health services, diagnosis confirmation, beginning treatment and interruption of life projects. Patients mobilized resources in the spiritual dimension that allowed them to redefine their distress positively. Chemotherapy brought hope back and promoted healing expectations. Higher average scores for distress were found in patients with advanced stage and receiving palliative chemotherapy. Not having begun chemotherapy and having head and neck cancer were associated with higher average scores for distress. Conclusion: Distress was greater among patients who had not yet begun chemotherapy; nearness of death and difficulty talking about feelings caused distress; distress was redefined by mobilization of spiritual resources. Summary statement: What is already known about this topic? There are conflicting results about distress between patients with cancer.The distress of cancer patients has been little reported or treated in cancer care units.There are no mixed‐method studies on distress in chemotherapy patients that have combined a measuring instrument and a phenomenological approach. What this paper adds? Distress among patients with cancer derives from elements that relate to health services, as well as the individual's ability to deal with the situation.Distress is greater among patients who have not begun chemotherapy and those who have head and neck cancer diagnoses.Phenomenological method can complement the use of scales to assess the subjective experience of distress in the context of cancer and chemotherapy. Implications of this paper Distress evaluation must encompass listening and the use of measurement instruments to strengthen the implementation of patient‐centred nursing care.Nurses are in a unique position to identify and approach distress, because they are often at the side of patients throughout the course of treatment.Professional training for reporting of difficult news is required. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a public health problem globally. Understanding the perceived challenges of low‐income older people populations with chronic disease is an obstacle the world is facing today. Aim To explore perceived challenges of self‐management in low‐income older people with hypertension. Methods: Data were collected in three communities from September 2019 to October 2019 by semi‐structured interviews. Interviews were audio‐taped by digital voice recorder and analysed according to Colaizzi's seven steps. Results: Participants demonstrated perceived challenges concerning hypertension self‐management. Six themes were identified: hypertension belief bias, family dysfunction, deep‐rooted habit, elder self‐neglect, medical informatization and supportive health policy. Each theme was identified with several subthemes. Conclusions: Findings implied that most of the low‐income older people lacked self‐management behaviours. Future research is needed to address perceived challenges related to self‐management behaviour for patients with hypertension worldwide. Summary statement: What is already known about this topic? Self‐management of hypertension is a cornerstone for blood pressure control.Most older patients lack self‐management behaviours.Low‐income older people with hypertension are the population most vulnerable to poor self‐management.What this paper adds Low‐income older people are more likely to have biased perceptions of hypertension self‐management, which might be affected by social customs, peer behaviour and personal preference.Older people also tend to ignore their health to meet the needs of family members as a priority.With the development of information technology, more effort should be taken to help low‐income older people acquire medical information via e‐health.The implications of this paper Proper awareness of the importance of self‐management is the priority for hypertension control.Managing physical, psychological and social frailty in older people and reducing elder self‐neglect rates are significant to improve self‐management behaviours.Family plays an important role in self‐management of low‐income older people with hypertension and family empowerment programs are suggested. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore perceptions of people with spinal cord injuries regarding the information they received during their rehabilitation programme on post‐injury sexual functioning. Background: Spinal cord injury is a traumatic, life‐altering event that is associated with loss of motor and sensory function and sexual impairment. Existing evidence suggests that sexual issues are poorly handled during the rehabilitation phase of the patient's journey. Design A descriptive qualitative design was utilized in this study. Methods: Twenty‐nine people with spinal cord injury participated in qualitative in‐depth interviews between November 2017 and April 2018, and data were analysed using the Burnard (1991, https://doi.org/10.1016/0260-6917(91)90009-y) thematic analysis framework. Results: Some participants indicated they were sexually inactive prior to their spinal cord injury. They testified that they had not received information on post‐injury sexual functioning. Many participants who received post‐injury information on sexual functioning reported dissatisfaction with the content and timing of this information. Conclusion: Personal conversations between spinal cord injured patients and dedicated members of the interdisciplinary health team can enhance the quality of rehabilitation care and patients' satisfaction with rehabilitation care. Nurses are central clinicians in the rehabilitation programme of spinal cord injured patients and should engage in individually designed conversations about post‐injury sexual functioning. Summary statement: What is already known about this topic? Spinal cord injury causes significant disturbances of sexual functions and sexuality with potential serious implications for sexual relationships.Sexual health issues are considered important aspects of holistic care but are not routinely addressed in health‐care settings.Spinal cord injuries units provide rehabilitation for people with spinal cord injuries. What this paper adds? There are multiple barriers to providing high‐quality information on sexual functioning within the rehabilitation setting, associated with personal, clinician and systems‐related factors.Determinations regarding individualized plans for sexual health conversations must be collaborative with the patients and possibly their family members, considering the individual views of patients regarding the best timing, content and most appropriate method for such interventions.The experiences and views of people with spinal cord injury are diverse and probably culturally dependent, and there are inherent risks associated with stereotypical attitudes to sexual behaviour and age. The implications of this paper: Spinal cord rehabilitation services must respond to the identified unmet needs of people with spinal cord injury regarding education on sexual functioning.Multidisciplinary teams that utilize a holistic approach designed collaboratively with the individual with spinal cord injury will have the best potential for success.To be able to successfully realize rehabilitation standards, clinicians must be immersed in techniques and strategies that motivate and guide them in discussing sexual functioning and other sexual health‐related issues. [ABSTRACT FROM AUTHOR]

Aim: The aim of this research was to provide an in‐depth study about the life experiences of patients with inflammatory bowel diseases. Methods: The phenomenological (hermeneutic) method was used to analyse data. The data were collected between March 25 and July 1, 2019. A homogeneous group of 25 patients were included as participants by purposeful sampling methods. Interviews were conducted in the hospital patient‐education room. Results: The results of this study emphasize the importance of understanding the fears, worries, difficulties and life experiences of patients with inflammatory bowel diseases. Three main themes were identified: a flare phase of the disease, a remission period and coping behaviours. Study findings included the experiences of social isolation; inability to perform daily activities of living and to work; stress in the flare phase of the disease; concerns about the future in the remission phase and physical and spiritual strategies used for coping. Conclusion: Coping with the physical symptoms and emotional difficulties of inflammatory bowel diseases can prevent patients from living a normal life. The results of this article highlight the importance of understanding the fear, anxiety, difficulties and life experiences of these patients. Summary statement: What is already known about the topic? Some research on inflammatory bowel disease exists, but patient experiences differ.IBD patients may not be able to maintain a normal life due to the effects of the disease. What does this paper add? It enables nurses to know and understand the life experiences of IBD patients. The implications of this paper: Knowing and understanding the experiences of IBD patients, nurses can provide personalized care and support tailored to each patient's needs and concerns [ABSTRACT FROM AUTHOR]

Aim: This qualitative study explored de‐implementation of feeding tube auscultation practice in adult patients by critical care nurses. Background: Despite years of evidence suggesting inaccuracy and harm, auscultation (air bolus method) continues to be used by the majority of critical care nurses to verify small‐bore feeding tube placement in adults. Design This descriptive qualitative study used thematic analysis with telephone interview data. Methods: Fourteen critical care nurses from four stratified groups within the United States (by hospital type and auscultation practice) participated in telephone interviews. Results: Two major themes of individual influence and organizational leadership emerged from the data. Categories identified key components required for auscultation de‐implementation. Conclusions: Nurses feel obligated to follow hospital policies and expressed less accountability for their own practice. Organizational leadership involvement is recommended to facilitate de‐implementation of this tradition‐based, low‐value practice and mitigate harm events. Summary statement: What is already known about this topic? Auscultation is not an accurate method to identify feeding tube placement.Many critical care nurses continue to use the auscultation method (a low‐value, tradition‐based practice) to verify feeding tubes.Factors associated with de‐implementation of auscultation method for feeding tube verification are unknown. What this paper adds? Many nurses are aware that auscultation is not evidence based for adult feeding tube verification and are falsely comforted by hearing the whoosh sound (psychological bias).A combination of individual and organizational factors are barriers to de‐implementing auscultation of feeding tubes.Nurses seek guidance from leaders within their organization to facilitate de‐implementation, which is a necessary component of evidence‐based practice. The implications of this paper: A major challenge to de‐implementation of auscultation is the lack of valid bedside methods to assess feeding tube placement. Active involvement by organizational leaders will facilitate decision‐making to recommend a safe substitution for the auscultation method.Nurses expressed eagerness to incorporate evidence into their practice if they have adequate leadership support and the necessary resources to make practice changes.Formal intervention by organizational leaders is needed to promote de‐implementation of auscultation for feeding tubes. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether a novel decision support tool would effectively minimize physical restraint use in critically ill adult patients. Design A nonequivalent quasi‐experimental design combined with a descriptive qualitative approach was used. Methods: A Restraint Decision Tree was developed based on a qualitative study that explored the barriers to employ the Restraint Decision Wheel. During the quasi‐experimental study, patients admitted to the unit between October 2017 and March 2018 were enrolled as the control group receiving the Restraint Decision Wheel (n = 528), whereas patients between April 2018 and September 2018 were enrolled as the intervention group receiving the Restraint Decision Tree (n = 564). The physical restraint rate, accidental catheter removal rate and nurses' satisfaction were compared. Results: The Restraint Decision Tree significantly decreased physical restraint use. No significant difference in the rate of accidental catheter removal was found. Nurses reported increased satisfaction with the restraint decision‐making. Conclusions: The Restraint Decision Tree could minimize physical restraint use. Physicians' involvement in the restraint decision‐making and nurses' competence in delirium assessment may be essential for successful implementation of the Restraint Decision Tree. Summary statement: What is already known about this topic? Physical restraint is a common practice in the intensive care unit.Minimizing physical restraint use does not increase the risk of catheter self‐removal.Nurses equipped with clinical decision‐making skills could promote the appropriateness of restraint application. What this paper adds? The Restraint Decision Tree could help nurses make appropriate restraint decisions for critically ill adult patients, thus decreasing the use of physical restraint.Multidisciplinary decision‐making improves nurses' satisfaction with the restraint decision process. The implications of this paper: This study suggests that the Restraint Decision Tree can be implemented in the intensive care unit as an effective decision‐making tool to decrease physical restraint use while maintaining patient safety.A strong culture of multidisciplinary collaboration and delirium screening is called for prior to utilizing the Restraint Decision Tree. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to describe the experiences of nurses and other health care workers who were infected with coronavirus disease 2019. Methods: An empirical phenomenological approach was used. Sixteen participants were recruited in Wuhan using purposive and snowball sampling. Semistructured, in‐depth interviews were conducted by telephone in February 2020. Interviews were transcribed verbatim and analysed following Colaizzi's method. Results: Two themes emerged: (1) Intense emotional distress since becoming infected. Participants were fearful of spreading the virus to family and overwhelmed by a lack of information, experienced uncertainty and worried about treatment, felt lonely during isolation and reported moral distress about inadequate health care staffing. (2) Coping strategies were needed. They tried their best to address negative psychological reactions using their professional knowledge and gaining support from others and community resources. Conclusions: Preparedness for catastrophic events and providing timely and accurate information are major considerations in government policy development, related to pandemics and adequacy of health care personnel. Mental health resources and support, both short‐ and long‐term should be anticipated for health care providers to alleviate their fear and anxiety. Summary statement: What is already known about this topic? Health care workers, including nurses, are at the frontlines of the COVID‐19 outbreak and at high risk of infection.Experts have called for infection prevention for health care providers.Limited research has reported the experiences of health care workers infected by COVID‐19 using an empirical phenomenological approach. What this paper adds? Upon diagnosis, nurses and other health care workers experienced fear, uncertainty and distress like general patients.Health care workers reported moral distress about inadequate health care staffing issues.Health care workers could cope with their negative psychological reactions using professional knowledge and support from significant others and the community. The implications of this paper: Preparedness for large‐scale pandemics and a system that can provide openness and timely information needs consideration in policy development.Accurate information and good communication are vital to support infected health care workers and enhance their sense of safety and belonging.Long‐term support should be available when these health care workers return to work. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore nurses' views and experiences regarding remaining silent. Background: Silence is a barrier for organizational improvement and can occur for many reasons; it cannot be simply defined as the opposite of speaking out. Method: An exploratory qualitative design was used for this study. Data were collected using semi‐structured interviews in 2016 with 24 nurses who were recruited by using a snowball sampling method. Results: Three themes emerged as a result of the thematic analysis: fear, silence climate and disengagement. The first theme contained three subthemes: avoidance of being seen as a troublemaker, financial loss and reluctance to reveal lack of ability or knowledge. The results indicated that nurses remained silent when they felt unsupported or psychologically unsafe in their work environment. Conclusion: Encouraging nurses to express their opinions is essential for creating a psychologically safe nursing work environment and an organizational climate that supports open communication. Because the majority of healthcare professionals are nurses, they can act as role models and change agents for other nurses if they are encouraged to share their ideas and opinions without fear of retribution. Summary statement: What is already known about this topic? Silence negatively affects work environment and causes job dissatisfaction.Silence is a threat to the development of new ideas and prevents nurses from raising concerns about critical issues. What this paper adds? Nurses remain silent when they fear losing their jobs, showing weakness or being labelled as a troublemaker.Nurses' work environment affects their decision to speak up.If nurses do not receive any support or see any change, they tend not to speak up. The implications of this paper: Hospital managers should support a work environment that encourages open communication and productive feedback systems.Silence can be prevented by creating a psychologically safe environment in which no one is judged for their opinion. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions This qualitative systematic review aimed to consolidate existing evidence on the self‐management experience of older patients with multimorbidity worldwide.Nine databases were searched, for papers published from database inception to April 2023. The systematic review was conducted according to the systematic review method of qualitative evidence by the Joanna Briggs Institute (JBI).Seven studies were included. Finally, four themes and 12 subthemes were formed: (1) physical level: reduced physical function and lack of coordinated care; (2) psychological level: mental state of anxiety and positive attitude towards life; (3) social level: technical support, support from family, support from healthcare workers and support from others; and (4) practical level: economic burden, lifestyle changes, self‐care in daily life and compliance was much lower than expected.To improve self‐management in older people with multimorbidity, nurses should provide more guidance to patients to improve their self‐management skills, and clinicians should recommend effective self‐management behaviours. [ABSTRACT FROM AUTHOR]

Aim: To describe academic nurses' experiences engaging clinical nurses in utilizing and implementing developmental and research‐based knowledge in hospital settings. Methods: This study used a descriptive qualitative design. Fourteen academic nurses at Masters or PhD level from three different regions of Denmark participated in the study, relating their successful experiences engaging clinical nurses in utilizing and implementing developmental and research‐based knowledge. Data were collected in February 2020 through qualitative semi‐structured interviews and analysed using a qualitative manifest content analysis. Results: The main theme revealed was that academic nurses were 'Working towards creating a practice‐related culture for research' to engage clinical nurses. This was supported by three subthemes: 'Focusing on evidence‐based practice knowledge', 'Facilitating knowledge through a pedagogical approach' and 'Aiming for future changes'. Conclusions: The academic nurses experienced their engagement of clinical nurses and the subsequent change of practice in patient care and nurses' workflows in the department settings, as successful due to the academic nurses' pedagogical actions to educate clinical nurses and due to the academic nurses' practice‐related approach to research and implementation. Summary statement: What is already known about this topic? Nurses who utilize research and work with evidence‐based practice are more satisfied with their work, have better patient outcomes and become advocates for patients as they focus on improving the quality of patient care.Engaging nurses in nursing research can be a difficult task due to barriers to research utilization. However, most nurses have positive attitudes towards research.Knowledge is needed about how nurses have been successfully engaged in utilizing and implementing developmental and research‐based knowledge. What this paper adds? Academic nurses have successfully engaged clinical nurses in research and development by creating a practice‐related research culture.Engaging clinical nurses in research and development can be improved by focusing on evidence‐based knowledge to solve practical problems in nursing.Facilitating knowledge of research through pedagogical actions of education and involvement is often more important than the academic knowledge itself. The implications of this paper: Engaging clinical nurses in research and development depends upon making practice‐related research culture a natural part of daily nursing practice.Dual management, consisting of two head nurses—one for practice and one for research—should be established to improve academic nurses' authority to implement changes in nursing practice. [ABSTRACT FROM AUTHOR]

Background: This study focuses on hospital‐employed researchers, a relatively new staff group. Their job descriptions vary, which may lead to lack of clarity or preparedness regarding their roles and core tasks during a crisis such as COVID‐19. Aim: The aim of this study was to explore hospital‐employed healthcare researchers' experiences of work during the COVID‐19 pandemic. Design A qualitative design based on Graneheim and Lundman's latent content analysis of two focus groups with researchers in clinical practice was chosen to explore researchers' experiences of work during the COVID‐19 pandemic. Methods: Fifteen hospital researchers participated in two focus groups, divided into predoctoral and postdoctoral researchers. Focus groups were conducted in May 2020 during the COVID‐19 pandemic, using the voice over IP service, Skype®, due to risk of contagion. Findings 'Searching for a new normal during the COVID‐19 pandemic' was the main theme during the latent content interpretation, with subthemes of (i) balancing calm and insecurity, (ii) negotiating core tasks and (iii) considering the future. Conclusion: The 15 researchers tried to balance calm and insecurity within work and family, on standby for the hospital's contingency plan, and in their research tasks. This led them to negotiate their core tasks and to reflect on the changes and consequences for their positions as researchers in clinical practice in the future. Summary statement: What is already known about this topic? During a major healthcare crisis, normal plans and procedures at hospitals are set aside.Working under unexpected and unsecure conditions may lead to postcrisis reactions.Researchers with nursing and allied health backgrounds, who are the first generation of these researchers at hospitals, do not have fully developed and recognized positions. What this paper adds? Nurse and allied health researchers searched for a new normal in their work during the COVID‐19 pandemic.Nurse and allied health researchers tried to balance calm and insecurity during the COVID‐19 pandemic, due to the imbalance between their research‐related tasks and their status on standby for clinical tasks in the hospital contingency plan.Nurse and allied health researchers struggled with identifying and negotiating their core tasks by reconsidering possible changes and consequences for their positions as researchers in clinical practice in the future. The implications of this paper: Nurse and allied health researchers employed in clinical practice were willing to participate on the frontline, monitoring and evaluating major healthcare crises like the COVID‐19 pandemic.This could potentially lead to new and important context‐sensitive learnings after crisis but only if healthcare leaders and organizations clearly formulate the expectations for the researchers. [ABSTRACT FROM AUTHOR]

Aims: The aim was to describe the experiences of nurses in broaching the issue of overweight and obesity at maternity and child health clinics. Background: The mother's obesity and excessive weight gain during pregnancy and rapid weight gain in early childhood increase the risk of obesity of the newborn baby both in childhood and throughout life. Attention must be paid to the prevention of weight gain in families already during pregnancy and before school age. Methods: Informants were nurses working at maternity and child health clinics (N = 28). The qualitative data were collected by a focus group interview in spring 2016 and analysed using inductive content analysis. Findings The nurses interviewed considered it their duty to broach the issue and felt that they have sufficient courage to bring up overweight. They sometimes found it frustrating to talk about overweight and obesity, because families do not commit themselves to making lifestyle changes, and changes happen slowly. Nurses found the lasting relationship with families helpful for bringing up overweight. Conclusion: Nurses need more broaching skills, more training, supervising and tools for bringing up overweight and obesity with client families. The continuity of care in primary health care supports bringing up overweight. Summary statement: What is already known about this topic? Overweight means the risk of obesity, and obesity is defined as excessive fat accumulation in the body.Early recognition of the risk factors for overweight and addressing them play a key role, because treating obesity and reaching lasting results is difficult.Nurses working at maternity and child health clinics play an important role in preventing overweight and obesity in pregnant families and families with children and in broaching the issue, because almost all families use maternity and child health clinics' services. Whatthis paper adds? Nurses consider broaching the issue of overweight and obesity as their duty and an integral part of their work.Nurses recognize the feelings of frustration and negative emotions sometimes associated with taking up the issue of overweight and obesity, but they have difficulties to support families in this kind of situations.Nurses found the lasting relationship with families helpful for bringing up overweight. The implications of this paper: When in practice both nurses and clients recognize bringing up overweight and obesity, nurses need more training and support how to motivate families for the necessary change, identify family‐specific ways and utilize the family's own resources in spite of their own frustration.More attention has to be paid in nursing education on how to bring up overweight or some other emotional issues with clients. Nurses need more broaching skills, more training, supervising and more tools for bringing up overweight and obesity.We need more scientific knowledge about how negative emotions steer the operation of nurses and how they affect the willingness of families to make lifestyle changes. [ABSTRACT FROM AUTHOR]

Aim: To identify fathers' perceptions and experiences of caring for their children with congenital heart disease. Design A qualitative systematic review. Data sources PubMed, Clinical Key, the Joanna Briggs Institute Evidence‐based practice database, CINAHL Complete, Embase and PsycINFO were searched for all journal articles published before May 2020. Review methods: After applying the selection criteria, five studies were identified reporting on fathers with children between 1 month and 12 years. The quality of the articles was evaluated. Results: Six main themes regarding fathers' perceptions and experiences of caring for their children with congenital heart disease were identified: (1) lack of disease knowledge, (2) responsibility to the family and emotional suppression, (3) gratitude for the sustained life of their children, (4) acceptance of being different from others, (5) regrouping and planning for the future and (6) the struggles of father–child relationships. Conclusion: In caring for their children with congenital heart disease, fathers are akin to a suffering warrior, full of hardship. With a self‐imposed sense of responsibility and suppressed emotions, fathers may feel lonely and hurt, but they must fight for their families and children. Summary statement: What is already known about this topic? Congenital heart disease is one of the most common chronic illnesses in childhood.Parents of children with congenital heart disease face cardiac‐related medical problems, decision‐making and economic circumstances throughout their healthcare experience including impact on their physiological and psychological health.Previous studies have focused on the roles of mothers of children with congenital heart disease. What this paper adds: This systematic review identifies six themes regarding fathers' perceptions and experiences of caring for their children with congenital heart disease: (1) lack of disease knowledge, (2) responsibility to the family and emotional suppression, (3) gratitude for the sustained life of their children, (4) acceptance of being different from others, (5) regrouping and planning for the future and (6) the struggles of father–child relationships.In caring for their children with congenital heart disease, fathers are akin to a suffering warrior, full of hardship.With a self‐imposed sense of responsibility and suppressed emotions, fathers may feel lonely and hurt, but they must fight for their families and children. The implications of this paper: The findings about fathers' perceptions and experiences of caring for their children with congenital heart disease can be beneficial in improving nursing practice.Health care professionals need to actively involve and support fathers in caring for their children with congenital heart disease. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the experiences of family caregivers interacting with people with dementia. Background: A majority of people with mild‐to‐moderate dementia live at home with family caregivers. This interaction creates positive experiences and challenges for these caregivers. Design Descriptive phenomenological qualitative inquiry guided this study. Methods: This qualitative study involved semi‐structured interviews with the caregivers of people with mild‐to‐moderate dementia (n = 10). Data were collected from June to September 2018, and then data were thematically analysed. Results: Six categories of themes were identified from the interviews: (1) unexpected things often happen; (2) positive coping strategies; (3) sense of accomplishment because people with dementia actively participate in activities; (4) sense of frustration because of the reluctance of people with dementia to participate in activities; (5) hope for the happiness of people with dementia; and (6) want to have their own life. Conclusions: This study reveals that caregivers could positively interact with people with dementia through creating opportunities and arranging meaningful activities. Future research should focus on family management and training on how to help caregivers interact effectively with people with dementia. SUMMARY STATEMENT: What is already known about this topic? A majority of people with mild‐to‐moderate dementia live at home with family caregivers.Many caregivers suffer from depression, anxiety, fatigue, insomnia, family conflicts and low levels of life satisfaction.How caregivers interact with people with dementia at home remains unclear. What this paper adds? Caregivers experience various feelings, such as a sense of accomplishment and occasionally frustration, when interacting with people with dementia.Caregivers stated that they wanted people with dementia to be happy and live their life. Thus, the caregivers changed their attitude, accepted the situation and organized meaningful activities for people with dementia.Caregivers employed various strategies for handling situations involving people with dementia and shared how they interacted with such individuals. The implications of this paper: Care organizations that can offer certain services for people with dementia should be developed to lessen caregivers' burden.Community nurses should develop caregivers' strengths and enhance their abilities to improve interaction with people with dementia.Future research should focus on family management and training on how to help caregivers interact effectively with people with dementia. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to describe the experience of nursing care provided to the deceased organ donor by the nurse transplant coordinator. Methods: A qualitative exploratory study was conducted within the National Transplant Organization and the Regional Office for Transplant Coordination. A purposive sampling method was used. Data collection methods included semistructured interviews. Sampling and data collection were pursued until the researchers achieved information redundancy. A systematic text condensation analysis was performed. The Guba and Lincoln criteria for guaranteeing trustworthiness were followed. Results: A total of 16 participants were recruited, and three themes were identified regarding care of organ donors by the nurse transplant coordinator during the organ donation process: (a) fulfilling the desire and will of the donor patient; (b) the family as an extension of the donor; (c) coordinating the organ donation process. Conclusions: The donation process is both complex and delicate, and nursing care is an essential component. The care provided by the nurse transplant coordinator has the donor at the centre of the process, driven by respect for their decision. The family is seen as an extension of the donor. Nursing care should focus on continuous, honest communication, coordinating care with the intensive care unit, ensuring privacy and intimacy. SUMMARY STATEMENT: What is already known about this topic? Spain is the world leader in organ donation, with a rate of 48.0 donations per million population.The nurse transplant coordinator plays a significant role in the organ donation process, dealing with the difficulties of a tight schedule, in order to shorten ischemia times, while addressing grief, family decision making and donor care. What this paper adds? The hospital‐based nurse transplant coordinator is an essential role that links the donor's family and health professionals related to the donor hospital. Support within the nurse transplant coordinator team is key for organization and to prevent failure of the organ donation process.Donor care interventions are aimed at facilitating the donation process while maintaining the dignity of donors.The donor's family needs constant communication, based on reliable, empathetic and organized information. These results highlight family care as part of the donor care provided by nurse transplant coordinators, seen as an extension of the donor. The implications of this paper: This study captures the importance of the hospital‐based nurse transplant coordinator as the role able to provide donor centre care, ensuring the success of the organ donation process.Hospital structures and intensive care units (ICUs) must guarantee adequate spaces for communication with the family, respecting privacy and specific family needs.Maintenance and improvement of support among nurse transplant coordinators should be implemented to coordinate times and ensure the safety and success of the organ donation process. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to investigate stereotypes of occupational gender roles about male nurses, as viewed from both emic and etic perspectives. Background: Male nurses are a minority group in health institutions. Stereotypes have been questioned regarding these males' occupational role and presence in the nursing profession. Design A qualitative description design was used. Methods: During 2016, semi‐structured interviews (N = 30) were conducted with male nurses (n = 10) (emic group), female nurses (n = 10) and discharged patients (n = 10) (etic groups) from four public hospitals. Results: Seven categories with respective themes and subthemes emerged. Three categories were captured for emic groups, namely, existing stereotypes, experiences of stereotyping and the influences of stereotypes on work performance. Four categories emerged for etic groups, namely, treatment preferences, types of stereotyping towards male nurses, origin of stereotypes and effects of stereotypes. Conclusion: Positive and negative stereotypes were reported by both emic and etic groups, with etic groups revealing more stereotypes. Effort should be made by both management in the practice environment and the media to counter the stereotyping of male nurses. SUMMARY STATEMENT: What is already known about this topic? Stereotyping of male occupational roles in the nursing profession has been questioned.Limited information is available on male occupational stereotypes in the nursing profession within low‐ and medium‐income countries such as South Africa. What this paper adds (research findings/key new information)? This paper describes perspectives with both an emic (male nurses) and etic (female nurses and discharged patients) focus on occupational stereotyping of males in the nursing profession.The findings indicated more stereotyping towards male nurses from etic groups compared with emic groups. The implications of this paper (how findings influence or can be used to change policy/practice/research/education): The media and the Departments of Education and Health should assist by creating public awareness on the importance of male nurses in the profession.Practice environments should support male nurses through in‐service training and open discussions between various categories of staff, to prevent stereotyping and sensitize staff on the impact of stereotyping on male nurses. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to identify barriers and benefits in establishing a model for integration of palliative care of cancer patients in daily clinical practice in tertiary health institutions. Methods: This was a qualitative design study using in‐depth interviews with four stakeholders and focus group discussions with 19 nurse managers using purposive sampling to select the participants, utilizing interpretive paradigm method. Need was ascertained for a model that would guide nursing care for cancer patients. Results: Barriers identified in relation to integrating palliative care in daily clinical practice included lack of hospital policies about palliative care activities, cultural influences, denial or rejection of diagnosis by patients, inappropriate attitude of health care workers, patients failing to keep check‐up appointments and financial implications of setting up a dedicated palliative care team. Benefits of the model were twofold: hospital outcomes and patients/family outcomes. Conclusions: Quality care for cancer patients/families calls for the adoption of clearly set out principles of palliative care as an integral component of daily practice. Challenges to implementation of palliative care services in hospitals can be overcome by establishing workable policies and allocating adequate funds for palliative care activities. SUMMARY STATEMENT: What is already known about this topic? There is high incidence rate of cancer globally and Nigeria is not an exception.Diagnosis of cancer brings about fear and psychological distress to patients and their families.There is absence of health policy in Nigeria on prevention, control or even care of conditions such as cancer. What this paper adds? Barriers to adapting a palliative care model can be overcome by instituting policies, guidelines and palliative care teams to monitor all patients diagnosed with cancer.General positive attitude of health care professional towards cancer patients and families.Barriers to palliative care model implementation can be overcome by proper follow‐up of patients on first diagnosis. The implications of this paper: Hospital management can develop and implement interventions based on patients identified needs.Nurses should be properly trained on palliative care principles.There should be medium of educating patients and families after diagnosis of cancer to avoid negative cultural influence. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to determine the need for and value of nurse and midwife prescribing in Ireland as identified by these prescribers—the people most able to provide relevant insights and information. Background: Since 2007, nurses and midwives in Ireland who have passed an additional educational program can prescribe medicinal products relative to their clinical practice areas. Research evidence of efficacy is needed now for prescribing sustainability in Ireland and to encourage, if successful, the adoption or expansion of frontline nurse/midwife prescribing rights in other countries. Design A qualitative study was undertaken. Methods: Interviews with registered nurse and midwife prescribers were conducted in 2017 until data saturation. Constant‐comparative coding and categorization of data revealed themes and categories, with explanatory quotes for research trustworthiness and credibility purposes. Results: Six data themes emerged: (a) more than just writing prescriptions; (b) highly individualized evidence‐based specialist care; (c) assured, timely and rapid accessibility to needed care; (d) health system and healthcare efficiency gains; (e) satisfaction with nurse/midwife prescriber services and (f) quality care improvements. Conclusion: Nurse/midwife prescribing in Ireland was identified as needed, safe, effective and cost‐effective. Prescribing permitted accessible, thorough and proactive holistic health promotive care to be provided in nurse‐ or midwife‐led outpatient clinics. SUMMARY STATEMENT: What is already known about this topic? Nurse prescribing has been demonstrated in general so far as being safe and effective.Nurse prescribing is typically done by nurse practitioners or advance practice nurses.A growing number of countries are considering or initiating nurse prescribing. What this paper adds? Evidence is gained from Irish nurse and midwife prescribers revealing the need for and value of their prescribing.Information on how nurse/midwife prescribers do their prescribing work is provided.Insight into outpatient clinics where nurse/midwife prescribers provide primary care services enabling medical specialists to be more available for complex cases. The implications of this paper: New ways of meeting the healthcare needs of chronically ill and other at‐risk populations should be considered and particularly when ER and hospital admissions occur because of unmet care needs.Every developed and developing country should consider initiating prescribing education for nurses and midwives with defined specialty knowledge and skills.Every developed and developing country should pilot test nurse and midwife prescribing. [ABSTRACT FROM AUTHOR]

Aims and objectives: The study aims to explore and describe nurses' behaviours towards physical restraint (PR) use in intensive care units (ICUs) and identify key characteristics of these experiences. Background: Patients within the ICU are always vulnerable, which requires a thoughtful deliberation when employing PR in ethically laden situations. Considering that the qualitative study on nurses' behaviours towards PR use in ICUs is limited, a deep understanding of how nurses reason and restrict patients is necessary before developing a minimizing programme in hospitals. Methods: A descriptive qualitative study was conducted in this paper. Data were collected by 24 semistructured, in‐depth and individual interviews about PR, where 24 nurses were drawn from six ICUs of four hospital settings from a comprehensive tertiary care hospital in Qingdao. The QSR NVivo 11.0 software program was used to manage the interview data, and data analysis was guided by the Qualitative Analysis Guide of Leuven. The checklist of Consolidated Criteria for Reporting Qualitative Studies was followed as a guideline in reporting the study. Results: Regarding PR, nurses' behaviours start with a hazard perception, followed by hesitation about whether to restrict the patient. They would usually decide to apply PR when they think that no other choice to control the situation is available. Then, they would reflect on and rationalize their behaviours. Nurses, intensivists, patients and their families participate in and affect this process directly or indirectly. Conclusions: Nurses' behaviours towards PR use comprise a series of complex processes centred on safety. Nurses' decision making should be performed with the participation of intensivists, patients and family caregivers. SUMMARY STATEMENT: What is already known about this topic? The use of physical restraint (PR) is common in ICUs and is always a highly controversial topic.Nurses play a key role in PR practice.PR use from the perspective of nurses is rarely investigated in the literature. What does this paper add? Nurses' behaviours towards PR use comprise a series of complex processes centred on safety.In most cases, nurses' PR practice includes phases of perception, hesitation, implementation and reflection.Nurses, intensivists, patients and their families participate in and affect this process directly or indirectly. The implications of this paper: This paper provides a nuanced understanding of the complexity of nurses' behaviours towards PR use.The use of PR is never experienced as a single, fixed binding technique but a series of complex behavioural processes. Nurses, intensivists, patients and family caregivers contribute to the dynamic character of the practice.Taking targeted interventions from nurses, intensivists, patients and family caregivers is urgently needed to regulate PR application. [ABSTRACT FROM AUTHOR]

Background: Preoperative skin preparation is performed differently by different operating room nurses. Aim: To deepen the understanding of skin preparation within an orthopaedic surgical setting from the operating room nurse perspective and to explore their experiences. Methods: A qualitative exploratory design was used. Four focus group interviews were conducted during 2016–2017, at four hospitals in Sweden, using procedures developed by Krueger and Casey. A total of 19 operating room nurses were recruited through purposive sampling. Results: Statements were categorized into four categories of experiences: (1) Knowing, which related to learning and sources of knowledge; (2) Doing, which related to skin preparation and activities based on tradition and evidence; (3) The Team, which related to the assignment of responsibility and collaboration with patients and other professions; and (4) The Setting, which related to factors around the patient and included feelings of time pressure and access to supplies. Conclusions: Theory and practice differ, and some skin preparation used are based on tradition rather than on evidence or recommendations. Elements both within the team in the operating room and within the organization influence the result. Operating room nurses' duty to perform safe skin preparation must be respected in the team. SUMMARY STATEMENT: What is already known about this topic? Skin preparation before surgery is performed differently at different clinics and by different operating room nurses.The procedures used deviate from manufacturers' recommendations and available guidelines.Several skin preparation methods are based on traditional routines that lack scientific support. What this paper adds? Skin preparation is mostly taught and learned in a traditional manner, and a knowledge/practice gap exists.The organization, the team, the patient and the availability of supplies influence the performance and results of skin preparation.A rising demand for keeping up with productivity made operating room nurses concerned for patient safety. The implications of this paper: To provide safe care, skin preparation needs to be based on evidence.To ensure patient safety, management and head nurses must address the insufficiency of resources, the most prominent of which is insufficient time for the assessment and performance of careful skin preparation to prevent surgical site infections. [ABSTRACT FROM AUTHOR]

Aim: To synthesize qualitative evidence on nurses' end‐of‐life care practices in long‐term care settings for older adults. Background: Qualitative evidence on how nurses describe their own end‐of‐life care practice has not been reviewed systematically. Design Qualitative systematic review. Data Sources: Databases MEDLINE, CINAHL, PsycINFO, EMBASE, Mednar, Google Scholar, and Ichushi were searched for published and unpublished studies in English or Japanese. Methods: The review followed the Joanna Briggs Institute approach to qualitative systematic reviews. Each study was assessed by two independent reviewers for methodological quality. The qualitative findings were pooled to produce categories and synthesized through meta‐aggregation. Results: Twenty studies met all inclusion criteria. Their 137 findings were grouped into 10 categories and then aggregated into three synthesized findings: playing multidimensional roles to help residents die with dignity, needing resources and support for professional commitment, and feeling mismatch between responsibilities and power, affecting multidisciplinary teamwork. Conclusion: Nurses play multidimensional roles as the health care professionals most versed in residents' complex needs. Managers and policymakers should empower nurses to resolve the mismatch and help nurses obtain needed resources for end‐of‐life care that ensures residents die with dignity. SUMMARY STATEMENT: What is already known about this topic? End‐of‐life care in long‐term care settings for older adults is now a global concern.End‐of‐life care is one of the essential competencies of nurses working in long‐term care settings for older adults.How nurses working in long‐term care settings describe their own end‐of‐life care practice for dying residents has not been reviewed systematically. What this paper adds? Nurses working in long‐term care settings play multidimensional roles in end‐of‐life care to help residents die with dignity.Long‐term care nurses need resources and emotional and educational support for professional commitment to their roles.Long‐term care nurses value collaborating with other health care professional on end‐of‐life care but feel mismatch between their responsibilities and their power in this regard. The implications of this paper: Long‐term care nurses should understand and be able to handle the challenges of helping residents die with dignity, such as alleviating suffering and mediating the wishes of residents with cognitive decline or dementia.Facility managers and policymakers should empower long‐term care nurses with concomitant power to meet these challenges, consistent with education and training.Further research is needed to clarify how the culture and systems of long‐term care settings in various countries influence end‐of‐life nursing care practice. [ABSTRACT FROM AUTHOR]

The utility of qualitative research findings in the health sciences has been the subject of considerable debate, particularly with the advent of qualitative systematic reviews in recent years. There has been a significant investment in the production of guidance to improve the reporting of quantitative research; however, comparatively little time has been spent on developing the same for qualitative research reporting. This paper sets out to examine the possibility of developing a framework for refereed journals to utilize when guiding authors on how to report the results of qualitative studies in the hope that this will improve the quality of reports and subsequently their inclusion in qualitative syntheses and guidelines to inform practice at the point of care. [ABSTRACT FROM AUTHOR]

Aim: To build a comparative understanding of nurses' experiences with caring for burned patients with the goal of eliciting possible support strategies. Background: Considering the stressful nature of burns nursing, there is a need to develop support strategies for burn care nurses. Design This meta‐ethnographic study used Noblit and Hare's approach and followed PRISMA guidelines. Data sources The search databases included PsycINFO, EbscoHost, Google Scholar, ScienceDirect, and PubMed from 1990 to 2017. Review methods: Qualitative studies were included in the review if they examined burn care nurses' experiences. The Critical Appraisal Skills Programme quality assessment tool was used to appraise each study. Results: Ten papers (six articles and four theses) published between 1998 and 2014 met the criteria for inclusion. Three key concepts were generated from the synthesis: becoming a burns nurse, work environment, and nurses' emotional responses. The relationships between the concepts were noted to be reciprocal, from which a line of argument was developed using Schutz notion of constructs. Conclusion: There is a need to establish structures that can encourage burn care nurses to verbalise their feelings as well as strengthen the nursing team. SUMMARY STATEMENT: What is already known about this topic? Burns are common injuries in societies and caring for burned patients has been described as stressful.Nurses play essential role in caring for the burned patientIt is unclear how burn care nurses can be supported What this paper adds? The burn care environment is a major source of stress for nursesThe nursing team forms a major source of support for burn care nursesAvenues of release are required in the burn care environment to enhance nurses' verbalisation of concerns as they provide care. The implications of this paper: There is a need to include "managing emotional issues" in nursing curriculaFindings imply the need to encourage the development of a strong nursing team as they ensure the provision of support to membersCounselling services need to be made available for nurses in burns units. [ABSTRACT FROM AUTHOR]

Baillie L, Gallagher A. International Journal of Nursing Practice 2011; 17: 336-341 Respecting dignity in care in diverse care settings: Strategies of UK nurses This paper presents nurses' views of dignity issues in diverse UK health-care settings. A qualitative multisite case study was conducted at seven organizations: four National Health Service hospitals, two independent care providers and one mental health-care provider. The paper reports on the data from qualitative semistructured interviews ( n = 51); the participants worked in a wide variety of care contexts. The data were analysed thematically and this paper reports on the theme 'strategies to respect dignity in care'. The subthemes were: recognizing vulnerability to dignity loss; enhancing privacy; improving communication between staff and patients/families and building relationships; improving the care environment; and addressing issues that matter to individuals. The findings indicate core elements to promoting dignity that apply across all care settings but suggest that nurses should identify and address dignity issues specific to their own practice areas [ABSTRACT FROM AUTHOR]

Abstract: Aims: To determine the factors contributing to managerial competence of first‐line nurse managers. Background: Understanding factors affecting managerial competence of nurse managers remains important to increase the performance of organizations; however, there is sparse research examining factors that influence managerial competence of first‐line nurse managers. Design: Systematic review. Data sources: The search strategy was conducted from April to July 2017 that included 6 electronic databases: Science Direct, PROQUEST Dissertations and Theses, MEDLINE, CINAHL, EMBASE, and Google Scholar for the years 2000 to 2017 with full text in English. Quantitative and qualitative research papers that examined relationships among managerial competence and antecedent factors were included. Review methods: Quality assessment, data extractions, and analysis were completed on all included studies. Content analysis was used to categorize factors into themes. Results: Eighteen influencing factors were examined and categorized into 3 themes—organizational factors, characteristics and personality traits of individual managers, and role factors. Conclusion: Findings suggest that managerial competence of first‐line nurse managers is multifactorial. Further research is needed to develop strategies to develop managerial competence of first‐line nurse managers. [ABSTRACT FROM AUTHOR]

Tuckett A, Hegney D, Parker D, Eley RM, Dickie R. International Journal of Nursing Practice 2011; 17: 444-454. The top eight issues Queensland Australia's aged-care nurses and assistants-in-nursing worried about outside their workplace: A qualitative snapshot The attainment of a work-life balance is an important issue for recruitment, retention and workforce planning. This paper aims to report on the free text data provided by the aged-care sector nurses around perceptions of important work-life issues. Data were written responses of aged-care nurses to the open-ended request at the end of a survey, which asked them to list up to five political/social/environmental issues concerning them outside of their work. For aged-care nurses, when asked to list political/social/environmental issues they were concerned about outside of work in late 2007, there emerged considered issues around work and life. Among the top eight themes there is an intriguing balance between the themes work, industrial relations, aged care/elder care and health-care services compared with the themes environment, water, societal values and housing. Qualitative insights into the political/social/environmental issues aged-care nurses are concerned about outside of your work suggest their desire for a labour/life or work/life harmony. Aged-care nurses place an equal importance on the nature of labour and the basics of life. The findings provide information for aged-care sector managers and workforce planners on areas in need of consideration to recruit and retain a workforce within aged care. [ABSTRACT FROM AUTHOR]

McGrath P, Phillips E, Vaughan G. International Journal of Nursing Practice 2010; 16: 274–281 Vaginal birth after Caesarean risk decision-making: Australian findings on the mothers' perspective The purpose of this paper is to explore, from the mothers' perspective, the decision-making experience with regard to subsequent birth choice for women who had previously delivered by Caesarean section. A qualitative methodological approach was taken to the exploration of mothers' knowledge of the risks of vaginal birth after Caesarean (VBAC) or elective Caesarean following a prior birth by Caesarean section. This paper presents the insights provided by the four women who chose VBAC. The health professionals' attitude to birth, and thus the support they offer to mothers, is predominantly pro-Caesarean. In view of the declining numbers of VBACs and the fact that the clinical literature documents risks for both elective Caesarean and VBAC, it is important for health professionals to be very sensitive and balanced in the information and support offered for the VBAC birth option. [ABSTRACT FROM AUTHOR]

McKenna L, McCall L, Wray N. International Journal of Nursing Practice 2010; 16: 176–182 Clinical placements and nursing students' career planning: A qualitative exploration Many nursing students enter undergraduate programmes with preconceived ideas about their future nursing careers, and intend to practice in particular areas such as midwifery or paediatrics. Through clinical placements, students are exposed to different clinical areas and professional socialization is facilitated. However, little is known about the influence of clinical placements on students' career intentions. This paper reports nursing findings drawn from a large qualitative study conducted in Victoria, Australia that sought to explore the influence of health professional students' clinical placements on their future career intentions. Participants were invited to be involved in either face-to-face or focus group interviews depending upon their own preference. Thematic data analysis revealed three main themes: ‘re-affirming career choice’, ‘working in a particular area’ and ‘work location’. Findings from the study add to our understanding of factors influencing nursing students' planning for their future careers including the impact of clinical placements. [ABSTRACT FROM AUTHOR]

Aim: Globally, the rapid increase of hypertension is particularly prevalent in low‐ and middle‐income countries. Hypertension is the most significant modifiable risk factor for stroke and ischaemic heart disease, the leading cause of mortality in Vietnam. The aim of this study was to gain insight into the provision of hypertension care in Vietnam by exploring provider perceptions. Methods: A sequential exploratory mixed‐method design was selected to allow for the initial qualitative interview findings to be incorporated into the development of the hypertension education workshop. Data were collected through semistructured interviews of 15 Vietnamese clinicians involved in the care of patients with hypertension. Results: Anxiety related to diagnosis of hypertension and specifically fear of having a stroke was mentioned by half of the participants. Several themes also emerged regarding barriers to implementing lifestyle modification to improve patient hypertension outcomes. There were contradictory opinions on the nurse's role in providing patient education across clinical settings. A lack of systematic structure and evidence‐based teaching resources was also noted. Conclusions: Gaining the provider's perspective increases understanding of the regional culture and context of hypertension care. The increased understanding can be used to improve provider education and enhance hypertension population outcomes. SUMMARY STATEMENT: What is already known about this topic? There is an increasing global prevalence of hypertension, the leading modifiable risk factor for cardiovascular morbidity and mortality.Lifestyle modifications are first‐line treatment to attaining hypertension goals and improving patient outcomes.Strengthening nursing intellectual capital by building nurse skills and knowledge can maximize their contribution and enhance population health. The implications of this paper: Awareness of patient culture strengthens patient education and enhances uptake of lifestyle modifications.Nurses, when appropriately equipped and supported, are ideally situated to significantly improve hypertension outcomes.Appropriately educating nurses and clarifying role expectations would develop nursing intellectual capital and add value to the health‐care system in Vietnam. [ABSTRACT FROM AUTHOR]

Aim To explore how and why mobile instant messaging applications are used by Filipino nurses as part of their work. Methods Guided by the uses and gratifications theory, in-depth interviews with 20 staff nurses working in 9 hospitals (ie, 4 private and 5 public hospitals) in the Philippines were conducted in July 2015. Interview data were analysed through a phenomenological perspective to thematic analysis. Results Results show that mobile instant messaging applications such as Facebook Messenger and Viber were mostly used by staff nurses and these were accessed using their own smartphones. Thematic analysis indicates that they were used to meet staff nurses' need for information exchange, socialization, and catharsis. Moreover, user interactions vary depending on members within a chat group. For instance, communication via mobile instant messaging applications are much formal when superiors are included in a chat group. Conclusion In general, the results show that mobile instant messaging applications are routinely used by Filipino staff nurses not only for clinical purposes (ie, information exchange) but also for non-clinical purposes (ie, socialization and catharsis). This paper ends with several practical and theoretical implications including future research directions. [ABSTRACT FROM AUTHOR]

Aims: Scientific discovery in general, and nursing research specifically, is an increasingly global effort consistent with changing demographics and the need to provide culturally competent care in a diverse society. Given that Arabs account for an increasing proportion of the populations in many Western countries, this study presents findings from the first bibliometric analysis of nursing research conducted through December 2017 in the Arab region. Methods: We used quantitative and qualitative indicators to analyse bibliometric data from Scopus. Results: We provided significant data on Arab nursing publication output and growth trends; types of published documents; publication geographic loci, focus, and subject categories; authors' collaboration patterns; core publishing journals and their impact; and citation patterns. Conclusions: Our findings highlighted the need for Arab policy makers and funding agencies to allocate research funding that supports the dissemination of Arab nursing research into the broader scientific community so that Western researchers, policymakers, and health care providers can appropriately address the health care needs of Arab individuals and families. The insights gleaned regarding the performance of journals, authors, countries, and institutions are discussed in relation to the potential impacts of the publish‐or‐perish culture of the current academic world. SUMMARY STATEMENT: What is already known about the topic? The advancement of nursing research has occurred rapidly in high‐income countries.No studies have examined the ways in which nursing research in the Arab countries has evolved over the same time period.Arabs account for an increasing proportion of the populations in many Western countries, requiring studies that promote cultural competency and transcultural nursing. What this paper adds? This is the first study to describe the growth trend of Arab nursing research publications compared with nursing research publications worldwide.This is the first study to reveal the nature of published Arab nursing research in terms of publication types, geographic loci, focus, authors' collaboration patterns, core publishing journals and their impact, and citation patterns. The implications of this paper: The study provides important information for Arab policy makers and funding agencies to promote allocating research funding that supports the dissemination of Arab nursing research into the broader scientific community.The study highlights the potential impacts of the publish‐or‐perish culture of the current academic world on the quantity and quality of nursing research. [ABSTRACT FROM AUTHOR]