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Supportive counseling and facilitated referrals to support organizations have shown positive effects on mental health and coping with domestic and family violence. However, the reasons why and how such effects are significant remain unknown. The current paper used data from a randomized controlled trial of a psychosocial intervention implemented in Nepal among 140 abused pregnant women. The hypothesized mediating effects of self‐efficacy and social support on mental health and quality of life of abused pregnant women were tested using serial mediation analyses. Significance of parameter estimates and bias‐corrected 95% confidence intervals (CIs) for the indirect effects were generated using bootstrapping. The postintervention changes in self‐efficacy and social support were found to have significant mediating effects on the relationship between the intervention and changes in both mental health and quality of life of participants post intervention. The positive effects on outcomes were seen at follow‐up as well, though to a lesser extent. Further interventions should focus on enhancing abused women's self‐efficacy and social support to ensure their positive mental health and better lives. [ABSTRACT FROM AUTHOR]

Since 2002, the Practice Environment Scale of the Nursing Work Index has been used worldwide to evaluate nurse work environments. High quality translations in different languages can help advance science and inform practice globally. The study purposes were to conduct a systematic review of published translations of the instrument and to assess their linguistic equivalence and psychometric performance. We conducted a comprehensive search, a quality assessment and synthesis of linguistic equivalence, reliability, and validity data. Studies published through July 2021 were identified in the CINAHL, LILACS, EMCare, and Scopus databases. Thirty‐eight publications were selected, comprising 46 translations into 24 languages and 15 language variants, and 35 countries. Translations are in predominantly European, Southeast Asian, and Middle Eastern languages. Two‐thirds of the translations reflected medium to high fulfillment of translation quality criteria. The GRADE ratings, reflecting satisfactory fulfillment of cross‐cultural equivalence and psychometric properties, were predominantly high (n = 23), then low (n = 15), then moderate (n = 8). The identified translations will support the advancement of global science and the improvement of nurses' work environments. [ABSTRACT FROM AUTHOR]

In the UK and Japan, midwives provide health services for women with concerns about a genetic condition or who are considering antenatal screening. In both countries, competences related to genetic health care have been devised but there is little evidence about midwifery competence in practice. A systematic literature review was undertaken to determine the extent to which midwives are achieving the genetic competences that are prescribed for their practice. English and Japanese literature from January 1999 to March 2009 was retrieved. Original studies or reviews, in which an aspect of midwifery practice was related to genetic competences, were eligible for inclusion. After a critical appraisal, six UK and five Japanese papers were eligible for inclusion. The findings indicated that midwives are not achieving the competences, nor are they confident about their genetics knowledge. Moreover, women are not being supported to make informed decisions regarding antenatal screening. We have confirmed that little research is being undertaken in both countries regarding competency achievement in practice. Changes to midwifery curricula and further continuing education are required to ensure that midwives are able to provide effective care regarding genetics. [ABSTRACT FROM AUTHOR]

The scoping review is one of the alternatives of producing a literature review. However, this approach still lacks a clearly accepted definition, and the scoping terminology is also somewhat fuzzy. Although the methodology of scoping review processing is relatively uniform, terminological chaos appears in the titles of studies with scoping review methodology. This paper presents an analysis of selected published studies with a focus on the content of their titles. A total of 13 thematic dimensions were identified covering the content of titles that show a degree of inconsistency and frequent terminological and methodological "chaos." This study includes a broad scope of themes and areas for which scoping reviews were produced. We would like to recommend to authors (especially scoping review beginners) to – if not necessary or desirable – avoid introducing new concepts and specifications of titles of produced and published scoping review studies. In the case of literature reviews and knowledge synthesis it is necessary to search according to specific keywords and search phrases – more fragmented scoping review terminology makes literature search more difficult or even impossible. [ABSTRACT FROM AUTHOR]

There is a dearth of research exploring the development of postdoctoral nursing research careers in non-Western contexts. This paper reports on a qualitative study of Jordanian graduates of UK PhD programs. Interviews were held with 16 graduates who worked in the nursing faculty of seven different universities in Jordan. Participants reported that their doctoral degree had equipped them with confidence and enthusiasm for developing a research career. Mentorship, leadership, and peer support were identified as essential to supporting ongoing research activity. Access to these sources of support was variable and participants also described a range of institutional and organizational structures that directly or indirectly discouraged them from developing research productivity. This research suggests that support for postdoctoral novice researchers is an important area for further attention - for Jordanian universities, for UK PhD supervisors (and their associated academic departments), and for the wider nursing community. [ABSTRACT FROM AUTHOR]

Culture influences the way health‐care professionals communicate with each other and their ability to relate to colleagues in an assertive manner. Cultural barriers can also make it difficult for nurses to speak up even when they have concerns about patient safety. An understanding of the potential impact of cultural factors is therefore needed when developing assertiveness communication training programs. This paper presents the findings from a study that explored Japanese nurses' perceptions of how culture and values impact assertive communication in health care. Semistructured interviews with 23 registered nurses were undertaken, and data were analyzed using directed content analysis. Two major themes were identified: collectivism and hierarchy/power. In the present study, we discuss the cultural values related to collectivism that included four categories of "wa" (harmony), "uchi to soto" (inside and outside), implicit communication/ambiguity, and "nemawashi" (groundwork). The findings highlight the impact of culture on nurses' assertive communication behaviors and can be used to inform the design of culturally‐appropriate assertiveness communication training programs for Japanese nurses working both within their own country or internationally. [ABSTRACT FROM AUTHOR]

Abstract: Turkey receives the largest number of Syrian refugees in the world. Some of these refugee women become mothers in Turkey. This paper reports on a qualitative, descriptive study that investigated the experience of seven Syrian women migrants who gave birth in Turkey, and explores their experiences of transition to motherhood in a foreign country. The research identified that aspects of transition can be clustered under five main themes: difficulties during the pregnancy period, giving birth in a foreign country, problems of refugee mothers, milestones in life of refugee mothers, and influence of cultural beliefs of refugee mothers on baby care. Key findings revealed that the women in the study had negative experiences related to being pregnant and having a baby in a foreign country. In addition to identifying challenges associated with migration, such as language barriers, racism, discrimination, poverty, and separation from their culture and family, the study highlighted the fears and difficulties experienced by refugee mothers, the cultural beliefs of refugee women about caring for their babies, and turning points in the life of refugee mothers. [ABSTRACT FROM AUTHOR]

As preliminary research into the childbirth experience of migrants in China, this paper presents a systematic review of Chinese and English literature published between 1999 and 2011 on childbirth in migrants in China. Electronic databases were accessed and papers were found by keyword search. A total of 132 Chinese and 9 English papers were catalogued for review. These papers address migrant maternity issues concerning antenatal, intrapartum, postnatal care, institutional issues, family planning or birth control. Since China's economic reforms, the healthcare infrastructure has been inadequate for childbirth in migrants. They experience more adverse birth outcomes than local residents. This suggests that the effects of change upon childbirth and the existing urban and rural care systems cannot meet the needs of the migrants. There is a lack of research in the childbirth experience of women. Knowledge of their childbirth experience will contribute to the understanding of these needs, informing systems' reform. The medical approach results in many unnecessary interventions and higher costs. It is argued here that a midwifery model of care is most appropriate for the childbirth experience of migrant women. [ABSTRACT FROM AUTHOR]

This paper summarizes, elaborates upon, and contrasts the findings of two research projects that explored how general practitioners and nurses coped with the dual challenge of personal and work demands following the earthquakes in Canterbury, New Zealand, in 2010 and 2011. Qualitative data from two separate studies - the first with general practitioners and the second with nurses - are compared to identify the challenges faced during and following the earthquakes. Semi-structured interviews took place with eight general practitioners two years after the start of the earthquake sequence and 11 nurses a year later to enable exploration of the longer-term aspects of the recovery process. The interview transcripts were analyzed and coded using a constructivist grounded theory approach. The analysis identified that the earthquakes had a significant impact on nurses and general practitioners both in terms of their professional and personal lives. The nurses and general practitioners commented on the emotional impact and their support needs, as well as some of the longer-term recovery issues. [ABSTRACT FROM AUTHOR]

This paper presents the initial translation process and follow-up psychometric evaluation of the Japanese version of the Primary Communication Inventory (J-PCI). The J-PCI was developed using the committee approach to translation and then used in a study exploring Japanese couples' communication satisfaction while separated during Satogaeri Bunben - a Japanese perinatal tradition. The committee approach attends to cultural nuance and context and is especially useful when languages have dissimilar linguistic roots and cultures, such as Japanese and English. The translation process and evaluation included five steps; (i) selection of the original PCI for research; (ii) selection of translators; (iii) development of the J-PCI using a committee approach; (iv) an initial small pilot study; and (v) a larger follow-up study. The J-PCI has good initial validity and reliability, although some nuances were observed in scoring. [ABSTRACT FROM AUTHOR]

This paper examines the psychometric properties of the Learning Experience Scale. A survey method was used to collect data from a total of 502 nurses. Data were analyzed by factor analysis and the known-groups technique to examine the construct validity of the scale. In addition, internal consistency was evaluated by Cronbach's alpha, and stability was examined by test-retest correlation. Factor analysis showed that the Learning Experience Scale consisted of five factors: learning from practice, others, training, feedback, and reflection. The scale also had the power to discriminate between nurses with high and low levels of nursing competence. The internal consistency and the stability of the scale were also acceptable. The Learning Experience Scale is a valid and reliable instrument, and helps organizations to effectively design learning interventions for nurses. [ABSTRACT FROM AUTHOR]

The music-with-movement intervention is particularly suitable for people with dementia because their gross motor ability is preserved until the later stage of dementia. This study examines the effect of music-with-movement on reducing anxiety, sleep disturbances, and improving the wellbeing of people with dementia. This paper reports the first stage of the study - developing the intervention protocol that staff can use to teach family caregivers. A registered music therapist developed a music-with-movement protocol and taught staff of two social service centers over five weekly 1.5 h sessions, with center-in-charges (social workers and occupational therapists) and our research team joining these sessions to provide comments from their professional perspective. Each discipline had different expectations about the content; therefore, numerous meetings and discussions were held to bridge these differences and fine-tune the protocol. Few healthcare professionals doubt the merits of interdisciplinary collaboration at all levels of health promotion. In practice, interdisciplinary collaboration is complex and requires commitment. Openness and persistence is required from all stakeholders to achieve a successful intervention for consumers. [ABSTRACT FROM AUTHOR]

Little is known about the impact of living with pulmonary hypertension. This paper reports data exploring the experience of living with pulmonary hypertension. Qualitative, semistructured, one-to-one interviews were conducted in participants' homes to understand their experiences of living with pulmonary hypertension. Thematic analysis was used to identify codes and generate themes from the interview data. The identification of initial codes was conducted independently by the first author, and checked by the second. Thirty patients recruited through the pulmonary hypertension descriptions of living with pulmonary hypertension are presented under five themes that center on the invisibility of pulmonary hypertension, and its complex treatment are presented: (i) living with a hidden illness; (ii) being on a symptomology rollercoaster; (iii) expectations from treatments; (iv) treatment burden; and (v) awareness of financial burden of treatments. Key findings included daily challenges of living with a rare condition that is largely 'hidden' and its related complex treatment regimes. People with pulmonary hypertension would benefit if more healthcare professionals, as well as family and friends, would validate their condition and provide them with appropriate support. [ABSTRACT FROM AUTHOR]

This qualitative descriptive study, underpinned by the naturalistic inquiry, explored the lived experiences of individuals awaiting coronary artery bypass grafting in Thailand. Eleven northern Thai individuals volunteered to participate. Data were gathered through in-depth interviews and analyzed using content analysis. Two major themes arose: uncertainty of life and striving to balance well-being. The first of these themes is presented in this paper. Uncertainty of life was recognized as a dynamic emotional state of being unsure or insecure in life, but its occurrence depended on the individual situation; it was described through two subthemes that had a profound effect on the participants: fear of death and fear of disability. Participants' uncertainty of life encompassed being unsure about the risks of dying from illness, both prior to and following the surgery, and surviving the surgery with a disability. These findings provide insight into the experiences of individuals awaiting coronary artery bypass grafting and will assist nurses and other healthcare providers in creating timely programs and appropriate interventions to reduce uncertainty of life while awaiting surgery. [ABSTRACT FROM AUTHOR]

This paper examines the prevalence of multiple symptoms and the relationships between future expectations and multiple symptoms in a cross-sectional study of 100 patients with chronic obstructive pulmonary disease. A questionnaire was used to examine the patients' symptoms of breathlessness, anxiety, depression, sleeplessness, fatigue, and pain, and their outlook for the future. All patients reported breathlessness, 64% anxiety, 69% depression, 28% sleeplessness, 72% fatigue, and 45% pain. Those with anxiety reported significant depression ( P < 0.001), and those with fatigue reported significant depression ( P = 0.004). Patients who reported pain also reported significant sleeplessness ( P = 0.022). A negative outlook for the future was reported by 42% of patients who also reported significantly more anxiety, depression, sleeplessness, fatigue, and pain ( P ≤ 0.049). Multiple symptoms are common in chronic obstructive pulmonary disease, and patients with a pessimistic view of the future reported more symptoms. Those with multiple symptoms and a negative outlook toward the future may benefit from interventions to help them achieve a more positive outlook for the future, which may relieve symptom burden. [ABSTRACT FROM AUTHOR]

The prevalence of metabolic syndrome is consistently increasing among Korean adults and is reported to be particularly high among older adults in Korea. This paper reports the prevalence of metabolic syndrome and identifies the association between metabolic syndrome and physical activity in Korean older adults. Subjects of this study were 3653 older adults who participated in the fourth Korean National Health and Nutrition Examination Survey during the years 2007-2009. The prevalence of metabolic syndrome in the study population was 46.84%. The prevalences of abdominal obesity, elevated fasting glucose, elevated triglycerides, reduced high-density lipoprotein cholesterol, and elevated blood pressure were 39.51, 45.53, 39.55, 48.24, and 69.14%, respectively, in the study population. Compared to subjects who reported low levels of physical activity, the odds ratios of metabolic syndrome for those who were moderately active and highly active were 0.93 and 0.63, respectively. Nurses should develop metabolic syndrome management programs that are tailored to the needs of the targeted group and that include individually adapted physical activity programs to promote health. [ABSTRACT FROM AUTHOR]

Recognizing the ageing of populations and expected increase in prevalence of dementia, the necessity of research involving persons with dementia is widely agreed upon. Autonomy is key to nursing home residents' well-being and quality of life, but this phenomenon has not been thoroughly assessed from the residents' perspective. The aim of this cross-sectional study was to investigate perceived autonomy of nursing home residents. Data on 560 randomly selected residents in 40 nursing homes in two German federal states were generated by face-to-face interviews, psychological and physical assessments, analysis of nursing records, and acquisition of institutional parameters. This paper reports on a subsample ( n = 179) that met screening requirements, including subjects with and without mild cognitive impairment ( Mini Mental Status Examination score 30-18), who completed the Hertz Perceived Enactment of Autonomy Scale ( HPEAS). The mean score of HPEAS was 101.1 ± 14.5 (range 54-122). In our population, Cronbach's alpha was 0.89. Scores in HPEAS were not related to demographical factors but positively associated with increasing self-efficacy and absence of pain. The novel findings contribute to an understanding of autonomy from the residents' perspective. [ABSTRACT FROM AUTHOR]

Most humans desire a good death, but the nursing literature on culture-specific responses to older life, especially on issues of death and dying among Japanese Americans, is still limited. The pattern of beliefs about a good death held by elderly Japanese Americans living in Hawaii was explored. A qualitative study using ethnography and in-depth interviewing was employed. Eighteen healthy and active elderly participants were interviewed, and data analyzed using ethnography to extract categories and themes, and four supplementary interviews with experts were held for triangulation of the data. Four themes emerged, however, in this paper, the predominate one, not being a burden to family, was discussed. The participants believed burdening someone in their culture has an extremely negative implication. Sufficient preparation for older life and death, family support, friends support, and finance were their strategies to avoid being a burden. Nurses need to understand that the concept of good death is unique to every culture. Such knowledge will help them to plan and provide appropriate end-of-life care, and will reduce the risk of living wills being ignored. [ABSTRACT FROM AUTHOR]

This study aims to explore the early experiences of frontline nurses at the beginning of the COVID‐19 pandemic in China as expressed through social media posts. This study used an explanatory sequential mixed‐method design. Text mining was used for sentiment analysis. The chi‐square test was used to compare the differences in the composition ratio of sentiment classification of posts in different months. Word frequency was statistically analyzed. Further thematic analysis was also performed. The primary sentiments of the posts were discovered to be positive and neutral. The number of posts containing positive emotions was the lowest in January, peaked in March, and gradually declined in April 2020. The following nurse‐oriented narrative themes were developed: "To see and be seen," "Moving forward amid adversity and support," and "Returning to everyday life and constructing meaning." The sentiments of Chinese nurses in response to the pandemic fluctuated, with positive emotions in the early stage, but it could not be sustained. This study recommends nurses could be encouraged to engage in expressive writing while adhering to ethical guidelines. [ABSTRACT FROM AUTHOR]

Physical symptoms induced by pregnancy are often perceived as a normal part of the physiological process and therefore not commonly discussed in clinical settings during prenatal care. This study aimed to explore how pregnant individuals adapt to physical symptoms related to their pregnancy, using the perspective of collective sensemaking. A retrospective study design with an inductive thematic analysis approach of qualitative data extracted from web‐based forum posts was conducted. Among 574 initial posts and 2801 comments, three themes were identified: (i) awareness of changing pregnancy body, (ii) uncertainty about physical symptoms, and (iii) coping with discomforts associated with pregnancy. A shared identity as a group of individuals dealing with similar challenges enables pregnant individuals to develop a better comprehension of their experiences. Healthcare professionals should recognize the importance of individual and collective sensemaking in pregnancy forums and strive to provide a supportive and empathetic environment for pregnant individuals to share their experiences and seek guidance. [ABSTRACT FROM AUTHOR]

An active transport mode provides an opportunity for integrating physical activity into one's daily life through walking, cycling, and the use of public transportation. The purpose of this study was to compare urban adults with chronic conditions who used active and inactive transport modes and to find differences in their health outcomes. A cross‐sectional study was conducted from September 2019 to May 2020. Participants were urban adults who self‐reported being overweight or obese, or having a diagnosis of chronic disease. Anonymous structured self‐reported questionnaires were used for data collection, including the World Health Organization Quality‐of‐Life Scale, International Physical Activity Questionnaire Short‐Form, and the frequency of eight modes of transportation. According to differences between the frequency score of weekly active and inactive transportation, participants were categorized into inactive, balanced, and active transport modes. In total, 617 valid responses were obtained. Participants who engaged in an active transport mode were found to have significantly less sedentary time, and better comprehensive, social, and environmental aspects of quality of life than those with an inactive transport mode. Engaging in active transportation and avoiding inactive transportation are recommended for urban adults with chronic diseases. [ABSTRACT FROM AUTHOR]

Over the last decade, the importance of Advanced Care Planning has been recognized in Japan. However, it is still difficult for healthcare providers and patients to verbalize how they want to spend the last days of their lives and what unfinished business they have left to accomplish. This study aimed to clarify how nurses intervened to assist patients with cancer at the end of life to express their thoughts and concerns. Twenty‐four nurses were interviewed regarding how they intervened for patients' thoughts and concerns, and data were analyzed qualitatively using a modified grounded theory approach. A 25‐item scale was selected, and the questionnaires, which included the scale, were distributed to nurses in general wards, palliative care units, and home visiting nurse services. A total of 1864 responses were analyzed. Factor analysis and structural equation model analysis were used, and three factors were identified: "assessment and intervention," "basic care," and "knowledge and communication," which led to the formulation of an intervention structure model for uncovering thoughts and concerns. These results indicate the importance of basic care and communication during interventions for patients. [ABSTRACT FROM AUTHOR]

In health care, high-fidelity simulation has been shown to result in increased student learning outcomes when compared to low-fidelity simulation. With educational facilities investing significant amounts of money into purchasing high-fidelity simulators, it is imperative to identify if the midlevel simulator, which is less costly, will result in the same learning outcomes. In this study, we examined the effect of midlevel-fidelity simulation versus low-fidelity simulation on Bachelor of Science in Nursing nursing students' knowledge, self-confidence, and skill performance. A quasi-experimental design examined the effects of midlevel-fidelity simulation ( n = 37) versus low-fidelity simulation (case study) ( n = 37) in junior-level nursing students. There was a significant difference for both groups in knowledge and skill performance (measured with a mini Objective Structured Clinical Examination), but not between the groups. Unexpectedly, the case-study group had a higher level of self-confidence (self-reported). The results of this study indicate that further research is needed to support faculties' selection of learning strategies with the lowest cost and highest effectiveness in achieving the desired learning outcomes. [ABSTRACT FROM AUTHOR]

Nursing handovers represent an important and complex form of communication in healthcare organizations that involve the exchange of patient‐related information between nurses. This qualitative descriptive study aimed to identify the intershift handover experiences among nurses working in small and medium‐sized hospitals. Focus‐group interviews were conducted with 30 nurses who directly participated in patient care in such hospitals in South Korea. The reporting of the study findings adhered to the Consolidated Criteria for Reporting Qualitative Research checklist. The data were analyzed using content analysis. Under the main theme of "baton touch in a relay," 6 categories, 17 subcategories, and 45 codes (concepts) were derived. The six categories were "procedural rituals for shifts," "nonstandardized handover training," "inconsistent handover style," "stress due to handovers," "coping strategies for handovers," and "interruptions of handovers." Nurses in small and medium‐sized hospitals strive to improve the quality of handovers by preparing individual‐level coping strategies under difficult conditions. This indicates that standardized handover education strategies need to be developed for nurses that are suitable for the personnel systems of small and medium‐sized hospitals. [ABSTRACT FROM AUTHOR]

HIV prevalence among men who have sex with men in China has increased dramatically, and timely linkage to care after being diagnosed with HIV is important to treatment success. This cross‐sectional study aims to utilize structural equation modeling to test a hypothesized model of timely linkage to care adapted from the HIV‐related stigma framework. Data were collected from 257 men who have sex with men living with HIV. The proportion of participants with timely linkage to care within 1 month was 63.42%. The model result showed a good fit. Higher HIV‐related stigma was significantly associated with a lower level of social support, mental health, maladaptive coping (three mechanism variables), and attitude toward linkage to care. Higher CD4+ T‐cell count, disclosure of HIV positivity to sexual partners, and greater convenience of accessing care were related to timely linkage to care (p < 0.05). These model results suggest that enhancing attention to family reactions and social support are needed for further research and interventions to accelerate newly diagnosed people's access to HIV care in China. [ABSTRACT FROM AUTHOR]

Graduate entry healthcare students experience many challenges during their academic journey. The impact of these challenges needs to be considered to support students through their training and education. In this study, we examined the impact of experiencing these role conflicts (at the outset of the academic year), for example, family and caring responsibilities, activities with family/friends, and daily tasks/chores, on the academic performance (at the end of the academic year) of graduate‐entry healthcare students. We also investigated the potential of students' self‐efficacy for learning to mitigate the extent to which such role conflicts impact academic performance. Findings demonstrate that the more graduate entry healthcare students experienced conflicts between their life responsibilities and their academic responsibilities, the worse their academic performance was across the year. This negative relationship was somewhat mitigated by high self‐efficacy for learning. The practical implications of our research suggest the need to provide specific mitigation strategies to support healthcare students regarding conflicts between their life/family responsibilities and their academic work. [ABSTRACT FROM AUTHOR]

Current conceptualizations of patient self‐advocacy focus on women with cancer, leaving knowledge of male self‐advocacy deficient. The purpose of this study is to describe the key components of self‐advocacy among men with cancer. Adult (≥18 years old) men with a history of invasive cancer were recruited from cancer clinics and registries. Trained researchers led individual semi‐structured interviews regarding participants' challenges, how they overcame those challenges, and barriers and facilitators to their self‐advocacy. All interviews were analyzed using descriptive content analysis methods and synthesized into major themes. These themes were refined after receiving feedback from key stakeholders. Participants (N = 28) reported three major self‐advocacy themes: (i) managing through information and planning; (ii) finding the best team and falling in line; and (iii) strategic social connections. These themes are richly described with representative quotations for each theme and subtheme. Based on these findings, existing models of patient self‐advocacy should be adjusted to encompass how men self‐advocate. Clinicians should consider how gender may impact how and why patients with cancer self‐advocate so that they can best support their patients in achieving patient‐centered care. [ABSTRACT FROM AUTHOR]

Emergencies can negatively affect the morbidity and mortality of nursing home residents. As nurses employed at nursing homes play a key role in such situations, their conceptualizations of emergency management should be considered to improve care. Accordingly, this study aimed to identify nurses' conceptualizations of managing emergencies in nursing homes. A qualitative research design was conducted using interviews with 20 nurses working in five different nursing homes in the Republic of Korea between September 2019 and August 2020. The data were analyzed using phenomenography. This study identified two main perspectives used by nurses in nursing homes to manage emergencies, depending on the resident's condition: emergency care and daily preventive care. Nurses' conceptualizations of care provided in emergencies were organized under the frames of assessment and intervention, whereas routine care carried out during daily life activities fell under the frame of prevention. This study's findings, which elucidate nurses' complex practical and experiential knowledge, provide insights for the development of emergency management training. [ABSTRACT FROM AUTHOR]

As an evaluation method, standardized patients have a long history in medical education and research yet are less established in nursing. This paper explores the reliability of using standardized patients as the evaluative method in a communication competence pilot study with international nurses. Standardized patients and second raters scored the same encounters. We examined the scores by intraclass correlation coefficients. Anecdotal comments by the two types of raters were assessed qualitatively to highlight similarities and areas of difference between them. The results of reliability analysis for standardized patients scores for the composite variables of Establishing Communicative Rapport, Therapeutic Communication, Non-Verbal Communication, and Overall Satisfaction ranged from 0.755 ( P < 0.01) to 0.42 ( P = 0.09). In this study, the results showed standardized patient evaluation has moderate to substantial reliability when compared to second raters of the same set of clinical encounters. This is similar to the reliability established over many decades of medical research. Greater use of this dynamic and interactive technique may be beneficial to nursing education and research. [ABSTRACT FROM AUTHOR]

This paper explores the methodological challenges associated with undertaking qualitative observation in the clinical setting at end of life. The authors reflect on their experiences of using non-participant observation to explore the nursing care delivered to dying patients in acute hospital wards. The challenges of observation as a method, clearly defining the participant group and involving vulnerable populations, such as the dying patients and their families, will be discussed. Consideration is also given to defining and working within the observational field, the researchers' dual roles, cost versus benefit, impact of culture, religion and ethnicity, and the determination of research limits/boundaries, with reflections from the authors' own experiences used to exemplify the issues. [ABSTRACT FROM AUTHOR]

This paper describes how peer assessment was implemented in an undergraduate nursing program in Ireland to enhance student engagement, and reports students' ( n = 37) experiences of the process. The process involved second year Bachelor of Nursing Science students developing marking criteria and marking two of their colleagues' assignments anonymously. A qualitative descriptive design using focus group interviews was used to collect data on students' experiences. Demographic data were collected through questionnaires. The analysis identified three themes: (i) impact on student engagement; (ii) challenges of peer assessment; and (iii) making it better. The findings revealed that most students enjoyed the process, and that peer assessment facilitates and enhances student engagement. The findings also provide evidence to support the self-regulation theory of learning. A detailed account of the methods used to implement peer assessment is also provided, which might be useful for other nurse educators seeking to implement peer assessment at an undergraduate level. [ABSTRACT FROM AUTHOR]

This qualitative study explored the clinical nursing leadership competency perspectives of Thai nurses working in a university hospital. To collect data, in-depth interviews were undertaken with 23 nurse administrators, and focus groups were used with 31 registered nurses. Data were analyzed using content analysis, and theory development was guided by the Iceberg model. Nurses' clinical leadership competencies emerged, comprising hidden characteristics and surface characteristics. The hidden characteristics composed three elements: motive (respect from the nursing and healthcare team and being secure in life), self-concept (representing positive attitudes and values), and traits (personal qualities necessary for leadership). The surface characteristics comprised specific knowledge of nurse leaders about clinical leadership, management and nursing informatics, and clinical skills, such as coordination, effective communication, problem solving, and clinical decision-making. The study findings help nursing to gain greater knowledge of the essence of clinical nursing leadership competencies, a matter critical for theory development in leadership. This study's results later led to the instigation of a training program for registered nurse leaders at the study site, and the formation of a preliminary clinical nursing leadership competency model. [ABSTRACT FROM AUTHOR]

The effects of chronic cardiovascular disease can challenge the achievement of treatment goals and recovery outcomes. This study explores the ways in which patients cope with the effects of chronic cardiovascular disease, from the perspectives of patients, family caregivers, and health professionals. The qualitative study was conducted from May 2019 to September 2020 in Isfahan, Iran. Thirteen people with chronic cardiovascular disease, 6 family caregivers, and 16 healthcare professionals participated in semi‐structured individual interviews. Transcripts were analysed thematically. Findings suggest that people with chronic cardiovascular disease use a range of coping strategies, both positive and negative, to adjust to their conditions. The positive strategies include managing their health‐related symptoms, drawing on religious or spiritual beliefs, and accessing social and relational supports. Negative strategies can include over‐reliance on family members for support, leading to reduced activity and loss of independence. Understanding the nature of the strategies used by patients provides an important means by which health service providers can support patients to further develop positive coping strategies. This, in turn, will enable patients to achieve higher levels of wellbeing. [ABSTRACT FROM AUTHOR]

The purpose of this cross‐sectional study was to examine factors associated with nurses' resilience during the COVID‐19 pandemic. Data were collected in the latter half of 2020 from 904 nurses across Japan, Republic of Korea, Republic of Turkey, and the United States. The questionnaire included the Connor‐Davidson Resilience Scale 10, plus demographics and 20 questions about practice environment, workplace safety concerning infection control, COVID‐related experience, and organizational support. Fear of becoming infected, intention to leave nursing, and having had a positive COVID‐19 test were inversely associated with resilience (p < 0.05). Regression analysis indicated that U.S. nurses had significantly greater resilience than nurses in the other countries examined (p < 0.001). Nurses reporting organization support and those who participated in policy and procedure development had higher resilience scores (p < 0.01). Organizational support, involving nurses in policy development, and country of practice were found to be important resilience factors in our research, which aligns with other findings. Further research is recommended to determine the optimal practice environment to support nurse resilience. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the resilience of nurses who cared for patients with a confirmed COVID‐19 diagnosis, as well as factors that potentially contributed to that resilience. A total of 23 frontline nurses who cared for patients with COVID‐19 were recruited from a COVID‐19–designated facility in Shanghai, China, using purposive sampling strategies. In‐depth interviews were conducted from March to May 2020. Qualitative data were transcribed verbatim and content analysis was used. Nurses exhibited psychological resilience while caring for patients with COVID‐19. They displayed an ability to bounce back from negative mental experiences and transform to a positive mindset to cope with the stress they faced. Factors that enhanced the nurses' resilience during the pandemic were their becoming familiar with infectious disease protocols, having a sense of professional achievement, receiving social support, having trust in the infection‐control response team in the hospital, and using self‐regulation strategies. This study could guide the design of future resilience‐enhancing interventions that provide positive coping strategies for nurses caring for individuals with infectious diseases during a pandemic. [ABSTRACT FROM AUTHOR]

Workplace cyberbullying has emerged as a new issue. This study aimed to explore individual and organizational factors that affect nurses' workplace cyberbullying in hospital settings. A multicenter, cross‐sectional study was conducted using a self‐report questionnaire. Three tertiary and 18 general hospitals were selected from one city in Korea. A total of 270 nurses with 6 months to 10 years of experience in the current department were enrolled. Multiple regression analysis was conducted to identify the factors associated with cyberbullying. Workplace cyberbullying was affected by self‐labeled victimization due to face‐to‐face bullying, subjective health level, years of experience as a nurse (β = 0.148, p = 0.009), and relation‐oriented nursing organizational culture. Face‐to‐face bullying must be addressed to prevent workplace cyberbullying. It is important to assist nurses to maintain good health—considering that, new nurses with less than 1 year of experience are vulnerable to being victimized. Effective prevention strategies should be prepared to control workplace cyberbullying in clinical practice. [ABSTRACT FROM AUTHOR]

Non‐urgent and urgent telephone nursing services are increasing globally, and phenomenographic research has shown that how work is understood may influence work performance. This descriptive study makes a qualitative inductive investigation of understandings of emergency medical dispatch center work among registered nurses. Twenty‐four registered nurses at three mid Swedish emergency medical dispatch centers were interviewed. Analysis based on phenomenographic principles identified five categories in the interviews: (i) Assess, prioritize, direct, or refer; (ii) Facilitate ambulance nursing work; (iii) Perform nursing care; (iv) Always be available for the public; and (v) Have the person behind the patient in mind. The first constitutes the basis of the work. The second emphasizes cooperation with and support for the ambulance staff. The third entails remotely providing nursing care, whilst the fourth stresses serving the entire population. The fifth and most comprehensive way of understanding work involves having a holistic view of the person in need, including person‐centered care. Provision of high‐quality emergency medical dispatch center work involves all categories. Combined, they constitute a "work map," valuable for reflection, competence development, and introduction of new staff. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore nursing students' perceptions of their final clinical learning environment and its association with their self‐assessed competence, satisfaction with nursing education, and turnover intentions at graduation in six European countries. A multi‐country comparative cross‐sectional study was conducted with nursing students (n = 1746) from the Czech Republic, Finland, Italy, Portugal, Slovakia, and Spain using the Nurse Competence Scale and the Clinical Learning Environment and Supervision scale. Nursing students' overall perceptions of their final clinical learning environment and supervision were positive in all the countries studied. The correlation between the students' perceptions of their final clinical learning environment and competence was statistically significant and positive. Satisfaction with the nursing program and clinical practicum and no consideration of career change were related to positive perceptions of the final clinical learning environment. Highlighting the importance of the supervisory relationship and pedagogical atmosphere, nursing students' positive perceptions of the final clinical learning environment and supervision contribute to a better level of self‐assessed competence and satisfaction with the nursing program and clinical practicum, leading to lower turnover intentions. [ABSTRACT FROM AUTHOR]

The concept of Entrustable Professional Activities, recently pioneered in medical education, has emerged to support the implementation of competency‐based education. Although competency‐based frameworks are widely used in healthcare professional education to develop outcomes‐based curricula, assessment of student competency in professional placement settings remains challenging. The novel concept of Entrustable Professional Activities together with established methods of competency assessment, namely e‐portfolios and self‐assessment, was implemented in the "[La Trobe University Dietetic program in 2015–2016. This study aimed to appraise the e‐portfolio and evaluate the use of Entrustable Professional Activities to assess competence. A mixed‐methods evaluation, using qualitative and quantitative surveys with follow‐up structured consultations, was conducted with final year dietetics students and their supervisors. Dietetics students were comfortable with Entrustable Professional Activities and competency‐based assessment, whereas supervisors preferred Entrustable Professional Activity based assessment. All stakeholders valued student self‐assessment and the ongoing use of structured e‐portfolios to develop and document competency. The use of structured e‐portfolios, student self‐assessment, and the emerging concept of Entrustable Professional Activities are useful tools to support dietetics student education in professional placement settings. [ABSTRACT FROM AUTHOR]

Evidence points toward the impact of nurses' personal views and knowledge about religion, religiosity, and spirituality on health care. This qualitative research investigates nurses' concepts of religion, religiosity, and spirituality and how they use these concepts in practice. Thirty‐four nurses were interviewed at a hospital in the state of São Paulo, Brazil. Content analysis was used to organize and code the results. Three main themes generated from the interviews were (i) religiosity/spirituality as an important dimension in life; (ii) notions of religiosity and spirituality; (iii) formal knowledge of the concept of religion, religiosity, and spirituality. The results indicate that religion, religiosity and spirituality should be incorporated into nurse training to improve the comprehension and competence of nurses in these areas of practice. It is recommended that to ensure holistic and person‐centered care, there must be constant reflection on these concepts. [ABSTRACT FROM AUTHOR]

People with chronic obstructive pulmonary disease exhibit various symptoms, some of which can negatively affect their daily lives. Thus, they may adopt coping behaviors to improve their condition. This qualitative descriptive study investigated symptom distress and coping behaviors among 19 Chinese patients with chronic obstructive pulmonary disease using individual, semi‐structured, face‐to‐face interviews. We identified the following three themes for the patients' symptom distress: distressing symptoms, inescapable imprisonment, and no choice other than being a burden to the family. The various coping behaviors of the patients were categorized into the following three themes: struggle during the medical treatment process, careful maintenance of daily life, and coping with negative emotions. Although all patients experienced physical and psychological distress, they displayed a strong desire to improve their lives and health. By recognizing the patients' symptom distress and coping behaviors, tailored interventions could be developed to improve the quality of their lives. [ABSTRACT FROM AUTHOR]

This study aimed to understand school nurses' perceptions regarding barriers to and facilitators for health care services for children with chronic diseases in school settings. Using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Web of Science databases, a mixed studies review was conducted for literature published between January 2011 and June 2020. We performed a mixed‐methods systematic review using a convergent integrated approach. A quality appraisal of the included studies was conducted using a mixed‐methods appraisal tool. Twenty‐seven articles (10 qualitative, 10 quantitative, and seven mixed‐methods) that met the inclusion criteria were analyzed. Integrated findings that emerged from data synthesis were categorized into four levels (intrapersonal level, interpersonal level, institutional level, and community and public policy level) based on a socio‐ecological model framework. This mixed systematic review provides a comprehensive understanding of school nurses' perceived barriers and facilitators when providing school health care for students with chronic diseases and how these barriers and facilitators interact across multiple systems. Further policies and strategies should be developed to provide effective school health services considering this study's findings. [ABSTRACT FROM AUTHOR]

Long‐term care for older people with dementia can adversely impact a family caregiver's life. A decrease in their quality of life may compromise the quality of care they provide to older people and their own quality of life. The samples include 76 family caregivers of older people with dementia in Thailand. Six questionnaires and the EuroQoL Five Dimensions Questionnaire were used in data collection. Descriptive and inferential statistics were used in data analysis. The findings revealed that quality of life of family caregivers was at a high level. Experiences of close relationships between care dyads and perceived social support were positively related to family caregiver's quality of life, whereas perceived stress and burden were negatively related. Perceived social support and experiences of close relationships might be predictors of family caregiver's quality of life. High quality of life levels among Thai family caregivers of older people with dementia were influenced by high perceived social support and high experiences of close relationships. An intervention focusing on modifying such predicting factors may effectively help maintain quality of life of these family caregivers. [ABSTRACT FROM AUTHOR]

This authors report on the findings of a study designed to establish website‐based self‐management recommendations for sickle cell disease. Google and Yahoo search engines were used to search the World Wide Web. Purposive sampling was used to select 28 websites that met the inclusion criteria. Data were manually collected from health education materials and subjected to qualitative content analysis. Self‐management was conceptualized as actions involving preventive health, self‐monitoring, self‐diagnosing, and self‐treatment. The results show that the websites recommend more self‐management actions for preventive health and self‐treatment than for self‐monitoring and self‐diagnosis. Frequent oral fluid intake, limitation of overactivity, eating a healthy diet, avoiding extreme temperatures, and infections were the most common preventive health recommendations. Daily pain monitoring and general bodily inspections were the most frequent self‐monitoring recommendations. Commonly cited self‐diagnostic indicators were fever, persistent pain, enlarged spleen, and leg ulcers. The use of analgesics and nonpharmacological measures were regularly cited for self‐treatment. Most recommendations were assessed as clinically safe as they align with standards for sickle cell management. Nurses and other professionals should teach clients how to assess the credibility of websites. [ABSTRACT FROM AUTHOR]

In South Africa, various treatment models from abroad have been implemented for patients diagnosed with borderline personality disorder. This report is based on a South African model that has been developed, implemented, and evaluated for mental health nurses to use in facilitating the self‐empowerment of women living with borderline personality disorder. The aim of this study was to describe the implementation of a model to facilitate self‐empowerment in women living with borderline personality disorder and to describe mental health nurses' experiences of implementing this model. A qualitative, exploratory, descriptive, and contextual research design was used for the study. Participants were mental health nurses working in an inpatient psychotherapy unit in a mental health hospital. Findings revealed that mental health nurses experienced the model as a secure framework to assist women living with borderline personality disorder in making a shift to being self‐empowered. The mental health nurses found that they had to adapt the model's timeframe to the women's own pace. Through use of the model, the mental health nurses also gained self‐leadership. This report provides evidence from mental health nurses that the model was practical and helpful in working with women living with borderline personality disorder. The mental health nurses saw signs of self‐empowerment in women living with borderline personality disorder. [ABSTRACT FROM AUTHOR]

Women's delay in seeking medical advice for abnormal vaginal discharge can cause serious effects such as infertility, ectopic pregnancy, and advanced cervical cancer. Family healthcare workers are in a unique position to help in the promotion of vaginal health. A nonrandomized controlled trial was conducted among a sample of family healthcare workers in the intervention (n = 37) and a control (n = 37) group to assess the effectiveness of an educational intervention, which was a 2‐day intensive workshop combining reading materials. Data were analyzed using SPSS software (version 20), and the effectiveness of the intervention was determined using a mixed between‐within subjects analysis of variance. The total knowledge and attitude scores were significantly greater for family healthcare workers in the intervention group immediately and at 3 and 6 months after the educational intervention, compared to the control group. A substantial main effect was observed concerning the time, showing an increase in family healthcare workers' knowledge and attitude scores across the four time periods. A statistically significant difference in the median overall health education competency score across the two groups was also observed. The mean score differences in all sub‐competencies in health education were significantly higher among the intervention group, compared to the control group between second postintervention and the baseline. The educational intervention had revealed successful and sustainable improvements in family healthcare workers' knowledge, attitude on vaginal discharge, and health education competency. This can be implemented as an in‐service program for family healthcare workers to improve health education practices. [ABSTRACT FROM AUTHOR]

Factors affecting independence in basic and instrumental activities of daily living have been established in older adults, but not centenarians. The purpose of this study was to examine the state and factors affecting activities of daily living independence in centenarians who resided in Guangxi Province, China. A cross‐sectional design was used. Activities of daily living, physical activity, mobility, and physical performance were measured by the Population Study of ChINese Elderly study instruments, and demographics and cognition were assessed. Of the 228 participants, 57% were independent in basic activities of daily living and 5.7% in instrumental activities of daily living. Stepwise regression showed physical activity, cognition, calf circumference, and self‐reported health were associated with basic activities of daily living. Physical activity, mobility, cognition, and physical performance were correlated with instrumental activities of daily living. In conclusion, the Chinese centenarians showed impaired instrumental activities of daily living but mostly maintained basic functioning. Physical activity and cognition were associated with activities of daily living independence. [ABSTRACT FROM AUTHOR]

Psychological well‐being may play an important role in health behavior adherence and cardiovascular health, but there has been limited study of well‐being in patients with heart failure. In this descriptive qualitative research study, we interviewed 30 patients with heart failure to explore their psychological experiences with heart failure and the perceived associations between positive psychological constructs and adherence to physical activity, diet, and medication recommendations. Interviews were transcribed, then coded in NVivo using directed and conventional content analysis, and the Consolidated Criteria for Reporting Qualitative Research checklist was applied to report our findings. Participants spontaneously reported positive psychological constructs both during an acute phase of illness and 3 months later. Participants most commonly experienced gratitude, acceptance, connectedness, and faith in the setting of heart failure. In contrast, pride, determination, and hope were identified most frequently as playing a role in health behavior adherence. Finally, participants reported a reinforcing relationship between positive constructs and health behavior engagement. These findings suggest that interventions to boost positive constructs have the potential to improve well‐being and health behavior adherence in patients with heart failure. [ABSTRACT FROM AUTHOR]

Nurses' health literacy knowledge and communication skills are essential for improving patients' health literacy. Yet, research on nurses' health literacy knowledge and perception is limited. The study aimed to evaluate nurses' health literacy knowledge, communication techniques, and barriers to the implementation of health literacy interventions. A cross‐sectional study was used, and a total of 1697 nurses in 104 community hospitals in Thailand completed self‐report measures. Approximately 55% of the participants had heard about the concept of health literacy; 9% had received formal training specific to interaction with patients with low health literacy. About 50% of the nurses were aware of their patients' low health literacy; therefore, they applied the recommended communication techniques for them. Delivery of effective health literacy training was hampered by a lack of assessment tools, health literacy training and specialists, educational materials, and health provider time. Hospital administrators, nurse managers, health leaders should develop strategies to create environments and resources supporting health literacy interventions. [ABSTRACT FROM AUTHOR]

There is a paucity of summarized evidence concerning coping with multiple chronic conditions. An integrative review approach was used to synthesize current evidence on: (i) coping in forms of perceptions and strategies, (ii) relationship between coping and health‐related outcomes, and (iii) factors related to coping. Five electronic databases were searched without time limitation. Thirty‐two studies met inclusion criteria and were included for full‐text review: 24 qualitative, seven quantitative, and one mixed‐methods study. Studies were assessed for quality using an appraisal system of rigor and relevance. A constant comparison method was used to synthesize findings from eligible studies. This review synthesized perceptions of multiple chronic conditions involving negative moods and physical limitations, and strategies of coping with multiple chronic conditions including problem‐ and emotion‐focused strategies. Findings suggested that coping is a promising path to manage multiple chronic conditions and emphasized that appropriate coping might have positive impacts on health‐related outcomes. Five impact factors including age, gender, clusters of multiple chronic conditions, social support, and ethnicity and culture were associated with people's coping. Future healthcare plans should address the physical and psychological needs of people with multiple chronic conditions and highlight the importance of modifying their illness perceptions and enhancing appropriate coping strategies. [ABSTRACT FROM AUTHOR]