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Aim: The aim of this study is to investigate the pesticide safety behaviours and related factors among cabbage farmers in Kalaw Township, Myanmar. Background: Unsafe chemical pesticide practices affect farmers' health and the environment. Understanding pesticide safety behaviours is necessary for healthcare providers to protect agriculture workers against unwanted adverse health effects. Methods: The cross‐sectional study was conducted among 195 cabbage farmers from March to May 2019. Safety behaviours and factors applied in the PRECEDE–PROCEDE model as a framework were assessed using questionnaires. Bivariate and multivariate logistic regression was applied to identify any associations. Results: Altogether, 72.1% of the farmers had a low level of safety behaviours. Goggles and masks were rarely used before and during pesticide applications. All of the farmers experienced adverse health effects after using pesticides. The attitudes toward pesticide poisoning; support from family, co‐workers and healthcare providers; and the availability of personal protective equipment were significantly associated with safety behaviours. Conclusion: Our data provide novel empirical evidence for an opportunity to design effective nursing interventions to promote pesticide safety behaviours among Myanmar agricultural workers. Nurses should pay more attention to promoting comprehensive interventions to reduce both exposure and health effects among agricultural workers through the involvement of supported stakeholders. Summary statement: What is already known about this topic? Farmers and agricultural workers have extensively used pesticides in all steps of cultivation and face a greater risk of pesticide exposure, which could result in adverse health effects.Owing to the lack of research on community health promotion conducted in Myanmar, the burden of the consequences and adverse effects of pesticides remains a significant health issue. What this paper adds? Findings reveal a clear framework for better understanding and assessing pesticide safety behaviours among agricultural workers and farmers in Myanmar.Findings contribute new knowledge for nursing community health promotion by enhancing understanding of multilevel factors, including international and external factors, associated with safety behaviours among agricultural workers and farmers. The implications of this paper: Nurses and other healthcare professionals should be aware of the importance of preventing adverse health effects among agricultural workers in the community and interventions aimed at promoting safety behaviours should be focused not only on individuals but also on the involvement of social supports—particularly family and co‐workers.Nursing policymakers should consider strengthening the nursing role in the recognition of pesticide risk exposure and health outcomes, management of pesticide poisoning and exposure and prevention of pesticide‐related health conditions both in nursing education and nursing practice.Local authorities and policymakers should focus their attention on health promotion and health services to promote safety behaviours when using pesticides, and treatment and extension services should be provided for cases of suspected pesticide poisoning. [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]

Aim: The aim of this study was to evaluate the effect of motivational interviewing based on the trans‐theoretical model promoting physical activity in older adults. Methods: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans‐theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24‐week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. Results: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self‐Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre‐test, while in the post‐test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post‐test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. Conclusion: The trial indicated that after the trans‐theoretical model‐based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans‐theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults. Summary statement: What is already known about this topic? Physical immobility ranks fourth among the leading risk factors for mortality globally.Older adults constitute the age group which leads the most sedentary life in society and is most affected by physical inactivity.In Turkey, one out of every two people undertakes insufficient physical activity, and this rate increases with advancing age. What this paper adds? Nurse‐led motivational interviewing based on the trans‐theoretical model was effective in increasing the physical activity levels of the older adults. The implications of this paper: It is recommended that the trans‐theoretical model and motivational interviewing should be used by nurses to improve healthy lifestyle behaviours in older adults.It is recommended that studies be conducted to assess the effectiveness of interventions aimed at promoting physical activity in older adults via both qualitative and quantitative methods. [ABSTRACT FROM AUTHOR]

Aim: This study examined the preliminary effects of a nurse‐led self‐management education and support programme on the self‐management behaviours and quality of life among people with type 2 diabetes in Western Ethiopia. Methods: A pilot randomized controlled trial was conducted between January and August 2021. Participants were recruited in the hospital and randomly assigned to the control arm to continue usual care (n = 38) or the intervention arm to receive usual care and the diabetes self‐management education and support programme (n = 38) in the community. Self‐management behaviours and quality of life were assessed using a 10‐item summary of diabetes self‐care activity (expanded) scale and a 34‐item diabetes quality of life measure, respectively, at baseline and 2 months after follow‐up. Generalized estimating equation models were used to examine the preliminary effects of the programme on the outcomes. Results: Preliminary results indicated that the programme outperformed usual care in self‐management practise, with large effect sizes immediately postintervention and at 2 months after the intervention, and quality of life at 2 months after the intervention. Conclusion: A nurse‐led diabetes self‐management education and support intervention, including the families of people with diabetes, may be an option to boost the self‐management practise and quality of life of patients with diabetes. Summary statement: What is already known about this topic? Family‐supported diabetes self‐management education intervention produced inconclusive effects on self‐management behaviour and quality of life. What this paper adds? A social‐cognitive theory‐guided, culture‐tailored, and community‐based diabetes self‐management education and support programme resulted in a preliminary effect on improving self‐management behaviour and quality of life.A nurse‐led diabetes self‐management education and support programme intervention, including the families of patients, may be an option to boost the self‐management practise and quality of life of people with diabetes. The implications of this paper: Culturally tailored diabetes self‐management education and support programme could be an option to improve self‐management behaviour and enhance quality of life.Community‐based nurse‐delivered diabetes self‐management education and support can improve self‐management behaviours and enhance quality of life in 2 months duration. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess the validity and reliability of the Salutogenic Health Indicator Scale (SHIS) among a sample of Turkish university students. Methods: This study was conducted with 291 university students. The SHIS was evaluated in terms of language equivalence, validity and the reliability. Content validity was assessed with the content validity index (CVI). Construct validity was determined by confirmatory factor analysis (CFA). A Cronbach's alpha reliability coefficient was used for the analysis of internal consistency, a Pearson's correlation coefficient was used for parallel form reliability, and the intraclass correlation coefficient (ICC) was used for the test–retest technique. Results: The CVI of the SHIS was between 0.80 and 1.00. When the results of the CFA were examined, the factor loadings of all items were above 0.50. A statistically significant moderate positive correlation was found between the SHIS and the Sense of Coherence (SOC) scores for parallel form reliability (r = 0.489). Within the scope of the test–retest analysis, an ICC = 0.762 was determined (p < 0.001). Conclusion: The findings obtained from this validity and reliability study carried out on a sample of Turkish university students showed that the SHIS was both valid and reliable. Summary statement: What is already known about this topic? In recent years, as awareness of the impact of stress on human life has grown, the significance of the salutogenesis concept has increased, resulting in an upsurge in related studies.Several studies have shown the robust psychometric properties and validity of the Salutogenic Health Indicator Scale (SHIS).SHIS, being a semantic type of scale, sets it apart from other measurement scales in the literature that assess positive health and salutogenic health due to its structure. What this paper adds? The results of this adaptation study, which was carried out on a sample of Turkish university students, showed that the SHIS is a valid and reliable tool for measuring health in Turkish culture. The implications of this paper: A culturally and developmentally appropriate, valid and reliable tool can enable individuals to recognize health indicators, resources and coping skills.SHIS can be utilized by healthcare professionals, particularly nurses responsible for patient care, researchers, educators and university students. It proves valuable in conducting comprehensive evaluations of health, positive health and well‐being care, as well as in the planning, development and evaluation of suitable intervention programmes. [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]

Background: Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children. Design: This study was designed as an instrument development study. Methods: This study aimed to develop a scale to measure the attitudes of parents with children aged 0–5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item‐level test–retest analyses for reliability. Results: The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28‐item two factors = 62.47%). Conclusion: This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health‐care services based on the results of the measurement. Summary statement: What is already known about this topic? Vaccination plays an important role in health practice.Parents' attitudes towards vaccination affect their children's vaccination status.Increasing vaccination rates in children will contribute to the reduction of infectious diseases and mortality. What this paper adds? A new valid and reliable measurement tool for determining vaccine hesitancy has been developed.The validity and reliability of the scale of attitudes towards vaccination among parents of children aged 0–5 years were tested.The tool could be used to determine the attitudes of parents of children aged 0–5 years towards vaccination. The implications of this paper The scale may help in determining factors affecting parents' attitudes on vaccination.The scale can generate data to guide nursing practices to increase vaccination rates.The scale can be used to influence nursing practices to increase vaccination rates and promote vaccine awareness, trust and acceptance. [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]

Background: Choosing Wisely is an international movement that stimulates conversations about unnecessary care. The campaign created five recommendations including a statement that less wound care is sometimes better. Aims: The study aims to evaluate nurses' and physicians' adherence to the Choosing Wisely recommendations for acute wound care in the Netherlands and the barriers and facilitators to improve this. Design: This is a mixed methods study using a survey and interviews. Methods: The survey was completed by 171 nurses and 71 physicians from November 2017 to February 2018. A total of 17 nurses and 6 physicians were interviewed. Results: Awareness of the five recommendations ranged from 62% to 89% for nurses and 46% to 85% for physicians. However, up to 15% of the nurses and 28% of physicians were aware but did not adhere to the recommendations. Barriers to adhering were a lack of knowledge, the work environment and perceptions of patients' preferences. Repeated attention, cost‐consciousness and an open culture facilitated the implementation. Conclusion: Although most nurses and physicians were aware of the recommendations, not all adhered to them. Increasing awareness is not enough for successful implementation. A tailored approach that removes the barriers is necessary, such as increasing knowledge about wounds and changing the work environment. Summary statement: What is already known on this topic? Less wound care is sometimes better: cleaning wounds with tap water only, not bathing wounds, using simple bandages and not using bandages on wounds healing by primary intention leads to better wound care for lower costs.It is unknown to what extent this is known and practiced by nurses and physicians and what barriers and facilitators they experience in practicing this. What this paper adds? Although the majority of nurses and physicians were aware of the Choosing Wisely recommendations for acute wounds, not all adhered to them.Awareness is not always sufficient for successful implementation, which requires a broader approach that targets the barriers. The implications of this paper Implementation of these recommendations can be improved by increasing knowledge about wounds and wound care, changing the work environment, and verifying the patient's presumed preferences regarding wound care. [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]

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]

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 aim of this study was to determine the effects of solution‐focussed education and counselling on problematic internet usage, sleep quality and school achievement. Methods: This randomized controlled trial was conducted between January ‐ December 2016 with 44 adolescents who participated in a solution‐focussed intervention to address their problematic internet usage and poor sleep quality. After the intervention, the teens were followed up for 6 months to measure problematic Internet usage, sleep quality and school achievement using the Internet Addiction Test, Pittsburg Sleep Quality Index, Parent–Child Internet Addiction Scale and the students' end‐of‐term school grades. Data were analysed in Statistical Package for the Social Sciences programme using Chi‐square test, Independent t test, Man–Whitney U test, Friedman test and Spearman correlation analysis. Results: The median Internet Addiction Test and Pittsburg Sleep Quality Index scores of the adolescents in the intervention group were significantly lower than those of the controls (P < 0.05), and there was a positive and moderate association between problematic Internet usage and sleep quality in both groups after the follow‐up (r = 0.537, P = 0.010; r = 0.576 P = 0.005). Conclusion: The education and counselling intervention decreased problematic Internet usage and increased sleep quality. There was also an improvement in school achievement, but the difference was not significant. Summary statement: What is already known about this topic? Problematic internet usage is a common public health problem among adolescents, and it affects their physical, social and academic lives.There are some studies in the literature on the prevalence and treatment of problematic internet usage, but there are few on preventing its occurrence.Strengths‐based approaches in adolescent interventions encourage active learning. What this paper adds? A solution‐focussed approach was used for the first time in adolescents to prevent and manage problematic internet usage and accompanying problems.A programme of solution‐focussed health education and counselling was found to be an effective intervention for preventing problematic internet usage and some accompanying problems in adolescents. The implications of this paper: For the prevention and management of problematic internet usage school nurses should screen young adolescents for Internet addiction symptoms and accompanying problems.Nurses must have the benefit of multiple approaches to systematize health care in fulfilling their school health responsibilities.Health education programmes administered by school nurses to address Internet addiction in students can be based on solution‐focussed approaches. [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]

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]

Purpose This study aimed to develop and test the psychometric properties of a Professional Nursing Support Scale for patients with cancer in mainland China. Methods: The study was conducted in two phases from January 2017 to January 2020. Phase I involved item generation and developing a preliminary version of Professional Nursing Support Scale through literature review, qualitative interviews, content validity evaluation and a pilot study. Phase II involved psychometric properties testing of the Professional Nursing Support Scale in 700 patients with cancer recruited from four public hospitals in Anhui Province, China. Results: A 49‐item Professional Nursing Support Scale was finally developed. Exploratory factor analysis showed a four‐factor structure of the 49‐item Professional Nursing Support Scale, accounting for 56.95% of variance. Cronbach's α ranged from 0.91 to 0.94 for the four subscales. Confirmatory factor analysis further confirmed the best model fit of four‐factor structure of the Professional Nursing Support Scale. The Professional Nursing Support Scale also showed an acceptable concurrent validity with Supportive Care Needs Scale short form 34 (r = 0.75, p < 0.001) and Psychological Distress Thermometer (r = 0.39, p < 0.001). Conclusions: The Professional Nursing Support Scale is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the care in Chinese patients with cancer. Summary Statement: What is already known about this topic? Nurses generally provide supportive care services and play imperative roles in supporting patients in cancer.Using a valid and reliable instrument to assess supportive care needs for patients with cancer is a critical step for the improvement of clinical practice and research. What this paper adds? Mixed methods were beneficial for developing the new self‐report and culturally appropriate instrument for Chinese patients with cancer.The Professional Nursing Support Scale (PNSS) is a reliable and valid instrument to assess perceived needs of professional nursing support and support acquisition in relation to the needs. The implications of this paper: The PNSS is expected to a reliable needs evaluation tool. [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]

Background: Elders' disability severity and caregiver health could predict elders' informal care time, but the mechanism by which the degree of disability in the elderly affects informal care time is unclear. Aim: The aim of this works is to explore the mediating roles of caregiver health and home‐based care quality between disability severity of elders and informal care time in far north‐western low‐income areas in China. Method: From September 2017 to February 2018, three hundred fifty‐two dyads of Kazakh disabled elders and informal caregivers in Xinjiang were interviewed. Structural equation modelling analyses were applied. Results: Significant positive correlations were observed between elders' disability severity and informal care time, caregiver health and informal care time, elders' disability severity and caregiver health. Significant negative correlations were observed between home‐based care quality and informal care time, elders' disability severity and home‐based care quality, caregiver health and home‐based care quality. Elders' disability severity had 71.94% direct effect on informal care time, 28.06% indirect effect on informal care time mediated by home‐based care quality and caregiver health. Conclusion: Caregiver health and home‐based care quality play mediating roles on the path relationship between the elders' disability severity and informal care time. Summary statement: What is already known about this topic? Elders' disability severity and caregiver health are critical factors that affect informal care time.The mechanism by which the degree of disability in the elderly affects informal care time is unclear. What this paper adds? Elders' disability severity is positively associated with caregiver health and negatively associated with home‐based care quality.The better home‐based care quality, the shorter the informal care time.Disabled elders' severity degree had a direct effect on informal care time and indirect effects on informal care time mediated by caregiver health and home‐based care quality. The implications of this paper: Community nurses, doctors and health care teams should provide medical services, nursing skills and knowledge for the dyads of disabled elders and informal caregivers and should provide emotional support for other family members to enable growth of the entire family in the process of long‐term care and to reduce informal care time.The government should attach great importance to the informal care time for disabled elders and propose specific informal care time cost compensation policies based on path relationships that influence informal care time. [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]

Background: Multiple studies focus on the experiences of visiting students from high resource regions that participated in clinical placements in lower resource countries but less focus on the experiences of the educators accompanying students. Aim: The purpose of this study was to explore the experiences of educators during an international clinical placement of nursing students in a country in West Africa. Methods: We implemented a focussed ethnographic design. We purposively sampled educators who accompanied students on an international clinical placement. Data collection from 2018 to 2019 consisted of in‐depth individual interviews. We utilized Roper and Shapira's (2000, 10.4135/9781483328294.) data analysis process, which includes coding keywords, identifying patterns and theorizing. Findings Three themes emerged from the data: rewards in accompanying students, challenges experienced and the need for mentoring and continuous support. Educators found it rewarding to see growth in students, how students developed as global citizens, how students developed critical thinking and problem‐solving skills and create lifelong friendships. Conclusion: Educators who accompany nursing students to international clinical placement experience valuable learning and challenging issues. Educators must navigate, support and advance student learning when on an international placement. It is crucial to have adequate institutional support from both the home and host country. Summary statement: What is already known about this topic? Multiple research studies focus on the experiences of visiting students from high resource regions that participated in clinical placements in lower resource countries but less focus on the experiences of the educators accompanying students.Multiple rewards exist for educators who accompanying students on an international clinical placement.Nurse educators are expected to mentor students and provide continuous support. What this paper adds? The need for continuous contact between the educators and the home faculty is highlighted.Mentoring topics to 'soften' the impact of the challenges experiences by educators are identified; this includes regular debriefing with senior educators at the home and host university.The importance of working with the host during the predeparture period, as well as report on arrival and have regular meetings during the placement to ensure that both the needs of the visiting student group and the host are met, is highlighted. The implications of this paper: (how findings influence or can be used to change policy/practice/research/education) A well‐developed support system and debriefing sessions are necessary for the accompanying faculty member.Research is needed to develop the content of a mentorship model/framework for junior academics that plan to accompany students on international clinical placements to low and middle‐income countries.Additional research is needed on the value of pairing a junior academic with an experienced mentor to answer questions as they arise related to day‐to‐day challenges and student related questions during the international clinical placements. [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]

Aims: This study aims to report on the everyday concern of the 'potential for misinterpretation', which was the basic social problem revealed in a grounded theory study exploring male nurse practice in inpatient rehabilitation in Australia. Background: Male nurses account for approximately 10% of nursing workforce across western countries and they practice in a range of clinical areas; however, how they practice in inpatient rehabilitation remains unexplored. Methods: Constructivist grounded theory was used in this study and was conducted in two phases: (i) involved semi‐structured interviews with 11 male nurses from October 2013 to June 2014 and (ii) observation of practice of 12 male nurses and semi‐structured interviews with male nurses and 15 patients from February to April 2015. Results: Nurse participants encountered the intersection of two pervasive patient ideologies about male nurses. Patients perceived nursing to be women's work and that male nurses are sexual threats. These two intersecting ideologies created a concern for male nurses working in inpatient rehabilitation and that concern was labelled 'potential for misinterpretation'. Conclusion: Gender stereotypes impacted on the ability of male nurses to practise nursing in inpatient rehabilitation. Male nurses were mindful on a daily basis that misinterpretation could, and did, happen in inpatient rehabilitation. Summary statement: What is already known about this topic? Male nurses work in a range of specialties.Male nurses across many specialties commonly find the provision of nursing care requiring touch to be problematic.Nursing practice in inpatient rehabilitation is reported from a gender neutral or female perspective. What this paper adds? Male nurses encountered the intersection of two pervasive patient ideologies 'nursing is perceived as women's work' and that 'male nurses are perceived as sexual threats'.These two intersecting ideologies lead to the 'potential for misinterpretation' for male nurses.Men were mindful that misinterpretation could happen at any time which influenced their ability to practise nursing. The implications of this paper: The 'potential for misinterpretation' is useful for nurses and others to understand a main concern male nurses encounter in inpatient rehabilitation.Research can inform nurse education providers about gaps in nursing curricula with regards to male nurse practice.Rehabilitation service providers can use this research to support and inform male nurse workforce development. [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]

Aim: Women with a history of recurrent miscarriage are a vulnerable population. This study aimed to examine changes and relationships among anxiety, depression and social support across three trimesters of pregnancy in women with a history of recurrent miscarriage. Methods: A prospective, longitudinal study was employed. A convenience sample of 166 pregnant women with a history of recurrent miscarriage completed the measures at their 6–12, 20–24 and 32–36 gestational weeks. Results: The prevalence of anxiety at early, middle and late pregnancy was 47.6%, 36.1% and 32.5%, respectively, whereas that of depression was 38%, 34.3% and 31.3%, respectively. Social support scores increased from early pregnancy to middle pregnancy then remained in late pregnancy. There were correlations among anxiety, depression and social support across pregnancy. Conclusions: Anxiety and depression were highly prevalent in pregnant women with a history of recurrent miscarriage, especially in early pregnancy when the level of social support was the lowest. Social support is an essential buffer against anxiety and depression throughout the pregnancy. Summary statement: What is already known about this topic? Recurrent miscarriage is a significant loss in women's lives, and subsequent pregnancy is full of uncertainty for them.Research on changes in incidence and prevalence of anxiety and depression in pregnant women with a history of recurrent miscarriage is not available. What this paper adds? Anxiety and depression were highly prevalent and might harm pregnancy outcomes in women with a history of recurrent miscarriage.The anxiety, depression and social support changed with the trimesters in pregnant women with a history of recurrent miscarriage.Early pregnancy was when women have the highest level of anxiety and depression with the lowest level of social support. The implications of this paper: Tracking anxiety and depression in pregnant women with a history of recurrent miscarriage should be the routine of care as soon as possible.The trend of social support was not in line with that of anxiety or depression; research to develop evidence‐based interventions should enhance the level of social support in early pregnancy in pregnant women with a history of recurrent miscarriage.Social support during pregnancy could help to buffer depression and anxiety. Health providers should deliver timely support to reduce the potential negative impact of depression and anxiety. [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: This exploratory and cross‐sectional study aimed to evaluate the effects of technological device use on preschool children's life quality. Methods: One hundred twenty‐five preschool students were recruited from two kindergartens affiliated to the Directorate of National Education in provincial centre of Zonguldak, Turkey. Personal Information Form and Quality of Life Scale for Young Children (KINDL Quality of Life Scale) were tools for data, collected by the researcher herself from parents through face‐to‐face interview method. Results: It was found in the study that 54.4% of the parents and 42.4% of their children who were involved in the study were frequently used technological devices. Mean score of the children's KINDL Quality of Life Scale was 79.2 (9.5; range 57–99). When comparing this score and its subscales with children's desire to not sleep due to playing virtual games and so forth, the differences between all the other subscales except self‐esteem were significant (p < 0.05). A significant difference was also found between the children's sleeping hours and subscales such as self‐esteem, physical and emotional health (p < 0.05). Conclusion: The results show that more than half of the parents and their children frequently use the technological devices. Healthcare providers should inform the parents regarding the possibly negative consequences such as negatively affecting the children's quality of life. SUMMARY STATEMENT: What is already known about this topic? Technological device use is one of the challenging problems seen among children, and it has negative effects on children's health.This use negatively affects the children's quality of life. What does this paper add? The families' and their children's frequency of technological device use was demonstrated.The effect of children's technological device use on their quality of life was determined.The factors affecting the quality of life with respect to the technological device use were determined. The implications of this paper: Technological device use negatively affects children's quality of life.Education programmes should be organized for families and children in order to manage the use of technological devices frequently seen among preschool children. [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: Of the few instruments available to measure the important, positive aspects of caring, the Caregiver Reaction Assessment is regarded as the most suitable, but there is no validated Spanish version. The aim of this study was to translate the Caregiver Reaction Assessment into Spanish and assess its psychometric properties. Methods: The Caregiver Reaction Assessment was translated into Spanish and then back translated. Validation included construct validity, criterion validity and reliability: 287 interviews were conducted with informal caregivers of patients with dementia between November 2010 and April 2012. Results: Principal component analysis confirmed the original instrument's five subscales. Criterion validity showed a moderate negative correlation between the impact on health and the EQ‐5D (r = −.43), that is, a greater impact on health correlated with lower health‐related quality of life. The Caregiver Reaction Assessment showed good internal consistency, with a Cronbach alpha of.804, and good temporal stability for the distinct subscales, with intraclass correlation coefficients varying from.683 to.729 (p <.001). Conclusion: The Caregiver Reaction Assessment is a reliable, valid instrument for the measurement of the reactions of informal caregivers of patients with dementia, with good psychometric properties. SUMMARY STATEMENT: What is already known about this topic? The Caregiver Reaction Assessment is one of the few instruments that measures positive reactions in caregivers.A validated Spanish version of the instrument is required for Spain and other Spanish‐speaking countries. What this paper adds? The Caregiver Reaction Assessment was shown to be a reliable, valid instrument for the measurement of the reactions of informal caregivers of people with dementia in Spain and has good psychometric properties. The implications of this paper: Once validation is complete, the Caregiver Reaction Assessment may be used in all Spanish‐speaking informal caregivers and is suitable for home care and long‐term care institutions.The Caregiver Reaction Assessment subscales allow healthcare professionals to identify and focus on the areas that could bring about the greatest improvements in the care of people with dementia.The Caregiver Reaction Assessment permits the caregiver's state to be viewed at any stage of dementia and offers healthcare professionals the opportunity to act to avoid physical and emotional overload in caregivers. [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 was to determine the effect of pedometer‐supported walking and telemonitoring after lumbar disc hernia surgery on pain and disability levels and quality of life. Methods: This was a randomized controlled trial with two randomly selected groups conducted between March 2018 and January 2019. Sixty‐seven participants (33 in the intervention group and 34 in the control group) who had undergone lumbar microdiscectomy were allocated to receive and not to receive walking exercise. Pain and disability levels and quality of life of groups were tested with the McGill Pain Questionnaire, the Oswestry Disability Index and the 36‐Item Short Form Survey. Measurements were taken 3 weeks after surgery and following completion of the first, second and third months. Results: Compared with the control group, pain level at the first and second months and disability level at the second and third months in the intervention group were significantly lower (p < 0.05), and in the third month, subdimension scores of quality of life (the physical role difficulty, energy and vitality, mental health, social functionality and pain) were higher (p < 0.05). Conclusions: Walking after herniated disc surgery decreased pain and disability levels and increased the quality of life; nurses can encourage adherence to walking as an effective intervention. SUMMARY STATEMENT: What is already known about this topic? After lumbar disc hernia surgery, patients experience low to moderate levels of pain and disability.Pain and disability levels can be decreased with appropriate post‐operative care and rehabilitation.Walking is a cheap and safe type of physical activity that is effective both in increasing physical activity after surgery and in decreasing pain and disability. What this paper adds? Walking was effective for reducing post lumbar disc hernia surgery pain and disability levels, positively contributing to better quality of life for these patients.This study showed that post discharge monitoring by nurses was necessary and important. The implications of this paper: Nurses should inform patients to gradually increase physical activity during discharge training.Walking is a simple and cheap activity with low risk of injury, which could be recommended as a type of exercise after lumbar disc herniation surgery.Nurses can use pedometers and the telemonitoring methods to motivate patients to walk. [ABSTRACT FROM AUTHOR]

Background: Patient‐ and family‐centred care practices are a recommended part of contemporary care for the acutely ill hospitalized adult patients. However, how patient‐ and family‐centred care is enacted in an adult hospital setting is not well understood. Aims and Objectives: The aim of this study is to explore the perceptions of patients, family members and nurses regarding family participation and collaboration in patient care within an acute care setting, including the barriers and facilitators. Design This study used a mixed‐methods sequential design. Methods: Observer‐as‐participant observations and semistructured interviews were undertaken. Integration of the data was achieved through triangulation. Results: Triangulation revealed two metathemes. The first metatheme, 'continuum of family involvement', explained the central viewpoint of how family participation and collaboration in the care of acutely ill hospitalized adult patients was enacted. The second metatheme, 'nurses value family involvement', helped to explain and understand the barriers and facilitators to enacting family participation in the acute care setting. Conclusion: Promoting family participation in the acute care setting requires supporting multiple levels of engagement. Developing a relationship, clear communication and open sharing of information amongst patients, family members and nurses is critical to supporting family involvement. SUMMARY STATEMENT: What is already known about the topic? Health service policy emphasizes that patients and families should be treated with dignity and respect, be active partners in all aspects of care and contribute to the development and improvement of health care.In the acute care setting, both patients and family members express the desire for a larger role in health‐care decision making; yet how this is enacted in an adult hospital setting is not well understood.Research in other settings has demonstrated the clinical benefits of family involvement in care include decreased mortality, reduced hospital length of stay, improved adherence to treatment regimens and decreased readmission rates. What this paper adds? Supporting meaningful family participation in the acute care setting requires supporting multiple levels of engagement. When families felt empowered and participated in care, patients and family members believed it helped nurses to keep the patient safe and individualize care.The tripartite relationship amongst patients, family members and acute care nurses is essential in empowering family members to participate in the care of acutely ill hospitalized adult patients. However, nurses' values, beliefs and attitudes towards involving families in patient care are seen to be crucial to the possibility of embedding family participation in the acute care setting. The implications of this paper: Policies that incorporate the patient and families' voice and behavioural change interventions may lead to the normalization of patient‐ and family‐centred practices in the adult acute care hospital setting. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to investigate the effect on health, well‐being and weight loss of a motivational support programme provided for adolescents who were overweight and obese. Methods: This was a randomized controlled trial. Sixty‐four adolescents (39 girls and 25 boys) who were overweight and obese and consulted at our polyclinic from January 2015 to February 2016 comprised the study population. The sociodemographic characteristics, well‐being levels and physical parameters of the adolescents were evaluated. Routine follow‐ups were practiced for both groups. The adolescents in the experimental group had motivational interviews and were sent reminder messages over a 6‐month period, and education programmes were conducted with the parents. Results: After 6 months, the body mass index values had decreased in the experimental group compared with baseline, with no decrease in the controls. Scores for the Paediatric Quality of Life total scale and physical health and psychosocial health subscale points were increased in experimental and control groups, but the quality of life scale points of the experimental group were higher than the control group. In the experimental group, aspartate aminotransferase, alanine aminotransferase, insulin, homeostasis model assessment of insulin resistance (HOMA‐IR) and total cholesterol were decreased. Conclusion: The motivational support programme affected the adolescents' health positively and can be recommended as a routine nursing intervention. SUMMARY STATEMENT: What is already known about this topic? Obesity is increasing in the world and becoming an important public health problem.Childhood obesity can critically affect health outcomes.Effective preventive interventions are greatly needed to decrease the prevalence of childhood obesity. What this paper adds? The motivational support programme that was provided to obese and overweight adolescents decreased their body mass index.The motivational support programme positively affected biochemical values and quality of life in adolescents who were obese and overweight.The present study found that this motivational support programme with parental involvement was an effective strategy in changing obesity‐related outcomes. Implications of this paper: Nurses evaluate adolescents who present to hospitals with other health problems and play an important role in recognizing overweight or obesityNurses could learn to apply this programme to decrease future health problems.Motivational support programmes can be applied to obese children and adolescents admitted to obesity clinics and their use should be more widespread. [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]

Aims: The aim of this study was to examine professional identity through the group performances of nurses within a specific work environment. Background: Professional identity and social identity are closely linked. Nurses undertake clinical practice usually within a social group environment. The literature is limited on the development of professional identity within the context of nurses' daily work. Design An integrated ethnographic case context design was adopted, consisting of two clinical wards in one acute health‐care facility in Australia. The application of the social identity theory (SIT) was used to study two specific professional activities to describe the group performance of nurses within this organizational cultural context and how this influenced nurses' professional identity. Method: The research was undertaken between 2012 and 2014. Data collection included observation, interviews and fieldnotes of a convenience sample of nurses and allied health‐care professionals who undertook two professional activities in their normal work environment. Findings The development of group efficacy contributed to the development of the professional identity in the homogenous handover activity. Self‐efficacy was demonstrated in the heterogenous multidisciplinary activity. Conclusion: The results indicated the importance of recognizing core identity‐building activities and understanding the value of these activities to professional identity development. SUMMARY STATEMENT: What is already known about this topic? Outside health care, it is well researched that social identity theory and group performance are important to group development within organizations.Professional identity during the training of undergraduate nurses is well researched.It is known, but under studied, that work contexts are significant arenas where nurses' professional identity is refined and expressed. What this paper adds? Social processes in the work environment sustain the construction of nurses' professional identities.Group efficacy during nurse‐to‐nurse activities contribute to the development of professional identity.Self‐efficacy during multidisciplinary interactions offers insights into the performance of professional identity. The implications of this paper: The findings have implications for informing the development of core identity‐building activities to purposefully enhance professional identity within nursing work contexts.The findings have implications for understanding how nurses self‐categorize their professional identity and how this is expressed differently in a homogenous nursing group from a multidisciplinary group.The findings are relevant to professional leadership, education and service development in the nursing profession and generate important possibilities for further research in other nursing work environments. [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: This study was conducted to determine the effects of demographic and obstetric variables with body image on sexual dysfunction in pregnant women. Background: Sexual dysfunction is frequent in pregnant women. To what extent body image plays a role is incompletely understood. Methods: In the research, a cross‐sectional and comparative study was conducted. A personal information form, body image scale, and female sexual function index were applied to 472 pregnant women. Descriptive statistics, the Student t‐test, the χ2 test, and logistic regression analysis were employed for evaluating the data. Results: Sexual dysfunction was found in 54.7%. The frequency of sexual dysfunction in the first trimester was lower. In addition, factors like the place of residence of the pregnant women and number of pregnancies were found to be related to sexual dysfunction in pregnant women. Each unit decrease in body image score resulted in women being 0.98 times more likely to experience sexual dysfunction. Conclusion: It was determined that approximately one in two pregnant women experienced sexual dysfunction, and body image, place of residence, trimester of the pregnancy, and number of pregnancies were important factors affecting sexual function. SUMMARY STATEMENT: What is already known about this topic? Many factors cause sexual dysfunction, and one of these factors in women is pregnancy.In addition to the anatomical, physiological, and psychological changes caused by pregnancy, some demographic and obstetric variables can affect sexuality during pregnancy.To what extent body image plays role on sexual dysfunction in pregnancy is incompletely understood. What this paper adds? Approximately one in two pregnant women experienced sexual dysfunction in this study.We determined body image, living place, trimester of the pregnancy, and number of pregnancies were important factors affecting sexual function. The implications of this paper: The integration of findings with prenatal care services can be used to assess risk factors and provide protective services.Sexual dysfunction in pregnancy should be considered in the presentation of prenatal care services.Body image and all other variables should be considered as part of holistic follow up of pregnant women. [ABSTRACT FROM AUTHOR]

Aim: To translate the International Consultation on Incontinence Questionnaire (ICIQ) Long‐Term Catheter Quality of Life (LTCqol) questionnaire (ICIQ‐LTCqol) from English to Arabic and evaluate its psychometric properties. Background: Currently, no tool for Arabic‐speaking patients is available to measure the quality of life in patients using long‐term urinary catheters. Design Translation and psychometric assessment of questionnaire. Methods: The internal consistency and construct validity of the translated Arabic version of the ICIQ‐LTCqol were evaluated in a convenience sample of 141 participants recruited from a hospital in Egypt from April to September 2017. Test‐retest reliability was assessed for a sample of 15 participants who completed this version at two time points. Construct validity was assessed by factor analysis. Results: The translated Arabic version of the ICIQ‐LTCqol showed satisfactory test‐retest reliability and internal consistency, with the Cronbach α =.75. Confirmatory factor analysis confirmed the same two factors ("catheter function" and "lifestyle") structure as found in the English version of the tool supporting the construct validity of the translated questionnaire. Conclusion: This original and significant study allows, for the first time, researchers and clinicians working with Arabic‐speaking patients, the opportunity to evaluate the quality of life in long‐term urinary catheter users. SUMMARY STATEMENT: What is known about this topic: The potential negative impact of using a long‐term indwelling urinary catheter on patients' everyday lives has been well documented.There is no available psychometrically robust self‐report questionnaire that can be used to assess the impact of living with a long‐term catheter among Arabic speakers.To date, the Incontinence Questionnaire (ICIQ) Long‐Term Catheter Quality of Life (LTCqol) questionnaire (ICIQ‐LTCqol) has not been translated into Arabic, and therefore, it has not been used with Arabic‐speaking catheter patients.In Arabic countries, no research has been conducted focusing on the experience of patients with urinary catheters. What this paper adds? The International Consultation on Incontinence Questionnaire (ICIQ) Long‐Term Catheter Quality of Life questionnaire (ICIQ‐LTCqol) Arabic version is a clear, understandable, and short questionnaire.The Arabic version of the ICIQ‐LTCqol has the same factor structure as the English version using confirmatory factor analysis.The Arabic version of the ICIQ‐LTCqol has good internal consistency. Implications of this paper: Clinicians and researchers working with Arabic‐speaking patients, who use long‐term urinary catheters, can utilize this version of the ICIQ‐LTCqol to evaluate their QOL.The Arabic version of the ICIQ‐LTCqol is a robust tool for assessing the impact of living with a long‐term catheter in Arabic countries.Further research is needed on the retest reliability of the ICIQ‐LTCqol in the Arabic‐speaking population.The impact of living with a long‐term catheter has not been investigated in Arabic countries. [ABSTRACT FROM AUTHOR]

Aim: The awareness for the need for end‐of‐life care has increased among noncancer patients. However, studies on the topic have rarely targeted the needs of noncancer patients who want to die at home. This study assessed the end‐of‐life care needs of noncancer patients who were receiving care and wanted to die at home. Methods: A cross‐sectional study design was used and involved 200 participants who were diagnosed as noncancer patients and receiving home care nursing. Data were collected on demographics, disease, Palliative Performance Scale (PPS) scores, and end‐of‐life care needs, in April and May, 2016. Results: Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives." Multivariate analysis revealed that the duration of home care nursing held a significant association with end‐of‐life care needs. Conclusion: By reflecting on the comprehensive care needs of patients with chronic illnesses and including them in the care process, it will be possible to provide better quality palliative care to patients at home in the end‐of‐life stages. SUMMARY STATEMENT: What is already known about this topic? Noncancer patients at the end‐of‐life stage have complex needs and problems that are difficult to solve, compared with cancer patients.Noncancer patients need to receive effective symptom management or sufficient support for satisfactory care.End‐of‐life care is still mainly focused on cancer patients and attention to noncancer patients is lacking. What this paper adds? Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives."Duration of home care nursing and an income level were significantly associated with higher end‐of‐life care needs. The implications of this paper: Home care nurses must clearly assess the care needs of noncancer patients at the end‐of‐life stage and subsequently provide comprehensive patient‐centered care based on this assessment.It is important to adjust the care direction between patient, family, and medical staff from early on for patients who want to die at home.The results highlight needs for the development of interventions that focus on the duration of home care nursing of patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine whether implementation of a healthy lifestyle education programme resulted in improved health literacy levels and healthy life style behaviours. Methods: A one‐group pretest‐posttest study design was used. This study was carried out with 30 women who were enrolled in a family health centre. A questionnaire comprising the Adult Health Literacy Scale, Healthy Lifestyle Behaviour Scale‐II, Perception of Health Scale, and Short Test of Functional Health Literacy was used for data collection. Eight home visits including training and follow‐up followed the first interview at the family health centre. The healthy lifestyle training was applied once per week during home visits. After the training sessions were completed, women were followed‐up through four home visits biweekly in the second and the third months. Results: The difference between the Adult Health Literacy Scale and Short Test of Functional Health Literacy pretest‐posttest mean scores was statistically significant (P <.05). Although the Perception of Health Scale and the Healthy Lifestyle Behaviour Scale‐II posttest scores were higher than the pretest scores, the difference between the groups was not statistically significant. Conclusion: The training and counselling intervention visits increased health literacy but did not significantly change the healthy life style behaviours and health perceptions of the women. SUMMARY STATEMENT: What is already known about this topic? Health literacy is an essential issue to consider in planning programmes to decrease inequalities and increase health promotion in disadvantaged groups.Women are one disadvantaged group who play a key role in protecting and promoting the health of both their society and their family. What this paper adds? Unlike many studies with disease‐specific samples, this was a community‐based study, conducted with community‐dwelling women without any co‐morbidity, using both national and global measurement tools.The health literacy levels of the women was increased via a training and counselling intervention delivered during home visits by public health nurses.The intervention did not have a significant effect on women's healthy life styles and health perceptions. The implications of this paper: The findings of our study indicate that public health nurses as educators and counsellors can impact health literacy levels of women.Public health nurses can improve women's health literacy by empowering women. More health literate women means more healthy generations, families, and communities. [ABSTRACT FROM AUTHOR]