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Aims: Inpatient falls among older adults are a relentless problem, and extant inpatient fall prevention research and interventions lack the older adults' perspectives and experiences of their own fall risk in the hospital. Theory‐guided research is essential in nursing, and the purpose of this paper was to describe the process of developing a theoretical framework for a phenomenological nursing study exploring older adults' lived experiences of being at risk for falling in the hospital. Method: Based on philosophical nursing underpinnings, the Health Belief Model (HBM) was selected as the theoretical model. The limitations of the model led to expansion of the model with established concepts associated with accidental falls among older adults. Results: The HBM was selected as the guiding model due to its ability to capture a broad range of perceptions of a health threat. The HBM was expanded with the concepts of embarrassment, independence, fear of falling, dignity and positivity effect. The addition of these concepts made the theoretical framework more applicable to age‐related developmental behaviours of older adult and more applicable to nursing research. Conclusion: The Expanded HBM theoretical framework may guide future nursing research to develop fall prevention interventions to decrease fall rates among hospitalized older adults. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: Patients' death or adverse events appear to be associated with poor healthcare decision‐making. This might be due to an inability to have an adequate representation of the problem or of the connections among problem‐related elements. Changing how a problem is formulated can reduce biases in clinical reasoning. The purpose of this article is to explore the possible contributions of psychoneuroendocrinoimmunology (PNEI) and psychology of reasoning and decision‐making (PRDM) to support a new nursing theoretical frame. Design: Discursive paper. Method: This article discusses the main assumptions about nursing and nurses' ability to face patient's problems, suggesting a new approach that integrates knowledge from PNEI and PRDM. While PNEI explains the complexity of systems, highlighting the importance of systems connections in affecting health, PRDM underlines the importance of the informative context in creating a mental representation of the problem. Furthermore, PRDM suggests the need to pay attention to information that is not immediately explicit and its connections. Conclusion: Nursing recognizes the patient–nurse relationship as the axiom that governs care. The integration of PNEI and PRDM in nursing theoretics allows the expansion of the axiom by providing essential elements to read a new type of relationship: the relationship among information. PNEI explains the relationships between biological systems and the psyche and between the whole individual and the environment; PRDM provides tools for the nurse's analytical thinking system to correctly process information and its connections. Impact on Nursing Practice: A theoretical renewal is mandatory to improve nursing reasoning and nursing priority identification. Integrating PNEI and PRDM into nursing theoretics will modify the way professionals approach patients, reducing cognitive biases and medical errors. No Patient or Public Contribution: There was no patient or public involvement in the design or writing of this discursive article. [ABSTRACT FROM AUTHOR]

Aim: The increase in the number of people with chronic obstructive pulmonary disease (COPD) and the disease burden, has prompted concerted efforts to improve healthcare, particularly outpatient services. In line with these attempts the Partnership-Based Nursing Practice Theoretical Framework for People with COPD was developed to guide outpatient nursing care. The principal approach of the framework is a ‘Dialogue’ with the patients, which has four components: ‘Establishing family involvement’, ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’, with the primary goal being ‘Enhancement of the health experience’. With new knowledge, research on the framework, and extensive experience in using it, a need arose to modify the framework to maximize its clinical utility. Design: Discursive paper. Methods: A narrative review and critical reflection was conducted to revise the nursing practice framework via selected literature search from 2012 to 2022, research on the framework, and the authors' reflections on the clinical experience of using the framework. Results: The nursing practice framework highlights capacities and possibilities that lie in the nurse–patient relationship. The overarching dialogue in the revised framework includes both patients and families. The action-related component ‘Assisting living with the disease’ was added to the framework to underscore the significance of attempting to understand what may lie ahead for patients and families. The other action-related components are as follows: ‘Assisting living with symptoms’ and ‘Facilitating access to healthcare’. The primary goal remains unchanged: enhancing the ‘Health experience’. Conclusion: Using the revised nursing practice framework in outpatient care may help to enhance the lives of people with COPD and their families, particularly at advanced stages of the disease. It may have transferability to other groups of people living with progressive diseases dealing with complicated health problems, and to reduce the usage of costly healthcare resources such as hospital care. Implications for the Profession and/or Patient Care: The partnership-based nursing practice framework assumes an extension of conventional specialized respiratory service and embraces a comprehensive account for that which may influence the patient's health problems. This guidance, which holistically attends to patient-family needs of living with complicated and progressive health predicaments, is fundamental. It contributes to strengthening the disciplinary focus of nursing, interdisciplinary collaboration, person-family-centred quality nursing care and inspires research initiatives. Critical reflections and updates on nursing practice frameworks, such as this revision, are essential to advance nursing and healthcare. [ABSTRACT FROM AUTHOR]

Aim: To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence‐based practices, from the perspectives of potential programme participants and deliverers. Design: A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China. Methods: We conducted individual semi‐structured interviews with unit‐level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability. Results: After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi‐modal training activities such as group work, experience‐sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID‐19 pandemic, and support from senior organizational leadership. Conclusions: The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success. Impact: The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally. [ABSTRACT FROM AUTHOR]

Aim: To present the development, implementation and evaluation of a theoretically grounded novel virtual dissemination evaluation (VDE) framework. Background: Care of intensive care unit patients requires access to the most up‐to‐date knowledge and best practices. To address this challenge, we present the development, implementation and evaluation of a theoretically grounded novel VDE framework. This framework is applied to a dissemination strategy, NeoECHO, in neonatal intensive care units. Evidence‐based virtual education is implemented to prevent, detect and treat necrotizing enterocolitis in neonates. Design: Research Methodology: Discussion Paper—Methodology. Methods: The virtual dissemination evaluation framework is a sequential combination of Integration of Integrated‐Promoting Action on Research Implementation in Health Services and Moore's Expanded Outcomes frameworks. The framework's conceptual determinants, virtual facilitators and implementation evaluations were operationalized in the NeoECHO dissemination strategy and evaluated for feasibility. The virtual dissemination evaluation framework was conceptually mapped, and operational activities were examined including theoretical constructs drawing on insights of nursing theorists, especially Fawcett's criteria (2005) for frameworks with practical application (significance, internal consistency, parsimony, testability and design fit). The NeoECHO strategy was evaluated for virtual dissemination evaluation adherence, operationalization and feasibility of implementation evaluation. Results: The virtual dissemination evaluation framework meets the criteria for a practical application and demonstrates feasibility for adherence and operationalization consistency. The implementation evaluation was usable in the virtual dissemination of best practices for neonatal care for necrotizing enterocolitis and healthcare providers were actively engaged in using NeoECHO as an implementation strategy. Conclusion: This examination of the foundational aspects of the framework underscores the rigour required for generalization of practical application. Effective virtual dissemination of evidence‐based practices to hospital units requires structured delivery and evaluation, enabling engaged healthcare providers to actualize education rapidly. The virtual dissemination evaluation frameworks' potential for narrowing the evidence‐based practice gap in neonatal care showcases its wider significance and applicability. Implications: Care of neonates in NICUs requires a multidisciplinary approach and necessitates access to the most up‐to‐date knowledge and best practices. More than traditional dissemination methods are required to bridge the implementation gap. Impact: The effective use of the VDE framework can enhance the design, implementation and evaluation of knowledge dissemination, ultimately elevating neonatal care quality. Clinical Relevance: This paper introduces the VDE framework, a sequential combination of the iPARIHS and Moore's EO frameworks—as a methodological tool for designing, implementing and evaluating a neonatal strategy (NeoECHO) for virtual dissemination of education in NICUs. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to gain insight in the transfer process from hospital to homecare or rehabilitation centre from a patient's perspectives and to describe the experienced involvement, information provision and information needs patients. Design: A multiple case study with a phenomenological approach. Methods: Observations and interviews were employed, between May 2019 and August 2019, to capture the patient's perspectives and experiences on involvement, information provision and needs. Observations were executed during the discharge process from hospital to homecare (n = 6) or revalidation centre (n = 1) and during admission interviews with community nurses (n = 6). Interviews were conducted at the patient's home and the revalidation centre. Results: Eight themes were identified within three phases of the transfer process. The Sign‐up phase contained two themes: 'organizing follow‐up care' and 'planning the moment of discharge from the hospital'. The two themes in the Transfer phase were, 'verbal information provision' and 'written information provision'. Four themes were identified in the End phase: 'nursing supplies', 'medication', 'the electronic patient portal' and 'continuation of (para)medical care'. Conclusions: Patient participation in the transition process from the hospital to follow‐up care can be improved. This study indicates that unsafe situations could be prevented by patient involvement and clear perceptions of the role and responsibilities of patients, family and healthcare professionals. Implications to Patient Care: Patient and family involvement has the potential to improve transition of care and techniques for shared decision‐making can be applied to a greater extent. Impact: This paper highlights that patients and families should be acknowledged as key figures in the transfer process and gives direction to healthcare professionals on how to increase involvement in the transfer process by actively inviting patients to participate in the transfer process. Reporting Method: COREQ guidelines for qualitative reporting. No patient or public contribution. Contribution to Global Clinical Community: This paper gives insights in patients' and families' perspectives on transition of nursing care and their involvement during the whole transfer process.This paper gives direction how to improve patient participation during the discharge process from hospital to follow‐up care. [ABSTRACT FROM AUTHOR]

Aim: To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic. Design: Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders. Methods: Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust. Results: Participants continued to deliver a significant proportion of patient care inperson. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks. Conclusion: The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice. Impact: The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward. Reporting method: Standards for Reporting Qualitative Research (O'Brien et al., 2014). Patient or public contribution: This was a workforce study so there was no patient or public contribution. Implications for the profession and patient care: The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward. [ABSTRACT FROM AUTHOR]

Aim: To highlight the value of utilizing the Listening Guide methodology for nursing research and provide an exemplar applying this methodology to explore a novel concept in an underrepresented group—inner strength in persons newly diagnosed with mild cognitive impairment along with their care partners. Design: Methodology discussion paper. Methods: The exemplar study used the Listening Guide methods for data elicitation and analysis. Methods included adaptations for the study population and novice qualitative researchers. Results: The Listening Guide methodology with adaptations enabled the research team to centre the voices of persons living with mild cognitive impairment, highlight an abstract phenomenon and attend to the influences of the sociopolitical context. Further, this methodology helped address common challenges emerging qualitative researchers encounter, including understanding methods of application, engaging reflexively and immersing in the data. Conclusion: The Listening Guide is a voice‐centred qualitative methodology that is well suited to foreground the experiences of groups underrepresented in research and explore emerging phenomena. Implications for Nursing: Nurses are central to striving for health equity. The Listening Guide methodology offers a valuable and accessible research tool to understand the experiences and needs of underrepresented groups and shape healthcare in response. Impact: The Listening Guide methodology can be broadly applied to research with persons with mild cognitive impairment, and other underrepresented groups, to explore other phenomena beyond inner strength and move the science forward in representing the perspectives of groups underrepresented by research. Patient or Public Contribution: Persons living with cognitive impairment and their care partners participated in study conceptualization, interview guide development, methods development and dissemination plans. [ABSTRACT FROM AUTHOR]

Aim: To identify barriers and facilitators impacting the implementation of a comprehensive transfer program aimed at parents of adolescents with chronic illness in clinical practice. Design: A real‐time, qualitative process evaluation. Methods: Individual interviews were conducted with 10 nurses and seven physicians from paediatric and adult outpatient clinics: Nephrology, hepatology, neurology, and rheumatology. Data were analysed through the lens of normalization process theory. Results: Themes were framed within the theory's four components. (1) Coherence: Healthcare professionals' views on their core tasks and on the parents' role influenced their perception of the program. (2) Cognitive participation: A named key worker, autonomy, and collaboration impacted healthcare professionals' involvement in the program. (3) Collective action: Department prioritization and understanding of the program's aim were key factors in its successful delivery. (4) Reflective monitoring: Participants experienced that the program helped parents during transfer but questioned if the program was needed by all families. Conclusion: We identified three barriers: Healthcare professionals' lack of understanding of the parental role during transfer, top‐down decisions among nurses, and physicians' uncertainty about their role in joint consultations. Facilitators: Healthcare professionals' understanding of the program's purpose and expected effect, the nurses' significant role as named keyworkers, and good collaboration across paediatric and adult departments. Implications for the Profession and/or Patient Care: Implementation strategies should be developed before implementing a transfer program in clinical practice. Impact: Implementing a parental transfer program in clinical practice can be challenging. Therefore, for successful implementation, it is crucial to identify barriers and facilitators.Barriers and facilitators exist at the personal, professional, and organizational levels, and it is important to understand them.The results of this qualitative study could support the implementation of transfer programs in other settings. Reporting Method: Consolidated criteria for reporting qualitative studies (COREQ). Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community?: Nurses' and physicians' experiences of ownership of the transfer program is essential for successful implementation.Clinics should appoint a named keyworker, preferably a nurse, as the driving force during the implementation of a transfer program.Nurses and physicians should receive training about the purpose, justification, and expected effect of a transfer program before implementation. [ABSTRACT FROM AUTHOR]

Introduction: It is necessary to re‐imagine nursing curriculums utilizing a postmodern approach, as outdated teacher‐centred methods of nursing education with emphasis on memorization versus critical thinking no longer meet the needs of the contemporary learner and the current challenges of the healthcare environment. There is an explicit need to redesign nursing curriculums that are future‐oriented, adaptive and flexible and serve the learners' best interests. Background: Distilled from a decade of teaching experience in an undergraduate, second‐degree entry, accelerated nursing program, this paper describes the construction of a learner‐centred, postmodern, concept‐based nursing curriculum that aims to foster learners' inquiry skills, critical thinking, problem‐solving, and experiential learning—all which develop learners' autonomy, self‐direction, and lifelong learning. The objective is to foster learners' transformational and emancipatory learning and metacognition. Discussion: An extensive review of the current trends, contemporary nursing knowledge for the past decade (2013–2023), and seminal literature on theories and frameworks paralleled with the review of current and future trends in Canadian and global health care, including the socio‐economic, politico and environmental contexts, led to the formulation of a concept‐based curriculum. Grounded in the constructivist paradigm, the curriculum applies interperetivist, critical, feminist, and indigenous lenses. The Strength‐Based Nursing framework was selected as the core guiding framework. The curriculum's four curricular themes and foundational pillars were adopted directly from the framework to provide a starting point for concept development. These initial themes were then juxtaposed with relevant nursing, and social theories, policies, and frameworks, ensuring a robust coverage of modern nursing knowledge and allowing for the core concepts of the curriculum to emerge. A total of 21 concepts and 192 sub‐concepts were developed. Conclusion: Implications for future practice require nursing educators to receive support and professional development opportunities in developing skills and confidence in entering a classroom as co‐learners and facilitators. [ABSTRACT FROM AUTHOR]

Aims: To elicit experiences of patients, family caregivers, and healthcare professionals in intermediate care units (IMCUs) in an academic medical centre in Baltimore, MD related to the challenges and intricacies of multimorbidity management to inform development of a multimorbidity symptom management toolkit. Design: Experience‐based co‐design. Methods: Between July and October 2021, patients aged 55 years and older with multimorbidity admitted to IMCUs at an academic medical centre in Baltimore, Maryland, USA were recruited and interviewed in person. Interdisciplinary healthcare professionals working in the IMCU were interviewed virtually. Participants were asked questions about their role in recognizing and treating symptoms, factors affecting the quality of life, symptom burden and trajectory over time, and strategies that have and have not worked for managing symptoms. An inductive thematic analysis approach was used for analysis. Results: Twenty‐three interviews were conducted: 9 patients, 2 family caregivers, and 12 healthcare professionals. Patients' mean age was 67.5 (±6.5) years, over half (n = 5) were Black or Hispanic, and the average number of comorbidities was 3.67. Five major themes that affect symptom management emerged: (1) the patient–provider relationship; (2) open and honest communication; (3) accessibility of resources during hospitalization and at discharge; (4) caregiver support, training, and education; and (5) care coordination and follow‐up care. Conclusion: Patients, caregivers, and healthcare professionals often have similar goals but different priorities for multimorbidity management. It is imperative to identify shared priorities and target holistic interventions that consider patient and caregiver experiences to improve outcomes. Implications for the Profession and/or Patient Care and Impact: This paper addresses the paucity of research related to the shared experience of disease trajectory and symptom management for people living with multimorbidity. We found that patients, caregivers, and healthcare professionals often have similar goals but different care and communication priorities. Understanding differing priorities will help better design interventions to support symptom management so people with multimorbidity can have the best possible quality of life. Reporting Method: We have adhered to the Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines in our reporting. Patient or Public Contribution: This study has been designed and implemented with patient and public involvement throughout the process, including community advisory board engagement in the project proposal phase and interview guide development, and member checking in the data collection and analysis phases. The method we chose, experience‐based co‐design, emphasizes the importance of engaging members of a community to act as experts in their own life challenges. In the coming phases of the study, the public will be involved in developing and testing a new intervention, informed by these qualitative interviews and co‐design events, to support symptom management for people with multimorbidity. [ABSTRACT FROM AUTHOR]

Aim: To report a methodological, co‐creative approach for developing an interactive digital educational resource to enhance the quality of student nurses' clinical education in nursing homes and to elucidate the lessons learned from this approach. Design: This study applied a co‐design methodology that builds on participatory design principles. Methods: Co‐creating the digital educational resource included multiple sequential and interactive phases inspired by the design thinking framework. Workshops were employed as the primary co‐creative activity. Results: Seven separate homogenous or joint heterogeneous workshops were conducted with student nurses, nurse educators, registered nurse mentors and e‐learning designers (n = 36) during the active stakeholder engagement phases to inform the educational content, design and functionality of the digital educational resource. These were informed by, and grounded in, learning theory and principles. Conclusion: Co‐creative approaches in nursing education are an essential avenue for further research. We still lack systematic knowledge about the impact and benefits of co‐created initiatives, stakeholders' motivations, barriers, facilitators to participation and the role of context in supporting effective co‐creative processes to increase the quality of nursing education. Impact: This paper demonstrates how digital educational initiatives to enhance quality in clinical nursing education can be co‐created with key stakeholders through a novel methodological approach inspired by design thinking. To date, the methodological development process of co‐created educational interventions has received limited attention and compared with the content and theoretical underpinnings of such interventions, has rarely been addressed. Therefore, this paper facilitates knowledge exchange and documents vital aspects to consider when co‐creating digital educational initiatives incorporating multistakeholder perspectives. This promotes a stronger academic–practice partnership to impact and enhance the quality of clinical nursing education in nursing homes. Public Contributions: Student nurses, nurse educators, and registered nurse mentors worked alongside researchers and e‐learning designers in the co‐creative process. [ABSTRACT FROM AUTHOR]

Aims: This paper focuses on the benefits of inclusive leadership when undertaking a priority setting partnership in community nursing, through providing a collaborative and committed nurse‐led forum for initiating impactful changes, identifying evidence uncertainties and driving research capacity‐building initiatives. Design: This is a Discussion paper. The project was undertaken between 2020 and 2021. Data sources This paper is based on shared reflections as 70@70 Senior Nurse Research Leaders and is supported by literature and theory. It draws on issues relating to collective leadership, stakeholder engagement, diversity, inclusivity and COVID‐19. Implications for nursing: The James Lind Alliance Priority Setting Partnership catalysed the development of a rigorous evidence‐base in community nursing. The collaborative opportunities, networks and connections developed with patients, carers, nursing leaders, policy makers and healthcare colleagues raised the profile of community nursing research. This will benefit nursing research, practice, education and patients in receipt of community nursing care. Collective buy in from national leaders in policy, education, funding and commissioning has secured a commitment that the evidence uncertainties will be funded. Conclusion: Four key learnings emerged: collective leadership can ensure learning is embedded and sustained; developing an engaged stakeholder community to promote community nursing research is essential; a diverse membership ensures inclusivity and representation; and insights into the impact of COVID‐19 aid progress. The process increased research engagement and created capacity and capability‐building initiatives. This will help community nurses feel empowered to lead changes to practice. Sustained engagement and commitment are required to integrate research priorities into community nursing research, education and practice and to drive forward changes to commissioning and service delivery. Impact The study promoted research capacity building through inclusive leadership. This can increase community nurses' research engagement and career development and patient care quality and safety; this can incentivize funders and policy makers to prioritize community nursing research. [ABSTRACT FROM AUTHOR]

Aims: To discuss existing conceptual frameworks that can be applied to the examination of health inequities in end‐of‐life care and related health outcomes. We used the Fawcett and Desanto‐Madeya evaluation technique modified by the National Institute on Minority Health and Health Disparities Research Framework to include individual, interpersonal, community, and societal levels of influence. Design: Discussion paper. Data sources We performed a systematic review of PubMed, CINAHL and Embase for conceptual frameworks of health inequities in end‐of‐life care and health outcomes published as of February 2022. Implications for nursing: There is a strong need for research that can address multiple factors influencing end‐of‐life care inequities and health outcomes. To mitigate the complex nature of social determinants of health and structural inequities, researchers, clinicians, educators and administrators should have solid conceptualizations of these multi‐level factors. Based on sound and comprehensive frameworks, nurses with interdisciplinary partnerships can promote health equity with a broader health care scope through addressing social determinants of health. Conclusion: We identified and reviewed three frameworks. We concluded all three frameworks have the potential for use in the examination of health inequities in end‐of‐life care and health outcomes. However, the Conceptual Framework of Minority Access to End‐of‐Life Care was more applicable to diverse studies and settings when adapted to include fundamental characteristics such as sex and gender. Impact Despite the substantial rise in end‐of‐life care delivery, health inequities persist in end‐of‐life care access and utilization. Though some studies have been conducted to promote health equity by addressing social determinants of health, progress is hampered by their complex and multi‐faceted nature. Through a concrete conceptual framework, researchers can comprehensively examine multi‐level factors influencing health inequities in end‐of‐life care. No patient or public contribution: This discussion paper focused on reviewing existing evidence. [ABSTRACT FROM AUTHOR]

Aims: To explore Australian healthcare providers' perspectives on factors that influence disclosure and domestic violence screening through the lens of Heise's (1998) integrated ecological framework. Design: This paper reports the findings that were part of a sequential mixed methods study with survey data informing interview questions. Participants for interviews were recruited after expressing an interest after completing surveys, as well as via snowball sampling. Methods: Semi‐structured interviews were undertaken in 2017 with 12 practicing healthcare providers delivering care to women in the perinatal period in Greater Western Sydney, NSW, Australia. Data were analysed using Braun and Clarke's (2006) six‐step thematic approach. Findings The findings were framed within Heise's integrated ecological framework under four main themes. The main themes were 'Ontogenic: Factors preventing women from disclosing'; 'Microsystem: Factors preventing healthcare providers from asking'; 'Exosystem: Organizational structures not conducive to screening'; and 'Macrosystem: Cultural attitudes and socioeconomic influences affecting screening'. Conclusion: Organizational policies are needed for better systems of reminding healthcare providers to enquire for domestic and family violence and mandating this within their practices. Mandatory domestic and family violence education and training that is suitable for the time constraints and learning needs of the healthcare provider is recommended for all healthcare providers caring for perinatal women. Further research is needed in addressing culturally specific barriers for healthcare providers to enquire about domestic and family violence in a culturally appropriate way. Public and Patient Engagement and Involvement in Research (PPEI): No Patient or Public Contribution was embedded into the research reported in this paper as this research was specifically exploring healthcare providers' perspectives on domestic violence screening within their own practice experience. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to explore and describe the translation and cultural adaptation of the Fundamentals of Care framework to a Swedish context, and highlight the need for a translated version. Design: An exploratory, descriptive approach was adopted. Methods: A structured forward‐backward translation process and cultural adaptation were used, considering situation and recipient as recommended for such process. Data such as literature and documents were collected during 2019–2021. The authors took systematic steps in collaboration with a strategic sample of experts: professional language service providers, clinicians, educators and a linguist. Results: The framework was mainly translated verbatim. A few fundamental care elements were adjusted to the Swedish language, context and clinical practice. Also, this work clarified the relational elements to be coherently seen as nursing actions. Addressing the need for a translated version was illustrated in activities in research, education and clinical practice. Conclusion: This paper highlights the importance of translating the Fundamentals of Care framework into a country's native language to gain acceptance and application there. Sharing the framework's translated version impacts nursing science, generating a consistent language in the development and conducting of research for the comparison and transferability or generalizability of findings. Together with a cultural adaptation, the translated framework can support and guide researchers, educators and nursing leaders in articulating fundamental nursing care for enacting change. By disseminating the first Swedish version of the framework we encourage a global discussion and sharing of examples of translation and cultural adaptation by others. Impact The framework's English version has limitations in various context. This paper shows a systematic translation and cultural adaptation process of the framework. We proclaim that this is necessary for nursing leaders and nurses to be able to apply it in guiding nursing practice and leading change. [ABSTRACT FROM AUTHOR]

Aim: To report the results of a mapping exercise by the European Federation of Nurses on current advanced practice nursing frameworks and developments across Europe. Design: Online, cross‐sectional, questionnaire study. Methods: An online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. The questionnaire solicited input on 60 items concerning key features of advanced practice nursing, intending to map existing developments and better understand the current state of advanced practice nursing in Europe. Data analysis used descriptive statistics, including counts and percentages, tabulation; open‐text responses were handled with thematic synthesis techniques. Results: The definition, sense‐making and operationalization of advanced practice nursing vary across Europe. Important variations were noted in the definition and requirements of advanced practice nursing, resulting in different views on the competencies and scope of practice associated with this role. Importantly, the level of education and training required to qualify and practice as an advanced practice nurse varies across European countries. Furthermore, only 11 countries reported the existence of a national legislation establishing minimum educational requirements. Conclusion: Significant variation exists in how countries define advanced practice nursing and how it is regulated at academic and practice levels. More research is needed to clarify whether this variation results from designing models of advanced practice nursing that work in different contexts; and what impact a standardized regulatory framework could have to grow the volume of advanced practice nurses across Europe. Impact: The current paper exposes the lack of clarity on the development and implementation of advanced practice nursing across Europe. We found significant variation in the definition, recognition, regulation and education of advanced practice nurses. Our data are essential to policymakers, professional associations and employers to ensure a coordinated and systematic effort in the consistency and ongoing development of advanced practice nurses across Europe. Patient or Public Contribution: No patient or public contribution applied; the participants were national nurses' associations. [ABSTRACT FROM AUTHOR]

Aim(s): This discursive article aims to examine how systemic factors of settler colonialism influence health outcomes among Indigenous peoples in the United States through pathways and processes that may lead to the embodiment of historical trauma. Design: Discursive paper. Methods: We completed a comprehensive search of empirical and grey literature between September 2022 and January 2023 in PubMed, CINAHL and Google Scholar. Using these articles as a foundation, we explored factors related to the pathways and processes leading to the embodiment of historical trauma rooted in settler colonialism. Results: A conceptual framework of the pathways and processes of the embodiment of historical trauma secondary to settler colonialism was developed, and is presented. Conclusion: The societal and historical context for Indigenous peoples includes harmful settler colonial structures and ideologies, resulting in stressors and historical trauma that impact health outcomes and disparities through the phenomenon of the process of embodiment. Implications for Nursing: To provide holistic nursing care, nurses must be aware of settler colonialism as a determinant of health. They must be attuned to the pathways and processes through which settler colonial exposures may impact health among Indigenous peoples. Nurses must challenge existing structural inequities to advance health equity and social justice. [ABSTRACT FROM AUTHOR]

Aim: To provide a practical example of how a novel methodology and paradigm was applied to a mixed methods study exploring the healthcare experiences of Australian adults who frequently use emergency department services. Design: Discussion Paper. Data sources: We explored published literature discussing philosophical and methodological issues related to mixed methods research. Literature searches were performed between July 2019 and February 2021. Implications for nursing: Phenomenology is a powerful methodology to explore the lived experience of research participants, but it is not without limitations. Mixed methods phenomenology allows nurse researchers to bring further clarity to their research phenomena, however, including phenomenology in mixed methods studies may be seen to be philosophically incompatible. The philosophical metaparadigm of dialectical pluralism provides nurse researchers with a new coherent methodological and philosophical framework for combining participants' descriptions of lived experience with a variety of data collection methods. It is effective when working with transdisciplinary research teams, and stakeholders representing diverse values and disciplines. Conclusion: Complex healthcare environments require sophisticated, flexible research approaches. This paper presents mixed methods phenomenological research combined with the metaparadigm of dialectical pluralism providing a methodological framework that can support multifaceted nursing research. Impact: The combination of mixed methods phenomenology and dialectical pluralism represents a novel solution for nurse researchers to articulate a research methodology and philosophical paradigm reflecting the complexity embedded in everyday nursing practice. This methodology offers a unique approach to exploration of challenging clinical and patient scenarios with multifaceted elements, and overcomes theories of philosophical incompatibilities between divergent methods. [ABSTRACT FROM AUTHOR]

Aims: Diagnostic Reasoning (DR) is an essential competency requiring mastery for safe, independent Nurse Practitioner (NP) practice, but little is known about DR content included in NP education programs. The aims of this study were to identify whether and how the concept of DR is addressed in NP education. Design: We conducted a scoping review on DR‐related content and teaching innovations in U.S. primary care NP education programs, with implications for NP education programs worldwide. Concepts and principles with global applicability include: conducting focused and hypothesis‐directed histories and exams, generating the problem statement, formulating the differential diagnosis, appropriate and relevant diagnostic testing, determining the working diagnosis and developing evidence‐based, patient‐centred management plans. Data sources N = 1115 articles retrieved from Medline, Embase, PsycINFO, and CINAHL for the period 2005–2021. Forty‐one scholarly articles met inclusion/exclusion criteria. Review methods: Data were extracted, synthesized and grouped by theoretical frameworks, content included, educational interventions and assessment measures. Results: Most articles provided descriptions of approaches for teaching NP clinical or diagnostic reasoning. Ten papers directly referenced the current science and theory of DR. Conclusion: The US NP education literature addressing DR is limited and demonstrates a lack of shared conceptualizations of DR. Whilst numerous components of DR are identifiable in the literature, a robust teaching/learning scholarship for DR has not yet been established in the US NP education literature. Impact Whilst primary care NP education programs are beginning to incorporate DR education into their curricula, little research has been conducted to demonstrate the effectiveness of educational outcomes. Increased integration of DR content into NP education is needed, including increased educational research on teaching DR competencies. Patient or public contribution: No patient or public contribution was included in this review, as the public is generally not familiar with DR or its teaching approaches. [ABSTRACT FROM AUTHOR]

Background: Whilst theoretical grounding is considered important for sound research methodology, consensus on the application of theory in qualitative research remains elusive. Novice researchers may experience challenges in applying theory in qualitative research and these may contribute to the under‐use, over‐reliance or inappropriate application of theory. Practical guidance on how theory can inform and guide the conduct of qualitative research is needed. Purpose: The purpose of this paper was to propose a framework for the application of theory in qualitative research and provide an exemplar. Methods: The Theoretical Application Framework for Qualitative Studies (TAF‐QS) was developed from the synthesis of existing literature and the authors' own experience of the application of theory. Results: The TAF‐QS encourages researchers to articulate which theoretical framework or conceptional framework they are drawing on and how this will be applied by reflecting on the purpose and the context of the study. Conclusion: The TAF‐QS provides support for researchers to explore how theory can be applied and how to achieve this in qualitative research. The use of theory in qualitative research. [ABSTRACT FROM AUTHOR]

Aim: This manuscript aims to provide a discursive description of how one academic health care centre is enculturating, embedding and investing in the fundamental care framework and lessons learned that can serve as a blueprint for other organizations. Background: A call to action to focus on fundamental care is not new as the initial Fundamentals of Care (FoC) Framework has been evolving over the last decade through efforts lead by the International Learning Collaborative (ILC). Now more than ever, there is a pressing need for leaders to influence a humane, compassionate evidence‐informed approach to the COVID‐19 pandemic and beyond by embedding an FoC framework and focusing on fundamental care as part of their academic mandate and daily care practices. Design: This discursive paper delineates an evolving and ongoing enculturation, embeddedness and investment in advancing fundamental care as part of a larger academic practice strategy and quality improvement plan that is evidence‐informed and collaborative in nature. Method: The action framework (value, talk, do, own and research fundamental care) developed by ILC guides efforts to how the FoC framework was embedded into one academic health science centre's strategic directions, academic practice strategy, professional practice model, quality plan and research and innovation platform. Conclusion: An overview of how we leveraged the FoC and ILC Leadership frameworks in our efforts to enculturate, embed and invest in advancing fundamental care and lessons learned that may inform other healthcare organizations in their efforts. Impact on nursing science, practice or disciplinary knowledge: Underpinning all of our efforts is the integral value we place on fundamental care to guide how we practice, educate and learn, discover and innovate and lead at x. We shared how we value, talk, do, own and research fundamental care by having it embedded into our strategic directions, academic practice strategy, professional practice model, quality aims and research and innovation platform. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore the nuances of theory utilization in qualitative methodologies, discuss the different relationships that applied qualitative methodologies have with theory and use the foundational underpinnings of interpretive description to challenge strongly entrenched ideas of theory that have extended into applied qualitative nursing research. Design: Methodology discussion paper. Data sources: Narrative literature review and personal observations. Conclusion: Many qualitative research traditions have viewed the use of an explicit theoretical framework as an integral grounding for qualitative research studies. Much of the discussion of theory in extant qualitative methodological literature focuses on its use in the context of traditional methodologies such as ethnography, phenomenology and grounded theory, with less attention on methodological approaches developed for applied and practice disciplines such as nursing. Uncritical adoption of ideas about theory based on traditional qualitative methodological conventions can result in findings with little utility for application to the practice context. Impact: Nursing researchers should think critically about how theory is used in research endeavours geared towards applied practice and ensure that their methodological choices are in alignment with their philosophical and disciplinary epistemological positionings. [ABSTRACT FROM AUTHOR]

Aims: This study explores how women diagnosed with breast cancer may be supported by physicians and nurses during physical and existential changes related to oncoplastic breast surgery in Denmark. The following research questions were addressed: (a) how do women experience oncoplastic breast surgery, and (b) how does cancer treatment affect their body image? Design: A descriptive qualitative study design with a six‐step thematic analysis influenced by Braun and Clarke was applied in this study. This paper has been prepared in accordance with the consolidated criteria for reporting qualitative research. Methods: Fourteen in‐depth interviews with seven women diagnosed with breast cancer were conducted from August 2018 to March 2019. In this qualitative study, data analysis was performed concurrent with data construction, recognizing that the process of analysis and making sense of data should start during the interviews. We explicitly frame the discussion of the findings in a theory of embodiment influenced by Merleau‐Ponty, consistent with the construct of exploring human experiences to generate meaningful knowledge for applied practice. Results: Two overall themes with related subthemes were identified: (1) 'Treatment is required for life‐threatening cancer', and (2) 'Striving for a new normal body'. Across both themes, women's experiences reflected a 'time pendulum' as they contemplated their past identity, their current rationale and their transition to a future beyond breast cancer with a changed body. Conclusion: Participants reflected on their past, present and future when facing an altered body image caused by their breast cancer diagnosis and oncoplastic breast surgery. The participants in the study expressed broad levels of satisfaction with the results of the oncoplastic breast surgery. The reconstructed breast helped them to live normally again, in particular maintaining interpersonal relationships. Breast reconstruction supported participants' embodiment experiences and redefinition of their 'new normal'. Impact This study showed the dynamic changes in self‐definition from receiving a breast cancer diagnosis and cancer treatment to oncoplastic breast surgery. The main finding of self‐redefinition was from the perspective of breast cancer women who were in a period of transition between post‐diagnosis and consultation for oncoplastic breast surgery. The findings indicate that advanced nurse specialists in the field of oncoplastic breast surgery can enhance psychosocial wellbeing and support women pre‐ and post‐operatively by focusing on patient experiences of self‐image and embodiment. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effect of a nurse support using a proactive mobile app to enhance parental self‐efficacy in symptom management for children with medical complexity. Design: A single‐blinded, randomized controlled trial with a two‐armed repeated measures design. Methods: Eligible parents and the children will be recruited from the special schools and non‐government offices. They will be randomly assigned either to the intervention or control groups. Subjects in the study group will receive nurse parental support using a symptom management mobile app for 3 months. The control group will receive the usual care that is available in the community. Data will be collected pre‐intervention (T1), immediately after the intervention (T2), and three‐month after intervention (T3). The primary outcome is parental self‐efficacy. The secondary outcomes include child's symptom burden and their health service utilization. Primary outcome will be compared across two groups in T2 and T3 using with control for the pre‐test value of parental self‐efficacy. Generalized estimating equation (GEE) will be used to address secondary objectives from T1 to T3 with appropriate link function. Discussion: As a result of the successful implementation of this nurse‐led symptom management, parental self‐efficacy will be enhanced. Both the symptoms reported by the children and their health service utilization will be reduced. Findings of this study will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and the children in local communities. Impact: The evidence produced in this study will enlarge the knowledge base that supports evidence‐based paediatric home nursing service with the use of health technology in symptom management. This evidence will also contribute to the development of other symptom management programs for other paediatric patient groups. Trial registration: NCT05765643 (ClinicalTrials.gov identifier). Patient or public contribution: Parents of children with medical complexity contributed in mobile application development by giving comments on the usability of mobile application. Impact will be generated through the following benefits: Improve health service delivery: Home nursing service may not be sustainable in a long run in Hong Kong, as the health care system has been facing a serious nursing workforce shortage in recent years. Besides, these services are affected or even suspended during the community outbreak of infectious disease, like recent coronavirus disease pandemic. Nurse parental support in symptom management for the CMC using a proactive mobile health application will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and their CMC in local communities.Improve physical and psychological health of parents and their CMC: The success of program implementation will help to increase parental self‐efficacy in symptom management for their CMC, as a result of decrease of children's symptom burden.Improve knowledge base: The evidence produced in this study will (1) enlarge the knowledge base that supports evidence‐based paediatric community nursing service related to symptom management for the CMC. This evidence will contribute to the development of other symptom management programs for other paediatric patient groups. [ABSTRACT FROM AUTHOR]

Aim: To construct a nursing assessment framework for patients in anaesthesia recovery period. Design: A three‐round modified Delphi method was employed to capture the consensus of 22 panellists. Methods: The initial items in the nursing assessment framework for patients in anaesthesia recovery period were developed based on the mini‐clinical evaluation exercise (mini‐CEX). A panel of 22 experts participated in this study. The panellists have more than 10 years of experience in either clinical anaesthesia, or post‐anesthesia nursing, or operating room nursing, or surgical intensive nursing. Between March and April 2023, the panellists evaluated and recommended revisions to the initial framework. Results: This study resulted in the development of a nursing assessment framework for patients in anaesthesia recovery period. The initial version of the framework consisted of six dimensions with 27 items. Six items were modified after the first round of consultation. After the second round, five modifications and four deletions were made based on expert opinion. The third round resulted in a convergence of expert opinion. The framework, which consists of 24 items across five dimensions, was refined. The five dimensions are as follows: History‐taking, Physical assessment, Clinical judgement, Organizational efficiency and Humanistic concern. Conclusion: The nursing assessment framework for patients in anaesthesia recovery period was reached consensus between the 22 experts' opinions. Implications for the profession and patient care: The assessment framework constructed in this study could be used for the process evaluation of post‐anesthesia nursing. The framework may guide perianesthesia nurses in the timely and effective assessment of patients during this critical phase of care. It may be used for perianesthesia nursing education or to evaluate nurses' assessment skills. Reporting method: The study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations. Patient or public contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID‐19 pandemic. Design: A secondary analysis of open‐ended responses from a cross‐sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID‐19 pandemic. Methods: Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open‐ended responses. Results: Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post‐traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense‐ of‐duty and (4) personal strength from new possibilities. Conclusion: The COVID‐19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth. Implications for the Profession and/or Patient Care: Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision‐making transparency are necessary. Impact: To better understand how frontline acute care nurses experienced stress during COVID‐19, a data‐informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post‐traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post‐traumatic growth in the post‐COVID years. Reporting Method: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To investigate the decisional needs in Denmark of people with kidney failure, relatives, and health professionals when planning end‐of‐life care. Design: A qualitative interview study. Methods: Individual semi‐structured interviews were carried out with people with kidney failure, relatives and health professionals from November 2021 to June 2022. Malterud's systematic text condensation was used to analyse transcripts. Results: A total of 13 patients, 10 relatives, and 12 health professionals were interviewed. Overall, four concepts were agreed on: (1) Talking about end of life is difficult, (2) Patients and relatives need more knowledge and information, (3) Health professionals need more tools and training, and (4) Experiencing busyness as a barrier to conversations about end of life. Conclusion: People with kidney failure, relatives, and health professionals shared certain decisional needs while also having some different decisional needs about end‐of‐life care. To meet these various needs, end‐of‐life conversations should be systematic and organized according to the patients' needs and wishes. Impact: Non‐systematic end‐of‐life care decision‐making processes limit patients' involvement. Patients and relatives need more knowledge about end‐of‐life care, and health professionals need more competences and time to discuss decisional needs. A shared decision‐making intervention for people with kidney failure when making end‐of‐life care decisions will be developed. Reporting Method: This empirical qualitative research is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Patient or Public Contribution: Patients, relatives, and health professionals have been involved throughout the research process as part of the research team and advisory board. The patients are people with kidney failure and the relatives are relatives of a person with kidney failure. For this study, the advisory board has particularly contributed to the validation of the invitation letter for participation, the interview guides and the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to evaluate a person‐centred model of clinical supervision to enhance person‐centredness. Design: Experimental, quantitative. Methods: One hundred and three New Graduates were supported to reflect through a person‐centred lens (July–December 2020). Evaluation was undertaken at 6 months using: the Manchester Clinical Supervision Scale‐26 (effectiveness of supervision) and the Person‐centred Practice Inventory (measures attributes of the nurse/midwife, the care environment and person‐centred processes). Due to participation difficulties, scores were calculated by attendance rates using descriptive and inferential statistics. Results: Regular attendees scored higher on the supervision's effectiveness; however, this did not reach efficacy. 'Finding time' to attend contributed to low scores. Supervision scored well on its supportive function when attended. Many New Graduates perceived a decline in their care environment. Attendance aside, New Graduates averaged an increased in their person‐centred attributes and processes. Greater participation was found in those who scored higher at baseline on their person‐centred attributes and processes, and this higher scoring continued at 6 months than those who attended less. Conclusion: New Graduates who perceive themselves as person‐centred and reflective at baseline are more likely to attend a person‐centred clinical supervision and score higher at 6 months than those who attended less often. New Graduates found support within supervision during challenging times. Implications for Practice for Professional and/or Patient Care: For successful implementation of Person‐centred Clinical Supervision, New Graduates need support to attend, as attendance supports them to begin seeing value in the process. Impact: This intervention kept person‐centred practice at the forefront of New Graduates reflection, in a time of extreme change. The research has implications for nursing and midwifery management with the imperative to deliver person‐centred care and create the person‐centred cultures for staff to feel supported and empowered. Reporting Method: Transparent Evaluation of Non‐randomized Designs (TREND). Patient of Public Contribution: No patient or public contribution. Contribution to Wider Community: New Graduates grow their person‐centredness over their transitioning year; however, this can be enhanced with regular clinical supervision underpinned by person‐centred theory.Clinical supervisors can provide support to New Graduates when the environment is challenged. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to investigate the experiences and transitional care needs of Turkish frail older adults living in the UK and determine how this information can be utilized to improve the provision of culturally sensitive care during the transitional period. Design: Qualitative descriptive research with semi‐structured individual interviews. Methods: "The 'Silences' Framework guided the research design, from conceptualizing the research question to structuring the report of final outputs. For this study, semi‐structured, in‐depth interviews were conducted with sixteen older adults living with frailty and five family caregivers between January and May of 2023 in the United Kingdom. Results: Major themes that were identified included: (i) information and communication, (ii) care and support, (iii) the role of culture and (iv) trust and satisfaction. Further analysis, through discussion and immersion in the data, revealed that care transition periods were presented alongside three phases of transitional care: pre‐transition (during hospitalization), early‐transition (the period between discharge and the 7th day after discharge) and late transition (the period between the 8th day and 12th month after discharge). Conclusions: Our study revealed that the communication and informational needs of frail older individuals change during the transition period. While Turkish older adults and family caregivers expressed satisfaction with healthcare services in the UK, many struggled due to a lack of knowledge on how to access them. Impact: The support of family caregivers is a crucial component in facilitating transitional care for frail older patients, as they help in accessing healthcare services and using technological devices or platforms. It should be noted that family caregivers often hold the same level of authority as their elderly Turkish counterparts. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To understand how student nurse experiences on clinical placement, within National Health Service (NHS) hospitals, differ for ethnic minority and White British groups. Design: A qualitative thematic analysis with an inductive approach. Methods: Data from semi-structured interviews with 21 London (United Kingdom) hospital-based student nurses were examined using thematic analysis. Participants were interviewed as part of the Tackling Inequalities and Discrimination Experiences in Health Services (TIDES) study and asked about their experiences during clinical placement. Results: Five main themes were identified: (1) Role of mentors, (2) Discrimination and unfair treatment, (3) Speaking up/out, (4) Career progression, and (5) Consequences of adverse experiences. All themes were linked, with the social dynamics and workplace environment (referred to as “ward culture”) providing a context that normalizes mistreatment experienced by nursing students. Students from ethnic minority backgrounds reported racism as well as cultural and/or religious microaggressions. While being valued for their race and ethnicity, White British students also experienced discrimination and inequity due to their age, sex, gender, and sexual orientation. Students from both White British and ethnic minority groups acknowledged that being treated badly was a barrier to career progression. Ethnic minority students also noted the lack of diverse representation within senior nursing positions discouraged career progression within the UK NHS. Conclusion: These initial experiences of inequality and discrimination are liable to shape a student's perspective of their profession and ability to progress within nursing. The NHS is responsible for ensuring that student nurses' developmental opportunities are equal, irrespective of ethnicity. Impact: Ward culture is perpetuated by others who normalize mistreatment and concurrently disadvantage ethnic minority students, making them feel unvalued. This in turn impacts both staff retention and career progression within the NHS. Training assessors should be aware of the existing culture of discrimination within clinical placements and work to eradicate it. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to provide insight from maternal survivors of intimate partner violence (IPV) describing their experiences with their ex-partners' firearm ownership, access, storage and behaviours in the context of co-parenting and separation. Design: We conducted a qualitative descriptive study informed by the IPV and Coparenting Model. Methods: The analytic sample consists of self-identified maternal survivors (n= 14) who completed semi-structured qualitative interviews between January and May 2023 describing experiences of post-separation abuse. Participants were recruited through social media and domestic violence advocacy and legal aid organizations. In the interview guide, participants were asked one item about firearm exposure: Have you or your children had any experiences with guns and your ex-partner that made you or your children feel scared? Interviews were audio-recorded and transcribed. Interview transcripts were managed and coded in ATLAS.ti using a codebook. Codes were applied using descriptive content analysis, discrepancies reconciled and themes related to firearm exposure in the context of post-separation abuse identified. Results: Six themes emerged related to firearm experiences and post-separation abuse: (1) gun ownership (2) gun access; (3) unsafe storage; (4) direct and symbolic threats; (5) involving the children; (6) survivors' protective actions. Conclusion: This manuscript provides context on how abusive ex-partners' firearm ownership, access and threats cause terror and pervasive fear for mothers and children following separation. Analysis of qualitative data provides important insights into opportunities to address firearm injury prevention. Impact: Findings add to the contextual understanding of how survivors of IPV experience non-fatal firearm abuse. Existing quantitative data may not capture the full extent of fear caused by perpetrators' gun ownership access and symbolic threats. Data from this study can help inform firearm injury prevention efforts. [ABSTRACT FROM AUTHOR]

Aim: To understand advanced nurse and midwife practitioners' experience of interprofessional collaboration in implementing evidence-based practice into routine care. Design: A qualitative interpretative phenomenological analysis. Methods: A purposeful sample of 10 Registered Advanced Nurse and Midwife Practitioners from a range of practice settings in the Republic of Ireland participated in semi-structured interviews over a 10-month timeframe. Interviews were transcribed verbatim and data were analysed using a multi-stage approach in line with guidance for interpretative phenomenological analysis. Results: Six superordinate themes emerged: Understanding of advanced practice; ‘Treated as an equal and as a “nurse”’; Nursing management support; ‘A voice to implement anything new’; Confidence and Emotional intelligence. These factors impacted interprofessional relationships and the extent to which advanced practitioners could implement evidence-based practice. Conclusion: There is scope to improve advanced practitioners' ability to collaborate with the interprofessional team in implementing evidence-based practice into routine care. Impact and Implications: The study findings demonstrate that enhancing understanding of the advanced practice role; increasing organizational support for advanced practitioners and augmenting specific practitioner skills and attributes will increase their ability to collaborate effectively and implement evidence-based practice. Supporting advanced practitioners in this important aspect of their role will positively influence health outcomes for patients. Contribution to the Wider Global Clinical Community: As numbers of both nurse and midwife practitioners increase globally, this study provides timely evidence from a range of practice settings to guide the design of education programmes and policies governing advanced practice. Study recommendations have broad applicability to all healthcare professionals who are engaged in implementing evidence-based practice into routine care. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ). [ABSTRACT FROM AUTHOR]

Aim: To understand the content and context of a realized peer mentor intervention, and to explore how mentors and mentees experienced the intervention. Design: The study was designed as a qualitative process evaluation of a 24-week peer mentor intervention. Methods: Semi-structured individual interviews were conducted from November 2021 to May 2022 in a purposeful sample of older vulnerable people with ischemic heart disease, referred to as mentees (n = 13), and their peer mentors (n = 12). Thematic analysis was used to analyse, categorize and interpret interview data. Results: Five themes captured the content and context of the peer mentor intervention as experienced by mentors and mentees. 'Takes one to know one', stressing the importance of the mentor--mentee matching process; 'Varying demand for mentors', illustrating the difficulties in predicting who has the greatest need for mentoring; 'Varying degree of familiarity', describing the mentor--mentee relationship as a continuum from formal mentor to informal friend; 'Putting the patient first', illustrating how mentors support mentees based on their personal experiences of successful recovery while letting the mentee set the pace and goals; and 'Varying view of success', showing how intervention success is perceived differently by mentors and mentees. Conclusions: The study provides new knowledge on how and under what contextual circumstances a mentor intervention works. These findings are important for the implementation of future peer mentor interventions to achieve successful peer mentor support. Implications and Impact: Non-attendance and drop-out from the cardiac rehabilitation program are prevalent problems among older vulnerable people with cardiovascular disease. This study describes a low-cost peer mentor intervention that can support this group of patients. Reporting Method: Standards for reporting qualitative research (SRQR) guided our study. Patient or Public Contribution: A board of cardiovascular patients have contributed to the development and implementation of the intervention being evaluated. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the relationship between advanced nurse practitioners' self-leadership and commitment to the workplace, work engagement and influence at work. Background: The concept of self-leadership is particularly suited to ANPs, who are required to take responsibility for their work roles. An optimum balance between the ANPs' psychosocial work environment and self-leadership may positively impact work ability in this group and can be compromised by interactions between and among these variables. Design: A cross-sectional correlational study was conducted from July 2020 to August 2020 on 153 ANPs across a national health service. Methods: The survey was distributed to respondents online. The revised selfleadership questionnaire was used to measure self-leadership, and three scales from the Copenhagen Psychosocial Questionnaire were used to measure commitment to the workplace, work engagement and influence at work. Multiple linear regression was used to examine the association between self-leadership and the psychosocial variables. Results: ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. No relationship was found between selfleadership and influence at work. Conclusion: Improving self-leadership among ANPs by involving them in strategic leadership activities at an organizational level could be an effective strategy for optimizing the role and facilitating ANPs to contribute at an organizational level beyond the clinical interface. However, organizational support is required to ensure that ANPs practise to the full potential of their training and capability. Patient or Public Contribution: No patient or public contribution. Impact: This study provided new evidence of a relationship between ANPs' selfleadership and psychosocial factors. This study found that ANPs with high levels of self-leadership reported high levels of work engagement and commitment to the workplace. Policymakers and organizational leaders can optimize the ANP role and facilitate ANPs to contribute strategically to improve care systems. This study identifies a relationship between ANPs' self- leadership and specific psychosocial variables. [ABSTRACT FROM AUTHOR]

Aim: Examine frameworks of myth in the theory and treatment of sequalae of intimate and interpersonal traumas, often seen and experienced by practicing nurses. Design: A discursive narrative review using a trauma-informed lens. Methods: Review of existing frameworks using myth to understand or treat trauma. Due to limited literature from 1945 to 2023, a strategy akin to snowball sampling was used: exploration of source references, an unstructured interview, and a synthesis of existing approaches to interpersonal and intimate trauma. Results: Effective treatments for post-traumatic stress disorder exist, but reach is limited. Nursing is under-represented in the existing literature on myth and trauma, which does not sufficiently include intimate and interpersonal traumas. Conclusion: Encounters with myths encourage healing from interpersonal violence by making clear connections to universal themes while engaging intellect and emotions. Implications for the Profession and/or Patient Care: Encounters with myths could help to mitigate trauma sequalae. Nurses are positioned to develop and test evidence-based, highly flexible, patient-centred interventions using myth. Impact: • Identified gap: research using myth to address intimate and interpersonal violence. • Under-studied intervention: a few works suggest myth encounters benefit combat trauma survivors. • All nurses encounter individuals with trauma histories. Myths may build empathy and efficacy. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to develop and psychometrically test the Ethical Conflict Scale for Nurses in Extraordinary Circumstances (ECSNEC). Design: This study is designed to develop and validate an instrument. Methods: There are four basic steps in the development process of ECSNEC: (1) establishment of the conceptual framework, (2) creation of the item pool, (3) preliminary evaluation and (4) psychometric evaluation. The data were gathered from 519 nurses who worked in two different hospitals operating in Istanbul between June 2022 and October 2022. Results: The scale had good content validity. The exploratory factor analysis revealed a three-factor construct which explained 47.31% of the total variance in the measured variable. The corresponding construct was confirmed by the confirmatory factor analysis. The Cronbach's alpha coefficients were greater than .60 for all dimensions. The test--retest reliability coefficient value of the scale was 0.90. Conclusion: ECSNEC is a valid and reliable tool to determine the ethical conflict experienced by nurses in extraordinary circumstances. Impact: The established scale allows the identification of factors influencing the ethical challenges nurses face in extraordinary circumstances. Thus, policies can be developed to prevent such ethical conflicts. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To describe experiences of work‐related stress, stress reactions and coping strategies among registered nurses (RNs) in the ambulance service (AS). Design: A descriptive and qualitative design. Methods: Participants were recruited from eight different ambulance stations from different geographical locations in central Sweden. Data were collected from 14 RNs during the period from January 2022 to May 2022 using a semi‐structured interview guide. Qualitative content analysis was used to analyse data using an abductive approach. Results: Three categories describe the RNs' experiences; (1) Situations that cause work‐related stress, (2) Reactions and feelings that occur and (3) Management of work‐related stress. These three main categories included a total of 12 subcategories. Work‐related stress was experienced when participants were a part of traumatic events or experienced insufficient cooperation or a disturbing event in the work environment. The different causes lead to different kinds of reactions with feelings of frustration, fear and loneliness being prominent. To manage the work‐related stress, RNs used different kinds of strategies and support from colleagues or lack thereof seemed to have a major impact. Conclusions: Findings revealed the importance of having competent colleagues in the AS. Working with a competent colleague can reduce experiences of stress and prevent feelings of loneliness. It is important for the AS to provide stress‐reduction support, to promote cooperation and to maintain and develop RNs' professional competence to ensure quality care and patient safety in the AS. [ABSTRACT FROM AUTHOR]

Aim: To understand the experience of critical care nurses during the COVID‐19 pandemic, through the application of the Job‐Demand‐Resource model of occupational stress. Design: Qualitative interview study. Methods: Twenty‐eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID‐19 pandemic took part in semi‐structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job‐Demand Resource model. Data were analysed using framework analysis. Results: The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post‐traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well‐being had negative organizational consequences with CCN expressing increased intention to leave their role. Conclusions: The combination of high demands and reduced resources had negative impacts on the psychological well‐being of nurses which is translating into increased consideration of leaving their profession. Implications for the Profession and/or Patient Care: The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions. Impact: Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention. Reporting Method: We used the COREQ guidelines for reporting qualitative studies. Patient and Public Contribution: Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this integrative review was to explore, appraise and synthesize the current literature on correlates of suicide risk in nurses. Design: Integrative literature review. Data sources: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, PubMed, PsycInfo and Scopus electronic databases were searched for abstracts published between 2005 and 2020. Reference lists were hand searched. Review methods: The integrative review was based on the Whittemore and Knafl review methodology. Primary qualitative and quantitative studies about suicidal behaviour in nurses published in peer‐reviewed journals were included. The methodological quality of included articles was assessed using the Mixed Methods Assessment Tool. Results: Separate correlates of risk and protective factors were identified for suicidal ideation, suicide attempt and death by suicide in nurses. Implications: Due to a number of factors at the individual, interpersonal and work levels, nurses are uniquely positioned to be at risk of dying by suicide. The ideation‐to‐action framework provides a theoretical guide to understand the interplay between correlates and the effect it has on increasing a nurses' capability for suicide. Conclusions: This review integrates the empirical literature to elucidate the concept of suicidal behaviour as it applies to nurses. [ABSTRACT FROM AUTHOR]

Background: Perceptions of the nursing profession influence career choices in nursing. An unrealistic perception might lead students to drop out of nursing education programmes. Objective measurement of the nursing applicants' perceptions at the student selection stage could enhance their career choices in nursing. Aim: To develop and psychometrically evaluate the Perception of Nursing Profession Instrument (PNPI). Design: Mixed method design. Method: Two versions of the PNPI were developed during the years 2016–2022. The first version was based on documents describing the nursing profession and the second version was based on an integrative literature review, a focus groups study and a document analysis of descriptions of the nursing profession. The meta‐ethnographic approach was used to synthesize the results and form a theoretical framework for developing the PNPI (60 items). Item content validity was evaluated by an expert panel of nurses (n = 7). The psychometric properties of the instrument were analysed using the item response theory approach. Results: The development process resulted in the 40‐item PNPI with the following subscales: the content of nursing work, the career in nursing, the nature of nursing work and the characteristics of a nurse. The psychometric analysis revealed unidimensionality and goodness of fit to the partial credit model; however, the item difficulty was not well matched with the participants' abilities. Conclusion: The PNPI is a novel instrument for objectively measuring perceptions of the nursing profession. For further development, item difficulty must be enhanced to improve the measurement accuracy of the nursing applicants' perceptions of the nursing profession. Impact: Perceptions of the nursing profession influence career choices, but there is a lack of objective assessment instruments that can be used in nursing student selection setting to measure the perception. The results of this study offer an instrument to measure perception, while also suggesting ideas for further development. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effects of mobile applications (apps) on college students with depressive symptoms. Design: Depression among college students is a school health issue, although little is known regarding effective app‐based interventions for managing depressive symptoms. This review follows the concept of (1) theoretical guidance framework on app design, (2) app‐based intervention study design and (3) effect of app‐based interventions. Data Sources: Cochrane Library, CINAHL Plus with Full Text and PubMed were searched in October 2022. Methods: English‐language reports of app‐based interventions for college students with depressive symptoms. Quality appraisal and data extraction of selected articles was conducted by two independent reviewers using the mixed methods appraisal tool. Data synthesis using core outcome and findings of intervention. Results: Five studies have shown that depressive symptoms significantly decreased after app use, specifically indicating the effects that occur in 4 weeks. Although four studies have applied the theoretical framework to the app design, the findings showed the low implementation of the intervention activities as originally designed and at the specified dosage and difficulty in understanding the processes through which the intervention resolves the depressive symptoms. Conclusion: App‐based intervention can decrease depressive symptoms; furthermore, 4 weeks was the time point at which the changes were expected to occur. However, the theory‐based app design for the depression population was rarely related, and studies clearly explaining the intervention measures, intervention dosage and duration required to achieve effectiveness are needed. Impact: This study provides the synthesis of evidence‐based app interventions to manage depressive symptoms to zoom in on different views and we suggest using the applications for at least 4 weeks before changes are expected to occur. Patient or Public Contribution: No patient or public involvement in this study. [ABSTRACT FROM AUTHOR]

Problem: Missed Nursing Care (MNC) is an error of omission which occurs when a necessary nursing intervention is not initiated, is not completed, or when it is delayed. The MNC model explains this problem and describes four antecedents that can lead to MNC: (1) demand for patient care, (2) available human resources, (3) material resources, and (4) and relationship and communication factors. Aims: This study aims to test the relationship between the theoretical antecedents of MNC and their impact on MNC. Design: A quantitative cross‐sectional study. Methods: The Austrian version of the revised MISSCARE Survey was completed by nurses working in general hospital units between May and July 2021. Recruitment followed a respondent‐driven sample via Austrian nursing education institutions and social media. One thousand six nurses fulfilled inclusion criteria. The structure of the theoretical constructs of the MNC model was tested using a confirmatory factor analysis approach. The relationships between the four antecedents and MNC were explored using structural equation modelling with 427 complete cases. Results: The results support the structural validity of the revised MISSCARE Austria concerning the defined theoretical constructs, although discriminant validity and measurement error should be further investigated. The antecedent "resource allocation: labor" had a statistically significant impact on MNC: The lack of adequate nursing staff played the most important role to explain missed care in our model. Conclusion: In our study in Austria, MNC was mostly influenced by a lack of appropriate labor resources. Further studies exploring mediation effects and non‐linear relationships may contribute to better understanding of reasons for MNC. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Racism is a social determinant of health that links to the health and well‐being of racial/ethnic marginalized populations. However, perceived racism among African Canadian adolescents has not been adequately addressed, especially the link between racism and psychosocial stressors in school settings. Aim: The aim of the current study was to assess racism and the link to school‐related psychosocial stressors in a population‐based sample of African Canadian adolescents. Design: Secondary analysis of the population‐based 2018 British Columbia Adolescent Health Survey dataset. Methods: Logistic regression and generalized linear models tested the link between racism and psychosocial stressors among African Canadian adolescents (n = 942), adjusting for sociodemographic factors. Results/Findings: More than 38% of the adolescents reported racism in the year preceding the survey. Regardless of gender and birthplace, and controlling for covariates, those who experienced racism were significantly more likely to report peer victimization, which includes teasing, social exclusion, cyberbullying and sexual harassment, and they felt less safe and connected to their schools compared to those who did not experience racism. With gender and birthplace differences, those who reported racism had higher odds of having been physically assaulted, stayed away from school, reported negative emotional responses and used avoidant behaviours to evade racism. Conclusion: African Canadian adolescents are a visible racialized ethnic group in British Columbia, who are at heightened risk of racism and the associated psychosocial stressors. Impact: These findings demonstrate the influences of racism on psychosocial stressors and related emotional responses among African Canadian adolescents. Nurses and other healthcare providers should be cognizant of racism and the psychological impacts when providing care to "at‐risk" populations. Promoting positive and inclusive school climates and addressing racism at all levels of the society will foster better social integration, as well as improve the health and academic achievement of African Canadian adolescents. Patient or Public Contribution: We presented the research and preliminary results of the data analysis to the African community (parents and adolescents who self‐identify as African). The African community who attended the gathering corroborated the link between racism and health and reiterated that addressing these psychosocial stressors can promote adolescent health and well‐being. The attendees accepted all the variables that we included in the analysis. However, they emphasized the need for more African representation among school staff and teachers to foster trust, feelings of safety and connectedness, and to promote African students' academic achievement and well‐being. They stressed the need to train and build the capacities of the school staff and teachers so that they can assist students regardless of race. They emphasized the need to promote cultural awareness and cultural sensitivity among all healthcare providers. We included the recommendations in the appropriate sections of the manuscript. [ABSTRACT FROM AUTHOR]

Aims: To map how frailty among older people is assessed at Swedish emergency departments and to describe fundamental nursing care actions for these patients. Design: Descriptive national survey and a qualitative analysis of text. Methods: A majority (82%, n = 54) of the Swedish hospital‐based emergency departments for adults were included, representing all six healthcare regions. An online survey was used to collect data, together with submitted local practice guidelines for older people at the emergency departments. Data were collected during February–October 2021. Descriptive and comparative statistics were performed together with a deductive content analysis framed by the Fundamentals of Care framework. Results: Sixty‐five per cent (35 of 54) of the emergency departments identified frailty, with less than half of them using an established assessment instrument. Twenty‐eight (52%) of the emergency departments have practice guidelines containing fundamental nursing actions for the care of frail older people. The majority of nursing actions in the practice guidelines were related to patients' physical care needs (91%), followed by psychosocial care needs (9%). No actions could be identified as relational actions (0%) according to the Fundamentals of Care framework. Conclusion: Many Swedish emergency departments identify frail older people, but they use a range of different assessment instruments. While practice guidelines directing fundamental nursing actions for frail older people are often in place, a holistic, person‐centred view addressing the patient's physical, psychosocial and relational care needs is missing. Impact: The population is growing older, and more people are needing more complex hospital care. Frail older people have an increased risk of negative outcomes. The use of a variety of assessment instruments for frailty may pose a challenge to equal care. To ensure a holistic, person‐centred view of frail older people, the Fundamentals of Care framework can be used in developing and reviewing practice guidelines. Patient or Public Contribution: Clinicians and non‐health professionals were invited to review the survey to ensure face and content validity. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe how nurses' dialogue compares with that of doctors in the Australian reality television program Emergency and to explain how this dialogue and the use of narration and direct‐to‐camera monologues contribute to the portrayal of nurses. The final aim was to outline how these findings can inform the actions of nurses, nursing organizations and writers and journalists. Design: A descriptive study conducted in 2021 and 2022. Methods: Character network analysis was used to describe the verbal interaction of nurses and doctors and identify major, minor and background characters. Narration and direct‐to‐camera monologues were analysed through frequency counts. Cultivation theory was used to interpret the results. Results: Fifty‐four characters were identified, with 19 of these being nurses. Doctors spoke 87.9% of the dialogue. Most of the dialogue (43%) was monologue by doctors directly to the camera. All major characters were doctors, and only one nurse was a minor character. The mean number of mentions by the narrator of a nurse per episode was 4, and 30 for a doctor. Conclusion: The portrayal of nurses in Emergency is inaccurate and the production methods are used to privilege the role of doctors. This finding comes after decades of research showing inaccurate images of nursing in television. Drawing on recent Australian inquiries and the challenges experienced by mental health and aged care nursing, several approaches for collaborative action to improve these images are suggested. Impact This is the first study of the portrayal of nursing in reality television. These results suggest that much effort is still required even in contemporary reality television to accurately reflect the work and contribution of nurses. It is the shared responsibility of individual nurses, nursing organizations and writers and journalists to accurately portray nurses in the media. No patient or public contribution: This network analysis of a postproduction television program did not allow patient or public involvement in the design or analysis. [ABSTRACT FROM AUTHOR]

Aims: To describe the monthly self‐scheduling process in nursing homes (NH), to determine how specific organizational design characteristics (including interpersonal relationships and leadership style) influence this process, and to examine the effect on individual, team, and organization‐related outcomes. Design: A multiple case study using an organizational design perspective as the overarching theoretical and explanatory framework. Methods: Data collection was performed in four Belgian NH during Spring 2019 using semi‐structured interviews (n = 39), documents, and observations. Open, axial, and selective coding was used for the data reduction process, and a within‐case and cross‐case analysis was performed. The COREQ checklist was used for reporting the findings. Results: One group (two NH) used self‐scheduling because it corresponds with their decentralized organizational design. Together with a motivating head nurse and additional resources during the core phase of the process, this led to positive outcomes. In contrast, another group used self‐scheduling under the assumption that it would solve the mismatch between their organizational design and other organizational problems, which resulted in less positive work attitudes. Conclusion: Self‐scheduling should match the organizational structure and culture. Additional resources and an adaptive leadership style can help mobilize and support employees. Future research may use quantitative methods to confirm positive outcomes. Impact This study contributes to the rare literature on self‐scheduling in NHs by focusing on the monthly self‐scheduling process and by including an organizational design perspective. NH management can become informed of different self‐scheduling methodologies and the impact of specific organizational characteristics on this process. Head nurses can become aware that they need to adapt their leadership style to obtain improved outcomes. Patient or Public Contribution: Three members of the study team met with several caregivers during field visits to conduct interviews and to observe the monthly self‐scheduling process. [ABSTRACT FROM AUTHOR]

Aims: To explore barriers to, and facilitators of, adherence to compression therapy, from the perspective of people with venous leg ulcers. Design: An interpretive, qualitative, descriptive study involving interviews with patients. Methods: Participants were purposively sampled from respondents to a survey exploring attitudes to compression therapy in people with venous leg ulcers. Sampling continued until data saturation: 25 interviews between December 2019 and July 2020. Inductive thematic analysis of interview transcripts was undertaken to create a framework for the data, followed by deductive analysis informed by the Common‐Sense Model of Self‐Regulation. Results: A range of knowledge and understanding about the cause of venous leg ulcers and the mechanisms of compression therapy was demonstrated, which was not particularly related to adherence. Participants talked about their experience with different compression methods and their concerns about the length of time healing could take. They also spoke about aspects of the organization of services which affected their care. Conclusion: Identifying specific, individual barriers/facilitators to compression therapy is not simple, rather factors combine to make adherence more or less likely or possible. There was no clear relationship between an understanding of the cause of VLUs or the mechanism of compression therapy and adherence; different compression therapies presented different challenges for patients; unintentional non‐adherence was frequently mentioned; and the organization of services could impact on adherence. Ways in which people could be supported to adhere to compression therapy are indicated. Implications for practice include issues relating to communication with patients; taking into account patients' lifestyles and ensuring that they know about useful 'aids'; providing services that are accessible and provide continuity of appropriately trained staff; minimizing unintentional non‐adherence; and acknowledging that healthcare professionals will always need to support/advise those who cannot tolerate compression. Impact Compression therapy is a cost‐effective, evidence‐based treatment for venous leg ulcers. However, there is evidence that patients do not always adhere to this therapy and there is limited research investigating reasons why patients do not wear compression. The study found no clear relationship between an understanding of the cause of VLUs or the mechanism of compression therapy and adherence; that different compression therapies presented different challenges for patients; that unintentional non‐adherence was frequently mentioned and that the organization of services could impact on adherence. Attending to these findings offers the opportunity to increase the proportion of people undergoing appropriate compression therapy and achieving complete wound healing, the main outcome desired by this group. Patient/Public Contribution: A patient representative sits on the Study Steering Group, contributing to the work from developing the study protocol and interview schedule to interpretation and discussion of findings. Members of a Wounds Research Patient and Public Involvement Forum were consulted about interview questions. [ABSTRACT FROM AUTHOR]

Aims: This article discusses possible barriers to help‐seeking that Indigenous and Black women encountered when seeking help related to experiences of intimate partner violence during the COVID‐19 pandemic. Design: This article is focused on understanding the impact of the COVID‐19 pandemic on populations at highest risk for intimate partner violence in its most severe forms. Data Sources: Literature sources range from 2010 to 2022. The article is also informed by the experiences of scholars and advocates working with Indigenous and Black women experiencing intimate partner violence in Wisconsin. In our write‐up, we draw on Indigenous feminism and Black feminist thought. Implications for Nursing: Help seeking is contextual. The context in which help seeking occurs or does not occur for Indigenous and Black women, due to the barriers we discuss is vital for nurses to understand in order to provide efficient and meaningful nursing care. Conclusion: Our goal is to center the nursing profession in a leadership position in addressing the complex and unique needs of Indigenous and Black women who experience the highest rates of intimate partner violence and also experience the greatest barriers to care and support. Impact We seek to contribute theory‐driven knowledge that informs the work of nurses who are often the first to encounter survivors of intimate partner violence within the clinical setting. Help‐seeking is often hindered by factors such as geographic and jurisdictional, economic, and structural response barriers. This knowledge will enhance nurses' ability to lead and advocate for clinical practice and policies that minimize the barriers women experience following intimate partner violence, especially during pandemics, disasters, and other extraordinary circumstances. Public Contributions: This article is based on the collaboration of community advocates, nurse scientists, and public health scholars, who work closely with Indigenous and Black survivors of violence and seek to meet their needs and offer them meaningful support. [ABSTRACT FROM AUTHOR]

Aims: The aim was to examine and describe women's emergency department visits and care‐seeking experiences, including recognition, evaluation and communication of symptoms, injuries and health risks after non‐fatal intimate partner strangulation. Design: Using a diagnostic process framework, this mixed‐methods study explores concordance and discordance of interview and medical records data to highlight opportunities for clinical diagnostic improvement. Methods: In‐depth, semi‐structured interviews with women after an emergency department visit for non‐fatal intimate partner strangulation, concurrent with medical records reviews, were conducted between March 2018 and January 2019. A constant comparative approach was used to analyse interview and medical record data using an a priori codebook designed based on the National Academies of Science, Engineering and Medicine's conceptual model of the diagnostic process and prior intimate partner violence research. Results: Interviews reflected participants did not have a sense of long‐term health risks from their strangulation beyond addressing emotional trauma. Women noted that forensic and emergency nursing support was treatment in and of itself that allowed them to be heard and validated. Medical record clinical impressions and final diagnoses included domestic violence, domestic abuse or sexual assault, but not specifically strangulation. Conclusion: This study contributes to the growing literature regarding strangulation diagnosis and care. Our findings provide new details of women's emergency department care‐seeking experiences which, whilst overall aligned with medical records documentation, were not reflected in final diagnostic impressions nor in patient recollection of long‐term health risks. Impact Nurses are strongly positioned as clinical practice leaders and policy advocates to improve collective responses to this dangerous violence mechanism. Actions such as improving patient education, referral and follow‐up options to better communication and address long‐term strangulation risk are one example. Further research on non‐fatal intimate partner strangulation and care‐seeking is warranted to expand this knowledge, particularly in longitudinal cohorts and varied geographical areas. [ABSTRACT FROM AUTHOR]