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Aim A discussion of the concepts of leadership and emotional intelligence in nursing and midwifery education and practice. Background The need for emotionally intelligent leadership in the health professions is acknowledged internationally throughout the nursing and midwifery literature. The concepts of emotional intelligence and emotional-social intelligence have emerged as important factors for effective leadership in the healthcare professions and require further exploration and discussion. This paper will explore these concepts and discuss their importance in the healthcare setting with reference to current practices in the UK, Ireland and internationally. Design Discussion paper. Data sources A search of published evidence from 1990-2015 using key words (as outlined below) was undertaken from which relevant sources were selected to build an informed discussion. Implications for nursing/midwifery Fostering emotionally intelligent leadership in nursing and midwifery supports the provision of high quality and compassionate care. Globally, leadership has important implications for all stakeholders in the healthcare professions with responsibility for maintaining high standards of care. This includes all grades of nurses and midwives, students entering the professions, managerial staff, academics and policy makers. Conclusion This paper discusses the conceptual models of leadership and emotional intelligence and demonstrates an important link between the two. Further robust studies are required for ongoing evaluation of the different models of emotional intelligence and their link with effective leadership behaviour in the healthcare field internationally. This is of particular significance for professional undergraduate education to promote ongoing compassionate, safe and high quality standards of care. [ABSTRACT FROM AUTHOR]

Aims A discussion of partnership in the context of family-centred care in the acute paediatric setting, through a critical analysis of partnership models. Background Paediatric healthcare practitioners understand the importance of family-centred care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family-centred care, yet less is known about strategies to fully engage or support parents in these partnerships. A rigorous examination of concepts embedded in family-centred care such as partnership may provide a better understanding of how to implement the broader concept and support exemplary care in today's clinical practice environment. Design Discussion paper. Data sources Electronic search (January 2000 - December 2014) performed on CINAHL, Medline, EMBASE, Sociological Abstracts and Psych INFO using keywords partnership, family-centred care and conceptual framework. Eligible references were drawn from the databases, reference lists and expert sources. Eight models met inclusion criteria and had currency and relevance to the acute paediatric setting. Implications for nursing Nurses should continue exploring partnership in various paediatric contexts given the wide-ranging definitions, lack of operational indicators and need for stronger relational statements in current models. An examination of key strategies, barriers and facilitators of partnership is recommended. Conclusion One partnership model had both high overall maturity and best fit with family-centred care principles. All models originate from Western and developed countries, indicating that future partnership models should be more geographically, culturally and economically diverse. [ABSTRACT FROM AUTHOR]

Aim To present a discussion on theoretical frameworks in infection prevention and control. Background Infection prevention and control programmes have been in place for several years in response to the incidence of healthcare-associated infections and their associated morbidity and mortality. Theoretical frameworks play an important role in formalizing the understanding of infection prevention activities. Design Discussion paper. Data sources A literature search using electronic databases was conducted for published articles in English addressing theoretical frameworks in infection prevention and control between 1980-2012. Results Nineteen papers that included a reference to frameworks were identified in the review. A narrative analysis of these papers was completed. Two models were identified and neither included the role of surveillance. Discussion To reduce the risk of acquiring a healthcare-associated infection, a multifaceted approach to infection prevention is required. One key component in this approach is surveillance. The review identified two infection prevention and control frameworks, yet these are rarely applied in infection prevention and control programmes. Only one framework considered the multifaceted approach required for infection prevention. It did not, however, incorporate the role of surveillance. We present a framework that incorporates the role of surveillance into a biopsychosocial approach to infection prevention and control. Conclusion Infection prevention and control programmes and associated research are led primarily by nurses. There is a need for an explicit infection prevention and control framework incorporating the important role that surveillance has in infection prevention activities. This study presents one framework for further critique and discussion. [ABSTRACT FROM AUTHOR]

Aim: To describe the implementation of a trauma‐informed model of care in the Post COVID Respiratory Clinic of a large tertiary referral centre in NSW. Design: Discussion paper. Data Sources: Evidence gathered from a literature search (2008–2022) was used to develop a framework for management of patients presenting to this Post COVID Respiratory Clinic. This paper outlines the personal reflections of the clinic staff as they developed and implemented this framework. Ethical approval was obtained to report the data collected from patient reviews. Discussion: The literature highlights the high prevalence of trauma in patients following COVID‐19 infection, as well as the larger population both during and after the pandemic. This experience of trauma was observed in patients seen within the clinic, indicating a need for specialized care. In response, a trauma‐informed model of care was implemented. Conclusion: Reconceptualizing COVID‐19 as a 'collective trauma' can help healthcare workers understand the needs of post‐COVID patients and enable them to respond empathetically. A trauma‐informed model is complementary to this cohort as it specifically addresses vulnerable populations, many of whom have been further marginalized by the pandemic. Implications for Nursing and Patient Care: Frontline healthcare workers, particularly nurses, are well positioned to implement trauma‐informed care due to their high‐level of patient contact. Adequate allocation of resources and investment in staff is essential to ensure such care can be provided. Impact: The COVID‐19 pandemic has led to adverse physical and mental health outcomes for many.Trauma‐informed care is a way to promote reengagement with the healthcare system in this group.Post COVID patients globally may benefit from this approach, as it aims to build trust and independence. Patient or Public Contribution: Feedback was sought from a patient representative to ensure this paper adequately reflected the experience of the post‐COVID patient. [ABSTRACT FROM AUTHOR]

Aim s : The objective of this study was to examine the relationship between caregiving burden and pre‐death grief, with a specific focus on adult‐child caregivers in mainland China. Additionally, the study explored whether coping strategies played a mediating role in this correlation. Methods: A convenience sample of 320 adult‐child caregivers of older parents with dementia from Kunming, mainland China, was recruited for the study. Data were collected using the Chinese version of the Marwit‐Meuser Caregiver Grief Inventory‐Short Form, the Burden Scale for Family Caregivers, and the Ways of Coping Checklist‐Revised. Results: Results using linear regression and multiple mediation analysis with Hayes' process model indicated that caregiving burden was positively related to pre‐death grief and that active coping mediated the relationship between them. In the female group, active coping partially mediated the association between caregiving burden and pre‐death grief, but in the male group, this mediating effect did not exist. Conclusion: The study found evidence supporting the link between caregiving burden and pre‐death grief among adult‐child caregivers of older parents with dementia in mainland China. Furthermore, the caregiving burden prevented the use of active coping, and this decrease in coping increased the perception of pre‐death grief. These associations only existed in the female group. Implications: This paper presented the importance of active coping skills in the dementia caregiving process. Impact: The findings of this study emphasize the necessity for health practitioners to provide targeted interventions regarding pre‐death grief among dementia caregivers and strengthen caregivers' active coping strategies to reduce their pre‐death grief. Community‐based and personal care support services should be promoted to alleviate their caregiving burden. Reporting Method: We have adhered to the transparent reporting of evaluations with quantitative design statements and the corresponding checklist was followed. Patient or Public Contribution: 'No patient or public involvement'. [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]

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]

Aim: This paper proposes a novel, trauma‐informed, conceptual model of care for Post‐Acute Sequelae of COVID‐19 illness (PASC). Design: This paper describes essential elements, linkages and dimensions of the model that affect PASC patient experiences and the potential impact of trauma‐informed care on outcomes. Data sources PASC is a consequence of the global pandemic, and a new disease of which little is known. Our model was derived from the limited available studies, expert clinical experience specific to PASC survivors and publicly available social media narratives authored by PASC survivors. Implications for nursing: The model provides a critical and novel framework for the understanding and care of persons affected by PASC. This model is aimed at the provision of nursing care, with the intention of reducing the traumatic impacts of the uncertain course of this disease, a lack of defined treatment options and difficulties in seeking care. The use of a trauma‐informed care approach to PASC patients can enhance nurses' ability to remediate and ameliorate both the traumatic burden of and the symptoms and experience of the illness. Conclusion: Applying a trauma‐informed perspective to care of PASC patients can help to reduce the overall burden of this complex condition. Owing to the fundamentally holistic perspective of the nursing profession, nurses are best positioned to implement care that addresses multiple facets of the PASC experience. Impact The proposed model specifically addresses the myriad ways in which PASC may affect physical as well as mental and psychosocial dimensions of health. The model particularly seeks to suggest means of supporting patients who have already experienced a life‐threatening illness and are now coping with its long‐term impact. Since the scope of this impact is not yet defined, trauma‐informed care for PASC patients is likely to reduce the overall health and systems burdens of this complex condition. [ABSTRACT FROM AUTHOR]

Aims: To outline the theoretical, philosophical, and major assumptions associated with phenomenography and then address the application of a phenomenographical approach within the context of midwifery research. Background: Phenemonography is a little‐known qualitative research approach amongst the main design traditions of phenomenology, grounded theory, case study, and ethnography more typically used within midwifery research. Phenomenography aims to describe the qualitatively different ways that people perceive, conceptualize, or experience a phenomenon. Phenemonography has a distinctly different approach from other qualitative methods as it places emphasis on the 'collective' meaning over individual experience. Methodology: Phenomenography, as an approach, rests within the interpretivist paradigm recognizing that there are multiple interpretations of reality. Phenomenography emphasizes the various ways that people experience the same phenomenon, including both the similarities and differences. The second‐order perspective embraced by phenomenography suggests that the researcher directs themselves towards people's understanding of the world; essentially the world is described as it is understood rather than as it is. It is the reporting about how these different realities appear at a collective level that is the output of phenomenographic research. Findings: A framework for conducting phenomenographic research is illustrated by outlining the steps within the methodological approach required to undertake a research study using phenemonography. Conclusion: Phenomenography is a qualitative research approach that can usefully be applied in many midwifery contexts where a collective understanding of a phenomena is required. Using a phenomenographic approach can provide the midwifery profession with knowledge about variations in how women and midwives think, and how aspects of different phenomena are experienced in within a midwifery setting. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to report: (1) an analysis of the concepts of coping, adaptation and self-management in the context of managing a neurological condition; and (2) the overlap between the concepts. Background The three concepts are often confused or used interchangeably. Understanding similarities and differences between concepts will avoid misunderstandings in care. The varied and often unpredictable symptoms and degenerative nature of neurological conditions make this an ideal population in which to examine the concepts. Design Concept analysis. Data sources Articles were extracted from a large literature review about living with a neurological condition. The original searches were conducted using SCOPUS, EMBASE, CINAHL and Psych INFO. Seventy-seven articles met the inclusion criteria of: (1) original article concerning coping, adaptation or self-management of a neurological condition; (2) written in English; and (3) published between 1999-2011. Methods The concepts were examined according to Morse's concept analysis method; structural elements were then compared. Results Coping and adaptation to a neurological condition showed statistically significant overlap with a common focus on internal management. In contrast, self-management appears to focus on disease-controlling and health-related management strategies. Coping appears to be the most mature concept, whereas self-management is least coherent in definition and application. Conclusion All three concepts are relevant for people with neurological conditions. Healthcare teams need to be cautious when using these terms to avoid miscommunication and to ensure clients have access to all needed interventions. Viewing the three concepts as a complex whole may be more aligned with client experience. [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]

Aim. The purpose of this paper is to identify practical suggestions that could enable other researchers to consider how quality may be evidenced using constructivist principles including the perspectives of older people and their caregivers. Background. Constructivism suggests that reality is part of a social construction, which holds different meanings for each person, in which people are active agents, making autonomous decisions. This approach to research has been identified as suitable for health and social care professionals because these underpinning principles reflect the values of these professions, facilitating the involvement of users and carers. The authenticity criteria have been developed to reflect these philosophical principles but have been criticized for their inaccessible language. To incorporate user and carer perspectives, the criteria have been revised into a more accessible model matrix known as the AldreVast Sjuharad criteria. Discussion. This paper reports on two constructivist studies that explored relationships between older people, families and staff in different settings - the community and care homes. Examples from both settings demonstrate how the perspectives of users and carers were incorporated throughout the research process. Following the AldreVast Sjuharad model matrix, practical guidance is provided on how the quality of constructivist research may be implemented in nursing research. Conclusions. The different settings in this paper influenced how the AldreVast Sjuharad model matrix was applied. Further work is needed in exploring how the perspective of users and carers may be incorporated into the quality process of constructivist research. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an analysis of the concept of vulnerability in homeless adolescents. Background. Caring for vulnerable populations and reduction of health inequities are top international healthcare priorities. Homeless adolescents experience health disparities as compared to their housed counterparts and are among the most vulnerable of all populations. Understanding the concept of vulnerability as it relates to the homeless adolescent population will assist nurses in addressing the health and social concerns of this population. Data sources. The PubMed, Medline, Cochrane and CINAHL electronic databases were used to search for research papers published between 1980 and 2009. The keywords 'vulnerable', 'vulnerability' and 'homeless', 'adolescent', 'street' and 'youth' were used. Twenty-three papers from multiple disciplines were reviewed in an effort to arrive at a global definition of homeless adolescents' vulnerability. Method. Rodgers' evolutionary method of concept analysis was used for the analysis. Results. Based on this analysis, vulnerability in homeless adolescents is defined as the constellation of past, present and future risk, perceived or real, because of the common human experience of risk, the increased vulnerability of the adolescent period, the consequences of family disruption, and the increased risks of life on the street. Conclusion. There was agreement in the literature regarding the antecedents, attributes, consequences and surrogate terms of the concept. However, differentiation between the concepts of risk and vulnerability, as suggested by seminal nurse researchers, was not supported. More research is needed into self-perceptions of vulnerability and vulnerability in subgroups of homeless adolescents. [ABSTRACT FROM AUTHOR]

Aim: To describe a small multidisciplinary team's experience of the process of embedding nurse‐led supportive care into an existing Chronic Obstructive Pulmonary Disease outpatient service. Design: Case study methodology Methods: Data were collected from multiple sources including key documents and semi‐structured interviews with healthcare professionals (n = 6) conducted between June and July 2021. A purposive sampling strategy was used. Content analysis was applied to key documents. Interviews were transcribed verbatim and analysed using an inductive approach. Results: Subcategories under the four‐stage process were identified from the data. Assessment: evidence of needs of patients with Chronic Obstructive Pulmonary Disease; gaps in care and evidence of other models of supportive care. Planning: setting the supportive care service structure and intention; resources and funding; leadership, specialization and respiratory/palliative care roles. Implementation: relationships and trust; embedding supportive care and communication. Evaluation: benefits and positive outcomes for staff and patients, and, improvements and future considerations for supportive care in the COPD service. Conclusion: A collaboration between respiratory and palliative care services resulted in successfully embedding nurse‐led supportive care in a small outpatient service for patients with Chronic Obstructive Pulmonary Disease. Nurses are well placed to lead new models of care that aim to address unmet biopsychosocial‐spiritual needs of patients. More research is needed to evaluate nurse‐led supportive care in Chronic Obstructive Pulmonary Disease and other chronic illness settings; the effectiveness of nurse‐led supportive care from the perspective of patients and caregivers and the impact of nurse‐led supportive care on health service usage. Patient or Public Contribution: The development of the model of care is informed by ongoing discussions with patients with COPD and their caregivers. Data availability statement: Research data are not shared (due to ethical restrictions). Impact Embedding nurse‐led supportive care in an existing Chronic Obstructive Pulmonary Disease outpatient service is achievable.Nurses with clinical expertise can lead innovative models of care that address the unmet biopsychosocial‐spiritual needs of patients with conditions such as Chronic Obstructive Pulmonary Disease.Nurse‐led supportive care may have utility and relevance in other chronic disease contexts. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a further analysis of data from an ethnographic study of the nature of communication between children and health professionals in a child hospital setting. Background. There is a paucity of research on the nature of communication between health professionals and child patients. Additionally, theory has not been developed to any great extent in the communication literature on children. Method. Using an ethnographic approach, fieldwork took place in one specialized children's hospital during 2005. Forty-nine children, aged 6-16 years, with a variety of medical and surgical conditions, participated. Data were collected through semi-participant observations, unstructured interviews, participatory activities and documentary evidence. Findings. Health professionals positioned children as either passive bystanders or active participants in the communication process. These two positions, passive bystander and active participant, signified the extent of children's inclusion or exclusion in the communication process and the degree to which children's communication needs were met or not. A Child Transitional Communication Model presented in this paper draws on multiple theoretical perspectives to explain why health professionals placed children as either a passive bystander or an active participant in the communication process. Conclusion. Children prefer to oscillate between a passive bystander and active participant position within the communication process, depending on their needs at any given point in time. This challenges the insistence for stronger child participation in all matters that affect them, in isolation of debates surrounding children's need for support/protection and any potential negative consequences of children's active participation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim A discussion of the conceptual elements of an intervention tailored to the needs of Lebanese families. Background The role of informal caregiving is strongly recommended for individuals with chronic conditions including heart failure. Although this importance is recognized, conceptual and theoretical underpinnings are not well elucidated nor are methods of intervention implementation. Design Discussion paper on the conceptual underpinning of the FAMILY model. Methods and data sources This intervention was undertaken using linked methods: (1) Appraisal of theoretical model; (2) review of systematic reviews on educational interventions promoting self-management in chronic conditions in four databases with no year limit; (3) socio-cultural context identification from selected papers; (4) expert consultation using consensus methods; and (5) model development. Results Theories on self-care and behavioural change, eighteen systematic reviews on educational interventions and selected papers identifying sociocultural elements along with expert opinion were used to guide the development of The FAMILY Intervention Heart Failure Model. Theory and practice driven concepts identified include: behavioural change, linkage, partnership and self-regulation. Implications for nursing Heart failure is a common condition often requiring in-hospital and home-based care. Educational interventions targeting the socio-cultural influences of the patients and their family caregivers through a structured and well-designed program can improve outcomes. Conclusion As the burden of chronic diseases increases globally, particularly in emerging economies, developing models of intervention that are appropriate to both the individual and the socio-cultural context are necessary. [ABSTRACT FROM AUTHOR]

Aims A discussion of conceptual frameworks applicable to the study of isolation precautions effectiveness according to Fawcett and DeSanto-Madeya's (2013) evaluation technique and their relative merits and drawbacks for this purpose. Background Isolation precautions are recommended to control infectious diseases with high morbidity and mortality, but effectiveness is not established due to numerous methodological challenges. These challenges, such as identifying empirical indicators and refining operational definitions, could be alleviated though use of an appropriate conceptual framework. Design Discussion paper. Data sources In mid-April 2014, the primary author searched five electronic, scientific literature databases for conceptual frameworks applicable to study isolation precautions, without limiting searches by publication date. Implications for nursing By reviewing promising conceptual frameworks to support isolation precautions effectiveness research, this article exemplifies the process to choose an appropriate conceptual framework for empirical research. Hence, researchers may build on these analyses to improve study design of empirical research in multiple disciplines, which may lead to improved research and practice. Conclusion Three frameworks were reviewed: the epidemiologic triad of disease, Donabedian's healthcare quality framework and the Quality Health Outcomes model. Each has been used in nursing research to evaluate health outcomes and contains concepts relevant to nursing domains. Which framework can be most useful probably depends on whether the study question necessitates testing multiple interventions, concerns pathogen-specific characteristics and yields cross-sectional or longitudinal data. The Quality Health Outcomes model may be slightly preferred as it assumes reciprocal relationships, multi-level analysis and is sensitive to cultural inputs. [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]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims This paper will examine understandings of autonomy and choice in relation to palliative and end-of-life care and identify implications for nursing practice. Background Autonomy in relation to patient-centred care and advocacy has been identified as a key component of palliative and end-of-life care provision internationally. Understandings of autonomy have emerged in an individualised framework, which may be inadequate in supporting palliative and end-of-life care. Design A critical discussion paper. Data sources Seminal texts provide a backdrop to how autonomy is understood in the context of palliative care. An overview of literature from 2001 is examined to explore how autonomy and choice are presented in clinical practice. Implications for nursing A model of autonomy based on a 'decision ecology' model may be more applicable to palliative and end-of-life care. Decision ecology aims to situate the individual in a wider social context and acknowledges the relational dimensions involved in supporting choice and autonomy. Such a model recognizes autonomy around wider care decisions but may also highlight the everyday personal aspects of care, which can mean so much to an individual in terms of personal empowerment and dignity. Conclusion A 'decision ecology' model that acknowledges the wider social context, individual narratives and emphasises trust between professionals and patients may support decision-making at end of life. Such a model must support autonomy not just at the level of wider decisions around care choice but also at the level of everyday care. [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]

Aim: To develop a nurse‐led model of analgesia to manage post‐operative pain in the surgical neonate. Design: A four‐round e‐Delphi study was conducted from March to December 2022. Methods: An e‐Delphi method was used seeking a consensus of 70% or greater. Fifty‐one experts were invited to join the panel. Members consisted of multi‐disciplinary healthcare professionals who work in areas associated with neonatal care. In round 1, 49 statements relative to neonatal pain assessment and management were distributed to the panel. Panel members were asked to rate their level of agreeance on a Likert scale from 1 to 5 (1 = strongly disagree to 5 = strongly agree). Ratings equal to or greater than 4 represented agreement, 3 indicated uncertainty and 2 or less disagreement with the proposed statement. An opportunity for free‐text responses after each statement was provided. This iterative process continued for three rounds. In the fourth and final round, the completed model of neonatal nurse‐controlled analgesia was presented along with a further opportunity to provide feedback on the final version. Results: Four rounds of statements and voting were required to reach consensus on a model of neonatal nurse‐controlled analgesia. The model consists of criteria for use, over‐arching guidelines and three separate pathways based on an individual baby's pain assessment scores, need for pain relieving interventions and time‐lapsed post‐surgical procedure. Conclusion: A comprehensive model of neonatal nurse‐controlled analgesia, applicable to the Australasian context, was developed in collaboration with a group of neonatal experts. Impact: This study provides a multi‐modal family‐integrated model to manage neonatal post‐operative pain. By providing nurses with increased autonomy to assess and manage acute pain, this model has the potential to not only provide a more responsive and individualized approach to alleviate discomfort, but highlights the integral role of parent partnerships in the neonatal intensive care. Reporting Method: This study was reported in line with the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies. Patient or Public Contribution: No patient or public contribution was utilized for this study. [ABSTRACT FROM AUTHOR]

Aim: To explore clinician-perceived barriers to and facilitators for the provision of actionable processes of care important for patients with persistent or chronic critical illness. Design: Qualitative descriptive interview study. Methods: Secondary analysis of semi-structured telephone interviews (December 2018 – February 2019) with professionally diverse clinicians working with adults experiencing persistent or chronic critical illness in Canadian intensive care units. We used deductive content analysis informed by the Social-Ecological Model. Results: We recruited 31 participants from intensive care units across nine Canadian provinces. Reported intrapersonal level barriers to the provision of actionable processes of care included lack of training, negative emotions and challenges prioritizing these patients. Facilitators included establishment of positive relations and trust with patients and family. Interpersonal barriers included communication difficulties, limited access to physicians and conflict. Facilitators included communication support, time spent with the patient/family and conflict management. Institutional barriers comprised inappropriate care processes, inadequate resources and disruptive environmental conditions. Facilitators were regular team rounds, appropriate staffing and employment of a primary care (nurse and/or physician) model. Communitylevel barriers included inappropriate care location and insufficient transition support. Facilitators were accessed to alternate care sites/teams and to formalized transition support. Public policy-level barriers included inadequacy of formal education programs for the care of these patients; knowledge implementation for patient management was identified as a facilitator. Conclusion: Our results highlighted multilevel barriers and facilitators to the delivery of actionable processes important for quality care for patient/family experiencing persistent or chronic critical illness. Impact: Using the Social-Ecological Model, the results of this study provide intra and interpersonal, institutional, community and policy-level barriers to address and facilitators to harness to improve the care of patients/family experiencing persistent or chronic critical illness. Reporting Method: Consolidated criteria for reporting qualitative studies. [ABSTRACT FROM AUTHOR]

Aim To interpret and synthesize stroke survivors' experiences of poststroke fatigue. Background Several studies have found fatigue to be a common and distressing difficulty experienced after stroke. This review has synthesized qualitative findings of stroke survivors' experiences of poststroke fatigue with the aim of guiding practice and further research. Data sources A computer-aided search of the PubMed, CINAHL, Psyc INFO, and Embase databases was performed up to April 2012. Design and review methods Interpretive qualitative meta-synthesis. Of 167 papers identified, 12 were included. Findings Three main themes of the experience of poststroke fatigue were identified. First, five characteristics were identified and interpreted as core characteristics of poststroke fatigue. These did not seem to be influenced by the context. Two additional, distressing characteristics were identified. These were interpreted as being more responsive to the context. Second, we found that the acknowledgement of poststroke fatigue by stroke survivors and their significant others were important for the experience of poststroke fatigue. This theme appeared to be consistent across studies and was interpreted as having a major impact on the third theme identified; coping with poststroke fatigue. Two main coping patterns appeared: one taking the fatigue into account and the other struggling to cope. Lack of acknowledgement of poststroke fatigue complicates the coping process and invokes additional emotional distress. Conclusion Poststroke fatigue is a complex phenomenon. Acknowledging its presence and impact is important to cope well with it. Lack of acknowledgement from significant others increases add to the burden. [Correction added after online publication 3 September 2012: Instances of the word 'statistically' have been removed from the Findings and Conclusion in the abstract section.] [ABSTRACT FROM AUTHOR]

ellenbecker c.h. & cushman m. (2011) Home healthcare nurse retention and patient outcome model: discussion and model development. Journal of Advanced Nursing 68(6), 1881-1893. Abstract Aim. This paper discusses additions to an empirically tested model of home healthcare nurse retention. An argument is made that the variables of shared decision-making and organizational commitment be added to the model based on the authors' previous research and additional evidence from the literature. Background. Previous research testing the home healthcare nurse retention model established empirical relationships between nurse, agency, and area characteristics to nurse job satisfaction, intent to stay, and retention. Unexplained model variance prompted a new literature search to augment understanding of nurse retention and patient and agency outcomes. Data sources. Data come from the authors' previous research, and a literature search from 1990 to 2011 on the topics organizational commitment, shared decision-making, nurse retention, patient outcomes and agency performance. Discussion. The literature provides a rationale for the additional variables of shared decision-making and affective and continuous organizational commitment, linking these variables to nurse job satisfaction, nurse intent to stay, nurse retention and patient outcomes and agency performance. Implications for nursing. The new variables in the model suggest that all agencies, even those not struggling to retain nurses, should develop interventions to enhance nurse job satisfaction to assure quality patient outcomes. Conclusion. The new nurse retention and patient outcome model increases our understanding of nurse retention. An understanding of the relationship among these variables will guide future research and the development of interventions to create and maintain nursing work environments that contribute to nurse affective agency commitment, nurse retention and quality of patient outcomes. [ABSTRACT FROM AUTHOR]

aston m., price s., kirk s.f.l. & penney t. (2011) More than meets the eye. Feminist poststructuralism as a lens towards understanding obesity. Journal of Advanced Nursing 68(5), 1187-1194. Abstract Aim. This paper presents a discussion of the application of a feminist poststructuralist-based theoretical framework as an innovative approach towards understanding and managing the complex health issue of obesity. Background. Obesity is often viewed as a lifestyle choice for which the individual is blamed. This individualistic, dichotomous and behavioural perspective only allows for a narrow understanding of obesity and may even lead to misperceptions, stereotypes and marginalization of clients experiencing obesity. Feminist poststructuralism can provide a critical lens to understand the social construction of obesity and the broader environmental and cultural contexts of this health issue. Data sources. The theoretical framework draws from the writings of Foucault, Scott, Butler, Cheek, and Powers, published between 1983 and 2005. Discussion. The concepts of discourse analysis and power relations are explored and discussed in a clear manner so that nurses can easily apply this framework to their practice as they observe, question, analyse, critique and assess the care experienced by clients who are obese. The concepts of personal and social beliefs, values and stereotypes are also discussed and examples of how to apply them in practice are provided. Implications. It is imperative that we continue to question our everyday nursing practices as we work to support clients, especially those who feel marginalized. This focus on power relations and reflective practice can give direction to new possibilities for change in obesity management. [ABSTRACT FROM AUTHOR]

ingram r.r. (2012) Using Campinha-Bacote's process of cultural competence model to examine the relationship between health literacy and cultural competence. Journal of Advanced Nursing 68(3), 695-704. Abstract Aim. This paper presents a discussion of the relation between health literacy and cultural competence in nursing practice. Background. Cultural competence involves understanding values, beliefs, traditions and customs of diverse groups. Health literacy is the degree to which individuals can obtain, process, and understand health information to make healthcare decisions. Cultural competence and health literacy are directly related to healthcare. Campinha-Bacote's Process of Cultural Competence Model can assist nurses in addressing cultural issues associated with a person's low health literacy. Data sources. Literature searches were performed using CINAHL, ERIC, Academic Search Premier, Health Source Nursing, MasterFILE Premier and Academic OneFile. All articles reviewed were published in peer reviewed journals in English from the 1990s to the present and were relevant to health literacy and cultural competence in nursing. Books and other supporting scholarly sources were also used. Discussion. Health literacy and cultural competence are related. Applying Campinha-Bacote's Process of Cultural Competence Model using the mnemonic ASKED (awareness, skills, knowledge, encounters and desire) involves incorporating culturally appropriate assessments and disseminating healthcare information at lower literacy levels and is needed for nurses to provide care for ethnic minorities and diverse populations. Implications for nursing. Health literacy should be assessed and care should be based on a client's level of understanding and cultural values and norms. Conclusion. Nurses can care for ethnic minorities by using resources that target health literacy deficits and by increasing their own cultural competence. [ABSTRACT FROM AUTHOR]

sieger m., fritz e. & them c. (2012) In discourse: Bourdieu's theory of practice and habitus in the context of a communication-oriented nursing interaction model. Journal of Advanced Nursing 68(2), 480-489. Abstract Aims. This paper presents a discussion on the potential of the theories of practice and habitus as espoused by the sociologist Bourdieu. Background. The interaction between nurses and patients is a constitutive element in the nursing process and a central aspect in the theories developed by Paterson and Zderad, and Orlando. Bourdieu′s theory of habitus and practices assists in understanding and explaining differentiated results concerning nurse-patient interaction. Data sources. In a study on interactions with paraplegic patients, distinguished levels of interactions, which show considerable diversity among one another, could be identified. The data were collected over a period of 20 months in 2004-2006. The results present the central topics of interaction and show that understanding-oriented interaction is rare. Discussion. Communicative acting in nursing always takes place in a social context. In the interaction with patients, nurses assign a higher distinctive value to the standardized concepts of care facilities than to the actually perceived need of care. An understanding-oriented interaction assumes that the nurses with their own contributions, themes and authorities, prove themselves in the eyes of the patient. It is expected from nurses that they habitualize their own concepts so that they can be represented in a convincing manner. Conclusion. If an understanding-oriented interaction is to extend into the practice of nursing, it is of crucial importance that both interaction partners assure each other how and with what capital their interaction is to be realized. Nurses need professional habitus to become agents in the social field of health. [ABSTRACT FROM AUTHOR]

myny d., van goubergen d., gobert m., vanderwee k., van hecke a. & defloor t. (2011) Non-direct patient care factors influencing nursing workload: a review of the literature. Journal of Advanced Nursing 67(9), 2109-2129. Abstract Aims. The aim of this paper was to detect which non-direct patient care factors are related to nursing workload in acute hospital nursing care and to develop a conceptual model to describe the relationship between the non-direct patient care factors and nursing workload. Background. Since the 1930s, efforts to measure nursing workload have been undertaken. Still, it remains unclear which of the non-direct patient care elements are essential to the nursing workload. Data sources. PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, Engineering Village 2, Elin and the British Nursing Index were searched from 1970 up to July 2009. Review methods. Studies were included in this integrative review if they described factors that are related to nursing workload or if they presented models that explored the association between potential factors, excluding the factors related to direct patient care. Results. Thirty publications were included. The influencing variables were classified in five categories based on their level of impact: the hospital and ward, nursing team, individual nurse, patient and family and meta-characteristics. The variables were also classified, based on their cause-effect relationship. Some factors have a direct impact on the patient-nurse relationship, while others have an effect on the work fluency or on the subjective perception of the nursing workload. A conceptual model was built, based on the interaction between both classifications and derived from the systems theory. Conclusions. Nursing workload has a multi-causal aetiology. The influencing factors from this review can be integrated in a workload measurement tool. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of an analysis of the concept of nursing surveillance. Background. Nursing surveillance, a primary function of acute care nurses, is critical to patient safety and outcomes. Although it has been associated with patient outcomes and organizational context of care, little knowledge has been generated about the conceptual and operational process of surveillance. Data sources. A search using the CINAHL, Medline and PubMed databases was used to compile an international data set of 18 papers and 4 book chapters published from 1985 to 2009. Review methods. Rodger's evolutionary concept analysis techniques were used to analyse surveillance in a systems framework. This method focused the search to nursing surveillance (as opposed to other medical uses of the term) and used a theoretical framework to guide the analysis. Results. The examination of the literature clarifies the multifaceted nature of nursing surveillance in the acute care setting. Surveillance involves purposeful and ongoing acquisition, interpretation and synthesis of patient data for clinical decision-making. Behavioural activities and multiple cognitive processes are used in surveillance in order for the nurse to make decisions for patient safety and health maintenance. A systems approach to the analysis also demonstrates how organizational characteristics and contextual factors in?uence the process in the acute care environment. Conclusion. This conceptual analysis describes the nature of the surveillance process and clarifies the concept for effective communication and future use in health services research. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to conduct a concept analysis of value in the context of community-based interventions for people affected by dementia. Background: Concepts of value play a critical role in shaping the delivery and distribution of community-based health interventions through related concepts. However, the use and meaning of 'value' is rarely clarified limiting the term's utility in practice and research. Increasing need for community healthcare and scarce public resources means developing understanding of value in community-based interventions for people affected by dementia is timely, and may support more informed approaches to exploring, explaining and delivering value. Design: Evolutionary Concept Analysis was used to systematically determine the characteristics of value. Data Sources: Peer-reviewed and grey literature databases were searched between April and July 2021, with 32 pieces of literature from different disciplines included in the final sample. No limits were set for the years of literature retrieved. Methods: Literature was thematically analysed for information on the antecedents, attributes and consequences of value. Results and Discussion: The analysis uncovered a need and/or desire to understand the experience of people affected by or that affect interventions; and to demonstrate, prove/disprove the (best) quality and nature of results of interventions as antecedents of value. Attributes of value were stakeholder/person centred, measurable, time and context dependent and multidimensional. Consequences of the concept included shared decision-making, valuation of interventions and internal/external investment and development of interventions. Conclusion: Through concept analysis value can now be better understood and applied. The development of a conceptual model to illustrate the constituent elements and relationships of the concept adds transparency to where, why and how concepts of value are enabled that supports future concept development. Patient and Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: Transitional care interventions have emerged as a promising method of ensuring treatment continuity and health care coordination when patients are discharged from hospital to home. However, few studies have investigated the frequency and duration of interventions and the effects of interventions on physical function. Therefore, this study aimed to determine the efficacy of transitional care for patients with stroke. Methods: Six databases and the grey literature were searched to obtain relevant articles from October 1, 2022 to March 10, 2023. The primary outcomes studied were motor performance, walking speed, activities of daily living (ADLs) and caregiver burden following hospital‐to‐home transitional care. The quality of the studies was assessed with Cochrane risk of bias version 2. The quality and sensitivity of the evidence were assessed to ensure rigour of the findings. Meta‐analyses were performed using stata 17.0. Results: A total of 2966 patients were identified from 23 studies. Transitional care improved post‐stroke motor performance, walking speed and ADLs, and reduced caregiver burden. Conclusion: The findings suggest that provision of transitional care model implementation in patients with stroke is important because it reduces disability in stroke patients and helps to decrease caregivers' burden. Impact: The findings of the study emphasize the importance of transitional care programmes for stroke patients after they are discharged from the hospital and returned to their homes. To meet the needs of patients, all levels of health professionals including nurses should be aware of the discharge process and care plan. [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]

Aims: To explore how emerging adult‐aged women self‐manage their sexual and reproductive health and to generate a grounded theory of these self‐management processes. Design: Grounded theory methods using a constructivist approach. Methods: Between September 2019 and September 2020, 18‑ to 25‐years‐old women (n = 13) were recruited from a 4‐year university, a 2‐year community college, and neighbourhoods surrounding the institutions of higher education. Individual interviews were transcribed verbatim and qualitatively analysed using a constant comparative method and inductive coding. Results: The theory purports that core processes of sexual and reproductive health self‐management used by the women in this study included both passive and (re)active processes. These processes expanded upon and/or maintained the women's accessible sexual and reproductive health knowledge, behaviour and beliefs, defined as the sexual and reproductive health repertoire. The processes appeared to be cyclical and were often initiated by a catalysing event or catalyst and resulted in conversations with confidantes, or trusted individuals. A catalyst was either resolved or normalized by expanding or maintaining the sexual and reproductive health repertoire. Conclusion: The resulting theory, EMeRGE Theory, offers insight into the complex and cyclical processes emerging adult‐aged women use to simultaneously develop and adapt their foundational sexual and reproductive health knowledge, behaviours and beliefs. Implications for the Profession and/or Patient Care: This explication of emerging adult‐aged women's sexual and reproductive health self‐management processes can be used by nurses and nurse researchers to better address this population's unique health needs. Impact: The EMeRGE Theory provides valuable guidance for future exploratory and intervention research aimed at improving the health and well‐being of emerging adult‐aged women. Reporting Method: The authors adhered to the Consolidated Criteria for Reporting Qualitative studies (COREQ) in preparation of this publication. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim This paper is a report of an analysis of the concept of patient autonomy Background Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Design Concept analysis. Data Sources Medline, CINAHL, The Cochrane Library and Psyc INFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved. Review Methods The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Results Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Conclusion Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context. [ABSTRACT FROM AUTHOR]

Aim This paper is a report of an analysis of the concept of watchful waiting. Background Little is known about differences between the intrapartum care processes of midwives and physicians. In this time of growing rates of surgical birth outcomes, intrapartum care processes are a key area for research and improvement. Watchful waiting is a common care plan used by both midwives and physicians that involves the timing of interventions in labour. Design Rodgers' Evolutionary Model was used to conduct a concept analysis of the term watchful waiting. Data sources Scientific literature authored by, and about, midwives and physicians, as located via an intrapartum-focused database search inclusive of years 1922-May 2012. Thirty English-language articles from nine different countries were located, representing the midwifery and physician scientific literature focusing on watchful waiting in labour and provider decision-making processes. Review method Attributes, consequences, antecedents and affecting themes were identified through a thematic analysis of the identified articles. Results Data analysis reveals that many midwives and physicians define watchful waiting differently, based on their philosophies of care. Conclusion The care of women in labour is complicated as a result of different understandings by some providers of common processes of intrapartum care. [ABSTRACT FROM AUTHOR]

Aim To present a case of knowledge translation in nursing education and practice and discusses mechanisms relevant to bringing knowledge into action. Background The process of knowledge translation aspires to close the gap between theory and practice. Knowledge translation is a cyclic process involving both the creation and application of knowledge in several phases. The case presented in this paper is the translation of the Model of Practical Skill Performance into education and practice. Advantages and problems with the use of this model and its adaptation and tailoring to local contexts illustrate the cyclic and iterative process of knowledge translation. Discussion The cultivation of a three-sided relationship between researchers, educators, and clinical nurses was a major asset in driving the process of knowledge translation. The knowledge translation process gained momentum by replacing passive diffusion strategies with interaction and teamwork between stakeholders. The use of knowledge creates feedback that might have consequences for the refinement and tailoring of that same knowledge itself. With end-users in mind, several heuristics were used by the research group to increase clarity of the model and to tailor the implementation of knowledge to the users. Implications for nursing This article illustrates the need for enduring collaboration between stakeholders to promote the process of knowledge translation. Translation of research knowledge into practice is a time-consuming process that is enhanced when appropriate support is given by leaders in the involved facilities. Conclusion Knowledge translation is a time-consuming and collaborative endeavour. On the basis of our experience we advocate the implementation and use of a conceptual framework for the entire process of knowledge translation. More descriptions of knowledge translation in the nursing discipline are needed to inspire and advise in this process. [ABSTRACT FROM AUTHOR]

gur-yaish n., zisberg a., sinoff g. & shadmi e. (2011) Development and psychometric testing of a measure of informal caregiving for hospitalized older adults. Journal of Advanced Nursing 68(4), 931-938. Abstract Aim. This paper is a report of the development and psychometric testing of the questionnaire evaluating informal caregiving for hospitalized older adults. Background. Informal caregiving of hospitalized older adults is an understudied phenomenon that lacks a valid and reliable measure to capture its multi-dimensionality. Methods. An instrument development procedure, followed by an empirical study, was conducted from February to November 2009. Instrument development included item generation and content validity, which was established by five experts. The validation study utilized a retrospective between-patients design. The sample consisted of 279 patients, aged 70 and older, who were hospitalized in a large medical centre in northern Israel. The internal consistency reliability, construct, convergent and divergent validity of the measure were tested. Results. The 14-item scale describes various aspects of informal caregiving for older adults in the hospital setting. The scale has four dimensions: Instrumental care, Supervision of care, Psychological support and Ensuring and Explaining care. Confirmatory factor analysis supported the theoretical model of the four dimensions of care. Reliability analysis revealed acceptable-to-high estimates for the total and for the dimensional scores (ranging from 0·78 to 0·89). The convergent and divergent validity coefficients were all in the expected direction. Conclusions. The preliminary psychometric properties of the measure showed acceptable results. The measure should be further explored in different cultural settings and for its ability to link between caregiving attributes, as captured by the measure, and hospitalization outcomes in older adults. [ABSTRACT FROM AUTHOR]

hatlevik i.k.r. (2011) The theory-practice relationship: reflective skills and theoretical knowledge as key factors in bridging the gap between theory and practice in initial nursing education. Journal of Advanced Nursing 68(4), 868-877. Abstract Aim. This paper is a report of a correlational study of the relations of nursing students' acquired reflective skills, practical skills and theoretical knowledge on their perception of coherence between theory and practice. Background. Reflection is considered a key factor in bridging the gap between theory and practice. However, it is not evident whether reflective skills are primarily generic in nature or whether they develop from a theoretical knowledge base or the acquisition of practical skills. Method. This study is a secondary analysis of existing data. The data are part of a student survey that was conducted among third-year nursing students in Norway during the spring of 2007. A total of 446 nursing students participated in this study and the response rate was 71%. Structural equation modelling analyses were performed. Findings. The results indicate that students' perception of coherence between theory and practice during initial nursing education is directly influenced by reflective skills and theoretical knowledge. The results also reveal that reflective skills have mediating effects and that practical skills have a fully mediated and theoretical knowledge a partially mediated influence on students' perception of coherence. Conclusion. The findings imply that helping students perceive coherence between theory and practice in nursing education, developing students' reflective skills and strengthening the theoretical components of the initial nursing education programme might be beneficial. The results suggest that reflective thinking is not merely a generic skill but rather a skill that depends on the acquisition of relevant professional knowledge and experience. [ABSTRACT FROM AUTHOR]

o'leary d.f. & ni mhaolrúnaigh s. (2012) Information-seeking behaviour of nurses: where is information sought and what processes are followed? Journal of Advanced Nursing 68(2), 379-390. Abstract Aim. This paper is a report of a study on how nurses inform their decision-making in the workplace. Background. Despite the growing availability of research evidence, nurses have been slow to adopt it into their daily decision-making. Method. The study was undertaken in Ireland between 2006 and 2007 using a sequential mixed methods approach. In phase 1, the views of a quota sample of 29 nurses were explored using semi-structured interviews incorporating vignettes. Phase 2 involved the design and dissemination of a survey to a disproportionate stratified random sample of 1356 nurses. The response rate was 29%. Findings. In decision-making, nurses accessed other people, especially nursing colleagues, the most frequently. Sources that provided prepackaged information such as guidelines were favoured over sources that provided access to original research. The process of information-seeking for routine and non-routine decisions was different. Nurses making routine decisions relied mostly on their experience and an assessment of the patient. In non-routine decision-making, participants experienced more uncertainty about their decisions. Accordingly, sources of information used were more varied and the information-seeking process more extensive. The study highlighted the complexities of establishing whether information used in decision-making is research based or not. Conclusion. Routine practices should be reviewed and updated regularly through organizational mandates, as nurses do not generally question them. Research information to inform non-routine decision-making must be easily available to nurses in their workplace, as information searches generally prioritize finding enough, rather than the best, information to make a decision. [ABSTRACT FROM AUTHOR]

salmela s., eriksson k. & fagerström l. (2012) Leading change: a three-dimensional model of nurse leaders' main tasks and roles during a change process. Journal of Advanced Nursing 68(2), 423-433. Abstract Aim. This paper is a report of a qualitative study which explored how nurse leaders described and understood their main tasks and roles during a change process. Background. During a database search for literature, no actual research that highlighted the main tasks and roles of nurse leaders during a change process was found. Earlier research has indicated the need for different leadership styles and the importance of strategies and values. Method. In-depth interviews with 17 nurse leaders took place in 2004. A phenomenological-hermeneutical approach was used for data analysis. Results. The findings resulted in a model of leading change in health care that focuses on good patient care and consists of three dimensions: leading relationships, leading processes and leading a culture. In addition to leading relationships and processes, nurse leaders, as role models, greatly impact caring culture and its inherent ethical behaviour, especially about the responsibility for achieving good patient care. Nurse leaders are also instrumental in leading ward culture. Conclusion. Nurse leaders need guidance and knowledge of what is expected of them during a structural change process. They play different roles by directing, guiding, motivating, supporting and communicating without losing their cultural ethos of caring and use various leadership styles to bring about actual change, which, in turn, requires learning so that the thought patterns, values and attitudes of personnel can be changed. [ABSTRACT FROM AUTHOR]

lasiter s. (2011) Older adults' perceptions of feeling safe in an intensive care unit. Journal of Advanced Nursing 67(12), 2649-2657. Abstract Aim. This paper is a report of a study of older adults' perceptions of feeling safe in an intensive care unit. Background. Significant ageing of the world population is expected. Correspondingly, there is a growing global urgency for healthcare systems to prepare for the increased number of older adults who will require intensive care. Although patients have recounted situations in which feeling safe was essential to their experience, there is little empirical evidence about feeling safe for older adults in intensive care. Method. In 2008, 10 older adults who suffered unexpected critical health events and who were admitted to intensive care units were recruited for this grounded theory study. Participants were interviewed after transferring to an intermediate care unit and again after discharge. They were asked to reflect upon and discuss their experiences of feeling safe in intensive care. Findings. Participants' actual and expected interaction with intensive care nurses was essential to their perceptions of feeling safe. Four main categories were identified as requisite to interaction with nurses: proximity, oversight, predictability and initiative. A substantive grounded theory of feeling safe for older adults in intensive care is presented. Conclusion. Nurses must present themselves as accessible so patients perceive that they can initiate interaction with a qualified nurse. Patients must also see that nurses are monitoring them and believe that the nurses will help them if they experience a critical health event while in the intensive care unit. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study that examines (1) whether emergency nurses differ from a general hospital nursing comparison group in terms of job and organizational characteristics and (2) to what extent these characteristics predict job satisfaction, turnover intention, work engagement, fatigue and psychosomatic distress in emergency nurses. Background. The work environment and job characteristics of nurses are important predictors of stress-health outcomes. Emergency nurses are particularly exposed to stressful events and unpredictable work conditions. Methods. This cross-sectional study (N = 254) was carried out in 15 emergency departments of Belgian general hospitals in 2007-2008 by means of the Leiden Quality of Work Questionnaire for Nurses, the Checklist Individual Strength, the Utrecht Work Engagement Scale and the Brief Symptom Inventory. Results. Emergency nurses report more time pressure and physical demands, lower decision authority, less adequate work procedures and less reward than a general hospital nursing population. They report, however, more opportunity for skill discretion and better social support by colleagues. Work-time demands appear to be important determinants of psychosomatic complaints and fatigue in emergency nurses. Apart from personal characteristics, decision authority, skill discretion, adequate work procedures, perceived reward and social support by supervisors prove to be strong determinants of job satisfaction, work engagement and lower turnover intention in emergency nurses. Conclusion. Emergency departments should be screened regularly on job and organizational characteristics to identify determinants of stress-health outcomes that can be the target of preventive interventions. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a pilot study to examine the relationship of nursing intensity, work environment intensity and nursing resources to nurse job satisfaction. Background. There is an ever increasing amount of information in hospital information systems; however, still very little of it is actually used in nursing management and leadership. Methods. The combination of a retrospective time series and cross-sectional survey data was used. The time series patient data of 9704 in/outpatients and nurse data of 110 nurses were collected from six inpatient units in a medical clinic of a university hospital in Finland in 2006. A unit-level measure of nurse job satisfaction was collected with a survey (n = 98 nurses) in the autumn of 2006. Bayesian networks were applied to examine a model that explains nurse job satisfaction. Results. In a hospital data system, 18 usable nurse staffing indicators were identified. There were four nurse staffing indicators: patient acuity from nursing intensity subgroup, diagnosis-related group volume from work environment subgroup, and skill mix and nurse turnover from nursing resources subgroup that explained the likelihood of nurse job satisfaction in the final model. The Bayesian networks also revealed the elusive non-linear relationship between nurse job satisfaction and patient acuity. Conclusion. Survey-based information on nurse job satisfaction can be modelled with data-based nurse staffing indicators. Nurse researchers could use the Bayesian approach to obtain information about the effects of nurse staffing on nursing outcomes. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of the development and testing of the Self-Efficacy for Preventing Falls Nurse and Assistant scales. Background. Patient falls and fall-related injuries are traumatic ordeals for patients, family members and providers, and carry a toll for hospitals. Self-efficacy is an important factor in determining actions persons take and levels of performance they achieve. Performance of individual caregivers is linked to the overall performance of hospitals. Scales to assess nurses and certified nursing assistants. self-efficacy to prevent patients from falling would allow for targeting resources to increase SE, resulting in improved individual performance and ultimately decreased numbers of patient falls. Method. Four phases of instrument development were carried out to (1) generate individual items from eight focus groups (four each nurse and assistant conducted in October 2007), (2) develop prototype scales, (3) determine content validity during a second series of four nurse and assistant focus groups (January 2008) and (4) conduct item analysis, paired t-tests, Student's t-tests and internal consistency reliability to refine and confirm the scales. Data were collected during February--December, 2008. Results. The 11-item Self-Efficacy for Preventing Falls Nurse had an alpha of 0.89 with all items in the range criterion of 0.3-0.7 for item total correlation. The 8-item Self-Efficacy for Preventing Falls Assistant had an alpha of 0.74 and all items had item total correlations in the 0.3-0.7 range. Conclusions. The Self-Efficacy for Preventing Falls Nurse and Self-Efficacy for Preventing Falls Assistant scales demonstrated psychometric adequacy and are recommended to measure bedside staff's self-efficacy beliefs in preventing patient falls. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study conducted to test a model linking new graduate nurses' perceptions of structural empowerment to their experiences of workplace bullying and burnout in Canadian hospital work settings using Kanter's work empowerment theory. Background. There are numerous anecdotal reports of bullying of new graduates in healthcare settings, which is linked to serious health effects and negative organizational effects. Methods. We tested the model using data from the first wave of a 2009 longitudinal study of 415 newly graduated nurses (<3 years of experience) in acute care hospitals across Ontario, Canada. Variables were measured using the Conditions of Work Effectiveness Questionnaire, Negative Acts Questionnaire-Revised and Maslach Burnout Inventory-General Survey. Results. The final model fit statistics revealed a reasonably adequate fit (χ² = 14.9, d.f. = 37, IFI = 0.98, CFI = 0.98, RMSEA = 0.09). Structural empowerment was statistically significantly and negatively related to workplace bullying exposure (β = -0.37), which in turn, was statistically significantly related to all three components of burnout (Emotional exhaustion: β = 0.41, Cynicism: β = 0.28, Efficacy: β = -0.17). Emotional exhaustion had a direct effect on cynicism (β = 0.51), which in turn, had a direct effect on efficacy (β = -0.34). Conclusion. The results suggest that new graduate nurses' exposure to bullying may be less when their work environments provide access to empowering work structures, and that these conditions promote nurses' health and wellbeing. [ABSTRACT FROM AUTHOR]