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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: A critical discussion comparing Newtonian science and complexity science as the philosophical basis for suicide research and its impact on suicide knowledge development and clinical practice. Design: Discussion paper. Data Sources: A review of literature on suicide research and complexity science ranging from 2000 to 2022. Implications for Nursing: Suicide research based on a Newtonian worldview can have negative consequences for suicide knowledge development and can permeate nursing practice in ways that take away from addressing the complex needs of patients, their families and healthcare teams. Conclusion: A Newtonian worldview as a philosophical basis for research is insufficient for the study of a phenomenon as complex as suicide. A complexity science approach is better suited to the study of suicide given the multiple, interrelated, emerging factors that can contribute to a person's decision to end their own life. Impact Suggestions are provided as to how a complexity science approach to the research of suicide can inform useful knowledge development that better meets the needs of individuals facing suicidality and their families. Researchers, healthcare administrators and nurses providing care to those struggling with suicidality can benefit from adopting a complexity science worldview in addressing this multifaceted phenomenon. [ABSTRACT FROM AUTHOR]

Aim To discuss the actual public image of nurses and other factors that influence the development of nurses' self-concept and professional identity. Background Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always value the skills and competences nurses have acquired through education and innovation. Design Discussion paper. Data sources We identified 1216 relevant studies by searching MEDLINE, CINAHL and Psyc INFO databases in the period 1997-2010. Finally, 18 studies met our inclusion criteria. Discussion The included studies show that the actual public image of nursing is diverse and incongruous. This image is partly self-created by nurses due to their invisibility and their lack of public discourse. Nurses derive their self-concept and professional identity from their public image, work environment, work values, education and traditional social and cultural values. Implications for nursing Nurses should work harder to communicate their professionalism to the public. Social media like the Internet and YouTube can be used to show the public what they really do. Conclusion To improve their public image and to obtain a stronger position in healthcare organizations, nurses need to increase their visibility. This could be realized by ongoing education and a challenging work environment that encourages nurses to stand up for themselves. Furthermore, nurses should make better use of strategic positions, such as case manager, nurse educator or clinical nurse specialist and use their professionalism to show the public what their work really entails. [ABSTRACT FROM AUTHOR]

Aims: To map the concepts of the caring life-course theory that are used in life-course approaches from different disciplines; establish whether there is a common recognition of, or language used, to describe care in those life-course approaches; and identify the role and contribution of care to the life-course literature. Design: This discursive paper uses a narrative review process to explore points of convergence and divergence between life-course approaches and the caring life-course theory. Methods: Categories for analysis were developed deductively and inductively, focusing on the constructs of fundamental care, capacity and capability, care network, care transition, care trajectory and care biography. Results: We identified four disciplinary perspectives: (1) life-course sociology; (2) life-course epidemiology; (3) lifespan developmental psychology; and (4) life-course health development. While six core constructs of the caring life-course theory were described, either explicitly or implicitly, in existing life-course approaches, no single approach fully describes the role and contribution of care across the lifespan. Conclusion: Life-course approaches have largely neglected the contribution and role of care in informing the life-course discourse. This review highlights the significance of care beyond traditional healthcare settings and recognizes it as a fundamental human need for well-being and development, which can contribute to existing lifecourse literature. Implication for the Profession and/or Patient Care: There is a need to understand care as a complex system and embrace a whole-system, life-course approach to enable nurses and other healthcare professionals to provide high-quality, patient-centred care. Impact: Incorporating care within a life-course approach provides opportunities to integrate and deliver care centred around the person, their life transitions, trajectories and care networks, including informal carers and healthcare professionals. No Patient or Public Contribution: Patients or members of the public were not involved in this study as it is a discursive paper based on the relevant literature. [ABSTRACT FROM AUTHOR]

Aim: To describe the application of selected creative and participatory research methods in nursing science. Design: Research methodology paper. Methods: Researcher‐initiated role play, stimulated recall interviews, the Storycrafting method, painting and drawing. Altogether, 11 children (5–7 years old) and 12 parents participated in the research. Results: Each small group (n = 3) acted differently during the data collection. Not every child wanted to play, draw or tell stories, but they all expressed their views through some method. Although the same themes emerged from children's narratives, they could not have been verified by just one method. Conclusions: Using creative and participatory methods and the principles of studies of child perspectives are applicable ways of conducting research in nursing science. Children must be treated as individuals during the research process, and they must have opportunities to use several communication methods to express their views. Implications for the profession and patient care: Understanding different ways to interact with children and hear children's views will help nurses to encounter children. Impact: In this article, we present a valid way of conducting research with children. By following our protocol, nursing research from a child perspective can be implemented. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ). Patient Contribution: The child participants were involved in choosing physical places for data collection and the usage and order of the selected methods. Both the children and the adult participants took part in interpreting the research data. [ABSTRACT FROM AUTHOR]

Aims: A discussion of the personal and social contexts for Millennial family caregivers and the value of including complex identity and intersectionality in Millennial family caregiving research with practical application. Design: Discussion paper. Data sources This discussion paper is based on our own experiences and supported by literature and theory. Implications for Nursing: Millennial family caregivers have distinct generational, historical and developmental experiences that contribute to the care they provide as well as their own well‐being. Complex identity, the integration of multiple identities, and intersectionality, systems and structures that disempower and oppress individuals with multiple identities, need to be addressed in nursing research so intervention tailoring and health equity can be better supported in this population. From research conceptualization and design to data analysis, data must be used intentionally to promote equity and reduce bias. The inclusion of diverse Millennial caregivers throughout all stages of the research process and having a diverse nursing research workforce will support these efforts. Conclusion: Millennial family caregivers comprise one‐quarter of the family caregiving population in the United States, and they are more diverse than previous family caregiving generational cohorts. Their needs will be more fully supported by nursing scientists with the adoption of methods and techniques that address complex identity and intersectionality. Impact: Nursing researchers can use the following research approaches to address complex identity and intersectionality in Millennial caregivers: inclusion of qualitative demographic data collection (participants can self‐describe); data disaggregation; data visualization techniques to augment or replace frequencies and descriptive statistics for demographic reporting; use of researcher reflexivity throughout the research process; advanced statistical modelling techniques that can handle complex demographic data and test for interactions and differential effects of health outcomes; and qualitative approaches such as phenomenology that centre the stories and experiences of individuals within the population of interest. [ABSTRACT FROM AUTHOR]

The article focuses on patient perceptions of pressure ulcer (PU) risk in community settings and highlights disparities between patient understandings and professional views. Topics include the impact of PU risk communication between nurses and patients, the underrepresentation of individuals with dark skin tones in research due to criteria based on skin assessment tools, and recommendations for inclusive recruitment strategies to improve healthcare outcomes across diverse populations.

Aims: To examine the differences in decisional conflict, decision regret, self‐stigma and quality of life among breast cancer survivors who chose different surgeries, as well as the effects of decisional conflict, decision regret and self‐stigma on quality of life. Design: Observational study. Methods: Paper and online surveys were used to collect data from March to September 2020. The Chinese version of the Decisional Conflict Scale, Decision Regret Scale, Self‐Stigma Form and Functional Assessment of Cancer Treatment‐B were used to measure the corresponding health outcomes for breast cancer survivors who chose different surgeries from three university‐affiliated hospitals. One‐way analysis of variance, Pearson's correlation coefficient and hierarchical multiple regression analysis were used for data analysis. Results: Among the 448 participants, only 21% chose breast conservative surgery, while 79% chose mastectomy with or without reconstruction. Women who chose mastectomy with reconstruction reported higher decisional conflict (p =.028) and more decision regret (p =.013) than women who chose breast conservative surgery; women who chose mastectomy without reconstruction indicated higher decisional conflict (p =.015), more decision regret (p <.001), and higher self‐stigma (p =.034) than women who chose breast conservative surgery. Decisional conflict (r = −.430), decision regret (r = −.495), and self‐stigma (r = −.561) were negatively correlated with quality of life. After controlling for sociodemographic and clinical variables, decisional conflict and decision regret explained 19.7% and self‐stigma explained 12.9% of the variance in quality of life. Conclusion: Decisional conflict, decision regret and self‐stigma vary according to different breast surgeries and are greatly associated with the quality of life of breast cancer survivors. Impact Future studies are warranted to investigate the decision‐making process and the underlying reasons for surgical choices. Decision support strategies pre‐surgery are needed to inform women about the risks and benefits of surgery options. Moreover, psychosocial support post‐surgery is warranted to relieve women's self‐stigma, thus improving their quality of life. [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.)

Aim. This paper presents an integrative literature review examining the attitudes and referral practices of midwives and other maternity care professionals with regard to complementary and alternative treatment and its use by pregnant women. Background. Use of complementary and alternative medicine during pregnancy is a crucial healthcare issue. Recent discussion has identified the need to develop an integrated approach to maternity care. However, there is a lack of understanding of attitudes and behaviours of maternity care professionals towards these treatments. Data sources. A database search was conducted in MEDLINE, CINAHL, Health Source, AMED and Maternity and Infant Care for the period 1999-2009. Review methods. An integrative review method was employed. Studies were selected if they reported results from primary data collection on professional practice/referral or knowledge/attitude towards complementary and alternative medicine by obstetricians, midwives and allied maternity care providers. Results. A total of 21 papers covering 19 studies were identified. Findings from these studies were extracted, grouped and examined according to three key themes: 'prevalence of practice, recommendation and referral', 'attitudes and views' and 'professionalism and professional identity'. Conclusion. There is a need for greater respect and cooperation between conventional and alternative practitioners as well as communication between all maternity care practitioners and their patients about the use of complementary and alternative medicine. There is a need for in-depth studies on the social dimension of practice as well as the inter- and intra-professional dynamics that shape providers' decision to use or refer to complementary and alternative medicine in maternity care. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to determine and explore the relationship between risk perception and health-protective behaviour in individuals with family history of breast cancer. Background Women with increased risk of breast cancer due to inherited predisposition can use health-protective behaviours to facilitate prevention or early detection of cancer. Data sources Four scientific literature databases ( CINAHL, Medline, AMED, PsychInfo) and three systematic review databases were searched. Design Mixed method systematic review. Review methods The systematic review of peer-reviewed literature was conducted following the method described by the Centre of Reviews and Dissemination. Research studies published in English between January 2004-December 2014 focussing on individuals with family history of breast cancer were included. Of 210 papers identified, 10 studies were eligible for inclusion. Studies were assessed for their quality. Due to the diversity of the studies, a three-step analysis was undertaken involving narrative summary of the quantitative data, thematic analysis and presentation of integrated results in narrative form. Results A clear link between breast cancer risk perception and some health-protective behaviour was identified. Screening administered by health professionals (mammogram screening, chemoprevention) were appropriately adopted. However, behaviours requiring high individual input (breast self-examination, lifestyle changes) were not as appropriately adopted and the decision process was not as clearly linked to risk perception. Conclusions There is limited understanding about the complex relationship between risk perception and health-protective behaviour. Risk communication and health promotion need to be further developed to assist individuals to better engage with their actual risk and risk-appropriate behaviours, particularly those that require regular personal effort. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

palacios-ceña d., losa-iglesias m.e., álvarez-lópez c., cachón-pérez m., reyes r.a.r., salvadores-fuentes p. & fernández-de-las-peñas c. (2011) Patients, intimate partners and family experiences of implantable cardioverter defibrillators: qualitative systematic review. Journal of Advanced Nursing 67(12), 2537-2550. Abstract Aim. This paper is a report of an interpretive review of qualitative research on how an implantable cardioverter defibrillator affects adult recipients and their significant others. Background. An implantable cardioverter defibrillator detects pathological cardiac rhythms and automatically converts the rhythm with electrical counter shocks. Data sources. A systematic literature search was conducted for qualitative research papers published between January 1999 and January 2009. PubMed, Medline, ISI Web of Knowledge and CINAHL databases were searched with the following key words: internal defibrillator, implantable defibrillator and qualitative research. Review Methods. Twenty-two papers were included. The Critical Appraisal Skills Programme and Prompts were used to appraise studies. Thematic analysis and synthesis approaches were used to interpret evidence. Findings. People with an implantable cardioverter defibrillator were found to experience physical, psychological and social changes. Shocks produce fear and anxiety, affecting relationships and sexual relations. The use of support groups and the use of the Internet are important in helping adjustment to an implantable cardioverter defibrillator. Women's responses to an implantable cardioverter defibrillator appear different than men's responses and include concerns about physical appearance and relationship issues. Postdischarge follow-up and educational programmes are still underdeveloped. Conclusion. Patients need additional education, support and follow-up care after hospital discharge. Patients and significant others benefit from collaboration between patient associations and healthcare professional societies. Future research is needed to identify the specific challenges that women recipients face. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study exploring and comparing the experience of men and women with colorectal cancer at diagnosis and during surgery. Background. Men have higher incidence and mortality rates for nearly all cancers and frequently use health behaviours that reflect their masculinity. There has been minimal investigation into the influence of gender on the experience of a 'shared' cancer. Methods. From November 2006 to November 2008, a qualitative study was conducted involving 38 individuals (24 men, 14 women) with colorectal cancer. Data were generated using semi-structured interviews at four time points over an 18-month period. This paper reports the participants' experience at diagnosis and during surgery (time point 1) with the purpose of examining the impact of gender on this experience. Findings. In general, men appeared more accepting of their diagnosis. The majority of females seemed more emotional and more affected by the physical side effects. However, there was variation in both gender groups, with some men and women portraying both 'masculine' and 'feminine' traits. There was also individual variation in relation to context. Conclusions. It appears that many men may have been experiencing side effects and/or psychological distress that they were reluctant to discuss, particularly as some men portrayed typical 'masculine' traits in public, but felt able to open up in private. Nurses should not make assumptions based on the traditional view of masculinity, and should determine how each man wants to deal with their diagnosis and not presume that all men need to 'open up' about their illness. [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: To determine the barriers and enablers to regular, women-oriented screening programmes for women with cerebral palsy (CP); and to discuss the participants' suggestions for change. Design: Qualitative life course approach. Methods: Twenty-five life course interviews were conducted with women in 2020 who identified as having a diagnosis of CP. Interviews were conducted in person or using electronic platforms. Framework analysis was used to interpret the data. Findings: Access and utilization of regular screening programmes for women with CP across the life course are determined by multiple socioecological factors. Three themes are discussed focusing particularly on cervical and breast screening: 1. barriers, 2. enablers and 3. women's suggestions for change. Some women chose to opt out of sexual health checks for fear they would be too uncomfortable or the procedure would be too difficult. Practitioner attitudes towards disability in general, as well as the extent to which they understood the effects of CP for women, was highlighted as a barrier. Accessibility and adaptability of the environment also influenced women's uptake of screening. Conclusion: Women with CP face many challenges to their sexual and reproductive healthcare. These can deter them from participating in regular women-oriented screening programmes, which puts them at higher risk of preventable diseases. Understanding the lifelong effects of CP for women, and the interaction with their reproductive health could help to reduce unmet needs and increase participation in relevant screening across the life course. Impact: Knowledge of the challenges to regular screening programmes experienced by women with CP across the life course is crucial to provide appropriate preventative healthcare for women with CP across different stages of life. Elements of this knowledge could have benefits for the care of all disabled women. [ABSTRACT FROM AUTHOR]

Aim To provide evidence on how women's circumstances and experiences influence their smoking behaviour in pregnancy, including their attempts to quit. Background Women in disadvantaged circumstances are more likely to smoke prior to pregnancy; they are also less likely to quit in pregnancy and, among those who quit, more likely to resume smoking after birth. Although there is a rich seam of qualitative research on their experiences, it has yet to be bought together and synthesized. Design The synthesis was conducted using meta-ethnography. Data sources A comprehensive search of five electronic databases (inception to May 2012) was completed to identify qualitative research exploring pregnant women's experiences of smoking in pregnancy. Review methods Following critical appraisal, 26 studies reported in 29 papers were included in the review. Over 640 pregnant women were represented, the majority drawn from disadvantaged groups. We carried out the synthesis using meta-ethnography. Results Four dimensions of women's circumstances and experiences of smoking in pregnancy were highlighted: the embeddedness of smoking in women's lives, questioned only because of pregnancy; quitting for pregnancy rather than for good; quitting had significant costs for the woman and cutting down was a positive alternative; the role of partners and the broader dynamics of the couple's relationship in influencing women's smoking habits. Conclusion Syntheses of qualitative research have an important role to play in producing the evidence base for midwifery, nursing, and public health policy and practice. The four dimensions identified in this review have implications for the design and delivery of interventions to support women to quit smoking in pregnancy. [ABSTRACT FROM AUTHOR]

muir l.a., george p.m. & whitehead l. (2012) Using the experiences of people with familial hypercholesterolaemia to help reduce the risk of cardiovascular disease: a qualitative systematic review. Journal of Advanced Nursing 68(9), 1920-1932. Abstract Aims. This paper presents the results of a systematic review of qualitative studies identifying the experiences and perceptions of people living with familial hypercholesterolaemia. Background. Familial hypercholesterolaemia is a genetic condition that causes cardiovascular disease and early death. It can be easily diagnosed and treated. Diagnostic rates sit around 20% of the at-risk population in western countries. Screening the relatives of diagnosed people is the best way of identifying those at risk so that, if necessary, treatment can be offered. Presentation for screening can depend on diagnosed people informing relatives of their increased risk and advising them to volunteer for testing. We conducted this review to identify if this approach to screening contributes to low diagnostic and treatment rates. Data sources. Searches were made of 11 electronic databases and grey literature from 1990-February 2011. Review method. A systematic review of studies that met the review aim was undertaken. Relevant data were extracted and a narrative synthesis conducted. Results. Poor health literacy, family and other social dynamics can both impede the ability and reduce the likelihood of diagnosed people approaching and adequately explaining the risk of familial hypercholesterolaemia to relatives. Relatives may misunderstand the significance of their messages or not see them as personally relevant. Conclusion. To ensure contact takes place and relatives are able to make informed decisions around being tested, expert clinicians must evaluate the health literacy and social contexts of diagnosed people before assigning them responsibility for contacting family and actively provide support and follow up. [ABSTRACT FROM AUTHOR]

cook c. (2012) Email interviewing: generating data with a vulnerable population. Journal of Advanced Nursing 68(6), 1330-1339. Abstract Aims. This paper describes online recruitment and the email interviewing data collection method with women diagnosed with a viral sexually transmitted infection. The paper highlights the advantages of the method to researchers and participants when conducting research where face-to-face participation may difficult. Background. Online recruitment and in-depth email interviewing have been used by only a small number of nurses internationally. The method enables inclusion of people who might otherwise be excluded from research, for reasons such as geographical distance, incompatible time frames, clinicians''gate-keeping' and participants' desire for anonymity for physical or emotional reasons. Methods. In-depth email interviews were conducted with 26 women in New Zealand, United States of America, Canada and England who had a diagnosis of either human papilloma virus or genital herpes simplex virus. Data were collected during 2007-2008 and analysed using a poststructuralist, feminist thematic analysis. Results. Participant retention was high. Women emphasized satisfaction with the process. Asynchronous interviews allowed for additional reflexivity in the researcher's responses and rich data generation. Conclusion. This method has the potential to enable nurses to include vulnerable and relatively inaccessible participants in 'sensitive' research. In-depth email interviews may generate rich data through a process participants deem to be of personal value. [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]

Aim. This paper is a report of a systematic review conducted to test the hypothesis that nurses and patients perceive the concept of caring in nursing differently. Background. Caring is viewed as the central focus of nursing. However, despite its fundamental place in clinical practice, researchers and scholars have failed in reaching a common definition. This failure has led to eliciting for nebulous interpretations of the concept often leading to perplexity and opposing views between patients and nurses. Data sources. Extensive search was conducted using MEDLINE, CINAHL and EMBASE between March and May 2009 with no publishing time limit and the keywords 'care', 'caring', 'nurse', 'nursing', 'behavio(u)rs', 'patient', 'perception', 'quantitative' and 'comparative'. Review methods. This quantitative systematic review of comparative studies followed the guidance of the Centre for Reviews and Dissemination. A seven-item 'yes' or 'no' checklist was developed and used for appraising the quality status of the selected literature. Narrative summary technique was used to report outcomes. Results. Evidence of incongruence of perceptions between patients and nurses is mainly supported by the literature. Few studies, however, report aspects of congruence. Conclusion. There is considerable evidence of the assertion that there is no congruence of perceptions between patients and nurses as regards to which behaviours are considered caring and intended caring is not always perceived as such by the patient. Further research is needed, however, to generate more knowledge on the relationship between caring behaviours, patient outcomes and health or nursing costs. [ABSTRACT FROM AUTHOR]

Aim: To explore young adults' experiences of living with type 1 diabetes in the transition to adulthood, including experiences of the transfer from paediatric to adult care. Design: A qualitative approach was used. Method: Ten young adults, six women and four men, aged 19–29 years, participated. Participants were recruited at their regular diabetes clinic from spring 2021 to spring 2022. Semi‐structured interviews were transcribed and analysed using qualitative content analysis. Findings: Dreaming of being nurtured towards self‐reliance was the overarching theme. Personal experiences of the transition to adulthood, including the transfer from paediatric to adult care, were described in terms of struggling to find balance in daily life, dealing with feelings of being different, being gradually supported to achieve independence, and wishing to be approached as a unique person in healthcare. Conclusion: In healthcare, it is important to emphasize not only diabetes‐related factors but also emotional and psychosocial aspects of life connected to the transition to adulthood, including the transfer to adult care. The young adults wished to be seen as unique persons in healthcare during their emerging adulthood and should therefore be supported to achieve self‐reliance through personal preparations for new challenges and for the consequences of transitioning to adulthood. Specialist nurses can provide appropriate knowledge and leadership. Implications for the Profession: These findings can guide nurse specialists in support for emerging adults to achieve self‐reliance and indicate the importance of person‐centred care when experiencing transition and transfer. Reporting Method: The study adhered to EQUATOR guidelines, and the COREQ checklist for qualitative studies was used as the reporting method. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of residents, families and staff in the establishment of a new small‐scale home model of care for people living with dementia. Background: New and innovative small‐scale models of care have the potential to improve outcomes for older people, especially those with dementia, who experience high rates of cognitive impairment in traditional residential aged care homes in Australia. Design: A qualitative descriptive study. Methods: Semi‐structured interviews with 14 guests, family and staff of a new small‐scale dementia home named 'Kambera House' in the Australian Capital Territory were conducted between July 2021 when the home opened and August 2022. Data were analysed using reflexive thematic analysis and reported according to the COREQ guidelines. Results: Two guests with mild‐to‐moderate dementia, five family and seven staff members participated in the study. The data revealed high satisfaction with Kambera House, generating five themes. Falls detection technology in the home provided a sense of safety, enabling more time for person‐centred care. Free, everyday technology connected the home with families as part of an overall community of care where staff were empowered to maximize choice and dignity of risk of guests living in the home. This contributed to the sense of community, rather than an institution, where the conditions of work supported the conditions of care, and were embedded in a culture of responsiveness, change and flexibility. Conclusion: Kambera House represents a successful example of a new small‐scale dementia home. Technology played an important background role in improving overall safety and flexibility as part of a model of care which demonstrated positive experiences for guests and families by being responsive to their individual needs. Impacts: Small‐scale homes for people with dementia offer an alternative model that may provide more individualized, person‐centred care compared with the traditional institutionalized care. Patient or Public Contribution: No patient or public contribution. [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 examine sexual desire in older age and the use of pharmaceuticals for sexual enhancement in the context of erectile dysfunction. Background The ability of the older person to fulfil sexual desire has not been well supported in Western society. Design The paper draws on themes that emerged during a phenomenological study of sexual desire in older age. Method Narratives were collected between 2008-2010 from in-depth interviews with six men and two women aged 65-84 years who were part of a larger Australian study of sexual desire in older age. Findings Emergent themes reveal that for some older people, the biomedicalization of sex can be a disappointing experience. Conclusion The findings illuminate the need for nurses who are at the front line of health care, health policy makers and educators, to consider sexual desire experienced in older age in the context of sexual health and healthy ageing. This study will contribute to a growing body of knowledge about sexual desire in older age. [ABSTRACT FROM AUTHOR]

Aim To present the findings of a dimensional analysis of isolation in the context, and from the perspective, of lesbian, gay, bisexual and transgender youth. Background Lesbian, gay, bisexual and transgender youth are often at greater risk for negative health outcomes compared with heterosexual youth. Isolation is one risk factor cited throughout the literature; however, the concept is complicated and has many uses and thus warrants clarification. Design Concept Analysis. Data Sources Sources comprise 35 English language research articles retrieved from CINAHL and EBSCOHost (1987-2012). Methods A dimensional concept analysis was undertaken to analyse how the concept, isolation, is socially constructed. Results This dimensional analysis revealed five socially constructed dimensions and four sub-dimensions. These findings indicate that there is substantial variability in the concept of isolation. These differences and variations are most notably observed in the 20 articles (57%) that had more than one dimension. Although some of these articles were explicit with the different meanings and use of the concept, most of the papers had wide variability in the use and meaning of the concept. Conclusion The disproportionately greater physical and mental health disparities between lesbian, gay, bisexual and transgender and heterosexual youth are a signal to conduct more research to clarify the concept of isolation, to develop instrumentation to identify at-risk youth and to explore predictors and consequences of isolation. Nurses and others can lead the way in translating this knowledge into strategies that will improve the health and lives of these young people. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study testing the validity and reliability of the Italian version of the Kogan Attitude towards Older People scale. Background. Nursing students' attitudes towards older people can affect their preference for working with them. One of the most common instruments used to assess these attitudes is the Kogan Attitude towards Older People scale. Previous validation studies performed on college students internationally have demonstrated good reliability and validity. The psychometric properties of the Italian version have not yet been tested. Design. A cross-sectional, descriptive study. Method. The study was conducted from March-June 2010 with a convenience sample of nursing students attending two Italian universities. Reliability was evaluated using internal consistency and item-to-total correlation. Content and construct validity were evaluated using a content validity index and principal factor analysis. Results. A total of 1637 nursing students participated in the study. Two factors were extracted from the factor analysis: prejudice describing a negative disposition and appreciation indicating a favourable feeling and opinion towards older people. Conclusion. The Kogan Attitude towards Older People scale applied to Italian nursing students exhibited good internal consistency. The two-dimensional construct of the scale was congruent with some, but not all, results of previous studies due to methodological differences among the studies. Based on the study findings, the scale can be recommended for future research studies in Italy including use as pre/post-test measurement associated with nursing education programmes. [ABSTRACT FROM AUTHOR]

bhimani r.h., mc alpine c.p. & henly s.j. ( 2012) Understanding spasticity from patients' perspectives over time. Journal of Advanced Nursing 68(11), 2504-2514. Abstract Aim. The purpose of this paper was to report patients' understanding and perceptions of personal spasticity experiences over time. Background. Spasticity is an unpleasant and poorly understood experience associated with upper motor neuron disease. Design. An original qualitative study was conducted in 2008-2009. Method. Content analysis was used to extract meaning from the responses of 23 patients to semi-structured interviews during 7 days of acute rehabilitation for neurological diseases associated with spasticity. Findings. Patients used words reflecting muscle tone and spasms to describe spasticity. Themes reflecting the spasticity experience over time were Ambiguous Experiences, Navigating Symptom Experience, Wounded Self, and Unending Journey. Conclusion. Spasticity as experienced is complex, involving a wide range of unusual sensations sensitive to stressors in everyday life. Clinical evaluation of spasticity should include patient reports. Knowledge about patient word choice used to describe spasticity can enhance communication with healthcare providers. [ABSTRACT FROM AUTHOR]

beech n., arber a. & faithfull s. (2011) Restoring a sense of wellness following colorectal cancer: a grounded theory. Journal of Advanced Nursing 68(5), 1134-1144. Abstract Aim. This paper reports a study to develop a grounded theory to explain the experience of recovery following surgery for colorectal cancer. Background. Studies have adopted a biomedical framework to measure quality of life and symptom distress following surgery for colorectal cancer. These studies suggest that symptoms of pain, insomnia and fatigue, may persist for many months following treatment. Fewer studies have considered the individual's experiences and perspective of the emotional, social and cultural aspects of recovery. Methods. A longitudinal study using grounded theory was conducted with 12 individuals, who had received surgery for colorectal cancer. Semi-structured interviews were conducted at four time points over 1 year following surgery, between 2007 and 2009. Grounded theory analysis was undertaken using Strauss and Corbin's framework. Findings. Recovery is described in three phases: disrupting the self; repairing the self; restoring the self. The core category is Restoring a sense of wellness; fostered through awareness and enjoyment of the physical, emotional, spiritual and social aspects of life. A sense of wellness exists as a duality with a sense of illness, where both perspectives may co-exist but one usually takes precedence. A sense of illness pervades when the individual is preoccupied with illness and the illness continues to disrupt their daily life. Conclusion. Recovery takes time and energy, particularly when the individual is at home and in relative isolation from health professionals. Opportunities exist for nurses to provide information and support to facilitate the individual in their progress towards achieving a sense of wellness. [ABSTRACT FROM AUTHOR]

burström m., brännström m., boman k. & strandberg g. (2011) Life experiences of security and insecurity among women with chronic heart failure. Journal of Advanced Nursing 68(4), 816-825. Abstract Aim. This paper is a report of a study illuminating women's experiences of living with chronic heart failure with a focus on feelings of security and insecurity. Background. To be secure is a basic human need. Although feelings of being insecure has been found to be a common problem among people who live with chronic heart failure few qualitative studies, particularly among women, have been carried out in the field. Method. Eight women took part in focus group interviews during 2006. The data were analysed using qualitative content analysis. Findings. The women's feelings of security include acceptance of the past, everyday life and the future, trusting the self and the body despite the disease, not having to deal with dependency alone, and faith in care and treatment. The women's feelings of insecurity include feeling guilty for being sick and incapacitated, fear of living with a frail and failing body, anxiety about growing dependence on others, loneliness and death and lack of faith in care and treatment. Conclusion. The outlook on the past, the present and the view about the future, can be fundamental for the quality of life, and the sense of security and insecurity among women living with chronic heart failure. To support a sense of security it seems essential that nursing staff attempt to understand the women's outlook on life and their personal interpretations of living with chronic heart failure. This can be crucial for enhancing feelings of security in daily life for these women. [ABSTRACT FROM AUTHOR]

kennedy f., harcourt d. & rumsey n. (2011) The shifting nature of women's experiences and perceptions of ductal carcinoma in situ. Journal of Advanced Nursing 68(4), 856-867. Abstract Aim. This paper is a report of a descriptive qualitative study of the evolution of women's perceptions and experiences of ductal carcinoma in situ from the period near to diagnosis to 1 year later. Background. Ductal carcinoma in situ is a non-invasive breast condition where cancer cells are detected but confined to the ducts of the breast. With treatment, the condition has a positive prognosis but ironically patients undergo treatment similar to that for invasive breast cancer. There is a lack of longitudinal qualitative research studying women's experiences of ductal carcinoma in situ, especially among newly diagnosed patients, and how experiences change over time. Methods. Forty-five women took part in an initial interview following a diagnosis of ductal carcinoma in situ and 27 took part in a follow-up interview 9-13 months later. Data were collected between January 2007 and October 2008. Transcripts were analysed using a hybrid approach to thematic analysis. Findings. Women's early perceptions of ductal carcinoma in situ merged and sometimes conflicted with their lay beliefs of breast cancer. Perceptions and experiences of the condition shifted over time. These overriding aspects were evident in four themes identified across the interviews: (i) perceptions of ductal carcinoma in situ vs. breast cancer, (ii) from paradox to acceptance, (iii) personal impact, and (iv) support and interactions with others. Conclusion. This study represents one of the few longitudinal qualitative studies with newly diagnosed patients, capturing women's initial and shifting experiences and perceptions of the condition. The issues identified need to be recognized in clinical practice and supported appropriately. [ABSTRACT FROM AUTHOR]

saarnio l., arman m. & ekstrand p. (2012) Power relations in patient′s experiences of suffering during treatment for cancer. Journal of Advanced Nursing 68(2), 271-279. Abstract Aim. This paper is a report of how patients who have cancer experience suffering in the context of power relations. Background. Many studies in Sweden and in other countries have detected inequality in healthcare use and resources, including unseen influences that can be connected to gender and distribution of resources. Few studies have examined how multiple relations of power - such as gender, ethnicity, age and education - influence how people with cancer experience suffering during treatment. Method. A hermeneutic design was used. Qualitative interviews were conducted with 12 women and 14 men receiving treatment for a variety of cancer diagnoses. The data collection was done at two hospitals in Sweden during 2008-2009. The interpretation of data was based on two theoretical perspectives - suffering and intersectionality. Results. The results highlight patients suffering where two or more positions of power relations interacted with each other. Three main themes were identified: the complexity of control, the vulnerable effects of body changes, and the internal battle of survival. Conclusion. A vulnerable social situation for people with cancer concretely increased their suffering. Social inequalities, seemingly linked to social hierarchy, increased the suffering of people with cancer. For example, women with cancer with a low education belonging to an ethnic minority suffered more than highly educated patients belonging to the ethnic majority. [ABSTRACT FROM AUTHOR]

zeng y.c., liu x. & loke a.y. (2012) Addressing sexuality issues of women with gynaecological cancer: Chinese nurses' attitudes and practice. Journal of Advanced Nursing 68(2), 280-292. Abstract Aim. This paper reports a study conducted to describe Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. Background. Women with gynaecological cancer face numerous challenges to their sexuality. The importance of addressing sexuality concerns of people with cancer is emphasized by a growing body of literature in Western countries. Methods. This is a descriptive and correlational study. An inventory was adopted to explore Chinese nurses' attitudes and practice related to sexuality care in nursing. Data were collected from December 2009 to February 2010. Results. A sample of 202 nurses working in gynaecological units in China was recruited. Study results revealed that the majority (77·7%) held the attitude that 'sexuality is too private an issue to discuss with patients'. Only 34·2%'make time to discuss sexual concerns with patients'. Regression analysis revealed that nurse' marital status and hospital type in which they were working influenced their practice in sexuality care. Nurses' conservative attitudes towards sexuality, their prejudices about gynaecological cancer, the lack of availability of private environment, the lack of sexuality care training and the failure to include sexuality care in routine nursing care, were found to be factors that significantly influenced sexual care and nursing practice (adjusted R2 = 0·542, P < 0·001). Conclusions. The study findings contribute to the understanding of Chinese nurses' attitudes and practice in addressing the sexuality concerns of people with gynaecological cancer. There is a need to increase Chinese nurses' awareness of their roles and the importance of equipping themselves with relevant skills in sexuality care in nursing practice. [ABSTRACT FROM AUTHOR]

roy d.e. & giddings l.s. (2012) The experiences of women (65-74 years) living with a long-term condition in the shadow of ageing. Journal of Advanced Nursing 68(1), 181-190. Abstract Aims. This paper reports on a study that explored experiences of women (65-74 years) as they grow older while living with a long-term condition. The phenomenon of focus was 'ageing with a long-term condition', rather than the experience of developing a long-term condition after reaching older adulthood. Background. People with long-term conditions are living into older age. There is limited literature on the nexus of ageing with a long-term condition. It is known that ageing shapes and is shaped by women's experiences of living with a long-term condition. Methods. In this interpretive descriptive study, nine women participated in a series of three focus groups held in 2007 and 2008. Transcripts were analysed thematically and participants given the opportunity to respond to the analysis. Findings. 'In the shadow of ageing' was the overarching theme. The women reported that although their long-term condition remained the referent point in their daily lives, for others including health professionals, the focus was on their appearance and the effects of older age. To overcome the back-grounding of their long-term condition, the women used 'strategies already-in-place'; it became 'just another thing to deal with'. Ageing, however, remained 'a privilege'. Conclusion. If health professionals focus on age and its concomitant effects, rather than a woman's long-term condition, they are at risk of delivering inappropriate care. They need to be prepared to advocate for the special needs of older women who live with a long-term condition and remain cognizant of the women's resourcefulness and expertise developed over time. [ABSTRACT FROM AUTHOR]

mccloud c., harrington a. & king l. (2012) Understanding people's experience of vitreo-retinal day surgery: a Gadamerian guided study. Journal of Advanced Nursing 68(1), 94-103. Abstract Aim. This paper is a report of a study that aimed to understand the individual's experience of day surgery for repair of vitreo-retinal pathology. Background. Day surgery evolved as a global phenomenon in response to tensions existing between community demand for health-care services and fiscal limitations. Since then vitreo-retinal surgery has been routinely performed as day surgery. Whilst studies have reported on patients' experience's following inpatient surgery, there has been limited investigation of vitreo-retinal day surgery from the patient's perspective. Methods. In-depth unstructured interviews with 18 people were conducted between July 2006 and December 2007. Data analysis using philosophical hermeneutic techniques enabled a co-constructed understanding, where, the 'conditions of understanding' as described by Gadamer were established. Findings. Guided by a Gadamerian approach to analysis, four constitutive themes were identified: 'the physical Self', 'the psychological Self', 'the historically located Self' and 'the Self located in the community'. Within each theme the participant's positive and negative experiences were understood in the context of human need, and gaps in nursing care became illuminated. These experiences included: pain, nausea, problematic self-care and psychological angst. Conclusion. Insights into the experience of vitreo-retinal day surgery, gained from this study can be used to inform nurses planning care for people with vitreo-retinal pathology. Nursing care must address broader patient needs that span multiple human domains, particularly when vision has been threatened by complex pathology. [ABSTRACT FROM AUTHOR]

dickinson t. & hurley m. (2012) Exploring the antipathy of nursing staff who work within secure healthcare facilities across the United Kingdom to young people who self-harm. Journal of Advanced Nursing 68(1), 147-158. Abstract Aims. This paper is a report of a study that compared relevant attitudinal dimensions of Registered Nurses and nursing aides working within a Young Offenders' Institute and two young people's forensic units in the United Kingdom towards young people in their care who self-harm. Background. Nurses caring for young people within secure environments may engage at some point with patients who harm themselves. These staff often experience strong negative emotional reactions which can lead to antipathy and alienation. Methods. Forty seven Registered Nurses and 22 nursing aides completed the Self-Harm Antipathy Scale, which consists of 30 attitudinal self-report items. The data were collected between June 2008 and December 2008, and analysed using spss version 17. Results. Results displayed that age per se, length of service with self-harming clients, and whether the participant was a Registered Nurse or nursing aide, and number of self-harming clients worked with did not influence the Self-Harm Antipathy Scale score or any of its component sub-scores. However, field of nursing the nurse was registered under, previous study of self-harm, year first registered and gender showed significant effects. Conclusions. Given that responses reflect a degree of both empathy and apathy it seems that there is a need to promote greater therapeutic alliances and communication; for example, the use of positive regard to help reduce the incidence of labelling and the negative effects this has upon relationships. There is a significant need for nursing staff working with young people who self-harm to have access to relevant educational programmes. A focus on harm minimization could be key areas for further development. [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]

wang j.-j. (2011) A structural model of the bio-psycho-socio-spiritual factors influencing the development towards gerotranscendence in a sample of institutionalized elders. Journal of Advanced Nursing 67(12), 2628-2636. Abstract Aims. This paper is a report of a study to determine the bio-psycho-socio-spiritual factors influencing the development towards gerotranscendence in institutionalized older people. Physical ability, depressive symptoms, social network support, meaning of life and life satisfaction were examined through a Structured Equation Modelling approach. Background. Older people's pursuit of gerotranscendence is believed to facilitate successful ageing and late-life growth. Although a few Scandinavian studies have identified the relationship between psychosocial factors and the development of gerotranscendence, there is little trans-cultural study of the model, which limits the ability of the gerotranscendence theory to be applied worldwide. Methods. Cognitively intact older residents ( N = 195) from six long-term care facilities in southern Taiwan participated in a structured interview using the Gerotranscendence scale, Barthel's Index, the Geriatric Depression Scale short form, the Inventory of Socially supportive Behaviour, the Life Meaning scale, and the Life Satisfaction scale. Data were collected over a 6-month period in 2008. Results. The model-fit indexes of the final model (χ2 = 32·08, d.f. = 14, P = 0·004; CMIN/d.f. = 2·29; GFI = 0·97, AGFI = 0·89, TLI = 0·94, NFI = 0·96) exceeded acceptable levels except for χ2. In the final model, social support, life satisfaction and meaning of life had direct effects on gerotranscendence (standardized regression weight 0·54, 0·43, and 0·76). Conclusion. The gerotranscendence model of healthy ageing is congruent in the Taiwanese population. Findings of this study can guide nursing and other health professionals in planning implementation of best practice in older people's care. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study identifying and describing the essences of patients' experience during the period leading up to the diagnosis of non-Hodgkin lymphoma. Background. Patient and doctor delays occur during diagnosis of non-Hodgkin lymphoma, and families can affect patients' help-seeking behaviours. Current guidelines state the need for immediate referral of patients with suspected non-Hodgkin lymphoma symptoms. Methods. A phenomenological approach was used. A purposive sample of 31 patients diagnosed with non-Hodgkin lymphoma was recruited through a hospital and a support group in the United Kingdom. In-depth interviews were tape-recorded, transcribed and then analysed using Colaizzi's method. Data collection took place over an 18-month period during 2003-2005 and data analysis was completed in 2006. Findings. The overriding theme was: Creating a pathway towards hearing the diagnosis of non-Hodgkin lymphoma. The three themes were as follows: Perceiving individual health and onward movement; Penetrating communication processes and investigations; Advancing towards focusing on the non-Hodgkin lymphoma diagnosis. Patients with non-Hodgkin lymphoma can have a diverse symptom presentation over long periods of time. Their help-seeking behaviours are an interplay of essences, including symptom type, attributions and emotional responses. Patients need tailored information to deal with the uncertainty of their situation at key points during their prediagnosis journey. Conclusion. Nurses should help patients identify and acquire the appropriate information at key points during the diagnosis period as this is a period of great uncertainty. Further research should be conducted into the quality of prediagnosis consultations and the extent to which patients think that their agendums have been met at this time. [ABSTRACT FROM AUTHOR]

sanders c., carter b. & goodacre l. (2011) Searching for harmony: parents' narratives about their child's genital ambiguity and reconstructive genital surgeries in childhood. Journal of Advanced Nursing 67(9), 2220-2230. Abstract Aim. This paper is a report of a narrative study of parents' experiences of their child's genital ambiguity and the place reconstructive surgeries have in their lives. Background. Increasingly, the use of early reconstructive genital surgery has come under criticism. Few studies have explored parents' inclusion in the surgical decision-making process, their experiences of their child's surgeries or of parenting a child born with ambiguous genitalia. Method. Narrative interviews about parents' experiences of having and caring for a child of uncertain gender and their rationale for reconstructive surgeries were conducted with 15 parents between October 2004 and February 2006. Interviews were recorded, transcribed verbatim and analysed in a narrative analysis framework. Results. Narrative analysis resulted in three increasingly contextual and conceptual levels of stories. Connections between stories gave the basis for the synthesis of the data; interpretation identified three elements of shock, protection and anxiety, which influenced the parents. The parents identified the need for early and ongoing support from healthcare professionals. The parents expected professionals to be knowledgeable about the dilemmas surround disorders of sex development and have experience in managing care for themselves and their child. Conclusion. For the parents seeking a sense of harmony between their child's genital ambiguity and gender during childhood was important. Searching for this harmony became a dynamic and evolving process, which was built on their knowledge and increasing willingness to engage with professionals, negotiate their social worlds, emotional responses and belief systems. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of the experiences of children (5-10 years) of procedural pain when they underwent a trauma wound care session. Background. Procedural pain in conjunction with trauma wound care often induces anxiety and distress in children. Children need to alleviate pain and avoid the development of fear in conjunction with examinations and treatments. The nurse could help children to reach this goal by using the comfort theory, which describes holistic nursing in four contexts: physical, psychospiritual, environmental and sociocultural. Few studies have focused on children's experiences of comforting activities in conjunction with trauma wound dressings. Methods. This study was conducted between May 2008 and January 2010. Thirty-nine participants aged 5-10 were consecutively included in this study. The wound care session was standardized for all the participants, and semi-structured qualitative interviews with open-ended questions were conducted with all the children in conjunction with the procedure. All the interviews were transcribed verbatim and analysed with qualitative content analysis. Findings. Four themes were identified: clinical competence, distraction, participation and security. The children were helped to reach comforting activities to enhance pain management. Conclusion. Children require more than just analgesics in wound care. They also need to experience security and participation in this context. When children feel clinical competence in wound care, they trust the nurse to carry out the wound dressing and instead can focus on the distraction that increases their positive outcomes. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study of the experience of living with advanced chronic obstructive pulmonary disease and long-term oxygen therapy when living alone. Background. Chronic obstructive pulmonary disease affects an increasing number of people. Breathlessness, fatigue and dejection are common symptoms during the last years of life. Method. Repeated qualitative interviews with four participants were conducted over an 8-month period in 2008. The data comprised 17 interviews, 15 telephone conversations and various field notes. A phenomenological hermeneutical method was used to interpret the text. Findings. The analysis resulted in two main themes and five sub-themes. The first main theme, Being subordinated to the sick body, implies that the body, assistive devices and entrusting oneself to the hands of others can both extend and restrict the living space. The second main theme, Protecting significant values of identity, encompasses both the struggle to maintain self-image and the awareness of one's own death. Conclusion. Living alone with advanced chronic obstructive pulmonary disease is a challenging and complex phenomenon. The everyday life was characterized by a struggle to keep autonomy during a time of increasing dependency and need for help. A person-centred nursing care, built upon peoples' own experiences, may be one way to promote identity and dignity in patients even when they are close to death. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study that explores and describes the meaning of the phenomenon of health-promoting self-care as experienced by people living with rheumatic diseases. Background. People with rheumatic diseases estimate health status as low and health belief and health status influence self-care behaviours. Several self-care behaviours are used in the efforts to mitigate the diseases. Method. The study had a descriptive phenomenological approach based on a reflective life-world perspective. Data were gathered in 2007 by unstructured open-ended interviews with 12 individuals living with rheumatic diseases. Findings. The meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care takes place against a background of continual hope and belief to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three inter-related constituents elucidated their experiences: dialogue, power struggle and choice. Self-care was experienced as dialogues with the body and with the immediate environment. In order to respond to signals from the body, power struggles were required to be entered into when fighting the diseases. Choices were required to be made and things that were beneficial for the body were prioritized. Conclusion. In this study, the meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care was a way of life. This meant to be ready to understand and respond to signals from the body. Self-care required dialogues, power struggles and choices. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a descriptive comparative pilot study of use of a method that simultaneously tests the content validity and quality of translation of English-to-Chinese translations of two patient satisfaction questionnaires: the La Monica-Oberst Patient Satisfaction Scale and Hospital Consumer Assessment of Healthcare Providers and Systems. Background. Patient satisfaction is an important indicator of the quality of healthcare services. In China, however, few good translations of patient satisfaction instruments sensitive to nursing services exist. Methods. The descriptive pilot study took place in 2009 and used content validity indexing techniques to evaluate the content, context and criterion relevance of a survey question. The expert raters were 10 nursing faculty and 10 patients who evaluated the two patient satisfaction questionnaires. The experts evaluated the relevance of each item on a scale of 1-4 and the research team compared their responses to choose the most appropriate. Only the nurse faculty experts, who were bilingual, evaluated the quality of the translation using a binary rating. Results. The 'Nurse Rater' relevance scores of the LaMonica-Oberst Patient Satisfaction Scale and the Hospital Consumer Assessment of Healthcare Providers and Systems were 0.96 and 0.95 respectively, whereas the patient's overall relevance scores were 0.89 and 0.95. A Mann-Whitney U-test demonstrated that results between the two groups were statistically significantly different (P = 0.0135). Conclusions. Using content validity indexing simultaneously with translation processes was valuable for selecting and evaluating survey instruments in different contexts. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a descriptive study of Chinese abdominal surgical patients' and nurses' perceptions of discharge information needs. Background. Discharge from hospital poses a potential threat to surgical patients' lives because they have to cope in daily life with the consequences of the illness and surgery. Recent studies indicate that nurses often underestimate or inappropriately perceive patients' discharge information needs. Few studies have examined the discharge information needs of patients who have undergone abdominal surgery, and research in Asian populations is particularly scarce. Methods. A descriptive qualitative study was conducted in 2008. Semi-structured interviews were performed with a convenience sample of 16 patients who had undergone an abdominal surgery and their 16 nurses in a regional general hospital in Hong Kong. Results. Results of content analysis indicated that to both the surgical patients and their nurses, three similar categories of information needs on discharge were health concerns upon discharge, addressing patients' information needs, and obstacles that hindered information seeking. Specific needs related to finance, knowledge of illness, psychological support and role of diet and traditional Chinese medicine perceived as important by the patients were underestimated by the surgical nurses and revealed important issues in providing holistic and culture-specific nursing care for surgical patients upon discharge. Conclusion. Surgical patients' information needs on finance, illness condition, psychological support and cultural practices were found not to be accurately and adequately understood by their nurses. Nurses should give culturally specific and appropriate predischarge education in terms of promotion of recovery from surgery, health maintenance practice and psychological support. [ABSTRACT FROM AUTHOR]

Aim. The paper is a report of one aspect of a hermeneutic study of lesbian women's experiences of maternity care, specifically interpretations of negative experiences. Background. There is a growing body of literature in relation to lesbian women's experiences of maternity care. Although most commentators discuss the negative experiences encountered by lesbian mothers, there has been no contextual analysis of these expressions of negativity in an increasingly positive environment. Methods. The study was undertaken using a qualitative approach using an adapted Gadamerian hermeneutic phenomenology using unstructured interviews with eight women. The interviews took place between November 2007 and March 2008. All of the participants had disclosed their sexual orientation in pregnancy. Snowball sampling was used. The data were then analysed using an iterative hermeneutic framework. Findings. The participants not only described their experiences of maternity care as being positive but also offered examples of negative experiences. These were analysed separately to explore the ways in which the women made sense of them in the context of an otherwise positive experience. These experiences were expressed in ways that distanced the negative and that seemed to rationalize behaviour or ascribe it to the health professional. Conclusions. Negative encounters with health professionals are processed by women in a way that protects their overall experience. Health professionals in maternity care should consider the impact of negative responses to lesbian mothers and the effect that it has in reducing the overall quality of this significant life event. [ABSTRACT FROM AUTHOR]

Aim. To explore the life experiences of those living with glaucoma and describe their strategies to deal with the consequences of this disorder. Background. Glaucoma, the second most common cause of worldwide blindness, often imposes limitations on the daily functions of its victims, thus resulting in a decline in their quality of life and high costs in healthcare. Methods. A hermeneutical phenomenological research approach was adopted. Fourteen people with glaucoma were selected for in-depth interviews, and another ten were interviewed in two focus groups. Participants were recruited from a specialized eye hospital in Shanghai. The data were collected from July to September 2009. An interpretive analysis of the data was performed. Findings. The core theme was identified while interpreting the data on the patients' life experiences as 'learning to living with glaucoma' by one of our participants. The meaning of this is demonstrated in four interwoven themes: (1) seeking support; (2) coping with everyday tasks; (3) living with future uncertainties; and (4) adapting to the declined quality of life. Conclusion. This paper provides an insight into the living experiences of the patients with glaucoma using 1-on-1 and focus-group interviews, suggesting that the latter can also offer a means of phenomenological inquiry. We found that those with glaucoma can experience uncertainty surrounding treatment, illness prognosis and family members' risk status. In addition, the Chinese culture can influence the patients' strategies of maintaining a healthy lifestyle. In helping those with glaucoma considerations should be taken towards the feelings of future uncertainty that may develop. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study of the choices patients make when offered home-based or hospital-based cardiac rehabilitation. Background. In some countries, patients may be offered a choice of home-based or hospital-based cardiac rehabilitation. While evaluating a home-based programme, Road to Recovery, developed by the British Heart Foundation, we examined patients' experiences of being offered this choice. Methods. Interviews were conducted with 35 patients and 12 staff members delivering the pilot programme in five rehabilitation services during 2006-2008. Findings. While the staff members interviewed reported that all patients were given a clear choice between a home-based and hospital-based or community-based programme, this choice was less clear-cut in the patient interviews. When choice was offered, the choice of a home-based programme was often based on constraints rather than on being a positive choice. Obstacles patients faced in making the choice included lack of information on which to base a choice; inadequate systems of referral; insufficient appropriately trained staff; restricted choice of times to attend the hospital programmes; the geographical location of services and restrictive socio-economic factors (inflexible working hours, access to transport). Conclusion. The possibility of informed choice relies in the first instance on the availability and accessibility of appropriate services. Nurses need awareness and commitment to finding out about and overcoming obstacles that impede patient participation in cardiac rehabilitation. Only in this manner will it be possible to fulfil the calls in national and some international clinical guidelines for 'individualized' or 'menu-based' programmes tailored to specific patient needs. [ABSTRACT FROM AUTHOR]