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Aims and objectives: This study aimed to measure the frequency of spiritual needs, identify the factors associated with these needs among Korean and American persons living with an advance chronic illness and compare them from a cross‐cultural perspective. Background: Persons with serious or life‐limiting illnesses often have spiritual needs. Unmet spiritual needs are associated with poor well‐being and threaten psychological health. Little is known about how specific spiritual needs vary across cultures. Design: A quantitative, cross‐sectional, observational cross‐cultural comparison was undertaken. Methods: The study has been prepared in accordance with the STROBE guidelines. Convenience sampling was used to recruit participants from outpatient clinics in South Korea and Southern California (N = 202). Spiritual needs were measured using the Spiritual Interests Related to Illness Tool (SpIRIT); demographic and illness‐related variables were also assessed using paper‐and‐pencil questionnaires. Data were analysed using various parametric statistical tests, including multiple regression analysis. Results: The findings quantify the intensity and types of spiritual needs that persons living with an advanced chronic illness experience. Furthermore, they show how the spiritual needs of religiously diverse samples of South Koreans and Americans differ. The findings also indicate that self‐reported spirituality and religiosity independently explain a substantial amount of the variance in spiritual needs. Conclusions: In both the samples, spiritual needs were reported and associated with spirituality and religiosity. Although all the eight domains of spiritual needs assessed by the SpIRIT were pertinent to the Korean and American samples, they were prioritised differently. Relevance to clinical practice: Screening patients to ascertain how important spirituality or religiosity is to them may help clinicians focus their in‐depth assessments on those who report high levels of spirituality or religiosity because these patients may experience the strongest spiritual needs. The SpIRIT shows promise as a measure of diverse spiritual needs. [ABSTRACT FROM AUTHOR]

Aim: To investigate the feasibility and acceptability of the training process, procedures, measures and recruitment strategies necessary for a future investigation to test the reliability and validity of using positivity resonance measures in health care encounters. Background: Although the measurement of positivity resonance is promising, and non‐participant observation is considered effective, their approaches to studying nurse–patient relationships have not been fully explored. Design: A mixed‐methods observational study. Methods: Video recordings of 30 nurse–patient dyads completing telehealth video visit encounters were edited and coded using behavioural indicators of positivity resonance. A post‐visit survey gathered data on the participants' perceptions of positivity resonance and the study procedures. The research team completed memos and procedural logs to provide narrative data on the study's training, coding, recruitment and operational procedures. The study included 33 persons with cancer and 13 oncology nurses engaging in telehealth video visit encounters at an academic oncology ambulatory care center located in the southeastern United States. Results: Study procedures were found to be feasible and acceptable to participants. An adequate sample of participants (N = 46) were enrolled and retained in the study. Interrater reliability, as evidenced by Cohen's weighted kappa, ranged from.575 to.752 and interclass correlation coefficients >.8 were attainable within a reasonable amount of time and with adequate training. Behavioural indicators of positivity resonance were observed in all telehealth visits and reported by the participants in the perceived positivity resonance survey. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided reporting. Conclusions: Designing research around the concept of positivity resonance is an innovative and feasible approach to exploring how rapport is cultivated within nurse–patient relationships. Relevance to Professional Practice: Measuring positivity resonance may hold promise for exploring patient and nurse outcomes including trust, responsiveness, health‐related behaviours, well‐being, resilience and satisfaction. Reporting Method: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided the reporting of results to ensure that adequate details of the study were provided to ensure an accurate and complete report. Patient or Public Contribution: Planning of the research design and study procedures was done in consultation with nurse clinicians with experience with telehealth and managers responsible within the practice setting where the study was conducted. This ensured the study procedures were ethical, safe, secure and did not create unnecessary burden to the study participants. The study included collecting data from nurse and patient participants about the acceptability of the study procedures. [ABSTRACT FROM AUTHOR]

Aim: To determine the association between nurse and institutional characteristics and perceived professional nurse knowledge and self‐efficacy of reporting child abuse and neglect. Design: A sample of N = 166 nurses were recruited to respond to the Reporting of Suspected Child Abuse and Neglect (RSCAN) survey. Methods: A multiple linear regression examined whether nurse characteristics and institutional characteristics were associated with the two RSCAN survey domain scores. Results: Perceived knowledge of a workplace child abuse and neglect protocol was associated with the knowledge subscale. Education and child abuse and neglect expertise were significant predictors of the self‐efficacy subscale. Nurses with a master's or higher degree and those who identified as being either forensic, paediatric or Emergency Department nurses, had less perceived institutional barriers to self‐efficacy of reporting child abuse and neglect. Conclusion: This study provides a preliminary insight into the institutional barriers and facilitators of nurses as child abuse and neglect mandated reporters. Implications for the profession and/or patient care: To encourage innovative education and collaborations to support nurses as fully informed child abuse and neglect mandated reporters. Impact: This research identifies the gaps and facilitators of nurses as child abuse and neglect mandated reporters to inform healthcare professionals and academic institutions on the importance of nurse education and experience in nurse knowledge and self‐efficacy in reporting suspected child abuse and neglect. Reporting methods: The authors of this study have adhered to relevant EQUATOR guidelines: STROBE. Patient or public contribution: There is no patient or public contribution as the study only looked at nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives: To describe the levels of insomnia, fatigue and intershift recovery, and psychological well‐being (burnout, post‐traumatic stress and psychological distress), and to examine differences in these measures based on work‐related characteristics among nursing staff during COVID‐19 pandemic in the United States. Background: The COVID‐19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide. A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic. Design: Cross‐sectional study. Methods: Hospital nurses and nursing assistants (N = 587) were recruited online between May–June 2020. The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery‐15), burnout (Maslach Burnout Inventory‐Human Services Survey), post‐traumatic stress (Short Post‐Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire‐4), and questions on work and demographics. The STROBE checklist was followed for reporting. Results: The sample had subthreshold insomnia, moderate‐to‐high chronic fatigue, high acute fatigue and low‐to‐moderate intershift recovery. The sample experienced increased emotional exhaustion and depersonalisation, increased personal accomplishment, moderate psychological distress and high post‐traumatic stress. Nurses who cared for COVID‐19 patients had significantly scored worse on almost all measures than their co‐workers. Certain factors such as working hours per week and the frequency of 30‐min breaks were significant. Conclusion: Nursing staff experienced poor sleep, fatigue and multiple psychological problems during the COVID‐19 pandemic. Moreover, staff who were involved in the care of COVID‐19 patients, worked more than 40 h per week and skipped 30‐min breaks showed generally worse self‐reported outcomes. Relevance to clinical practice: Nursing administration is recommended to monitor for fatigue and distress on nursing units, re‐visit current scheduling practices, reinforce rest breaks and provide access to mental health and sleep wellness resources with additional support for their front‐line nursing groups. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this study was to report the psychometric properties, including validity and reliability, of the decision fatigue scale (DFS). Background: Decision fatigue may impair nurses' ability to make sound clinical decisions and negatively impact patient care. Given the negative impact of the COVID‐19 pandemic on psychological well‐being and the workplace environment, decision fatigue may be even more apparent among clinical nurses. Valid assessment of this condition among clinical nurses may inform supportive interventions to mitigate the negative sequelae associated with states of decision fatigue. Design: This study was a secondary analysis of a parent study using a cross‐sectional descriptive design. Methods: A convenience sample of 160 staff nurses was recruited online from across the United States. Participants completed a demographic questionnaire and subjective measures of decision fatigue, nursing practice environment scale and traumatic stress. Exploratory factor analysis (EFA), correlation coefficients and internal consistency reliability coefficients were computed to examine the DFS's validity and reliability within this sample. Results: The EFA yielded a single factor, 9‐item version of the DFS. The DFS scores were strongly correlated with traumatic stress and moderately correlated with the nursing practice environment, and the scale displayed appropriate internal consistency. Conclusions: This is the first known study to provide evidence of the DFS's validity and reliability in a sample of registered nurses working during the COVID‐19 pandemic. The results of this study provide evidence of a reliable and valid assessment instrument for decision fatigue that can be used to measure the burden of decision‐making among registered nurses. Relevance to clinical practice: Given the relationship between traumatic stress and the nursing work environment, decision fatigue may be a modifiable target for interventions that can enhance the quality of decision‐making among clinical nurses. [ABSTRACT FROM AUTHOR]

Aims: To describe beginning nursing student learning styles and to determine whether there are relationships between learning style and sociodemographic or educational background. We also aim to compare these data with the normative values of the 3.1 version of the Kolb learning style inventory and verify its reliability. Background/Literature: Learning style is related to the way in which an individual interacts with learning conditions, involving cognitive, affective, physical and environmental aspects. In nursing education, few studies have focused on knowing the learning styles of beginning nursing students, despite the need for students to develop critical thinking skills required of nurses. Design: Descriptive, cross‐sectional, correlational, multi‐site study. Method: The study took place at five universities in Brazil and one university in the United States. Data were collected from a sample of beginning nursing students (n = 176) in 2019, using the Portuguese and English 3.1 versions of Kolb's learning style inventory. Results: Most students' learning styles were classified as divergers (34.10%), while 28.41% were assimilators, 23.86% were accommodators and 13.63% were convergers. Kolb describes learning as a four‐stage cyclical process grounded in experience. The mean score of one learning stage, the concrete experience, showed those who attended public high schools compared with private high schools was higher (mean = 26.22; p =.0019), and there were different results between Brazilian state universities, Brazilian federal universities and the American university (p =.0149). Conclusion: The diverger style was the most common among beginning nursing students in Brazil and the United States. There was a significant relationship between learning style, the educational background of students, the type of institution they attend and their previous experience with some active learning methodologies. Relevance to clinical practice: Aligned with Kolb's experiential learning theory, nurse educators must be aware of student learning styles so they may use teaching strategies to meet their students' needs. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine the feasibility of a culturally tailored education programme for Haitian immigrants diagnosed with hypertension. Background: Hypertension is a major public health problem, impacting more than 26% of the global population. The overall prevalence of hypertension is 45.4% in the United States with nearly 80,000 deaths due to hypertension in 2015. African Americans and other Black populations living in the U.S. are disproportionally affected by hypertension. Design: Pre‐test and post‐test feasibility study. Methods: A convenience sample of forty‐four participants who identified as Haitian immigrants was enrolled in this evidence‐based education programme. The intervention included culturally tailored education focused on improving knowledge, medication adherence and blood pressure. Outcomes were measured using the Hill‐Bone Medication Adherence Scale and Hypertension Knowledge Test. The SQUIRE 2.0 guidelines were used for reporting outcomes. Results: Of the participants that completed the study (N=42), the mean age was 61.95 (± 9.75) years and 59% were female. Baseline systolic and diastolic blood pressures were 143 (±18.15) and 85 (±7.23), respectively. Six weeks after the intervention, there was a significant decrease in mean systolic, 126 (±12.07) and diastolic 78.50 (± 7.23) blood pressures. An increase in medication adherence and hypertension knowledge was also noted at the six‐week follow‐up period. Conclusion: The feasibility of healthcare provider implementation of a culturally tailored intervention to manage hypertension has been demonstrated. However, future research is warranted to gain a more in‐depth understanding of how to approach hypertension management among Haitians and other Black immigrant communities. Relevance to clinical practice: Advanced practice nurses are uniquely qualified to implement evidence‐based programmes that improve patient knowledge and adherence to hypertension management. Through tailoring and adopting an evidence‐based methods for educating patients about medication adherence and adequate blood pressure management, there is a potential to see improvements in patient outcomes. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand how pain affects physical and mental health‐related quality of life during the third trimester of pregnancy. Background: Poor health‐related quality of life during pregnancy is associated with adverse maternal foetal health outcomes such as increased risk of low‐birth‐weight neonates. Poor health‐related quality of life is linked to pain, pain interference and anxiety in the general adult population. However, we do not know how pain, pain interference (i.e., interference of pain with patient function), and anxiety are interrelated during the third trimester of pregnancy. Methods: This exploratory cross‐sectional study followed STROBE guidelines. A mobile educational and tracking pregnancy application was used to obtain a racially/ethnically diverse convenience sample of 141 third trimester pregnant women from the U. S. In this sample, 58.2% of women had commercial health insurance, 68.8% were Caucasian, 86.5% were younger than 35 years, and 85.1% had a partner. Women completed demographics, Edinburgh Postnatal Depression Scale and the Brief Pain Inventory on REDCap. Path analysis was used to investigate a model for the relationships among pain intensity, pain interference, anxiety and physical and mental health‐related quality of life. Results: Pain intensity affected health‐related quality of life indirectly by increasing pain interference, which in turn, decreased both physical and mental health‐related quality of life. In addition, pain interference also increased anxiety, which in turn worsened mental health‐related quality of life, but not physical health‐related quality of life. Conclusions: Treating perinatal pain may improve health‐related quality of life by decreasing pain interference and anxiety. Relevance to clinical practice: Nurses should assess for pain interference and anxiety in women experiencing moderate to severe pain during the third trimester of pregnancy. With this knowledge, nurses may advocate for women in receiving effective treatment for their conditions and improvements in their physical and mental health‐related quality of life. [ABSTRACT FROM AUTHOR]

Aims and objectives: The current study surveyed nurse practice patterns for performing swallowing screens in an academic cardiac intensive care unit (ICU). It aimed to index: training and levels of confidence in conducting dysphagia screens; screening methods employed; timing and frequency of implement; and subsequent plan of care in identified high‐risk patients. Background: Swallowing impairment (dysphagia) is common following cardiac surgery and associated with significant morbidity and mortality. Early and accurate detection of dysphagia is therefore critical to afford implementation of interventions to optimise patient care. Currently, no validated instruments or guidelines exist for nursing screening of dysphagia in this setting. Methods: An anonymous and voluntary 10‐item mixed‐methods online survey was conducted using Qualtrics software. Nonprobability purposive sampling was utilised to recruit nurses working in an academic 24‐bed cardiac ICU. Thematic analysis using operationally defined coding, SRQR checklist and descriptive statistics were employed. Results: Sixty‐nine nurses completed the survey during a 1‐month period, representing an 84% response rate. Formal training in performing swallowing screens was reported in 18.6% of nurses. In rank order, reported level of confidence was the following: "moderately" (49%); "somewhat" (35%); "not" (13%); and "very" (3%). The majority of nurses performed screens within 1 hr (40.6%) or between 1–4 hr (43.8%) of extubation. Fifteen different methods were utilised to screen swallowing function by nurses who reported a total of 31 different clinical signs indicative of dysphagia. Conclusions: Survey data of practicing nurses in an academic cardiac ICU revealed limited formal training in swallowing screening methodology, a high degree of variability in screening methods employed and low levels of agreement for dysphagia signs. Relevance to clinical practice: Data highlight a knowledge gap and need for the development of formal education and validated rapid nursing dysphagia screening tools for standardised implementation in the cardiac surgery ICU setting. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study sought to understand the experience of living with cystic fibrosis (CF) as an adult. Background: Cystic fibrosis is one of the most difficult chronic diseases to manage long term because of numerous challenges faced on a day‐to‐day basis. The majority of studies focus on improving symptom response to new treatment regimens with the hope of prolonging life. Yet few qualitative studies explore the experience of adults with CF. What is missing from the current literature are the voices of people living with CF, especially as they age. Design: This study follows a hermeneutic phenomenology design guided by Martin Heidegger's philosophy. Methods: Semi‐structured interviews were conducted with nine adults living with CF. Hermeneutic phenomenology guided the data interpretation. This manuscript follows COREQ reporting guidelines. Results: Hermeneutic analysis revealed the overarching theme The Dance of Cystic Fibrosis which is supported by five themes: (a) the paradox of control, (b) living deaths, (c) dancing with death, (d) relearning to dance, and (e) role of the dance partner. Conclusions: The experience of living with CF as an adult is multidimensional and unique to each person. Despite the uniqueness, there is a shared experience that manifested as The Dance of Cystic Fibrosis. As life expectancy continues to increase for persons with CF, it is essential that researchers and healthcare professionals intentionally consider the life‐prolonging effects of the treatment regimen alongside the persons' experience with those effects. Relevance to clinical practice: Nurses at all levels of practice should be prepared to address the multifaceted experience of living with CF through thoughtful incorporation of open‐ended questions. This allows patients to share their experience with nurses, augmenting their practice of delivering holistic care. [ABSTRACT FROM AUTHOR]

Aim and objective: To describe factors associated with father involvement in the neonatal intensive care unit using the Heuristic model of the dynamic of parental behaviour and influence on children over time. Background: Research shows that infants with involved fathers have better cognitive development, fewer crying episodes after caesarean birth, improved breastfeeding exclusivity and duration, and more regular sleep patterns. Preterm infants with involved fathers have improved cognitive development. Design: This cross‐sectional exploratory study used survey methodology to explore factors associated with father involvement in the neonatal intensive care unit. Methods: The STROBE checklist for cross‐sectional studies was used (see Appendix S2). Biological fathers of infants in a 97‐bed neonatal intensive care unit in the southern USA completed a survey which asked about their involvement with their hospitalised infants and factors which affected that involvement. Eighty fathers completed the survey. Results: Age ranged between 20–53 with 43% first‐time fathers. Compared to less involved fathers, fathers who were more involved were younger, married or living with the mother, performed kangaroo care or fathers of multiple gestation. Fathers who had attended the delivery were more likely to bathe their infants than those who had not attended the delivery and fathers who performed kangaroo care felt more confident than those who did not. Compared to fathers who visited less often, fathers who visited more often were younger, had infants with a shorter hospitalisation time and lower acuity, and had fewer children in the family. Conclusions: Fathers are involved with their neonatal intensive care unit infants in many ways. Factors were identified that affect involvement in the neonatal intensive care unit. Relevance to clinical practice: Results can help nurses in neonatal intensive care units worldwide facilitate father–infant interaction, identify fathers at risk for decreased involvement and advocate for institutional policy development for supporting neonatal intensive care unit father involvement. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore staff nurses' discourses of workplace bullying, to critically examine how these discourses affect their responses to bullying. Background: Workplace bullying has been identified as a pervasive problem within the nursing profession. Efforts to eradicate workplace bullying need to involve staff—targets as well as bystanders. By understanding how this population conceptualises workplace bullying, more effective and targeted solutions to the problem can be devised. Design: This qualitative study used a critical discourse analysis method which was based on the work of Foucault. Methods: Thirteen staff nurses who worked in a variety of settings in the USA were interviewed. COREQ checklist was used for this article. Results: Three interrelated discursive strands were identified: "biased behaviour manifested as workplace bullying, workplace bullying disguised as performance review and workplace bullying as entrenched behaviour in nursing". Actions in response to bullying varied according to which discursive strand was invoked. Conclusions: The central theme at the intersection of the discursive strands was that workplace bullying is a mechanism for driving out nurses who are different. Relevance to clinical practice: Efforts to address workplace bullying among nurses need to include training on legitimate methods of performance review, workshops on how to interact with diverse co‐workers, and examination of how practices with nursing education contribute to the perpetuation of bullying in clinical settings. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore Somali Bantu refugee women's reproductive health decision‐making, as influenced by their resettlement in the USA. Background: Available literature on reproductive health of refugee women is mostly from the healthcare provider perspective, neglecting the lived experience of the population. Design: Qualitative descriptive. Methods: A purposive sample of 30 women was recruited for five focus groups. Data were collected via demographic survey and semi‐structured focus group discussion. Content analysis was used to analyse the data. Results: Our study revealed that Somali Bantu women considered children as wealth. Reproductive health decision‐making was influenced by three main factors: family influence, cultural/religious ideas and experience with various hormonal birth control methods. Conclusions: Nurses and other healthcare providers would better serve refugee women if equipped with a more nuanced understanding of factors in their reproductive healthcare decision‐making. This study can inform tailored and cultural relevant interventions to improve reproductive health among those at greatest need. Relevance to clinical practice: Our findings can serve to guide nurses and other healthcare providers' clinical approach to a subset of the population whose cultural beliefs and practices regarding reproductive health may be unfamiliar. Incorporating the perspective of the Somali Bantu women will facilitate the provision of person‐centred care and ensure women receive appropriate, efficient and quality care that meets their needs, which may potentially reduce financial costs to the healthcare system. [ABSTRACT FROM AUTHOR]

Aims and objectives Explore different methods by which intimate partner violence screening practices are implemented in clinic and emergency settings and better understand barriers and facilitators. Background Healthcare visits provide an opportunity for providers to identify and provide assistance to victims of intimate partner violence. However, wide variation exists in the implementation of screening and response protocols. In addition, providers experience barriers and facilitators to intimate partner violence screening and response. A comprehensive understanding of these factors is necessary to improve the role that providers play in detection and intervention of intimate partner violence. Design Qualitative descriptive research design. Methods Sixteen healthcare facilities were recruited from a large metropolitan area in the USA. Data were collected through semi-structured, in-depth interviews with individuals knowledgeable about intimate partner violence screening and response within their facility. Data were analysed using directive content analysis. Results Major themes and patterns concerning intimate partner violence screening and response were identified within the following areas: procedural characteristics, barriers, facilitators and additional needs. Patient-provider communication and operational/facility characteristics emerged as critical aspects that impact the successful implementation of intimate partner violence screening and response programmes. Differences were found between clinic and emergency settings stemming from variations in health delivery models. Conclusions Results provide important information on how healthcare facilities implement intimate partner violence screening and response, suggestions for practice improvement and directions for future interventions. Additional guidance is needed to ensure intimate partner violence identification, and response procedures are effective and tailored to needs of patients, providers and the facility. Relevance to clinical practice Nurses are in a strategic position to play a pivotal role in identification of and response to intimate partner violence. It is essential that nurses are cognizant of this, and understand the actions they can take to assist patients who have been victims of intimate partner violence. Recommendations on how to do this are provided. [ABSTRACT FROM AUTHOR]

Aims and objectives To examine and describe the transition process of military nurses from military nursing practice to civilian nursing practice. A second aim was to identify challenges and facilitators to this transition. Background Serving in the military, and embodying its values, can have a major impact on a person's worldview. These individuals serve not only as nurses but also as part of a larger military culture with a mission to protect. The decision to separate from the military and transition into the civilian workforce carries many challenges capable of influencing nurses' personal and professional identities. Design Qualitative descriptive. Methods Semi-structured interviews of 10 nurse veterans were conducted in 2015-2016. Data were collected until saturation was reached. Results The transition includes four major phases from military to civilian nurse: Separating from Military Life, Conflict and Chaos, Shifting Sands and Personal and Professional Reconstruction. Duration and progress through each phase varied slightly for individual nurses. Conclusions Both work-role and personal identity transition occur when a nurse leaves the military and enters civilian practice. Military and civilian organisations, in both the USA and other countries, can implement supports to aid these nurses during this personal and professional change. Recommendations from the study group are provided. Relevance to clinical practice The global nursing profession, as well as healthcare organisations that employ nurse veterans, has a commitment and obligation to understand the transition process of nurses who practise within the scope of military nursing and later in civilian nursing environments so that they may be supported and used to the extent of their prior experience. Lessons learned and advice from this group of nurses may positively aid others in their transition experience. [ABSTRACT FROM AUTHOR]

Aims and objectives The purposes of this study were to measure the prevalence of, and identify factors associated with, cervical cancer screening among a sample of lesbian, bisexual and queer women, and transgender men. Background Past research has found that lesbian, bisexual and queer women underuse cervical screening service. Because deficient screening remains the most significant risk factor for cervical cancer, it is essential to understand the differences between routine and nonroutine screeners. Design A convergent-parallel mixed methods design. Methods A convenience sample of 21- to 65-year-old lesbian and bisexual women and transgender men were recruited in the USA from August-December 2014. Quantitative data were collected via a 48-item Internet questionnaire ( N = 226), and qualitative data were collected through in-depth telephone interviews ( N = 20) and open-ended questions on the Internet questionnaire. Results Seventy-three per cent of the sample was routine cervical screeners. The results showed that a constellation of factors influence the use of cervical cancer screening among lesbian, bisexual and queer women. Some of those factors overlap with the general female population, whereas others are specific to the lesbian, bisexual or queer identity. Routine screeners reported feeling more welcome in the health care setting, while nonroutine screeners reported more discrimination related to their sexual orientation and gender expression. Routine screeners were also more likely to 'out' to their provider. The quantitative and qualitative factors were also compared and contrasted. Conclusions Many of the factors identified in this study to influence cervical cancer screening relate to the health care environment and to interactions between the patient and provider. Relevance to clinical practice Nurses should be involved with creating welcoming environments for lesbian, bisexual and queer women and their partners. Moreover, nurses play a large role in patient education and should promote self-care behaviours among lesbian women and transgender men. [ABSTRACT FROM AUTHOR]

Aims and objectives. To determine, from a systematic literature review, the experience of living with heart failure and to propose some practice guidelines and research questions. Background. Chronic heart failure has been one of the fastest growing illnesses in recent decades, with almost 23 million people affected worldwide. This complex syndrome has multiple causes and appears when underlying heart disease is advanced. Currently, heart failure has no cure and leads to a significant deterioration in patients' quality of life. Design. Qualitative meta-synthesis. Methods. A qualitative meta-synthesis was conducted to extract and analyse qualitative research from the Cochrane, PubMed, CINAHL, PsycINFO, Web of Science and Cuiden databases. Snowball sampling and a manual search were performed to identify other relevant studies. Results. Twenty-five qualitative studies were selected. The findings indicate that there are three main themes that describe the phenomenon. The first theme refers to the experiences related to the beginning of the process. The second theme is connected with the effects on the person: physical, emotional, social and spiritual changes. The third theme is linked with how to live with heart failure despite the illness, including the adjustment and coping process and how external resources can help them to manage. Conclusions. Heart failure has a major impact on the entire person, but some areas have not been addressed. By creating new tools to understand and evaluate the impact of this illness and interventions that prevent or improve some situations, we can promote the well-being and the quality of life of this population. Relevance to clinical practice. Nurses must have a personal knowledge of the experiences and needs of the patients. To do this, nurses should create care environments that promote an exchange of experiences and knowledge between the nurse and the patient and family. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aims to provide insight into key factors from a clinician's perspective that influence uninterrupted early skin-to-skin contact after vaginal and caesarean delivery of healthy full-term infants. Background Early skin-to-skin contact of healthy full-term infants ideally begins immediately after birth and continues for the first hour or the first breastfeed as recommended by the Baby Friendly Hospital Initiative. However, adoption of early skin-to-skin contact is low in many settings and the barriers that hinder its universal use are not well understood. Design An exploratory qualitative research design using semi-structured interviews. Methods Eleven clinicians were interviewed, including five registered nurses and one medical doctor from the obstetrics and gynaecology unit as well as four registered nurses and one medical doctor from the neonatal intensive care unit. Core topics that were discussed included perceptions on early skin-to-skin contact and facilitating factors and barriers to early skin-to-skin contact after vaginal and caesarean delivery. Interview sessions were recorded, transcribed and analysed using a thematic analysis approach. A coding framework was developed from which subthemes emerged. The overall themes were adopted from Lee et al.'s thematic framework to categorise factors into institutional, familial-level and implementation factors. Findings Critical institutional factors included inadequate staffing and education of clinicians on early skin-to-skin contact. On a familial level, parental education and motivation were identified as important factors. Barriers to implementation included the absence of a clinical algorithm and unclear definitions for eligible mothers and infants. Conclusions Various facilitating factors and barriers to early skin-to-skin contact of healthy full-term infants born via vaginal and caesarean delivery were identified. Relevance to clinical practice Addressing these factors can help to provide a better understanding of clinician perspectives on early skin-to-skin contact and help guide its implementation as standard of care for healthy full-term infants. [ABSTRACT FROM AUTHOR]

Aims and objectives. The aim of this investigation was to evaluate, monitor and manage the quality of projects conducted and work produced as evidence of scholarship upon completion of Doctor of Nursing Practice education. Background. The Doctor of Nursing Practice is a relatively new degree which prepares nurses for high impact careers in diverse practice settings around the globe. Considerable variation characterises curricula across schools preparing Doctors of Nursing Practice. Accreditation assures curricula are focused on attainment of the Doctor of Nursing Practice essentials, yet outcomes have not been reported to help educators engage in programme improvement. This work has implications for nursing globally because translating strong evidence into practice is key to improving outcomes in direct care, leadership, management and education. The Doctor of Nursing Practice student learns to accomplish translation through the conduct of projects. Evaluating the rigour and results of these projects is essential to improving the quality, safety and efficacy of translation, improvements in care and overall system performance. Design. A descriptive study was conducted to evaluate the scholarly products of Doctor of Nursing Practice education in one programme across four graduating classes. Methods. A total of 80 projects, conducted across the USA and around the globe, are described using a modification of the Uncertainty, Pace, Complexity Model. Results. The per cent of students considered to have produced high quality work in relation to target expectations as well as the per cent that conducted means testing increased over the four study years. Conclusions. Evaluation of scope, complexity and rigour of scholarly work products has driven improvements in the curriculum and informed the work of faculty and advisors. Relevance to clinical practice. Methods, evaluation and outcomes conformed around a set of expectations for scholarship and rigour have resulted in measurable outcomes, and quality publications have increased over time. [ABSTRACT FROM AUTHOR]

To measure the predictability of cultural orientation on organisational commitment, perception of practice environment and intention to leave amongst Asian nurses working in US hospitals. To alleviate the nursing shortage, healthcare institutions have increased recruitment of nurses internationally, with Asian nurses representing the largest proportion of international nurses working in the US. Whilst organisational commitment and perception of practice environment were related to intention to leave, few studies have been done on the predictability of intention to leave amongst Asian nurses. A cross-sectional postal survey design. One hundred and ninety-five Asian nurses working at least six months in US hospitals completed the survey. Most participants were Filipinos or Chinese, married and worked full-time. The Organisational Commitment Questionnaire, Practice Environment Scale of the Nursing Work Index, Anticipated Turnover Scale and Collectivist Orientation Scale with satisfactory reliability were used. Perception of practice environment was correlated with intention to leave and organisational commitment, which was correlated with intention to leave. Cultural orientation showed positive predictable effects on organisational commitment and perception of practice environment, but had negative predictability for intention to leave. The mediating effect of organisational commitment on practice environment and intention to leave was 93·98%, when cultural orientation was not controlled for. It increased slightly to 96·54% when cultural orientation was controlled for. Asian nurses who are more collectivist-oriented are more willing to accept the goals and values of the organisation, exert effort on behalf of the organisation, are more satisfied with their current practice environment and have less intention to leave their current job. Organisational commitment is a key predictor of Asian nurses' intention to leave. Hospital administrators can use cultural orientation as a strategy to promote organisational commitment amongst Asian nurses, thereby reducing the rate of turnover. [ABSTRACT FROM AUTHOR]

To evaluate cultural differences in sociodemographic factors, illness severity and parents' perception of their adolescent's quality of life for Icelandic and USA families of adolescents with asthma; and to determine predictors of parent-rated quality of life. Asthma is known to have an impact on the quality of life of affected adolescents and their families, but few studies have addressed parents' perception of their adolescent's health-related quality of life. Cross-sectional exploratory study. The study involved families of adolescents with asthma included 15 from Iceland and 15 from USA, recruited from paediatric practices. Parent and adolescent participants completed questionnaires; this study is based on the parent responses. Data were collected from January-May 2006. While parents from Iceland and USA were similar in demographic characteristics, parents from Iceland rated their children's health-related quality of life (PedsQL 3.0, ) more positively than did USA parents, even though Icelandic parents were more likely than their USA counterparts to report that their adolescent's asthma is severe. Significant predictors of parent-rated quality of life included location (higher scores for Icelandic parents), gender (higher scores for parents of boys), exposure to second hand smoke in the home (higher scores for those not exposed) and frequency of troublesome wheezing (higher scores for lower frequency). Quality of life has been acknowledged as an essential health outcome measure. Even though gender difference was not found in asthma severity, parents of boys perceived their adolescent's quality of life as more positive compared with parents of girls. It might be helpful for Icelandic and USA families to integrate into care delivery models, cultural differences in parent-rated quality of life. Asthma management interventions may improve quality of life for adolescents with asthma by reducing symptoms. Interventions promoting smoke-free homes and enhanced self-monitoring to prevent exacerbations may improve quality of life. [ABSTRACT FROM AUTHOR]