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Background: Wellness is a holistic, multidimensional, and process‐oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well‐being without an in‐depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer‐reviewed papers in English; papers published in scientific journals using the surrogate terms 'wellness', 'health', 'health care', and 'health care and wellness'; and papers discussing and/or defining the concept of wellness. Twenty‐six studies met the inclusion criteria. Results: Based on the findings from this concept analysis, a definition of wellness was developed: 'a holistic and multidimensional concept represented on a continuum of being well that goes beyond health'. Implications for nursing practice were correspondingly presented. Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well‐being without an in‐depth clarification of its theoretical foundation. [ABSTRACT FROM AUTHOR]

Personal health‐related resources are essential for women with breast cancer, as these help them to maintain their own health and well‐being during different phases of their illness. The purpose of this integrative review was to identify, describe and synthetise what personal health‐related resources have already been identified for this patient group. We carried out an integrative review to find papers that focused on personal health‐related resources for women with breast cancer aged 18–64 years. The search covered 1 January 2005 to 31 May 2021 and was carried out using the CINAHL, PubMed, PsycINFO, Web of Science and Cochrane Library databases. It was limited to peer‐reviewed scientific papers with abstracts published in English and 23 papers met the inclusion criteria. The data were analysed using content analysis. Personal health‐related resources for women with breast cancer consisted of three different, but inherently interconnected, categories of personal strengths, person‐centred cancer care and social support from and involvement in their cultural community. Personal health‐related resources for women with breast cancer were multifaceted. Women need nursing support to identify and use these resources and future studies are needed to strengthen how they are measured. [ABSTRACT FROM AUTHOR]

Aim: To review the evidence of the existing literature on the impact of guided self‐determination across methodologies in different healthcare settings. Methods: An integrated five‐stage review. Results: Forty‐five eligible papers were included. Guided self‐determination was applied in full‐ or small‐scale, or combined with another intervention or approach in different healthcare settings handling, for example diabetes, stroke survivorship, schizophrenia, attention‐deficit hyperactivity disorder and medical disorder, gynaecological and breast cancer, endometriosis, persons with chronic pain, persons in haemodialysis and intensive care survivors. The included studies covered 12 randomised trials, 26 qualitative and seven papers of different methodology. A statistically significant effect was found in three trials. Six main themes describe the qualitative findings across papers on patients: (1) Guided self‐determination reduces disease‐related loneliness, (2) Insight enables integration of life and disease, (3) Reflection sheets—appreciated but challenging tool to prompt insights and person‐specific knowledge, (4) New person‐specific knowledge enables person‐centred support, (5) Feeling seen and believed in a new and trusted relationship and (6) Exchange of knowledge enables the development of life skills. Four themes describe the healthcare professionals' experience: (1) Change of usual practice—a decision from above, (2) A new role—unlearning previous behaviour and need for support, (3) Reflection sheets as facilitators and barriers and (4) Discovering the benefits of changing to a person‐centred approach. Conclusion: Overall, guided self‐determination proved to have a great impact on patient important outcomes and was useful and well‐accepted by the majority of patients and healthcare professionals. Albeit guided self‐determination is not a 'one size fits all' method. Continuous training and supervision of professionals are a necessary mean when implementing guided self‐determination to enhance adoption and sustainability in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Social connection is a fundamental human need. Its absence can lead to loneliness and social isolation, adversely impacting health and well‐being. Given their regular contact and trusted relationships with older people, practitioners delivering community‐based primary care are well‐positioned to address this issue. However, their contribution to addressing loneliness and social isolation is unclear. Aim: This integrative review explores the contribution of the primary care workforce to interventions aimed at reducing loneliness and social isolation in community‐dwelling older people. Method: Using an integrative review method, Scopus, Web of Science, CINAHL and PubMed were searched for original research published between 2000 and 2022. Fourteen papers reporting 13 primary studies were appraised for methodological quality and included in the review. Data were extracted into a summary table and analysed using thematic analysis. Results: Included studies came from over six countries. Internationally, primary care services have diverse structures, funding and workforces influencing their response to loneliness and social isolation. All but one intervention was multi‐component, with ten studies including a group‐based activity and three providing primarily individual‐level activities. Only six studies reported reductions in loneliness following the intervention. Three themes were identified: characteristics of interventions; implementation context, barriers and facilitators; and differing contributions of primary care practitioners in addressing loneliness and social isolation of older people. Conclusion: There is increasing demand and scope for primary care practitioners to assist lonely and socially isolated older people. It is important to understand how to equip and incentivise these practitioners to routinely identify, assess and respond to lonely and socially isolated older people despite varying implementation contexts. There is a need for further research that explores how the primary care team can be better utilised to deliver effective interventions that reduce the health impacts of loneliness and social isolation. [ABSTRACT FROM AUTHOR]

Background: Nursing was established in Denmark as a scholarly tradition in the late nineteen eighties, and ethnography was a preferred method. No critical review has yet summarised accomplishments and gaps and pointing at directions for the future methodological development and research herein. Aim: This review critically examines the current state of the use of ethnographic methodology in the body of knowledge from Danish nursing scholars. Methods: We performed a systematic literature search in relevant databases from 2003 to 2016. The studies included were critically appraised by all authors for methodological robustness using the ten‐item instrument QARI from Joanna Briggs Institute. Results: Two hundred and eight studies met our inclusion criteria and 45 papers were included; the critical appraisal gave evidence of studies with certain robustness, except for the first question concerning the congruity between the papers philosophical perspective and methodology and the seventh question concerning reflections about the influence of the researcher on the study and vice versa. In most studies (n = 34), study aims and arguments for selecting ethnographic research are presented. Additionally, method sections in many studies illustrated that ethnographical methodology is nurtured by references such as Hammersley and Atkinson or Spradley. Conclusions: Evidence exists that Danish nursing scholars’ body of knowledge nurtures the ethnographic methodology mainly by the same few authors; however, whether this is an expression of a deliberate strategy or malnutrition in the form of lack of knowledge of other methodological options appears yet unanswered. [ABSTRACT FROM AUTHOR]

Background: Since the beginning of 2000, the primary healthcare services around the globe are challenged between demands of home care and number of staff delivering it. The delivery of healthcare needs new models to reduce the costs, patient's readmission and increase their possibilities to stay at home. Several paramedicine programmes have been developed to deliver home care as an integral part of the local healthcare system. The programmes varied in nature and the concept of Community Paramedicine (CP) has not been established, demanding clarity. The aim of this review was to identify and describe the core components of CP, and identify research gaps for the further study. Method: A scoping review was performed using five electronic databases: Medline; CINAHL; Academic Search Premier; PubMed and the Cochrane Library for the period 2005 – June 2018. The references of articles were checked, and papers were assessed against inclusion criteria and appraised for quality. Results: From 803 initial articles, 21 met the criteria and were included. Inductive content analysis was carried out. The four core components of Community Paramedicine emerged (a) Community engagement, (b) Multi‐agency collaboration, (c) Patient‐centred prevention and (d) Outcomes of programme: cost‐effectiveness and patients' experiences. Conclusion: The Community Paramedicine programmes are perceived to be promising. However, Community Paramedicine research data are lacking. Further research is required to understand whether this novel model of healthcare is reducing costs, improving health and enhancing people's experiences. [ABSTRACT FROM AUTHOR]

Background: Stroke survivors might perceive their quality of life (QoL) as being affected even years after onset. The purpose of this review was to go through the literature to identify factors related to QoL for persons with stroke in China and Western countries for possible similarities and differences in their respective cultural views. Method: A narrative literature review was conducted on the papers identified by searching PubMed, EBSCO/CINAHL, EMBASE, PsycINFO, China National Knowledge Infrastructure and Wanfang Data that published up to November 2016. Factors predicting QoL after stroke were extracted, and comparisons were made between Chinese and Western studies respecting cultural aspects. Results: A total of 43 articles were included in this review, with 31 conducted in Western countries and 12 in China. Predictors of QoL included Demographic factors: age, gender, marital status, education level, socioeconomic status; Clinically related factors: severity of stroke, physical function, depression/anxiety, cognitive impairment, incontinence and other comorbidities; Environmental factors: residential status, social support, social participation; and Individual factors: coping strategies and self‐perception. Being married and resident at home might be associated with the perception of QoL differently between Chinese and Western survivors. Conclusions: Most predictors of QoL in stroke survivors were the same in China and the Western countries. However, their QoL might be predicted differently regarding to the individualistic and collectivistic cultural differences. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to describe the association between adolescent sense of coherence ( SOC) and health and identify the future direction for research in this area. Systematic searches were conducted (2007-2014) in the PubMed, CINAHL, Psyc INFO and Cochrane electronic databases and carried out manual searches in three scientific journals. A total of 827 original papers were found and 23 were selected. Based on the results, adolescents' sense of coherence ( SOC) was related to health in terms of the adolescents' quality of life, health behaviour, mental health and family relationships by using 31 different health-related instruments. In conclusion, the use of the SOC approach for adolescents can provide a useful view of their health during this transition phase to adulthood. Due to the large variation in the additional instruments used, combining and comparing the results proved challenging. More comparative and longitudinal research is needed to increase understanding of adolescents' health in relation to SOC and develop services that support both elements. [ABSTRACT FROM AUTHOR]

Background Whittemore and Knafl's updated description of methodological approach for integrative review was published in 2005. Since then, the five stages of the approach have been regularly used as a basic conceptual structure of the integrative reviews conducted by nursing researchers. However, this methodological approach is seldom examined from the perspective of how systematically and rigorously the stages are implemented in the published integrative reviews. Purpose To appraise the selected integrative reviews on the basis of the methodological approach according to the five stages published by Whittemore and Knafl in 2005. Design A literature review was used in this study. CINAHL (Cumulative Index to Nursing and Allied Health), PubMed, OVID (Journals@Ovid) and the Cochrane Library databases were searched for integrative reviews published between 2002 and 2014. Papers were included if they used the methodological approach described by Whittemore and Knafl, were published in English and were focused on nursing education or nursing expertise. A total of 259 integrative review publications for potential inclusion were identified. Results Ten integrative reviews fulfilled the inclusion criteria. Findings from the studies were extracted and critically examined according to the five methodological stages. The reviews assessed followed the guidelines of the stated methodology approach to different extents. The stages of literature search, data evaluation and data analysis were fairly poorly formulated and only partially implemented in the studies included in the sample. The other two stages, problem identification and presentation, followed those described in the methodological approach quite well. Conclusion Increasing use of research in clinical practice is inevitable, and therefore, integrative reviews can play a greater role in developing evidence-based nursing practices. Because of this, nurse researchers should pay more attention to sound integrative nursing research to systematise the review process and make it more rigorous. [ABSTRACT FROM AUTHOR]

Aim This paper aimed to suggest possible answers to the question: Why do patients with COPD decline pulmonary rehabilitation ( PR)? Method The study is a metasynthesis inspired by Noblit of the existing qualitative research on the area. The data were collected during 2014. Six studies were found through a systematic literature search in relevant databases. In these six studies, 65 persons were identified as decliners of PR. Four themes were identified from these studies. Results The themes identified were as follows: the referral process, transport problems, perception of health and other obligations or priorities. The problems with the referral of patients relate to different areas: the referring health professional's conviction and commitment, and the patients' understanding of the referral. It seems that various transport problems cause decline, for example long distance to the PR centre or the expenses of getting back and forth. Perceptions of health cause decline. Decliners feel too sick to join PR or do not identify themselves as a sick person, and do not want undertake the 'patient role'. Other obligations or priorities such as work, family obligations and vacations are prioritised on behalf of PR causing decline. Conclusion The studies included show patients' rational accounts and reflections on declining PR. The included studies tend to describe accounts for deselection of PR in relation to the preferences and beliefs of the patients rather than including the social and economic variables framing the behaviour and choices of the patients. [ABSTRACT FROM AUTHOR]

Background In 2007, a literature review was undertaken of palliative care research from Sweden during the 1970s-2006, paving the way for a follow-up study to explore the recent developments. The aim was to systematically examine palliative care research from Sweden between 2007 and 2012, with special attention to methods, designs and research foci. Methods A literature review was undertaken. The databases Academic search elite, Age line, Ahmed, Cinahl, PsychInfo, PubMed, Scopus, Soc abstracts, Web of science and Libris were reviewed for Swedish palliative care research studies published from 2007 to 2012, applying the search criteria 'palliative care OR palliative medicine OR end-of-life care OR terminal care OR hospice care OR dying OR death'. Results A total of 263 papers met the inclusion criteria, indicating an increased volume of research compared to the 133 articles identified in the previous review. Common study foci were symptom assessment and management, experiences of illness and care planning. Targeting non-cancer-specific populations and utilisation of population-based register studies were identified as new features. There was continued domination of cross-sectional, qualitative and mono-disciplinary studies, not including ethnic minority groups, nonverbally communicable people or children <18 years of age. Conclusions The trend is that Swedish palliative care research has expanded in volume from 2007 to 2012 compared to during the 1970s to 2006, with increasing participation of non-cancer-specific populations. A domination of qualitative approaches and small, cross-sectional studies with few interventions is still characteristic. Still more strategies are needed to expand the knowledge development of palliative care to respond to demographical, epidemiological, therapeutic and healthcare structure changes. [ABSTRACT FROM AUTHOR]