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Aim: To describe the co‐designing process of an online support programme with and for informal carers of people with heart failure. Design: A co‐design process built on core concepts and ideas embedded in co‐design methodology. Data sources: Our co‐design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme. Outcomes: The co‐design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal. Conclusion: Co‐design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process. Relevance to clinical practice: Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person‐centred care and provides a valuable learning opportunity for those involved. Furthermore, a co‐designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self‐care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel. Reporting methods: Consolidated criteria for reporting qualitative research (COREQ). Patient or public contribution: Both informal carers and content creators were involved in developing the support programme. [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]

Aim: To summarise, interpret and synthesize research findings on patients' and nurses' experiences of caring in nursing across clinical practices. Background: Caring is a universal element of nursing; however, economic restrictions often negatively impact health services, and time shortages and limited numbers of staff may characterize care encounters. It is unclear how these contextual conditions affect patients' and nurses' experiences of caring. Design and Methods: This integrative literature review covers papers published between 2000 and 2022. Four databases—PubMed, PsycINFO (via Ovid), MEDLINE (via Ovid) and CINAHL (via EBSCO)—were systematically searched for eligible papers in May 2022. The included studies were critically appraised. Content analysis was performed to interpret and synthesize the findings. In accordance with the EQUATOR guidelines, the PRISMA 2020 and PRISMA‐S checklists were used. An Integrative review methodology guided the process. Findings: In total, 33 studies were included in the review. Three themes captured the experiences of caring in nursing: (1) the complexity of the nursing care context, (2) the professionalism of the nurse, and (3) the trusting patient–nurse relationship. Conclusion: The experience of caring in nursing depended on nurses' competence and discretion in the personal encounter framed by the nursing context. The caring relationship was based on reciprocity, but it remains asymmetrical, as the nurse had the power and responsibility to empower the patient. Barriers, such as increased demands for efficiency and resource scarcity, may hinder the experience of caring in nursing. Implications for the profession and patient care: By promoting an ongoing discussion of caring in nursing, nurse management can systematically support nurses in reflecting on their practice in diverse and complex clinical contexts. Patient or public contribution: No patient or public contribution was made due to the study design. [ABSTRACT FROM AUTHOR]

Aim: To identify and synthesize empirical evidence on the role of healthcare leaders in the development of equitable clinical academic pathways for nurses. Design: Integrative literature review. Data Sources: Literature was searched using CINAHL, PubMed, ProQuest and Google Scholar databases. Review Methods: A total of 114 eligible articles published between 2010 and2022 were screened, 16 papers were selected. Results: Results highlighted the need for consistent national, regional, and organizational policy approaches to developing clinical academic careers for nurses. Government health departments and National Health boards must focus on increasing engagement in research and evidence‐based nursing practice for high‐quality patient care. Discriminatory practices and attitudes were identified as barriers. Discrimination due to gender was evident, while the impact of race, ethnicity, and other social categories of identity are under‐researched. Educational leaders must unravel misconceptions about research, highlighting its relevance to patient care and bedside nurses' work. Academic leaders together with executive nurses, research funders and professional nursing bodies must create appropriately remunerated career structures. Transformative approaches are required to develop the clinical academic nurse role and understand its value in clinical practice. Conclusion: Multiple elements exist within complex systems that healthcare leaders can navigate collaboratively to develop and implement clinical nurse academic roles. This requires vision, acknowledgement of the value of nursing research and the importance of evidence‐based research infrastructures. Impact: Findings highlight the collaborative role of healthcare leaders as critical to the success of critical academic careers for nurses. This review can inform those still to formalize this innovative role for nurses. Reporting Method: The review complies with the PRISMA guidelines for reporting systematic reviews. This paper contributes evidence about the healthcare leader's role in developing clinical academic pathways for nurses to the wider global clinical community. Patient or Public Contribution: No patient or public contribution was included in this review. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known about the Subject?: One in five mothers and birthing parents are affected by postpartum depression (PPD), yet only a small proportion of those with PPD receive treatment.Given cost and accessibility barriers to treatment, brief therapies (e.g. 1 day) could help address PPD on a large scale, though understanding participants' unique experiences with this novel treatment will help guide its refinement and use. What this Paper Adds to Existing Knowledge?: This paper describes the experiences, perspectives and satisfaction of participants who attended a 1‐day workshop for PPD.Participants appreciate being taught practical techniques and the receipt of social support from facilitators and other attendees in the group setting, while some recommended further 'booster sessions' to enhance effectiveness. What Are the Implications for Practice?: One‐day CBT‐based workshops may be an effective, low‐intensity treatment option that provides helpful skills and builds social networks for individuals with PPD.Additional post‐workshop booster sessions may enhance participant satisfaction with this new treatment by providing a reinforcement of their learning and an opportunity to re‐connect with other birthing parents. Introduction: Postpartum depression (PPD) affects up to one in five mothers and birthing parents. Understanding their perceptions of therapeutic interventions is key to their effectiveness and scalability. Aim: The aim of the study was to understand participants' experiences attending an in‐person or online 1‐day cognitive behavioural therapy (CBT)‐based workshop for PPD and compare their experiences participating in either modality. Method: This descriptive qualitative study was embedded in two separate randomized controlled trials evaluating the effectiveness of 1‐day CBT‐based workshops for PPD delivered in‐person or online. Responses were provided by 94 in‐person and 95 online participants about their experiences. Content analysis was used to code and categorize the data. Results: Participants appreciated learning skills to improve PPD symptoms and joining a community of individuals with shared experiences. Integrating practical coping techniques after the workshop was reported to be most useful, though some wanted additional post‐workshop support. Online participants identified additional barriers to workshop engagement. Discussion: Participants who attended either workshop found them to be valuable and effective. Participants valued psychoeducation, social connections and applying practical CBT techniques. Implications for Practice: One‐day CBT‐based workshops may be an accessible treatment option for individuals with PPD, providing new skills and social support, though some prefer to receive additional post‐workshop support. [ABSTRACT FROM AUTHOR]

Background: Advance care planning is a process through which people communicate their goals and preferences for future medical care. Due to the complexity of the decision‐making process, decision aids can assist individuals in balancing potential benefits and risks of treatment options. Objective: While decision aids have the potential to better promote advance care planning, their characteristics, content and application effectiveness are unclear and lack systematic review. Therefore, we aimed to explore these three aspects and establish a foundation for future research. Design: Scoping review. Methods: This scoping review adheres to the framework proposed by Arksey and O'Malley and the PRISMA‐ScR list. Six English‐language databases were systematically searched from the time of construction until 1 December 2023. Two researchers conducted the article screening and data extraction, and the extracted data was presented in written tables and narrative summaries. Results: Of the 1479 titles and abstracts, 20 studies fulfilled the inclusion criteria. Types of decision aids were employed, mainly websites and videos. Decision aid's primary components center around 11 areas, such as furnishing information, exploring treatment and care preferences. The main manifestations were a significant increase in knowledge and improved recognition of patients' target value preferences. Among the aids, websites and videos for advance care planning have relatively high content acceptability and decision‐making process satisfaction, but their feasibility has yet to be tested. Conclusions: Decision aids were varied, with content focused on describing key information and exploring treatment and care preferences. Regarding application effects, the aids successfully facilitated the advance care planning process and improved the quality of participants' decisions. Overall, decision aids are efficient in improving the decision‐making process for implementing advance care planning in cancer and geriatric populations. In the future, personalised decision aids should be developed based on continuous optimization of tools' quality and promoted for clinical application. Reporting Method: The paper has adhered to the EQUATOR guidelines and referenced the PRISMAg‐ScR checklist. No Patient or Public Contribution: This is a review without patient and public contribution. Registration: https://doi.org/10.17605/OSF.IO/YPHKF, Open Science DOI: 10.17605/OSF.IO/YPHKF. [ABSTRACT FROM AUTHOR]

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

Accessible Summary: What is known on the subject?: Workplace violence is common in healthcare.Workplace violence remains a complex and serious occupational hazard in healthcare. What this paper adds to existing knowledge?: Since there is no study examining detailed explanations of experiences and perspectives of workplace violence among psychiatric nurses, this study will act as a guide for psychiatric nurses.This study provides information about how psychiatric nurses evaluate the concept of workplace violence from their perspective, what it means to them and the effects of workplace violence. What are the implications for practice?: Considering the effects of workplace violence, a preventive, systematic and holistic approach should be used in psychiatry and community mental health centres.Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Introduction: Workplace violence is common in healthcare and remains a complex and serious occupational hazard. Aim: This research was conducted to assess the workplace violence experiences and perspectives of psychiatric nurses. Method: This study was a qualitative study conducted using a grounded theory approach method. The study was conducted between November 2022 and January 2023. The purposeful sampling method was used, and 11 psychiatric nurses were interviewed. Data were collected with an information form and a semi‐structured interview form. The data were analysed using content analysis, and themes were created. Findings: The ages of the psychiatric nurses ranged from 38 to 57 years. Themes and sub‐themes related to the workplace violence experiences and perspectives of psychiatric nurses included the way of violence (rising tension, eruption of the volcano, unintentional violence and turning to ash) and empowerment (ash cloud and ring of fire). Conclusion: Psychiatric nurses stated that they were exposed to verbal and physical violence for many reasons, that this situation seriously affected their physical, mental and social health and that in addition to the devastating effects of violence, they became stronger by developing various skills to protect against violence. Implications for Practice: Supportive interventions should be used to improve the health and safety of psychiatric nurses and patients. Strategies can be developed to include psychiatric nurses in occupational health nursing courses. [ABSTRACT FROM AUTHOR]

Aims: To discuss the levels of structural empowerment (SE) and psychological empowerment (PE) and the factors that influence perceptions of empowerment among newly graduated nurses (NGNs). Design: Mixed methods study. Methods: The quantitative part of the study was conducted with 220 NGNs with <1 year of job experience. The study was conducted between February and May 2023. Focus group discussions were conducted with 30 NGNs. Data were collected by using the Conditions for Work Effectiveness Questionnaire (CWEQ‐II), the Psychological Empowerment Scale (PES) and a Semi‐Structured Interview Form. Quantitative data were analysed using stepwise regression analysis. Content analysis was used to analyse qualitative data. Results: CWEQ‐II and PES were moderate. The regression analysis showed that NGNs' SE scores increased in association with the following factors, including an increase in the total score on the PES, being married/having a partner, working a day shift, having career planning, increased satisfaction with the orientation programmes of the institution and increased satisfaction with the employing institution. As a result of the descriptive analysis of the focus group interviews conducted to determine the empowerment perceptions of NGNs, we identified three contexts along with the associated themes and subthemes. These three contexts were the 'concept of power', 'professional impression' and 'empowerment process'. Conclusion: The results of this study indicate that the SE and PE levels of NGNs are moderate, and their empowerment perceptions are influenced by many factors that can be individual, organizational and work environment relevant. Impact: This study's findings will guide policymakers, educators, researchers and administrators in empowering NGNs essential to the healthcare workforce. Reporting Method: The paper adheres to the COREQ checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness. Methods: A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self‐efficacy were measured at pre‐intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self‐efficacy was measured at pre‐intervention and 3 months later. Results: The intervention was feasible and acceptable. No difference in self‐efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group. Conclusion: The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics. Trial registration: ClinicalTrials.gov ID: NCT03944642. Summary statement: What is already known about this topic? Breastfeeding is the gold standard for infant and young child nutrition.However, national and global prevalence is lower than expected.Breastfeeding support has focused on a biomedical approach with a predominantly clinical approach to breastfeeding difficulties.What this paper adds? Establishes an intervention proposal from an integral approach centred on a woman, her child and her family.Considers the perspective of health professionals in relation to their strengths and difficulties in supporting mothers with breastfeeding.Estimates the effect of the intervention on the self‐efficacy of professionals and mothers.The implications of this paper: This intervention was feasible and accepted by participants and health professionals working in primary health care centres. Therefore, the exploratory trial can be subjected to a full trial following the protocol and recommendations from the findings at this stage.Although the effects measurements of the intervention effects are preliminary, they show promising results regarding breastfeeding (BF) maintenance rates, together with a recovery of exclusive breastfeeding at 4 months and a decrease in maternal postpartum depression risk. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences and emotions of individuals with depression and physical comorbidity within the context of psychoeducational group interventions led by primary care nurses in Catalunya (Spain). Method: A psychoeducational group intervention was conducted in the first semester of 2019 with 13 primary care teams (rural/urban) and 95 participants with depression and physical comorbidity. The qualitative research and phenomenological perspective were based on 13 field diaries and 7 semi‐structured interviews carried out with the observer nurses. The interviews were recorded and transcribed. Codes were identified by segmenting the text into citations/verbatim accounts and emerging categories/subcategories by regrouping the codes. The results were triangulated among the researchers to identify and compare similarities and differences. Results: Four major themes were found: (a) gender differences; (b) coping strategies and changes observed during the intervention; (c) functions of the group as a therapeutic element; and (d) the nurses' perceptions of the group experience. Gender differences were identified in relation to experiences and emotions. Conclusions: As some patients acquired skills/behaviours during the intervention that helped them initiate changes and the nurses were satisfied with the intervention, it is important to include this information when planning effective interventions for patients with this profile. Summary statement: What is already known about this topic? There are gender differences in the prevalence of depression. What this paper adds? This study describes the experiences and emotions of women with depression and physical comorbidity within the context of psychoeducational group intervention. The implications of this paper: The study provides information about the experiences and emotions of women with depression. It will be important to include this qualitative information when planning effective interventions directed at patients with this profile. [ABSTRACT FROM AUTHOR]

Aims: To describe nurse managers' perceptions of interventions to support nurses as second victims of patient safety incidents and to describe the management of interventions and ways to improve them. Design: A qualitative study using interviews. Methods: A purposive sample of nurse managers (n = 16) recruited from three hospital districts in Finland was interviewed in 2021. The data were analysed using elements of inductive and deductive content analysis. Results: The study identified three main categories: (1) Management of second victim support, which contained three sub‐categories related to the nurse manager's role, support received by the nurse manager and challenges of support management; (2) interventions to support second victims included existing interventions and operating models; and (3) improving second victim support, based on the sub‐categories developing practices and developing an open and non‐blaming patient safety culture. Conclusion: Nurse managers play a crucial role in supporting nurses as second victims of patient safety incidents and coordinating additional support. Operating models for managing interventions could facilitate nurse managers' work and ensure adequate support for second victims. The support could be improved by increasing the awareness of the second victim phenomenon. Implications for the Profession and Patient Care: Mitigating the harmful effects of patient safety incidents can improve nurses' well‐being, reduce burden and attrition risks and positively impact patient safety. Impact: Increasing awareness of the second victim phenomenon and coherent operation models would provide equal support for the nurses and facilitate nurse managers' work. Reporting Method: COREQ checklist was used. What does this paper contribute to the wider global clinical community? Nurse managers' role is significant in supporting the second victims and coordinating additional support.Awareness of the second victim phenomenon and coherent operating models can secure adequate support for the nurses and facilitate nurse managers' work. [ABSTRACT FROM AUTHOR]

Aim: To identify culturally related stressors that influence self‐care in Chinese older adults with multiple chronic conditions. Background: Effective self‐care can improve health outcomes for chronic conditions, but implementing self‐care is challenging. Individuals with multiple chronic conditions face even more self‐care complexity than those with single chronic conditions, generating additional stressors. Although stressors have been found to negatively influence self‐care in multiple chronic conditions, the role of culture in generating stressors has been neglected. Design: This paper reports on the qualitative component of a larger mixed‐methods study. Two free‐response items in a survey were used to identify culturally related stressors that influence self‐care. This report adhered to the SRQR guideline checklist. Methods: Data were collected between January and April 2022. One hundred and thirty‐eight free text responses asking participants to identify stressors that influenced their self‐care effectiveness were analysed sequentially using deductive content analysis and thematic analysis. Results: Findings from deductive content analysis largely confirmed published work in Western literature on stressors complicating self‐care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems. Conclusion: Chinese older adults with multiple chronic conditions identified a wide range of stressors that impacted their day‐to‐day self‐care. This study provided valuable insights into culturally related stressors in older adults with multiple chronic conditions. Findings deepened our knowledge of cultural influences on the success of self‐care in older adults with multiple chronic conditions, suggesting the potential for reaching populations across different cultures and regions. Implications for the profession and/or patient care: Stressors that might influence self‐care ability are important for nurses to assess in people with multiple chronic conditions. The design of self‐care interventions should take a culturally tailored intergenerational family‐centred approach to help mitigate the impact of stressors and ultimately improve patient outcomes. Impact: What problem did the study address?Stressors documented in older adults with MCCs have all been generated from research with Western populations. China is now home to the largest population of older people in the world. Understanding the influence of culturally relevant stressors on self‐care in Chinese older adults with MCCs is lacking.What were the main findings?Findings from deductive content analysis largely confirmed published work in Western literature on stressors that complicated self‐care, including symptom burdens, financial strains, social disconnection, caregiving responsibilities and major life events. Findings from reflexive thematic analysis extended current literature by identifying three culturally relevant stressors in older adults with MCCs in China: intergenerational obligations and commitments, ambivalence about receiving care and worries about potential problems.Where and on whom will the research have an impact?The research will have an impact on guiding nurses' assessment of culturally relevant stressors' impact on self‐care for older adults with MCCs. In addition, findings could inform research and policy development to aim at mitigating the impact of culturally based stressors on self‐care. Reporting Method: This study adhered to the Standards for Reporting Qualitative Research (SRQR) guideline checklist. Patient or Public Contribution: During the member‐checking process, the validation of findings for accuracy was carried out by 10 participants, who also found resonance between these findings and their own experiences. [ABSTRACT FROM AUTHOR]

Background: Sensory‐based program for people with advanced dementia aim to address unmet needs and to improve behaviours, mood or cognition. Pleasurable, involuntary sense memories stimulated by sensory‐based program are difficult to evaluate because it is not possible to ask what people with dementia remember about their past, or what sense memories are being evoked. Notwithstanding the challenges in identifying what sense memories people with dementia experience, nurses and caregivers should recognise the potential value of sense memories for pleasure and happiness and provide optimum conditions to stimulate the senses. Aims and objectives: To examine the potential for involuntary sense memories to be activated by sensory stimulation, with a focus on the effects of the Namaste Care programme. Design: This is a discursive paper applying a content analysis to the qualitative findings of studies reporting on the Namaste Care programme to critically evaluate the topic of involuntary sense memories for people living with advanced dementia. Methods: A literature review and content analysis of qualitative findings on the Namaste Care programme was performed. Findings are reported in line with the COREQ checklist. Results: Eleven studies met the inclusion criteria. Codes were grouped into four categories representing enhanced mood, pleasure, happiness and comfort capturing the effects of the sensory stimulation observed or perceived by nurses and family caregivers. Descriptions provide some evidence of sensory memories activated by stimulation of some senses but not all. Conclusion: Involuntary sense memories contribute to well‐being of people living with advanced dementia. Caregivers, including nurses, need to be aware that involuntary sense memories that do not rely on cognitive processes can be triggered by sensory stimulation and have the potential to enhance mood and bestow pleasure, happiness and comfort over and above the "activity" of the sensory programme. Relevance to clinical practice: By integrating the documented experiential findings and conceptual understandings of sense memory, this paper contributes to advancing the understanding of the value of involuntary sense memories for people living with dementia that nurses and caregivers need to be aware of and, in turn, provide the optimum conditions for memory of the senses to be activated. A sensory‐based programme, such as Namaste Care, provides optimum conditions at low cost to activate sense memories. [ABSTRACT FROM AUTHOR]

Aims: To investigate factors that influence the willingness of inactive nurses to return to nursing in a crisis situation and to identify aspects that need to be considered with regard to a possible deployment. Design: A deductive and inductive qualitative content analysis of semi-structured focus group interviews. Methods: Semi-structured focus group interviews with inactive or marginally employed nurses, nurses who have been inactive for some time and nursing home managers in October and November 2021. The participating inactive nurses had declared their willingness for a deployment during the COVID-19 pandemic or not. Data were analysed using qualitative content analysis. Results: Communication was seen as essential by the participants for an informed decision for or against a temporary return to nursing and to potential or actual deployments. To make them feel safe, inactive nurses need to know what to expect and what is expected of them, for example, regarding required training and responsibilities. Considering their current employment status, some flexibility in terms of deployment conditions is needed. A remaining attachment to care can trigger a sense of duty. Knowledge of (regular) working conditions in nursing can lead to both a desire to support former colleagues and a refusal to be exposed to these conditions again. Conclusion: Past working experiences and the current employment situation play a major role in the willingness of inactive nurses to return to nursing in a crisis situation. Unbureaucratic arrangements must be provided for those who are willing to return. Summary Statement: • What already is known - In crisis situations, not every inactive nurse is willing or able to return to nursing and therefore, the 'silent reserve' may not be as large as suspected. • What this paper adds - Inactive nurses need to know what to expect and what is expected of them for their decision regarding a return to active patient care during a crisis situation. • Implications for practice/policy -- Inactive nurses need to be informed and should be offered free training and refresher courses to ensure patient safety. Impact: This research shows that the group of inactive nurses are not a silent workforce which can be activated anytime. Those who are able and willing to return to direct patient care in crisis situations need the best possible support -- during and between crises. Reporting Method: This study adhered to COREQ guidelines. No Patient or Public Contribution: The involvement of patients or members of the public did not apply for the study, as the aim was to gain insight into the motivations and attitudes of the group of inactive nurses. [ABSTRACT FROM AUTHOR]

Aim: To explore the satisfaction and experiences of women and staff with the BSOTS in an Australian hospital. Design: Cross‐sectional descriptive survey. Methods: Surveys were distributed to women and staff between February and May 2022. Survey questions reflected satisfaction with triage and provision of care under the BSOTS system (for women) and confidence in using the BSOTS system and its impact on triage‐related care (for staff). Survey data were summarized using descriptive statistics, and qualitative responses were analysed using content analysis. Results: There were 50 women and 40 staff (midwives and doctors) survey respondents. Most women were satisfied with triage wait times, the verbal information they received and the time it took for them to receive care. Nearly all midwife participants indicated they had high knowledge and confidence in using the BSOTS. Most staff indicated that the BSOTS supported the accurate assessment of women and had benefits for women, staff and the hospital. Conclusion: The findings showed that women and staff were satisfied with receiving and providing care in a maternity triage setting under the BSOTS system. Implications for the Profession and/or Patient Care: Implementing standardized maternity triage approaches such as the BSOTS in health settings delivering care to pregnant women is recommended for improving flow of care and perceptions of care quality by women. Impact: Quality of maternity triage processes is likely to impact the satisfaction of women attending services and the staff providing care. The BSOTS was shown to improve maternity triage processes and was associated with satisfaction of women and staff. Maternity settings can benefit from implementing triage approaches such as the BSOTS as it standardizes and justifies the care provided to women. This is likely to result in satisfaction of women and staff engaged in maternity triage and improve the birth outcomes of women and babies. Reporting Method: The reporting of this paper has followed SQUIRE guidelines. Patient or Public Contribution: Women engaged with maternity services were participants in the study but did not contribute to the design, conduct or publication of the study. [ABSTRACT FROM AUTHOR]

Background: Vicarious trauma can significantly affect the physical and mental health of nurses, as well as their ability to provide quality of care. However, the concept of vicarious trauma has received limited attention and remains controversial in the nursing context. Objective: The purpose of this study was to clarify and define the concept of vicarious trauma as it pertains to the nursing context. Methods: The Schwartz and Kim's three‐stage hybrid concept analysis method was used to define the concept. In the theoretical phase, PubMed, CINAHL, OVID, Medline, Embase, Web of Science, Scopus, ProQuest, PsycINFO, CNKI database, VIP database and Wanfang database were used using keywords "nurs*"and "vicarious trauma*", resulting in a total of 25 papers. In the fieldwork phase, we conducted participatory observations in three hospitals and semi‐structured in‐depth interviews with 18 clinical nurses from seven cities. In the analysis phase, the results of the previous two phases were integrated to develop a comprehensive concept of vicarious trauma in nursing. Results: Based on the results of the theoretical and field phases, we propose the concept of vicarious trauma in nursing as follows: vicarious trauma is a psychological trauma impacting nurses' cognitive schema which they may experience in clinical settings or on social media, resulting from deeply empathize with the physical or emotional trauma of patients, family, or colleagues, such as patients' physical injuries or death, family's grieving feelings and colleagues' received threats and attacks. Positively, vicarious trauma can transform into vicarious post‐trauma growth through repositioning and connection, nourishing nurses and promoting their personal and professional development. Conclusion: The concept of vicarious trauma in nursing is multidimensional and holistic. This study clarifies the concept of vicarious trauma in nursing using the hybrid concept analysis, providing a framework for future research and practice on vicarious trauma in the nursing field. Patient or Public Contribution: Nurses contributed to the conduct of the study by participating in the data collection via interviews. [ABSTRACT FROM AUTHOR]

Aim: To identify structural barriers to the uptake and practice of anti‐racism in nursing education, specifically in the Canadian context. Design: A deconstructive, critical, qualitative inquiry informed by critical race theory, critical whiteness, feminism and post‐colonialism. Methods: This study employed an anonymous online open‐ended questionnaire and online focus groups with Canadian nurse educators from April to June 2021. The data were analysed through a contextualist thematic analysis that accounts for data as essential experience and also a product of discourse. Results: Structural barriers identified are organized into themes of: the academic environment; position and power; racism; program delivery; and Whiteness. Pervasive silence, especially white silence, can be interpreted in related contexts of precarity, self‐interest and institutional violence. Overarching processes of precarity and resistance exert power over the environment of nursing education which act to destabilize, disrupt and discourage anti‐racist efforts and education. Conclusion: The sustainability of anti‐racism should be a primary focus. This entails attending to structures in nursing and higher education that make nursing education precarious work, especially for educators racialized as Other in the white supremacist racial binary of White: non‐White. Explicit and ongoing attention to conditions that silence is necessary for any progress to be made. Strategies of applying anti‐racism need to be as complex as the barriers. Implications: Many schools of nursing are engaged in attempts to include anti‐racism as learning and environment. The structural barriers that interfere with effective integration of anti‐racism as a lens for nursing education must be named and addressed so educators and schools can be successful. The implication of trying to incorporate anti‐racism without addressing the barriers is a very superficial or pocketed application of anti‐racism, and a continuation of the status quo that reproduces Whiteness and excludes and harms people racialized otherwise. Impact: The study addressed both strategies and barriers to anti‐racism in nursing education. This article addressed structural barriers in anti‐racism in Canadian nursing education. The main findings are that processes of precarity specific to nursing education in institutions of higher learning, and resistance through Whiteness, decision‐making hierarchy and regulatory structures interfere with the application of anti‐racism. This research impacts nurse educators in all nursing schools and leaders in higher education. It also impacts all current and future nursing students as the recipients of the education we provide. Reporting Method: The paper adheres to COREQ checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: Identify and synthesize evidence of nurses' competency in electrocardiogram interpretation in acute care settings. Design: Systematic mixed studies review. Data sources: Cumulative Index to Nursing and Allied Health Literature, Medline, Scopus and Cochrane were searched in April 2021. Review methods: Data were selected using the updated Preferred Reporting Items for Systematic Reviews and Meta‑Analysis framework. A data‐based convergent synthesis design using qualitative content analysis was adopted. Quality appraisal was undertaken using validated tools appropriate to study designs of the included papers. Results: Forty‐three papers were included in this review. Skills and attitudes were not commonly assessed, as most studies referred to 'competency' in the context of nurses' knowledge in electrocardiogram interpretation. Nurses' knowledge levels in this important nursing role varied notably, which could be partly due to a range of assessment tools being used. Several factors were found to influence nurses' competency in electrocardiogram interpretation across the included studies from individual, professional and organizational perspectives. Conclusion: The definition of 'competency' was inconsistent, and nurses' competency in electrocardiogram interpretation varied from low to high. Nurses identified a lack of regular training and insufficient exposure in electrocardiogram interpretation. Hence, regular, standard training and education are recommended. Also, more research is needed to develop a standardized and comprehensive electrocardiogram interpretation tool, thereby allowing educators to safely assess nurses' competency. Impact: This review addressed questions related to nurses' competency in electrocardiogram interpretation. The findings highlight varying competency levels and assessment methods. Nurses reported a lack of knowledge and confidence in interpreting electrocardiograms. There is an urgent need to explore opportunities to promote and maintain nurses' competency in electrocardiogram interpretation. [ABSTRACT FROM AUTHOR]

Aims: To (a) explore risk indicators related to interpersonal violence occurring under the influence of alcohol and to (b) search for interventions addressed towards violence perpetrators to prevent violence occurring under the influence of alcohol. Design: Mixed method systematic review. This study has been registered in the International Prospective Register of Systematic Reviews with register number CRD42021217848. Data sources A systematic search was conducted on PubMed, CINAHL, PsycINFO and Scopus in October 2021. Review methods: Two researchers independently examined 1076 papers following the inclusion criteria. After three rounds of selection (title, abstract and full text), the quality and bias assessments were conducted independently by two reviewers. The data were analysed with inductive and deductive content analyses. Results: Of the 1076 papers retrieved, 16 papers were eligible for inclusion, addressing 13 different interventions. Interventions were divided into three types (individual‐, group‐ and family‐level) and were constructed on several background frameworks, with cognitive behavioural therapy being the most common framework. Family‐level interventions seemed to yield the most effective results. Violence occurring under the influence of alcohol was mostly researched as men being the perpetrators and women being the victims of violence. Several indicators that increased the risk of violence victimization or perpetration, such as trait jealousy and disparity in education, were identified. Conclusion: Interventions emerging from the systematic review were heterogenous, and the outcomes of the interventions were versatile. The disparity between interventions and outcome measures made it challenging to reliably compare the effectiveness between interventions. Using standardized outcome measure instruments and unifying research on interventions are needed to reliably assess the effectiveness of different interventions. [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.)

Purpose: To identify the risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease based on Antonovsky's salutogenesis theory. Methods: This study used a qualitative descriptive design. We interviewed adolescents diagnosed with Moyamoya disease and their parents and experts with experience in treating them from 4 July 2019 to 10 October 2019. Data analysis was performed according to the process of deductive content analysis based on Antonovsky's salutogenesis theory. Results: This study identified risk and protective factors affecting a salutogenic sense of health in adolescents with Moyamoya disease. Risk factors were closely related to problems with friends, parent relationships and academic work. Protective factors were identified as emotional support through interpersonal relationships, positive attitudes to the disease situation, ability to understand and predict patterns of symptoms, increasing strength to resolve the state of tension and developing available resources. Conclusion: The factors affecting a salutogenic sense of health in adolescents were identified reflecting on the characteristics of the developmental stage of adolescents and the symptoms and situations that are unique to adolescents. It is important for adolescents with Moyamoya disease to recognize available resources and use them appropriately to successfully manage the state of tension caused by stress. Summary statement: What is already known about this topic? Adolescence is an important developmental stage in which individuals experience rapid physical and cognitive changes; these developmental changes can be more stressful for adolescents with Moyamoya disease.Stressful situations increase the frequency and worsen the symptoms of transient cerebral ischaemic attacks, and these negative experiences lead to depression, anxiety, low self‐esteem, negative self‐concept formation and social maladjustment, which persist until adulthood. What this paper adds? The risk factors affecting the salutogenic sense of health in adolescents with Moyamoya disease were related to problems with interpersonal relationships and academic work.The families of adolescents with Moyamoya disease play a pivotal role in increasing their strength to resolve their state of tension.It is important for adolescents with Moyamoya disease to identify and understand the resources available to them and use them appropriately to manage the state of tension. The implications of this paper: This study is meaningful in that the factors affecting the salutogenic sense of health were identified by reflecting on the unique characteristics of the developmental stage of adolescents.The results of this study will guide clinical nurse and researchers in developing interventions to maintain and promote the health of adolescents with Moyamoya disease. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore and understand the barriers perceived by Italian nurses to adopting self‐monitoring for managing oral anticoagulation in real‐life settings. Background: Barriers to self‐monitoring implementation for managing oral anticoagulation have been poorly described. Design: The study had a qualitative descriptive and exploratory design with a hybrid approach. Methods: A literature review was conducted to identify a priori barriers (deductive approach), while a small and semi‐structured focus group discussion was performed to explore the contextual barriers experienced by Italian nurses (inductive approach). A classic content analysis technique was adopted. Data were collected in 2019. Findings Two main categories were identified. Organizational barriers referred to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring. Individual barriers encompassed professional characteristics (e.g. university background, professional knowledge, continuum education and accountability/responsibility) and patient characteristics (e.g. patient health literacy and knowledge, engagement/empowerment and educational programmes). Finally, unwarranted clinical variation in oral anticoagulation management arose as a barrier determined by organizational and individual elements. Conclusions: The results of this study pointed out an urgent public health issue in addressing barriers influencing self‐monitoring practice and in sustaining care models that might enhance the quality improvement of self‐monitoring for managing oral anticoagulation. Summary statement: What is already known about this topic? Anticoagulation therapy is one of the leading chronic treatments worldwide to prevent stroke in atrial fibrillation patients.Self‐monitoring is a valuable option to further improve the quality of anticoagulation surveillance and patient medication adherence compared to standard care models.Thus far, the barriers underpinning self‐monitoring implementation experienced by Italian nurses are mainly unexplored.What does this paper add? This study is the first Italian description regarding the main barriers perceived by Italian nurses to adopting SM in patients treated using oral anticoagulation therapy.Organizational barriers refer to the lack of inter‐professional collaboration and health‐care system strategies to provide clinical pathways for self‐monitoring.Individual barriers encompass professional characteristics and patient characteristics, and unwarranted clinical variation arose as a barrier determined by both organizational and individual barriers.The implications of this paper Description of the main barriers perceived by Italian nurses to adopt self‐monitoring of oral anticoagulation is required to prioritize policies and system‐level interventions.Health institutions, patient associations and scientific societies should develop policies that enhance the continuum of professional education of nurses regarding self‐monitoring for oral anticoagulation.Integrated care models where nurses have a leadership role in providing self‐monitoring practice are required to implement self‐monitoring widely. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This paper describes the development of a SBHC with an innovative model of care that grew out of a partnership between a public‐school district and a university nursing programme in the midwestern region of the United States. Background and Purpose: Persistent barriers to health and health care experienced by youth are well documented. School‐based health centres (SBHCs) can improve educational and health outcomes, positively impacting health equity. Academic systems are positioned to address health care needs of the school‐aged population, yet educators face challenges of accessing quality learning placements for students and faculty practice sites. Methods: A community‐based collaborative methodology guided the planning phases that were driven by priority needs identified by families and stakeholders. With the mission of "partnering with students, families, and communities in the promotion of health and wellness through engagement in practice, education, and research," an ongoing dialogue over a two‐year period led to articulating a vision, designing a plan and implementing a nurse‐managed SBHC. The Standards for Reporting Qualitative Research (SRQR) checklist was considered in the preparation of this paper. Results: In three years, this SBHC has addressed and identified priority needs and served individual youth and families. The SBHC provides opportunities for the faculty to fulfil a practice requirement for certification and accreditation. Nursing students engage with youth and families in health education and health promotion while strengthening their technical and relational skills. Family nurse practitioner students gain valuable clinical experience. Faculty with expertise in family nursing guide family assessments, support family resiliency and direct therapeutic conversations with family units. Conclusion: SBHCs serve youth, families, and community. This academic–practice partnership has the added benefit of providing faculty practice opportunities and nursing student experiential learning. Relevance to Clinical Practice: SHBCs provide practice opportunities that address needs in individuals, families, and communities. Partnerships should be considered at academic nursing programmes to support their needs and fulfil commitments to address health equity gaps. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Coercive measures represent an ethical conflict because they limit the person's freedom, compromising their personal autonomy, self‐determination and fundamental rights.The reduction of the use of coercive measures implies not only regulations and mental health systems, but also cultural aspects, such as societal beliefs, attitudes, and values.There is evidence about the professionals' views on coercion in acute mental health care units and community settings, but they remain unexplored in inpatient rehabilitation units. What the paper adds to existing knowledge?: The knowledge about coercion varied from not knowing at all the meaning of the word, to a proper description of the phenomenon.Coercive measures are considered a necessary evil or normalized in mental health care and considered implicit to daily practice. What are the implications for practice?: The perceptions and attitudes towards coercion might be influenced by the knowledge about the phenomenon. Training of mental health nursing staff in non‐coercive practice could help professionals to detect, be conscious towards, and question coercive measures, thus orienting them to the effective implementation of interventions or programmes with evidenced effectiveness to reduce them. Introduction: Creating a therapeutic and safe milieu with the minimum coercive measures requires knowing professionals' perceptions and attitudes towards coercion, but they remain unexplored in medium and long‐stay inpatient psychiatric rehabilitation units. Aim: To explore the knowledge, perception and experience of coercion among nursing staff at a rehabilitation medium‐stay mental health unit (MSMHU) in Eastern Spain. Method: Qualitative phenomenological study including 28 face‐to‐face, semi‐structured interviews based on a script. Data were analysed using content analysis. Results: Two main themes were found: (1) therapeutic relationship and treatment in the MSMHU, which included three subthemes: qualities of the professionals for building the therapeutic relationship; perceptions about the persons admitted to the MSMHU; views of the therapeutic relationship and treatment in the MSMHU; (2) Coercion at the MSMHU, comprising five subthemes: professional knowledge; general aspects; emotional impact of coercion; opinions; alternatives. Discussion: Coercive measures are often normalized in mental health care and considered implicit to daily practice. A proportion of participants who did not know what coercion is. Implications for Practice: Knowledge about coercion might influence attitudes towards coercion. Mental health nursing staff could benefit from formal training in non‐coercive practice, facilitating the operative implementation of effective interventions or programmes. [ABSTRACT FROM AUTHOR]

Background: Older people in the nursing home environment are much less mobile and capable of taking care of themselves as they age, and most of them face the plight of loneliness, which seriously affects the quality of life of older people in their later years. Aims: A systematic review and synthesis of older people's experiences of loneliness in nursing homes. Design: Following ENTREQ, do a systematic evaluation and synthesis of qualitative investigations. Methods: A search of PubMed, Cochrane Library, Web of Science, Embase, the Chinese biomedical literature service system, the China National Knowledge Infrastructure, the Wanfang Database and the Wipu Database for qualitative studies of older people's experiences of loneliness in nursing homes was conducted with a search time frame of March 2023. Evaluation of the quality of the literature using the Joanna Briggs Institute's Australian Centre for Evidence‐Based Health Care Quality Assessment Criteria for Qualitative Research, And the data were synthesised using Thomas and Harden's method of thematic and content analysis. Results: A total of 13 papers were included, and 36 research findings were distilled and integrated into three themes: causes of loneliness; feelings of loneliness; coping with loneliness; and seven sub‐themes: aging and loss; environmental transformation; loneliness is a pain; loneliness is a choice; participation; strengthening social ties; and diverting attention. Conclusions: Older people in nursing homes face varying degrees of loneliness, which is a subjective feeling influenced by the interplay between personal awareness and the external environment, so future care interventions should be developed in a comprehensive manner, taking into account the characteristics of the older people themselves and their external environment. No Patient or Public Contribution: This study is a meta‐synthesis and does not require relevant contributions from patients or the public. [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.)

Aims and objectives. To examine the effect of the introduction of an electronic nursing documentation system on the efficiency of documentation in a residential aged care facility. Background. Modern technology has the potential to free caregivers in residential aged care facilities from their burden of paper documentation and allow them more time to care for residents. To date, there is inadequate evidence to verify this assumption. Design. Longitudinal cohort study with work sampling method for data collection. Methods. This study was conducted between 2009-2011; two months before and 3, 6, 12 and 23 months after implementation of an electronic documentation system. A work classification tool was used by an observer to record documentation activities being performed on paper or on a computer by the caregivers. Results. When compared with the proportion of time caregivers spent on documentation in the preimplementation period, personal carers' proportion reduced at three months after implementation. The proportion increased from six months and then dropped at 23 months. Recreational activity officers' proportion increased at three months after implementation. It stabilised at six months and increased again at 12 months. At 23 months, the proportion returned to the preimplementation level. Less than half of the caregivers' time on documentation after implementation was associated with computer-related tasks. Conclusions. Introduction of an electronic documentation system may not necessarily lead to efficiency in documentation for the caregivers. Charting some information items on paper and others on a computer may hinder realization of documentation efficiency. Relevance to clinical practice. To optimise the efficiency benefit of electronic documentation in a residential aged care facility, it is not only necessary to automate all nursing forms but also to ensure that the system is aligned with caregivers' documentation practice. Continuous education and mentor support is essential to ensure caregivers' effective usage of the electronic system. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Police and ambulance staff are increasingly asked to help people experiencing mental health crises, but they often feel under‐prepared.The single frontline service approach is time‐intensive and risks a coercive pathway to care.The emergency department is the default location for transfers by police or ambulance involving a person involved in a mental health crisis, despite being viewed as suboptimal. What the paper adds to existing knowledge: Police and ambulance staff struggled keeping up with the mental health demand, reporting inadequate mental health training, little enjoyment and negative experiences when trying to access help from other services.Most mental health staff had adequate mental health training and enjoyed their work, but many experienced difficulties getting help from other services.Police and ambulance staff found it hard to work with mental health services. What are the implications for practice: The combination of limited training, poor interagency referral processes, and difficulties accessing support from mental health services means that when police and ambulance services attend mental health crises alone, distress may be heightened and prolonged. Enhanced mental health training for first responders and more streamlined referral processes may improve process and outcomes.Mental health nurses have key skills that could be utilized in assisting police and ambulance staff who attend 911 emergency mental health calls.New models such as co‐response teams, whereby police, mental health clinicians and ambulance staff respond conjointly should be trialled and evaluated. Introduction: First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi‐agency perspectives of such work. Aim/Question: To understand the views of police officers, ambulance and mental health staff attending mental health or suicide‐related crises in Aotearoa New Zealand and to discover how they experience current models of cross‐agency collaboration. Methods: A descriptive cross‐sectional survey involving mixed methods. Quantitative data were analysed using descriptive statistics and free text by content analysis. Results: Participants included 57 police officers, 29 paramedics and 33 mental health professionals. Mental health staff felt adequately trained, but only 36% described good processes for accessing inter‐agency support. Police and ambulance staff felt undertrained and unprepared. Accessing mental health expertise was considered difficult by 89% of police and 62% of ambulance staff. Discussion: Frontline services struggle managing mental health‐related 911 emergencies. Current models are not working well. Miscommunication, dissatisfaction and distrust exist between police, ambulance and mental health services. Conclusion: The single‐agency frontline response may be detrimental to service users in crisis and under‐utilizes the skills of mental health staff. New ways of inter‐agency cooperation are required, such as co‐located police, ambulance and mental health nurses responding in partnership. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Communication between nurses and patients is essential in mental health nursing.Lack of communication during seclusion causes dissatisfaction among patients.Coercive practices can cause psychological discomfort for patients and staff members.Research related to nurses' perceptions of nurse–patient communication during seclusion events is scant.In Finland, the use of coercive practices has been high despite efforts to reduce the need for coercive practices through the National Mental Health Policy since 2009.Nurse–patient communication is referred to in the Safewards model as one issue of delivering high‐quality care. What this paper adds to existing knowledge?: Nurses aim to achieve high‐quality communication while treating patients in seclusion.Nurses aim to communicate in a way that is more patient‐centred.Various issues affect the quality of communication, such as nurses' professional behaviour and patients' state of health. What are the implications for practice?: Improved communication between nurses and patients will support therapeutic relationships and could lead to a better quality of care.Nurses' enhanced communication may promote the use of noncoercive practices more frequently in psychiatric settings.Improving nurses' communication skills may help support the dignity and autonomy of secluded patients, resulting in patient experiences that are more positive in relation to care offered in seclusion.Nurses should be offered opportunities to take part in further training after education to enhance communication skills for demanding care situations.Further research that incorporates the perspectives of patients and those with lived experience of mental health problems is needed.Components of evidence‐based Safewards practices, such as using respectful and individual communication (Soft Words), could be relevant when developing nurse–patient communication in seclusion events. Introduction: Communication between nurses and patients is essential in mental health nursing. In coercive situations (e.g. seclusion), the importance of nurse–patient communication is highlighted. However, research related to nurses' perceptions of nurse–patient communication during seclusion is scant. Aim: The aim of this study was to describe nurses' perceptions of nurse–patient communication during patient seclusion and the ways nurse–patient communication can be improved. Method: A qualitative study design using focus group interviews was adopted. Thirty‐two nurses working in psychiatric wards were recruited to participate. The data were analysed using inductive qualitative content analysis. Results: Nurses aimed to communicate in a patient‐centred way in seclusion events, and various issues affected the quality of communication. Nurses recognized several ways to improve communication during seclusion. Discussion: Treating patients in seclusion rooms presents highly demanding care situations for nurses. Seclusion events require nurses to have good communication skills to provide ethically sound care. Conclusion: Improved nurse–patient communication may contribute to shorter seclusion times and a higher quality of care. Improving nurses' communication skills may help support the dignity of the secluded patients. Safewards practices, such as respectful communication and recognizing the effect of non‐verbal behaviour, could be considered when developing nurse–patient communication in seclusion events. Relevance Statement This study deepens the understanding of nurse–patient communication during seclusion events from the perspective of nurses. Caring for patients in seclusion presents challenging situations for nurses and demands that they have good communication skills. To enhance their communication skills in seclusion events, nurses require opportunities to take part in further training after education related to communication skills for demanding care situations. Knowing the appropriate ways to interact with individual patients during seclusion can help nurses create and maintain communication with patients. For mental health nursing, nurses' enhanced communication may promote increased use of noncoercive practices in psychiatric settings. For patients, improving nurses' communication skills may help support dignity and autonomy during seclusion and shorten the time spent in seclusion, resulting in a better quality of care and more positive patient experiences related to care offered in seclusion. In this, the perspectives of people with lived experience of mental health problems should be acknowledged. Components of Safewards practices, such as using respectful and individual communication and paying attention to one's non‐verbal communication (Soft Words), could be useful when developing nurse–patient communication in seclusion events. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Problematic internet use (PIU) negatively affects adolescents' lives biopsychosocially.There is limited qualitative research examining the problem of PIU in adolescents. These studies focused more on the non‐clinical population. Adolescents' perceptions of the internet, their thoughts, feelings and behaviours in situations where they can and cannot access the internet have rarely been examined. What does the paper add to existing knowledge?: This research provides an in‐depth look at the experiences of adolescents with PIU in a clinical population.Unlike previous studies, adolescents mentioned that they turned to the internet for reasons such as lack of activity, their need to spend time with their friends and better getting along with people they met on the internet. They also described a world without internet as apocalypse, desert and grave.In this study, a holistic emphasis was placed on the thoughts, feelings and behaviours of adolescents in situations where they could and could not access the internet. This may contribute especially to mental health nurses working in clinics in terms of understanding the thought‐emotion and behaviour patterns of adolescents with PIU.Adolescents also stated that their lives were affected positively and negatively as a result of PIU. What are the implications for practice?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self‐awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. What are the implications for practice?: Mental health nurses can use activity therapy, behaviour modification: social skills, coping enhancement, parent education: adolescent, self‐awareness enhancement, cognitive restructuring, emotion and behaviour management interventions to reduce the risk of PIU and the problems it causes for adolescents. Introduction: Studies on problematic internet use (PIU) are mostly on the non‐clinical population. Understanding the experiences of adolescents with PIU is critical in shaping nursing interventions and improving the quality of care. Aims: A comprehensive description of the experiences of adolescents with PIU. Methods: In the study, descriptive phenomenology design, one of the qualitative research methods, was used. Data were collected using a personal information form and a semi‐structured interview form and analysed using Giorgi's phenomenological method (n = 11). Results: As a result of the content analysis, five main themes were identified: reasons of PIU, internet‐related perceptions, experiences in accessing the internet, experiences in not being able to access the internet and consequences of internet use. Discussion: Different from previous studies, adolescents stated that they use the internet because of their lack of activity and their need to spend time with their friends. They stated that when they could not access the internet, they thought they could never live without the internet and started quarrel. [ABSTRACT FROM AUTHOR]

Aim: If not conducted correctly, nursing handover can threaten patient safety, and so nursing students require good handover education. This study evaluated a handover education programme based on situated learning theory in a clinical practicum. Methods: A quasi‐experimental design and convenience sampling technique were used. The participants (fourth‐grade nursing students recruited from a college in the C province of South Korea) were assigned to an intervention group (n = 38) or a control group (n = 39). A handover education programme that included lectures, expert observations, role playing, peer learning and reflection was received by the intervention group. The control group attended lectures and observed handovers. The handover skills of all participants were tested 2 weeks before and on the last day of the clinical practicum. Handover performance ability, handover clinical judgement ability and handover self‐efficacy were outcome variables. Results: Significant improvements in handover performance ability, handover clinical judgement ability and handover self‐efficacy were observed in the intervention group compared with the control group. Conclusion: The significance of this study lies in the development and application of a programme based on situated learning theory for handover education. Application of theory‐based handover education in clinical practicums is recommended to improve the handover capabilities of nursing students. Summary statement: What is already known about this topic? Nursing handover is considered very important for optimizing nursing performance and securing the continuity and safety of patient care.Nurse educators must develop and validate educational strategies to resolve handover deficiencies among nursing students. What this paper adds? The self‐evaluation of handover performance ability, handover clinical judgement ability and handover self‐efficacy were better in nursing students who received handover education based on situated learning theory than in the control group. The implications of this paper: Theory‐based handover education applied in a clinical practicum context can allow nursing students to improve relevant capabilities prior to graduating as a clinical nurse.Situated learning theory provides a theoretical basis upon which to support practical handover learning. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Medicinal plants are a part of everyday life.Medicinal plants have many effects on the lives of individuals diagnosed with mental illness. What the paper adds to existing knowledge?: Since there is no qualitative study in which individuals diagnosed with mental illness provided a detailed explanation of their views about the use of medicinal plants, this study will fill a gap in the literature and guide mental health nurses.This study provides information for mental health nurses about how individuals diagnosed with mental illness evaluate medicinal plants, what it means to them and the effects of medicinal plants.It provides ideas about the use of medicinal plants as a tool to protect and improve mental health.In addition, since the majority of the studies on mental illnesses and medicinal plants are quantitative studies, it was thought that this study was different from the seminal studies in the literature and could offer new ideas for future studies. What are the implications for practice?: The results of this study show mental health nurses that the positive aspects of medicinal plants can be used to maintain and improve the mental health of individuals diagnosed with mental illness.Mental health nurses should evaluate the treatment and maintenance process in detail, considering that medicinal plants may interact with drug treatment or the risks of using medicinal plants in terms of adverse effects.Moreover, mental health nurses should fight against the negative aspects of medicinal plants.Mental health nurses and individuals diagnosed with mental illness should be made aware of the use of medicinal plants. Aim: There was no qualitative study found in which individuals diagnosed with mental illness explained their views in detail about the use of medicinal plants. It is therefore thought that this study will fill this gap in the literature and guide mental health nurses in the field. The research was carried out to determine the use of medicinal plants by individuals diagnosed with mental illness. Method: This research was a qualitative study conducted using the case study design. Ten individuals diagnosed with mental illness for at least 10 years, determined by the purposeful sampling method were interviewed. The data were collected between March and April 2022 with information form and semi‐structured interview form and analysed with the content analysis method. Findings: Four of the participants had depression, four had anxiety and two had mood disorders. Themes were determined to be a source of healing (ointment for the soul, body tonic and organic and nature's miracles) and cultural accumulation (faith and inheritance, counselling helpline). Conclusion: Participants described medicinal plants as a source of healing, stating that medicinal plants are good for bodily and mental health and provide purification. Individuals stated that the information about medicinal plants represents cultural accumulation as an inheritance, they applied them as a counselling helpline in case of illness. Implications for Practice: The positive effects of medicinal plant use can be supported by mental health nurses. Considering that medicinal plants may interact with the drug treatment, the use of medicinal plants should be evaluated in detail by mental health nurses. [ABSTRACT FROM AUTHOR]

Aim: To describe academic nurses' experiences engaging clinical nurses in utilizing and implementing developmental and research‐based knowledge in hospital settings. Methods: This study used a descriptive qualitative design. Fourteen academic nurses at Masters or PhD level from three different regions of Denmark participated in the study, relating their successful experiences engaging clinical nurses in utilizing and implementing developmental and research‐based knowledge. Data were collected in February 2020 through qualitative semi‐structured interviews and analysed using a qualitative manifest content analysis. Results: The main theme revealed was that academic nurses were 'Working towards creating a practice‐related culture for research' to engage clinical nurses. This was supported by three subthemes: 'Focusing on evidence‐based practice knowledge', 'Facilitating knowledge through a pedagogical approach' and 'Aiming for future changes'. Conclusions: The academic nurses experienced their engagement of clinical nurses and the subsequent change of practice in patient care and nurses' workflows in the department settings, as successful due to the academic nurses' pedagogical actions to educate clinical nurses and due to the academic nurses' practice‐related approach to research and implementation. Summary statement: What is already known about this topic? Nurses who utilize research and work with evidence‐based practice are more satisfied with their work, have better patient outcomes and become advocates for patients as they focus on improving the quality of patient care.Engaging nurses in nursing research can be a difficult task due to barriers to research utilization. However, most nurses have positive attitudes towards research.Knowledge is needed about how nurses have been successfully engaged in utilizing and implementing developmental and research‐based knowledge. What this paper adds? Academic nurses have successfully engaged clinical nurses in research and development by creating a practice‐related research culture.Engaging clinical nurses in research and development can be improved by focusing on evidence‐based knowledge to solve practical problems in nursing.Facilitating knowledge of research through pedagogical actions of education and involvement is often more important than the academic knowledge itself. The implications of this paper: Engaging clinical nurses in research and development depends upon making practice‐related research culture a natural part of daily nursing practice.Dual management, consisting of two head nurses—one for practice and one for research—should be established to improve academic nurses' authority to implement changes in nursing practice. [ABSTRACT FROM AUTHOR]

Background: This study focuses on hospital‐employed researchers, a relatively new staff group. Their job descriptions vary, which may lead to lack of clarity or preparedness regarding their roles and core tasks during a crisis such as COVID‐19. Aim: The aim of this study was to explore hospital‐employed healthcare researchers' experiences of work during the COVID‐19 pandemic. Design A qualitative design based on Graneheim and Lundman's latent content analysis of two focus groups with researchers in clinical practice was chosen to explore researchers' experiences of work during the COVID‐19 pandemic. Methods: Fifteen hospital researchers participated in two focus groups, divided into predoctoral and postdoctoral researchers. Focus groups were conducted in May 2020 during the COVID‐19 pandemic, using the voice over IP service, Skype®, due to risk of contagion. Findings 'Searching for a new normal during the COVID‐19 pandemic' was the main theme during the latent content interpretation, with subthemes of (i) balancing calm and insecurity, (ii) negotiating core tasks and (iii) considering the future. Conclusion: The 15 researchers tried to balance calm and insecurity within work and family, on standby for the hospital's contingency plan, and in their research tasks. This led them to negotiate their core tasks and to reflect on the changes and consequences for their positions as researchers in clinical practice in the future. Summary statement: What is already known about this topic? During a major healthcare crisis, normal plans and procedures at hospitals are set aside.Working under unexpected and unsecure conditions may lead to postcrisis reactions.Researchers with nursing and allied health backgrounds, who are the first generation of these researchers at hospitals, do not have fully developed and recognized positions. What this paper adds? Nurse and allied health researchers searched for a new normal in their work during the COVID‐19 pandemic.Nurse and allied health researchers tried to balance calm and insecurity during the COVID‐19 pandemic, due to the imbalance between their research‐related tasks and their status on standby for clinical tasks in the hospital contingency plan.Nurse and allied health researchers struggled with identifying and negotiating their core tasks by reconsidering possible changes and consequences for their positions as researchers in clinical practice in the future. The implications of this paper: Nurse and allied health researchers employed in clinical practice were willing to participate on the frontline, monitoring and evaluating major healthcare crises like the COVID‐19 pandemic.This could potentially lead to new and important context‐sensitive learnings after crisis but only if healthcare leaders and organizations clearly formulate the expectations for the researchers. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Advanced clinical practitioners (ACPs) are, typically, non‐medical healthcare professionals, who possess advanced clinical skills, a master's level qualification and evidence of leadership, management and research abilities.Most ACPs are nurses and new ACP roles are increasingly being established around the world.The views of senior staff towards new mental health nursing roles in organizations are likely to influence their introduction and sustainabilityResearch on mental health nursing ACP roles is sparse. What the paper adds to existing knowledge?: The paper uniquely provides specific information as to factors perceived by senior staff as affecting the implementation of ACP roles in mental health services.A wide range of mental health services were perceived as potentially benefiting from ACPs.Establishing role clarity for MHN ACPs is perceived as being as essential to successful introduction of the role, as has been found for other specialities. What are the implications for practice?: Participants identified a need for early engagement with service users and professions about new ACP roles and for processes that can evaluate ACP roles once they established.Some mental health nurses may require long‐term developmental pathways to help prepare them to take on a master's level course and then the ACP role. Introduction: Advanced clinical practice (ACP) roles are increasingly being developed internationally. Identifying factors perceived as affecting the development of ACP can support effective implementation. Aim: To understand the views of senior health service staff as to factors influencing the development of ACP roles in mental health services. Method: Focus group and semi‐structured interviews. Participants were directors of nursing (n = 10) and other senior staff from roles important to workforce development (n = 10). Results: Content analysis suggested seven categories: understanding the role and national guidelines, attitudes to the role, learning from implementing other roles, understanding prerequisites for development, challenges, opportunities and future support/actions. Prerequisites for success would include early engagement with stakeholders. Medical attitudes towards ACP roles were perceived as generally more positive than previously. Discussion: The study provides unique information regarding perspectives of senior staff regarding the implementation of ACP roles in mental health services. A wide range of mental health services were perceived as potentially benefiting from ACPs, with the importance of role clarity being highlighted and long‐term developmental pathways for staff. Implications for practice: Successful Implementation of ACP roles may require clear role definition, early engagement with stakeholders and processes to evaluate role outcomes. [ABSTRACT FROM AUTHOR]

Aims: The aim was to describe the experiences of nurses in broaching the issue of overweight and obesity at maternity and child health clinics. Background: The mother's obesity and excessive weight gain during pregnancy and rapid weight gain in early childhood increase the risk of obesity of the newborn baby both in childhood and throughout life. Attention must be paid to the prevention of weight gain in families already during pregnancy and before school age. Methods: Informants were nurses working at maternity and child health clinics (N = 28). The qualitative data were collected by a focus group interview in spring 2016 and analysed using inductive content analysis. Findings The nurses interviewed considered it their duty to broach the issue and felt that they have sufficient courage to bring up overweight. They sometimes found it frustrating to talk about overweight and obesity, because families do not commit themselves to making lifestyle changes, and changes happen slowly. Nurses found the lasting relationship with families helpful for bringing up overweight. Conclusion: Nurses need more broaching skills, more training, supervising and tools for bringing up overweight and obesity with client families. The continuity of care in primary health care supports bringing up overweight. Summary statement: What is already known about this topic? Overweight means the risk of obesity, and obesity is defined as excessive fat accumulation in the body.Early recognition of the risk factors for overweight and addressing them play a key role, because treating obesity and reaching lasting results is difficult.Nurses working at maternity and child health clinics play an important role in preventing overweight and obesity in pregnant families and families with children and in broaching the issue, because almost all families use maternity and child health clinics' services. Whatthis paper adds? Nurses consider broaching the issue of overweight and obesity as their duty and an integral part of their work.Nurses recognize the feelings of frustration and negative emotions sometimes associated with taking up the issue of overweight and obesity, but they have difficulties to support families in this kind of situations.Nurses found the lasting relationship with families helpful for bringing up overweight. The implications of this paper: When in practice both nurses and clients recognize bringing up overweight and obesity, nurses need more training and support how to motivate families for the necessary change, identify family‐specific ways and utilize the family's own resources in spite of their own frustration.More attention has to be paid in nursing education on how to bring up overweight or some other emotional issues with clients. Nurses need more broaching skills, more training, supervising and more tools for bringing up overweight and obesity.We need more scientific knowledge about how negative emotions steer the operation of nurses and how they affect the willingness of families to make lifestyle changes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Only a small number of adolescents with suicidal behaviour receives any follow‐up treatment.The implementation of recurrent behaviour prevention strategies is crucial in the period following suicide attempts and should take into account adolescents' opinions to be effective and congruent. What does this paper add to existing knowledge?: This paper shows that the 33 adolescent participants in the study identified the following protective factors of recurrent suicidal behaviour: family, friends and other trusted persons, as well as the self and newly learned strategies.The adolescents described their family as a constant presence and reported wishing that their parents maintain their current family support.Psychological support, health professionals and occupational activities are what the adolescents value most about hospitalization, and some criticisms are related to the environment, activities and health professionals.The adolescents also emphasize the need to maintain contact with the nurses after hospital discharge and make suggestions for service improvement related to the environment and the interventions implemented. What are the implications for practice?: Knowing the protective factors of recurrent suicidal behaviours, perception of the impact of the intervention, the expectation of future support and healthcare follow‐up is crucial for adapting suicide prevention strategies to be put in place by health services for better quality care delivery.The results obtained allow us to define as specific implications the implementation of psychoeducational intervention directed at the adolescent's family with suicidal behaviour during hospitalization and the definition of strategies for maintaining contact and follow‐up with the adolescent after discharge.This study emphasizes the need to reinforce training in suicidology for all health professionals for the improvement of clinical practice. Introduction: The prevention of recurrent suicidal behaviours in adolescents should consider their perceptions, needs and expectations. Aim/question: To identify the protective factors of recurrent suicidal behaviours in adolescents; To describe the family and the expectations for future involvement; To know the most important aspects of hospitalization and discuss expectations of nursing care follow‐up after hospital discharge. Method: A descriptive, qualitative and exploratory study was carried out in a sample of 33 adolescents with suicidal behaviours. Data were collected through semi‐structured interviews, and the data processing used the content analysis technique. Results: Findings arising from data allowed identifying the protective factors: family, friends and other trusted persons. During the hospitalization, the adolescents reinforce the knowledge about themselves and the newly learnt coping strategies. Psychological support and health professionals are what they value most about hospitalization and emphasize the need to maintain contact with the nurses after discharge. Discussion: Knowing the needs and expectations of adolescents with suicidal behaviour will make nursing psychotherapeutic interventions more effective and congruent in this vulnerable group. Implications for Practice: Ensuring psychoeducational intervention to the families of adolescents with suicidal behaviour and continuity of care after discharge, and reinforcing the training in suicidology for all health professionals. [ABSTRACT FROM AUTHOR]

The experiences of nurses who blew the whistle during the COVID‐19 pandemic have exposed gaps and revealed an urgent need to revisit our understanding of whistleblowing. Aim: The aim was to develop a better understanding of whistleblowing during a pandemic by using the experiences and lessons learned of Quebec nurses who blew the whistle during the first wave of COVID‐19 as a case study. More specifically, to explore why and how nurses blew the whistle, what types of wrongdoing triggered their decision to do so and how context shaped the whistleblowing process as well as its consequences (including perceived consequences). Design: The study followed a single‐case study design with three embedded units of analysis. Methods: We used content analysis to analyse 83 news stories and 597 forms posted on a whistleblowing online platform. We also conducted 15 semi‐structured interviews with nurses and analysed this data using a thematic analysis approach. Finally, we triangulated the findings. Results: We identified five themes across the case study. (1) During the first wave of COVID‐19, Quebec nurses experienced a shifting sense of loyalty and relationship to workplace culture. (2) They witnessed exceedingly high numbers of intersecting wrongdoings amplified by mismanagement and long‐standing issues. (3) They reported a lack of trust and transparency; thus, a need for external whistleblowing. (4) They used whistleblowing to reclaim their rights (notably, the right to speak) and build collective solidarity. (5) Finally, they saw whistleblowing as an act of moral courage in the face of a system in crisis. Together, these themes elucidate why and how nurse whistleblowing is different in pandemic times. Conclusion: Our findings offer a more nuanced understanding of nurse whistleblowing and address important gaps in knowledge. They also highlight the need to rethink external whistleblowing, develop whistleblowing tools and advocate for whistleblowing protection. Impact In many ways, the COVID‐19 pandemic has challenged our foundational understanding of whistleblowing and, as a result, it has limited the usefulness of existing literature on the topic for reasons that will be brought to light in this paper. We believe that studying the uniqueness of whistleblowing during a pandemic can address this gap by describing why and how health care workers blow the whistle during a pandemic and situating this experience within a broader social, political, organizational context. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Mental Health First Aid Training Programmes with a pathogenic perspective are implemented worldwide for different participants and contexts. These interventions can promote the medicalization and psychiatrization movement of human suffering.Training programmes should teach about mental health nursing problems rather than disorders. However, there seem to be no studies describing these healthier interventions targeting adolescents in upper secondary schools. Nurses can explore these interventions and target them towards these participants and contexts. What the paper adds to existing knowledge?: The perspective of nurses on the characteristics of Mental Health First Aid Training Programmes for adolescents in Portuguese upper secondary schools is reported.Experts recognize that the nurses who perform these interventions must have personal, pedagogical and mental health competencies. Therefore, mental health nurses may be considered. The components of mental health literacy, mental health nursing problems and a dynamic first aid plan can be taught using different classroom training strategies. What are the implications for practice?: The role of mental health nurses in promoting health literacy is highlighted. They have the opportunity to lead multidisciplinary teams in using these healthier training programmes.These expert opinions can shape the planning, implementation and evaluation of these interventions. In turn, training programmes can promote the identification, assistance and/or adequate and timely referral of people with mental health nursing problems. Introduction: Mental Health First Aid Training Programmes performed by nurses can empower adolescents to aid people with mental health problems. There do not appear to be any studies that describe these healthier interventions aimed at adolescents in upper secondary schools. The development of these educational interventions benefits from the input of their participants and facilitators. Aim: To explore the perspective of nurses about Mental Health First Aid Training Programmes for adolescents in upper secondary schools. Method: A qualitative, descriptive and exploratory study was conducted. Data were collected from seven mental health nurses during two focus group sessions. Data were analysed using content analysis. Results: Twelve themes were identified around nine main areas: facilitators, intervention foci, outcomes assessment methods, process assessment methods, participants, implementation context, duration and frequency, intervention methods and strategies, and contents. Discussion: Mental health nurses can regularly perform these classroom interventions to improve the mental health competencies of adolescents. Various educational methods can facilitate learning related to mental health literacy components, mental health nursing problems and the first aid plan. Valid and appropriate assessment methods enhance a good representation of these interventions. Implications for Practice: This evidence can guide the creation and modelling of these first aid training programmes. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Previous studies on leadership in psychiatric care have focussed on a diversity of staff and on different healthcare settings.Nurses in both Sweden and internationally, working with patients newly diagnosed with psychosis and addiction, describe an overwhelming workload.Existing research points out that experience and leadership training are the most important factors to exert a good nursing leadership. In Sweden, requirements for leadership exists already from the first day of a nurse's career.The relationship and communication between nurses in psychiatric care and members of the staff is decisive for whether the leadership will work. What the paper adds to existing knowledge: The study adds knowledge regarding the challenges leading the nursing care for patients diagnosed with psychosis and addiction.Ambivalence in the leadership role is prominent among nurses in psychiatric care and feelings of responsibility and meaningfulness are mixed with feelings of powerlessness and uncertainty.Swedish psychiatric nurses lack mandate to lead psychiatric nursing care. This may increase the feelings of uncertainty in their leadership role. What are the implications for practice?: A mandate to lead as well as a leadership guidance in communication and teambuilding will enhance the leadership, especially among newly graduated nurses.Heightened awareness within the healthcare organization about nurse's experience of difficulties in leading the psychiatric nursing care of the most severe psychiatric illnesses could increase the right prerequisites for leadership. Introduction: Research shows that psychiatric nursing care puts additional demands on the nurse as a leader due to the psychological complexity of care. Experience and leadership training are most important to exert leadership. In Sweden, demands for leadership exist already at the beginning of a nursing career, and in psychiatry, it may lead to an overwhelming workload. Aim/Question: The aim of the present study is to highlight nurses' experiences of leading the psychiatric nursing care in an adult psychiatric context. Method: A qualitative interview study of eleven registered nurses within psychiatric inpatient care. Content analysis was used for analysis. Results: Leading with combined feelings of both meaningfulness and uncertainty were the theme arising from the result. Discussion: Findings from Swedish and international studies stress special demands on leadership in psychiatric care. The result shows that nurses perceived an ambivalence of their leadership in terms of both meaningfulness and uncertainty. Implications for Practice: An official mandate to lead as well as leadership guidance in communication and teambuilding will enhance leadership, especially among newly graduated nurses. Heightened awareness within healthcare organizations about difficulties in leading psychiatric nursing care could increase the possibility to create right prerequisites for leadership. [ABSTRACT FROM AUTHOR]

Aim: To determine if there are cross‐national differences in nurse understandings of the terms: missed care, rationed care and care left undone. Background: Nurse researchers from a number of countries have published studies on missed and rationed care. It is not clear if there are differences in understanding the key terms across various language groups. Design A mixed method questionnaire was distributed to 26 member countries of a nursing research consortium in 2017. Methods: Forty‐five responses to a qualitative questionnaire were received; 80% were nurse researchers. These responses were categorized into language groups and analysed for congruence and differences. Findings There was congruence across all language groups in interpreting the three terms. Giddens' theory of globalization provides an explanation for this congruence. Conclusion: Shared understandings are explained by the fact that the majority of participants are nurse researchers with knowledge of English and the research literature. Shared understanding within the globalized academic community does not necessarily translate for clinical or nurse managers, nor does it predetermine solutions. SUMMARY STATEMENT: What is already known about this topic? Missed care is a global problem.Various research teams have conducted studies on missed, rationed and unfinished care, including cross‐national studies. What this paper adds? The findings suggest that there is a shared understanding of the terms despite language differences.This shared understanding is restricted to nurse researchers and does not include nurse clinicians or managers.Giddens' theory of globalization provides an explanatory theory for this shared understanding. The implications of this paper: While there might be a shared understanding within the academic research community, this does not mean this extends to nurse clinicians or managers.Globalization of missed nursing care concepts is currently achieved through increased digital communication technologies, international research and the diffusion process of peer reviewed science.Nurse researchers are faced with the challenge of ensuring globalized concepts are translated across cultures into clinical and managerial practice and effective change strategies. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Nursing observations at night are conducted on psychiatric wards to ensure the safety and well‐being of patients as well as to reduce the risk of suicide or severe harm.To our knowledge, no studies have examined the lived experience of the psychiatric ward environment and of nursing observations at night. What does the paper add to existing knowledge?: The main complaint from patients was the constant interruption of their sleep, as most of the patients in this study were observed 2–4 times an hour. Their sleep was interrupted by (a) the light from torches shone into their faces by staff checking on their safety, (b) the noises produced by the opening and closing of bedroom/ward doors, and/or (c) staff talking to each other during the observation. Patients also reported that they found having somebody enter the room in the middle of the night intimidating and unsettling. What are the implications for practice?: Poor sleep has been associated with an increase in suicide risk and mental health problems.Identifying practices that promote sleep hygiene is vital.The study could be used to develop a Quality Improvement Project to improve patients' sleep and perhaps reduce duration of stay. Introduction: A fundamental component of nursing care is observations at night to ensure the well‐being of patients. However, there is no literature on the lived experience by inpatients of such observations or of the general environment of a psychiatric ward at night. Aim/Question: This study aims (a) to understand the lived experience of being an inpatient on a psychiatric ward at night with a focus on intermittent observations and (b) contribute to developing a tool to monitor the psychiatric ward environment for use in quality improvement projects. Method: Semi‐structured interviews were conducted with twelve inpatients from five psychiatric wards who had experienced intermittent observations at night. These interviews were subsequently transcribed and analysed using content analysis. Results: Environmental disturbances including light and noise, invasion of privacy and safety considerations on the ward all contributed to sleep disturbance. The unintended consequences of disturbances caused by intermittent night observations, and by staff in general and other patients formed the core of the inpatients' experience. We developed a clinical tool that could be used to identify the factors that are relevant on an individual ward. Discussion: Participants interviewed unanimously agreed that poor sleep quality had a significant negative impact on their psychological and social well‐being. These were discussed in relation to the environment and the experience of observations at night. Implications for nursing practice: Deprivation of inpatients' sleep is currently under‐reported, and the usefulness of intermittent observations at night in psychiatric wards is questioned. Much could be done to adjust the environment at night to support quality sleep and improve psychiatric symptoms. This paper aims to highlight the lived experience of patients to help bring improvements. [ABSTRACT FROM AUTHOR]

Aim: To develop a comprehensive, hands‐on assessment tool for assessing health in children under five in underserved regions. Design Methodological study design and usability testing were used. Sample Eight nurses working at two health posts and 261 children under five living in the migrant villages participated in the study. Measurement The developed tool was evaluated using 10 items of a questionnaire based on the honeycomb model of Morville (2004). Community nurses administered the questionnaire then followed with a focus group interview after completing a child health exam using the developed tool. Data were collected during July 2017. Results: The Hands‐on Assessment Tool for Child Health is composed of developmental screening, identification of risk factors and clinical signs, growth measurement, diagnostic tests and interpretation of each subdomain, and final impressions. Management strategies include parent education, resource networking, referral to a paediatrician, and follow‐up plans. Usability testing revealed high scores on the facets "valuable," "useful," "desirable," and "findable." Conclusions: Considering the demand for hands‐on tools in underserved regions, the developed tool can provide nurses with resources for competent management of child assessment, interpretation, and nurses' intervention strategies, fortified with clinical judgement processes. SUMMARY STATEMENT: What is already known about this topic? Many child health problems are preventable with early detection and intervention. Health problems in children under five affect the growth and development of the whole life.Community nurses in underserved regions need comprehensive and hands‐on assessment tools with point‐of‐care to identify child health problems and provide right care.Currently developed assessment tools for child health have limitations for use in underserved areas. What this paper adds? The Hands‐on Assessment Tool for Child Health (HATCH) helped community nurses to identify the child's health status and nurses to establish a proper care plan.The tool provided clinical judgement process of assessment, interpretation, and nurses' intervention strategies. The implications of this paper: The result of the research can contribute to a concrete intervention strategy for child health promotion by assessing health and development in underserved regions. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Patient and public involvement (PPI) is recognized as an increasingly important feature of healthcare research, education and public policy.In mental health, PPI is increasingly seen as evidence of the further democratization of services, which started with de‐institutionalization in the 1960s and the recovery movement in the 1990s.While much is known about learning enablers and learning gains on generic community‐based training programmes, less is known about PPI‐specific programmes in mental health. What this paper adds to existing knowledge?: Participants at a national training programme to support the engagement of service users, their families and carers in mental health services identified training topics of greatest importance to them and reported on what they learnt and what helped their learning.Patient and public involvement training initiatives aimed at supporting the engagement of service users, their families and carers should emphasize individual needs and local contexts.Training programmes should not make artificial or actual distinctions between the programme participants who are health professionals and those who are non‐professionals, such as service users.To our knowledge, this PPI initiative is the first time a national health service provider has sought to develop an engagement structure in mental health on a state‐wide basis. What are the implications for practice?: Participants in training programmes designed to support patient and public involvement believe that such programmes should include understanding how conflict is resolved, how committees work effectively and how to develop interpersonal and facilitation skills.Training programmes in mental health involving both professional and non‐professional participants requires all the participants to work together in particular at commissioning and design stages to achieve their desired outcome.The evaluation of the training programme to support the roll‐out of this initiative offers lessons to others who may wish to pursue similar structures in other jurisdictions. Introduction: The Irish national mental health service provider commissioned a national training programme to support a patient and public involvement (PPI) initiative in mental health services. The programme evaluation afforded an opportunity to describe the learning gains and learning enablers and the factors that support PPI in mental health. Aim: We aimed to evaluate a PPI training programme across nine regional administrative units in a national mental health service. Methods: We conducted a participant exit survey, using the Student Assessment of Learning Gains (SALG) instrument. We analysed the survey responses using SPSS version 24 software and applied directed content analysis to the narrative comments provided in open‐ended questions. Results: A total of 54 participants returned the completed questionnaire, yielding a response rate of 60%. The overall mean SALG score yielded was 3.97 (SD 0.66; range 1–5), indicating that participants reported very good to excellent gains in their learning from the programme. Participants who offered narrative comments indicated an overall positive experience but suggested that all stakeholders should work together to co‐produce the training. Discussion: All the stakeholders in a PPI training initiative to support the engagement of service users, their families and carers in mental health should work together to achieve their desired outcome. This requires co‐production in the design, delivery and evaluation of the training initiative, and co‐production can impact at both individual and local levels. Implications for Practice: PPI training initiatives in mental health should retain a focus on understanding conflict resolution, committee effectiveness, interpersonal and facilitation skills. Ensuring a shared understanding of key concepts, such as co‐production, is a necessary prerequisite at the co‐commissioning, co‐design, co‐planning, co‐delivery and co‐assessment stages of programme development, as is the need to avoid artificial or actual distinctions between health professionals and those who are non‐professionals, such as service users. Relevance statement: Mental health engagement and PPI are key principles underpinning modern mental health services and may increasingly impact on wider health service provision including policy and research imperatives. This paper discusses the evaluation of a PPI training programme and offers practical insights as to how such initiatives can be improved. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Involuntary treatment orders are increasingly being used around the world to allow the treatment of individuals living with a mental illness deemed incapable of giving consent and who are actively refusing treatment.The use of involuntary treatment orders can impact the nurse–patient therapeutic relationship, which is essential to offer quality care and promote recovery. What the paper adds to existing knowledge?: Nurses and patients do not agree on the possibility to develop a therapeutic relationship, with nurses believing they can build a bond with the patients despite the challenges imposed by the involuntary treatment order, and patients rejecting this possibility.Nurses caring for patients on involuntary treatment orders feel obligated to apply the conditions of this measure, even if it damages the relationship with their patients. This difficult aspect of their work leads them to question their role in relation to the management of involuntary treatment orders. What are the implications for practice?: Nurses need to be aware of the reasons why patients on involuntary treatment orders do not believe in the possibility of building a therapeutic relationship.Nurses need to reflect on and express their concerns about the damaging effects that managing involuntary treatment orders conditions can have on the nurse–patient therapeutic relationship. Introduction: Involuntary treatment orders (ITO) can impact the nurse–patient therapeutic relationship (TR) negatively. Despite the increasing use of ITOs around the world, few studies have explored their influence on the TR from the perspectives of nurses and patients. Aim: To describe the TR in the context of ITOs as reported by nurses and individuals living with a mental illness. Method: Secondary data analysis of qualitative interviews with nurses (n = 9) and patients (n = 6) was performed using content analysis. Results: Participants described the TR as fundamentally embedded in a power imbalance amplified by the ITO, which was discussed through the conflicting roles of nurses, the legal constraints imposed on patients and nurses, the complex relation between the ITO and the TR, and the influence of mental healthcare settings' context. Discussion: Nurses and patients' views were opposed, questioning the authenticity of the relationship. Implications for Practice: Nurses should be aware of the patients' lack of faith in the TR to ensure that they are sensitive to patients' behaviours that may falsely suggest that a relationship is established. Further studies should explore ways to alleviate the burden of the management of ITOs on nurses and allow for a trusting relationship to be build. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Some nurses develop positive relationships with people diagnosed with borderline personality disorder (BPD), while others have negative emotional reactions to people diagnosed with this disorder.The therapeutic relationship is key in the practice of mental health nursing.Enhanced knowledge of BPD allows mental health nurses to develop improved self‐awareness, knowledge and understanding of the individuals and insight into the therapeutic challenges, which can improve attitudes towards people with this diagnosis. What the paper adds to existing knowledge?: We are lacking knowledge about the perspective of people diagnosed with BPD on the attitudes of mental health nurses that facilitate a positive therapeutic relationship.The perspective of people with a BPD diagnosis on the therapeutic relationship offers key information about the attitudes that they credit with supporting their recovery.The participants—people diagnosed with BPD—perceived that the following attitudes of mental health nurses reinforced the therapeutic relationship: confidence in the person's recovery, non‐judgement, sense of humour, availability and humanity. What are the implications for practice?: The study highlights mental health nurses' attitudes that participants perceived as having a positive effect on the therapeutic relationship.The recognition among people diagnosed with BPD of the constructive attitudes of mental health nurses may improve nurses' motivation to improve care for these patients.This study will allow mental health nurses to increase their awareness of the importance of attitude in the therapeutic relationship with people diagnosed with BPD. Introduction: The therapeutic relationship between mental health nurses and people diagnosed with borderline personality disorder (BPD) is essential to successful treatment, and nurses' attitudes are a key component of this relationship. Some nurses develop positive therapeutic relationships with people diagnosed with BPD, while others have negative emotional reactions which in turn limit their ability to develop a positive therapeutic relationship. There is a gap in the literature with respect to how people diagnosed with BPD perceive the attitudes of mental health nurses that foster a positive therapeutic relationship. Aim: To describe how people diagnosed with BPD who have experienced an improvement perceive the role of the attitudes of mental health nurses in building a positive therapeutic relationship. Method: Qualitative descriptive design with 12 interviews; thematic content analysis. Results: Participants identified five attitudes of mental health nurses as contributing to a positive therapeutic relationship: confidence in their ability to recover, non‐judgement, humour, availability and humanity. Discussion: Nurses' attitudes are key to the therapeutic relationship. It may be possible for nurses to improve their attitudes towards patients diagnosed with BPD through self‐reflection. Implications for practice: Mental health nurses should incorporate methods that explore attitudes and attitudinal development of the workforce. [ABSTRACT FROM AUTHOR]

Aims and objectives To systematically review the literature on the outcomes of educational interventions relevant to nurses with regard to guideline implementation. Background Previous reviews on interventions to implement guidelines have focused on particular clinical problems, but only one included nursing studies. Design A systematic review based on the procedure of the Centre for Reviews and Dissemination. Methods We searched for papers published from 1 January 2008 to 26 February 2015 using the Cochrane, CINAHL and PubMed MEDLINE databases and paper references were searched manually. Quality appraisal was conducted with tools developed by Thomas et al.(Worldviews on Evidence-based Nursing, 1, 2004, 176) and National Heart, Lung, and Blood Institute. Data were analysed with qualitative content analysis and narrative synthesis. Results The data included 13 studies based on a quasi-experimental study design of 13 different educational interventions, described according to their development and realisation, learning content and teaching and learning methods. Seven interventions were supported by simultaneous strategies, 12 studies reported statistically significant outcomes for the interventions on at least one measurement area and six studies reported improvements in the quality of patient care. Interventions with multi-dimensional content, teaching and learning methods produced several good outcomes. Conclusion Guidelines were implemented in a heterogeneous way and the interventions were delivered once and mainly on a local basis. In the future, we need to test these interventions in different nursing contexts, measure the outcomes on patient care and carry out randomised controlled trials on their effectiveness. It is important to standardise interventions, as this will allow them to be replicated and compared. Relevance to clinical practice Educational interventions to implement guidelines could be beneficial in enhancing nurses' evidence-based decision-making and care practice. The combination of teaching and learning methods proved useful, and educational interventions should be supported with simultaneous strategies. There remains a lack of strong evidence on the subject. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify common themes about care failures in residential aged care as described from the perspectives of older people and their families in transcripts from hearings and submission to the Australian Royal Commission. These failures are explored through the lens of moral disengagement. Background: Previous inquiries into care failures have highlighted widespread harm from inhumane care, caused by staff carelessness, indifference and callousness. In health care, limited consideration has been given to the moral engagement or disengagement of staff and the relationship of moral engagement with care failures. Method: Qualitative latent content analysis of 22 transcripts from the Royal Commission between March 2020–August 2020. Methods are reported using the SRQR. Results: This paper presents one theme, Dehumanisation of the care process: An aged life has less value, from a larger study. Care failures relating to morally disengaged staff were found to be widespread and influenced by the environments created by organisations. Conclusion: This study highlights the need for further research to identify indicators of moral disengagement among staff and explore strategies to reduce or prevent moral disengagement within organisations trusted with providing care to older people. Relevance to clinical practice: Caregiving is necessarily associated with, and shaped by, moral dimensions. The erosion or disengagement of these moral dimensions among care staff reveals important aspects of residential aged care's lived experience. Studying dynamics within aged care facilities can provide a useful analytic lens for illuminating ways that residents and their family or those close to them, experience or are impacted by moral dimensions and behaviours. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand Black women's perspectives on a pre‐exposure prophylaxis (PrEP) education intervention in a salon setting. Background: Black women have a significant lifetime risk of acquiring HIV. Pre‐exposure prophylaxis (PrEP) is an effective prevention approach in reducing that risk. Despite this, Black women are least likely to use PrEP. Design: This was a qualitative study to identify Black women's perspectives on acceptability of a PrEP education intervention in a salon setting using hair stylists. The paper adhered to the COREQ checklist in reporting. Methods: Seven focus groups among Black women (n = 44) living in north‐central North Carolina were conducted. Ethical approval was obtained. The interview guide included questions on knowledge of PrEP and barriers and facilitators to a PrEP promotion programme in a salon setting. Results: Conventional content analysis considered content in relation to themes of facilitators, barriers and women's preferences for intervention delivery. Facilitators included the salon characteristics, social culture and relationship with the stylist. Women noted concerns of accuracy of content from stylists and privacy as barriers. Conclusions: Participants' trust with their stylists make a PrEP education salon‐based intervention feasible. Salon‐based interventions are not one‐size‐fits‐all and researchers interested in this setting should tailor interventions to the individual salon. Interventions for PrEP in a salon setting should be culturally appropriate, confidential and consider the potential reach to the social networks of Black women in the salon. Relevance to clinical practice: The insights shared by Black women can contribute to developing a PrEP uptake intervention as a way of reducing new cases of HIV. [ABSTRACT FROM AUTHOR]