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Aim: To gain more insight into how nurses experience a participatory live music practice in relation to their ability to deliver compassionate care to medically hospitalised patients. Design: Qualitative interpretive design. Methods: Sixteen nurses participating in a live music practice with patients were interviewed using in‐depth interviews with open‐ended questions. Audio recordings were transcribed verbatim and subsequently coded. Theory‐driven inductive and deductive approaches were applied in thematic data analysis. Results: We identified four themes: (1) Nurses' empathy and compassion; (2) The caring nurse–patient relationship; (3) Person‐centred approaches to care and (4) Nurses' subjective wellbeing. By observing patients' reactions to the music, nurses described that they obtained a deeper insight and understanding of patients' emotional wellbeing. These observations led to increased feelings of compassion in patient contact and stimulated informal communication between nurses and patients through a sense of shared humanity. According to nurses, these aspects positively affected collaboration with patients in delivering care and stimulated them to pursue person‐centred approaches to care. Participating in the live music practice also positively affected nurses' wellbeing, enhanced relaxation and created an ambiance in which compassion could be expressed. Conclusion: A live music practice can positively contribute to the delivery of compassionate care by providing meaningful shared moments that increase feelings of empathy and compassion and strengthen the caring relationship. Implications for the profession: Offering a live music practice at the ward and bedside offers a unique possibility to enhance engagement in person‐centred, compassionate care. Impact: While compassion and compassionate care are essential component of nursing, nurses often experience multiple barriers to its provision in daily practice. An innovative way to stimulate compassionate care is through the participation of nurses and patients in a live music practice, providing a meaningful moment shared between them. This stimulates feelings of shared humanity and bonding in the caring relationship. Reporting Method: The COnsolidated criteria for REporting Qualitative research (COREQ). No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: To describe the childhood experiences of patients with polio from the acute phase of the disease during post‐war Finland in the 1950s and 1960s. Design: Qualitative empirical study based on self‐reported history of nursing rooted in the past, a history of experiences. Methodology: Interview materials were gathered in the form of themes (45) and written interviews (4) (29 September 2018 to 30 June 2019). Data were analysed by reflexive thematic analysis to highlight hidden and latent experiences. This approach generated the study's main theme, themes and subthemes. Results: The main theme, 'shattered childhood', generated from the study results and was then divided into two themes, both of which were influenced in part by the loss of a familiar childhood, the changed environment, the breakdown of the body and the absence of control. Through their childhood memories, polio survivors described their broken childhoods using the following themes: 'betrayal by their bodies' and 'isolation'. In the narratives, the theme 'betrayal by one's own body' was generated by the following subthemes: 'suddenness of the affliction', 'paralysis' and 'being moved to the hospital'. The 'isolation' theme developed from the subthemes 'isolation from the body and surroundings' and 'emotional and social loneliness'. Conclusion: Polio survivors' experiences during the acute stage of the disease were traumatic and demonstrated children's inferior nursing position in Finland in the 1950s and 1960s. Impact: The study increases our understanding of the history of caring for children and families who were affected and disabled by polio and the importance of their experiences in society and healthcare settings. Patient or Public Contribution: The authors collaborated with the Finnish Polio Association to recruit study participants and plan the study. Patients with polio during childhood underwent interviews, and their experiences formulated the data, which were analysed and the basis of the results. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ), a 32‐item checklist for interviews and focus groups, have been used as a reporting and checklist tool. All authors have agreed on the final version and the use of the COREQ criteria, relationship with participants, theoretical framework, setting, data collection and data analysis and report. [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: The aim of the study was to examine the effect of a caring leadership intervention program for first‐line nurse managers (FLNM) on their caring knowledge and managerial actions as well as nurses' perceived FLNM caring behaviours and nurse outcomes. Design: A quasi‐experimental study design was implemented on two groups; study and control, including 30 FLNM and 150 nurses for each. Methods: Self‐report questionnaires about FLNMs' knowledge of caring behaviours and their managerial actions, nurses perceived line nurse managers' caring behaviours and nurses' outcomes (job satisfaction and work engagement) were utilized to collect study data from 1 July 2022 to 30 December 2022. Results: A statistically significant difference and changes were revealed between the study and control groups in FLNMs' caring knowledge and their managerial actions, and nurses' perceived FLNMs' caring behaviours, nurses' job satisfaction and nurses' work engagement during post‐test in comparison to pre‐test. Higher total mean scores of post‐test in the study group were recorded compared to those of control group regarding FLNMs' caring knowledge and their managerial actions as well as nurses 'perceived FLNMs' caring behaviour, job satisfaction and work engagement. Conclusion: The caring leadership intervention program for FLNMs was highly effective in enhancing their caring knowledge and managerial actions as well as nurses' perceived FLNM caring behaviours and nurse outcomes. Implications for the Profession: Caring leadership can help FLNMs to create a healthy environment, resulting in a positive outcome for nurse staff, patients and healthcare organizations. Patient and Public Contribution: No patient and public contribution. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore the extent of missed nursing care in Turkey and identify its predictors. Design: This was a descriptive, cross‐sectional, multicentre study. Methods: A total of 477 nurses working in seven public hospitals participated in this study from March to July 2019. The survey included two components: a personal and professional characteristics data form and the MISSCARE survey. Results: The study revealed that emotional support, patient bathing and ambulation were the most frequently missed nursing care activities. An inadequate number of assistive personnel and staff, along with an unexpected increase in patient volume, were identified as the primary reasons for missed nursing care. Of the 21 missed nursing care activities, nine predictive models showed statistical significance (p < 0.05). Factors such as the type of unit, years of work experience, working hours, number of patients cared for in a shift and intention to leave the unit were found to be significant predictors of seven missed nursing care activities (p < 0.05). Conclusion: This study found that numerous variables influence each care activity, which suggests the need to devise more targeted and specific strategies to minimize missed nursing care. Thorough investigation into the impact of these strategies on each care activity is essential. Summary statement: What is already known about this topic? The problem of missed nursing care (MNC) affects healthcare institutions universally.MNC can serve as an indicator of patient safety, practice environment and quality of care.Intrapersonal, interpersonal, organizational and cultural factors may contribute to MNC.What this paper adds: This study found that nurses prioritize more structured and time‐sensitive care activities.This study showed the significant influence of staffing adequacy, patient volume and other variables on MNC.This study identified several significant predictors for each care activity, including the nature of the unit, weekly working hours, nurse‐to‐patient ratio, professional experience and intention to leave.The implications of this paper: To effectively reduce or eliminate MNC, the nature of each care activity should be examined separately.To develop more targeted, specific and comprehensive strategies, predictors of each care activity should be considered.A combination of observation and interview methods is recommended for a comprehensive evaluation of the effectiveness of the developed strategies. [ABSTRACT FROM AUTHOR]

Aim: To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID‐19 pandemic. Design: A phenomenological hermeneutical study guided by Lindseth and Norberg. Methods: In‐depth one‐on‐one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. Results: The findings comprise one main theme Caring through barriers and three themes with sub‐themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. Conclusion: Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. Impact The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. Public Contribution: This study involved new nurses in semi‐structured interviews. [ABSTRACT FROM AUTHOR]

Aims: This manuscript aims to provide a description of an evidence‐informed Science of Care practice‐based research and innovation framework that may serve as a guiding framework to generate new discoveries and knowledge around fundamental care in a more integrated manner. Background: New ways of thinking about models of care and implementation strategies in transdisciplinary teams are required to accelerate inquiry and embed new knowledge and innovation into practice settings. A new way of thinking starts with an explicit articulation and commitment to the core business of the healthcare industry which is to provide quality fundamental care. Design: This discursive paper delineates an iteratively derived Science of Care research and innovation framework (Science of Care Framework) that draws from a targeted literature review. Method: The Science of Care Framework integrates caring science with safety and symptom sciences with implementation, improvement, innovation and team sciences. Each science dimension is described in terms of seminal and evolving evidence and theoretical explanations, focusing on how these disciplines can support fundamental care. Conclusions: The Science of Care Framework can serve as a catalyst to guide future efforts to propel new knowledge and discoveries around fundamental care and how best to implement it into clinical practice through a transdisciplinary lens. Impact on nursing science, practice, or disciplinary knowledge: The Science of Care Framework can accelerate nursing discipline‐specific knowledge generation alongside inter and transdisciplinary insights. The novel articulation of the Science of Care Framework can be used to guide further inquiries that are co‐designed, and led, by nurses into integrated models of care and innovations in clinical practice. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim was to explore RNs' experiences of caring for patients with eating deficiencies in palliative care. Background: Food and mealtimes are fundamental aspects for wellbeing and social interactions. The worldwide trajectory of ageing populations may result in increased need for palliative care. Everyday life with chronic life limiting illness and eating deficiencies is challenging for patients and families. RNs are key care providers at end‐of‐life. Design: A qualitative study with an inductive approach was used. Methods: Nineteen experienced RNs in palliative care were interviewed through telephone; interviews were audio recorded and transcribed verbatim. Inductive qualitative content analysis was performed, and the COREQ checklist was used to guide proceedings. Results: The overarching theme, Supporting persons with eating deficiencies in‐between palliative care and end‐of‐life care, is represented by three sub‐themes: Easy to stick with doing, Just being, without doing, is hard and Letting go. Near end‐of‐life, eating symbolized social belonging and quality of life for RNs, whereas for patients and families, eating symbolized life. RNs tried practical solutions, however, not always according to patients' and families' preferences. Conclusions: RNs were well prepared to tackle physical inconveniences and provide support, however, less prepared to encounter existential, psychological and social issues in relation to eating deficiencies. Although RNs stated that human beings stop eating when they are about to die, letting nature run its' course and facilitating patients' transition to end‐of‐life care was challenging. Relevance to clinical practice: Food and mealtimes represent fundamental aspects of human life and denote central parts in RNs clinical practice in palliative care. The findings can inspire development of a comprehensive palliative care approach to support patients and families. Structured reflection in relation to clinical practice may support and encourage RNs, caring for patients with eating deficiencies, in mastering both doing and being. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study investigated the challenges of cross‐cultural communication among internationally qualified nurses, and the impact on nurse‐to‐nurse and nurse‐to‐patient relationships. Background: Open and authentic communication between nurses and patients is required as a foundation of patient‐centred practice; however, this may be a challenge in cross‐cultural settings. Design: An exploratory qualitative study with an inductive approach. Methods: Semi‐structured, face‐to‐face interviews explored the influences on communication and practice of 21 internationally qualified nurses practising in the United Arab Emirates. Manual and software‐driven processes guided coding and analysis of data. Caring theory guided the analysis of themes; while COREQ criteria guided research conduct and reporting. Results: Four key themes emerged; (a) Challenges in communication, (b) The science versus art of nursing; (c) The impact of ineffective communication and (d) Strategies for coping. Eleven sub‐themes are reported within these themes. Overall, nurses felt they had sufficient language and nursing skills to undertake the technical or scientific aspects of their work; however, they reported experiencing restricted ability to participate in complex cross‐cultural conversations, such as providing explanations and reassurance about treatment options or discussing end of life and treatment decisions. This limitation diminished the nurses' ability to engage in the art of nursing and left them unable to employ themselves therapeutically to attain a sense of true presence with patients and their families. Conclusion: This article highlights the need for language and communication support, and Arabic‐speaking advocates as partners in care for expatriate nurses. Relevance to practice: Internationally qualified nurses in this Middle Eastern setting lack cultural orientation and language skills to fully enact the art and true presence of nursing. Findings indicate that health service employers need to increase the employment of Arabic‐speaking nurses and provide additional language for other expatriate nurses. [ABSTRACT FROM AUTHOR]

Aims: We aim to evaluate the effectiveness of the Integrated Palliative Care Outcome Scale for people with dementia‐based case studies to improve the caring quality for people with dementia in nursing homes by frontline staff and family members. Background: Swiss nursing homes mostly care for people with dementia. This population is at high risk of receiving little to no palliation for their complex needs. The majority of Swiss frontline healthcare staff do not systematically report on the needs of their residents. Additionally, family members do not routinely participate in assessment processes. Design: We will conduct a stepped‐wedge cluster randomized trial of repeated assessment using the Integrated Palliative Care Outcome Scale for people with dementia (IPOS‐Dem) and subsequent case studies. Clusters will consist of Swiss nursing homes randomly assigned to one of three sequential intervention time points. Methods: The study population will consist of people with dementia living in nursing homes with and without specialized dementia care facilities. Over 16 months, staff working at the frontline and family members will assess the needs and concerns of people with dementia using IPOS‐Dem. Depending on sequence allocation, facilitated case studies will start after 3, 6 or 9 months. The primary outcome will be caring quality measured by QUALIDEM. The secondary outcome will be symptoms and concerns, as indicated by the IPOS‐Dem sum‐score. The Zürich Ethics Committee approved the study in 2019 (2019‐01847). Impact: The results of this study will contribute to improving the effectiveness of person‐centred care for people with dementia. Collaboration between healthcare staff and family members will be systematically developed and built upon thorough assessment using the IPOS‐Dem and related case studies. The use of IPOS‐Dem will offer all frontline staff a systematic approach to have an independent voice within the nursing process, regardless of their qualification or grade. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Developing sex type is the process in which one develops behavioural attributes and personality characteristics socially defined as matching one's biological sex."Psychological androgyny" means that a person should not be judged in terms of his or her traditional sex role. "Androgynous" sex type means that a person could have both female and male characteristics, depending on the circumstances. "Androgynous" sex‐type individuals show higher capacity to deal with a variety of roles and a healthier and more adaptive behaviour than those with the same gender sex typingPrevious studies focused on caring behaviours while examining the difference between female and male nurses but there are no studies on differences between female and male nurses in the mental health field in relation with sex types. What this paper adds to existing knowledge?: From a theoretical point of view, our study adds important information on specific associations between sex types and caring in mental health nurses.Nurses with different sex type perform caring behaviours at different levels. "Androgynous" sex‐type nurses perform caring behaviours at a higher level than others do. What are the implications for practice?: Our findings can contribute to raising awareness among head nurses and policy makers in the mental health field, of the differences between nurses, and among female and male nurses in mental health centres, regarding their caring behaviours.Understanding this association can assist in the recruitment and allocation of candidates in mental health nursing settings and later on, in developing appropriate instruction programs for these employees. Introduction: Understanding differences in caring behaviours by sex is crucial in light of the need to encourage men to join the nursing profession. Aims: To study the association between sex types and caring behaviours in female and male nurses in the mental health field. Methods: Cross‐sectional study including a convenience sample of 114 nurses in three mental health centres in Israel. Data were self‐reported in a structured form including validated scales for the assessment of sex types and caring behaviours. ANOVA and linear regression tests were used were performed with SPSS version 21. All the analyses were 2‐tailed, and p < 0.05 was considered statistically significant. Results: Androgynous female and male nurses displayed higher levels of caring than other sex types. Higher levels of caring were observed in female compared with male nurses overall (p = 0.011) and in behaviours showing respect (p = 0.020) and attentiveness to patients' needs and safety (p = 0.002). Conclusion: Our results suggest that different sex‐typed female and male nurses in the mental health field display different levels of caring behaviours. Implications for Practice: Our findings can help head nurses and policy makers in recruitment and allocation of nurses in mental health settings, as well as in developing educational programs for employees and nursing students. [ABSTRACT FROM AUTHOR]

Aim: To understand how registered nurses implement their nursing practice in correctional institutions with healthcare governance by a health authority (e.g. Ministry of Health). Design: Straussian grounded theory. Methods: Simultaneous data collection and analysis were undertaken using theoretical sampling, constant comparison and memo writing. Thirteen registered nurses engaged in semi‐structured telephone interviews about implementing their correctional nursing practice including, providing direct care to adult offenders. Data were collected (December 2018 to October 2019) until saturation occurred. Analytic coding (open, axial and final theoretical integration) was performed to identify the core category and subcategories around which the substantive theory was developed. Results: The theory of Caring Behind Bars refers to the process of how registered nurses implemented their correctional nursing practice to care for offenders. The core category of Caring Behind Bars is comprised of five subcategories: tension between custody and caring, adaptability and advocacy, offender population, provision of care, and challenging and positive elements. Conclusion: Caring Behind Bars required registered nurses to address tension between custody and caring by adapting and advocating to access offenders. The provision of care required registered nurses to use assessment skills and numerous resources to provide a variety of patient focused care to offenders. The consequences of Caring Behind Bars had challenging and positive elements. Impact: The tension provides purposeful space to continue improving teamwork among correctional officers and registered nurses. More research is required about the impact of correctional healthcare governance models on professional practice and health outcomes. Frontline registered nurses can use the theory to make informed choices when providing care. Registered nurses practising in other domains of correctional nursing (i.e. administration, education and research) can also use this theory to advance and inform practice with the goal of promoting offender health. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to describe nurses' experiences of continuity of care for patients with heart failure. Background: Heart failure is a life‐influencing condition that causes varying care needs over time with risks of fragmentation. Nurses play an important role in caring for patients with heart failure. However, nurses' experiences of continuity of care seem to be less explored in this context. Design: A qualitative study with a descriptive design. Methods: Four focus groups were chosen to collect the data, and the analysis was made by using a method for thematic analysis. A purposeful sampling of nurses (n = 14) with experiences from hospital‐connected heart failure clinics, primary healthcare centres and municipal home healthcare settings was recruited. The COREQ checklist was used in this study. Results: The nurses' experiences of continuity of care for patients with heart failure were described in four themes: access and flexibility, responsibility and transparency, trustful and caring relationships and communication and collaboration. Conclusions: The results indicate that nurses have an excellent position to act as the "hub" in caring for patients with heart failure, but they need to have the possibility of networking and establishing trusting relationships with their colleagues. From the nurses' point of view, mutual trust between the nurse, the patient and the patient's next of kin is crucial for promoting and maintaining continuity of care in patients with heart failure. Relevance to clinical practice: To promote continuity of care for patients with heart failure, nurses expressed the necessity of establishing trusting relationships in a continuity‐promoting organisation with seamless coordination. Nurses can be the "hub" supporting a person‐centred care approach based on the patients' needs. There seems to be a need for better collaboration with common guidelines across and within primary healthcare centres, hospital‐connected heart failure clinics and municipal home healthcare settings. [ABSTRACT FROM AUTHOR]

Aim: To develop and test the psychometric properties of three instruments that measure Person‐centred Caring: as Personalization, Participation and Responsiveness. Design: A three‐phase mixed methods design used two frameworks: content validity determination and quantification; consensus‐based standards for selection of health measurement instruments. Methods: A narrative literature review identified the domain definition. A systematic review of instruments provided the basis for item pools, which were refined by focus groups (N = 4) of multidisciplinary staff and service users (N = 25) and cognitive interviews (N = 11) with service users. Scale content validity indexes were calculated. Three cross‐sectional surveys were conducted between April 2015 and June 2016. The instruments' psychometric properties tested included factor structure, internal consistency and construct validity. Convergent validity was tested, hypothesizing that: Personalization related to relational empathy; Participation related to empowerment; and Responsiveness related to trust. Results: Scale content validity indexes were ≥0.96 in all instruments. Response rates were 24% (N = 191), 15% (N = 108) and 19% (N = 124). Two factors were revealed for the Personalization and Responsiveness instruments and one factor for the Participation instrument. All had acceptable: reliability (Cronbach's Alpha >0.7); construct validity (>50%); and convergent validity (Spearman's correlation coefficient >0.25, p < 0.05). Conclusion: This study composed definitions and instruments that reflect the multidisciplinary teams' caring behaviours, which have acceptable reliability and validity in the community population. Further psychometric testing of Participation and Responsiveness instruments should be undertaken with a larger sample. Impact: The instruments can be used to monitor the variability of multidisciplinary teams' caring behaviours; research effective interventions to improve caring behaviours; and increase understanding of the impact of caring on health outcomes. [ABSTRACT FROM AUTHOR]

Aims: This study was conducted to describe and compare nurses' and inpatients' perceptions of caring attitudes and behaviours in rehabilitation. Methods: A comparative descriptive design was used. Perceptions of caring attitudes and behaviours were compared between 34 nurses working in rehabilitation and 64 elderly patients, using the Caring Nurse Patient Inventory‐23, to explore Watson's carative factors through four dimensions. Patients' and nurses' ratings of importance for each dimension were compared. The study data were collected from 8 November 2017 to 5 May 2018. Results: Patients' and nurses' responses showed high scores in terms of their perceptions of caring, with nurses having the higher scores, and significant differences were found between patients and nurses. Patients scored items linked to clinical aspects of caring as the most important, whereas nurses scored items linked to humanistic and clinical caring as equally important. Comfort care was considered important for nurses and patients. Both groups considered relational caring items as the least important. Conclusion: Results show that patients and nurses value clinical aspects of care, which is the visible aspect of care. The Caring Nurse Patient Inventory‐23 is a reliable instrument to measure the nurses' and patients' perception of caring behaviours in rehabilitation. SUMMARY STATEMENT: What is already known about this topic? A caring humanistic approach emphasizes the specific role of the nurse and is compatible with recent models of nursing in rehabilitation.Few studies have measured the perceptions of caring attitudes or behaviours among patients and nurses in the context of rehabilitation. What this paper adds? Patients scored items linked to clinical and comfort aspects of caring as the most important suggesting that patients value tangible aspects of caring.Nurses scored items linked to humanistic and clinical caring as equally important stressing the importance for nurses to link positive support and values to instrumental caring.Patients and nurses considered relational caring items as the least important; it may due to the problem solving and spiritual nature of this dimension of care, requiring a deeper involvement of nurses and patients. The implication of this paper: Nurses need to ensure their technical skills are up‐to‐date, even in a low technical environment such as rehabilitation.The Caring Nurse Patient Inventory‐23 was shown to be reliable for measuring patients' and nurses' perceptions of caring in rehabilitation. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine the understanding of caring in the practice of community nursing from the perspectives of patients and nurses. Background: An increasing population of patients with chronic disease has produced a need for humanistic caring in communities. As a result, caring has become a core value of community nursing professionals. However, community nurses meet many difficulties in trying to practice person‐centred care with their clients. Furthermore, most community nurses—especially in China—lack systematic education and training about caring because the practical meaning of caring in community practice is unknown. Design: The qualitative study described herein employed inductive content analysis. Methods: Eleven community patients with chronic disease and fifteen community nurses who were nominated as a caring nurse from different community clinics in Beijing, China, participated in thirty‐one interviews during January to August in 2018. Nine documents from the interviewed nurses were collected. Both interview data and documents were analysed using strategies of inductive content analysis. The COREQ checklist was used. Results: Patients and their corresponding nurses described a wide range of caring experiences that were generalised into 28 concepts. Caring emerged as an inter‐dynamic system that comprised the foundation and quality of a caring relationship, the caring philosophy and behaviours of interactions, and positive feedback from caring interactions. A relationship‐based framework of caring in community nursing practice was constructed. Conclusions: Identifying this systematic concept of caring provides insights that are applicable to the creation of targeted management, education and practice interventions to ultimately enhance the quality of community health care—in China or elsewhere. Relevance to clinical practice: The systematic understanding of caring in community nursing practice will inform nurses in community health clinics, their educators and their managers on how to provide care to community patients and how to develop caring competence for community nurses. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To answer the question "What is the lived experience of hospitality during a patient's hospital stay for elective surgery?" Background: Hospitality centres on a host offering comfort to others, as in a personal care context. Caring constitutes the essence of what it is to be human, having a profound effect on well‐being and recovery from surgery. Caring is one of the most elusive and diversely contested concepts in nursing; however, care provided by nurses seldom transcends as deep human connections and social utility. This study explored the nature, meaning and experience of hospitality as care from the perspective of elective surgery patients. Consolidated Criteria for Reporting Qualitative criteria were used. Design: A hermeneutic phenomenological methodology. Methods: Data were gathered through semi‐structured, face to face interviews with seven patients from both private and public hospitals, and from different cultural backgrounds. Results: Three interpretative notions were as follows: experiences of hospitality as feeling "really" cared for, being at ease and being healed. Hospitality exists in the receiver's lived experience, evoking a special moment which leads to feelings of great comfort and feelings of being truly cared about. When hospitality is received, patients feel a connection; they begin to trust and their healing begins. Conclusion: The offering of often small, yet heartfelt acts of hospitality, indicated that nurses can evoke powerful lived experiences which benefit patients undergoing elective surgery. Relevance to clinical practice: The importance of prioritising emotional and social connections to the hospitality experience needs emphasis at all levels of the clinical structure. Hospitality as caring needs to form a part of all undergraduate and postgraduate nursing curricula, and ongoing professional development. The participant quotes presented in this article could form exemplars for the provision of hospitable nursing care practices, highlighting nurses getting to know and understand their patients, and being interested in their lives. [ABSTRACT FROM AUTHOR]

Aims: To explore the conditions that contribute to justification of aggression against nurses. Design: A 2 (aggressor distress as reflected in stressful behaviour: high vs. low) × 2 (target nurse's communication quality as reflected in provision of information and expression of caring: high vs. low) factorial design. Communication quality was operationalized as caring for half the respondents and information provision for the other half. Methods: Data were collected online in 2018. Respondents (N = 305) were presented with one of the eight versions of a hypothetical vignette. Aggressor distress and caring were manipulated for half the participants and aggressor distress and information provision for the other half. After reading the vignette, respondents reported their attitudes towards the aggressor's behaviour and sense of warmth towards the target nurse. Additional data collected included trait empathy (a control variable), demographic variables and responses to a manipulation check. Data were analysed using the analyses of variance. Findings: The results show the main effects of aggressor distress and nurse communication quality on justification of aggression and sense of warmth towards the nurse. An interaction effect between aggressor distress and (poor) nurse information provision was found on justification of aggression. Conclusion: The results extend extant research on the causes of aggression against the nurses by highlighting a tendency to view certain circumstances as justifying such behaviour. Impact: The study explored conditions that increase the justification of aggression against nurses, from the perspective of a third party. The results show that aggressor's distress, as well as the attacked nurse's communication quality affect the justification of aggression. The results contribute to knowledge about the causes of aggression against nurses and highlight the need for healthcare policy and public education activities designed to undermine the view that aggression against nurses can be justified. [ABSTRACT FROM AUTHOR]

Aim and objective: To test the psychometric properties of the nursing students' version of the 24‐item Caring Behaviours Inventory. Background: Caring is at the heart of nursing and should also be a core value in nursing education. Caring can be manifested through measurable behaviours. The Caring Behaviors Inventory is a valid and reliable measure of nurses' caring behaviours in clinical settings. It has already been used among nursing students, but it needs more psychometric testing. Design: Cross‐sectional validation study. Method: The questionnaire was filled in by 300 undergraduate nursing students at two Italian universities in May 2016. Exploratory factor analysis was conducted using Mplus maximum likelihood with GEOMIN oblique rotation. A multifaceted approach was used to evaluate the model fit. The STROBE checklist for cross‐sectional studies was followed. Results: Four dimensions were identified: "being with," "doing with competence," "responding to individual needs" and "providing effective care." Adequate fit indices and high reliability of the factors were found. Correlations between factors were positive and significant. Conclusion: This study makes it possible to use the same tool to compare the caring practices perceived by students, nurses and patients. Further studies with bigger samples could be stratified to investigate the associations between caring levels and student characteristics. The Caring Behaviors Inventory can be used to call attention to caring in nursing education, helping to make this concept less elusive. Relevance to clinical practice: The effective self‐assessment of nursing students' caring behaviours offers opportunities for reflection on their caring practice. This could improve the caring level of their behaviours in clinical practice and help them to become caring nurses in the future. [ABSTRACT FROM AUTHOR]

Aims and objectives: To get a deeper understanding of how mothers in same‐sex relationships think and reason about their parenthood in terms of gender equality, and how they experience early parental support from child healthcare professionals. Background: There is an increasing amount of research on how women in same‐sex relationships experience healthcare services when forming a family. Yet there is limited knowledge of what kind of early parental support these women may request. Design: Grounded theory. Follows guidelines for qualitative research (COREQ). Method: Twenty women ranging from 25 to 42 years of age participated in semi‐structured interviews. Data collection and analysis took place in parallel, as recommended in grounded theory methodology. Results: The results are described by the core category Same‐sex mothers request professional support to achieve equal parenthood, which includes five categories: (a) equality in everyday life, (b) diversity in mother and child attachment, (c) justification of the family structure, (d) ambivalent thoughts about their child's future and (e) a special need for networking and request for professional support. These findings provide a deeper understanding of how same‐sex mothers experience their parenthood and the parental support that is offered. Conclusion: Child healthcare professionals need to be sensitive and recognise both mothers as equal parents and offer early parenting groups where two‐mother families feel included and supported. Relevance to clinical practice: Healthcare professionals need to be aware of diverse family formations and meet each parent as a unique individual without heteronormative assumptions. Same‐sex mothers must be treated as equal parents and acknowledged as mothers. Healthcare professionals should offer inclusive and supportive parental groups to same‐sex families. They should also inform and support nonbirth mothers about the possibility to breastfeed. [ABSTRACT FROM AUTHOR]

Aims and objectives: To develop and validate the Chinese version of Verbal and Social Interaction Questionnaire for Nursing Students. Background: The development of caring interaction skills is particularly important for achieving better nursing student–patient interactions. Nursing students in China, as in most countries, have often failed to establish a caring interaction with their patients. There is a lack of instruments to explore the difficulties and problems in nursing student–patient interactions in China. Design: A descriptive, cross‐sectional survey was carried out. Methods: Data for cross‐cultural adaptation and psychometric testing purposes were collected between May 10, 2017 and November 11, 2017. Exploratory and confirmatory factor analyses were performed; pilot testing, content validity and reliability were assessed for the translated questionnaire. EQUATOR guidelines for observational studies (strengthening the reporting of observational studies in epidemiology) were applied. Results: 716 nursing students from four universities in China completed the questionnaire. A pilot testing (n = 32) was conducted at a university hospital. The internal consistency reliability and the intra‐class correlation coefficients were satisfactory. The overall content validity index was 0.95. Exploratory factor analysis resulted in a four‐factor solution, explaining 61.26% of the variance, and the items had factor loadings ranging from 0.46–0.82. The final model's fit indexes were relatively acceptable. Overall, this instrument demonstrated sound psychometric properties. Conclusion: The Chinese version of Verbal and Social Interaction Questionnaire for Nursing Students has a high level of reliability and acceptable content validity. However, some values in the construct validity assessment were lower than was hypothesised, suggesting a need for further model modification. Relevance to clinical practice: This easy‐to‐use instrument may help nursing educators, clinicians and managers in the assessment and development of students' interactional skills during their training or student–nurse transition period. Using the questionnaire could both provide the students with a greater understanding of caring interactions and help the nursing educators gain a better comprehension of the students' verbal, social and interactional skills. [ABSTRACT FROM AUTHOR]

Aims and objectives: The purpose of this article was to compare surgical oncology nurses caring behaviours to perceptions of their surgical oncology inpatients and determine internal consistency of the CAT‐Nurse. Background: Nursing practice at the H. Lee Moffitt Cancer Center & Research Institute in Tampa, FL is guided by Duffy's Quality‐Caring Model©. No study using Duffy's model for both oncology nurses and patients has been found. Design: A descriptive correlation design was used adhering to the STROBE guidelines. Data were collected using CAT‐Nurse and compared to data from a previous study using CAT (version V). Methods: Item responses were compared between nurses and patients using t tests. Results: Patients scored higher on perceptions of caring behaviours. Mutual problem solving was an area for improvement. The CAT‐Nurse demonstrated internal consistency reliability. Conclusion: Results from this study can make nurses more aware of the caring perceptions that are not as strong as others, and therefore may have the ability to promote transformation. Relevance to clinical practice: The results can serve as foundational knowledge for action plans aimed at increasing nurse comfort addressing lower scoring caring behaviours that would then result in improving patient perceptions which could be linked to patient satisfaction and reimbursement. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate nurses' experiences of caring for older (65+ years) patients afflicted by delirium in a neurological department. Background: Delirium is a frequent, acute and potentially fatal condition. Patients experience delirium as painful and stressful. The literature shows that nursing care is crucial in the prevention and treatment of delirium. The nurses' approach to the patient with delirium is essential for the quality of care provided to the patient. Design: A qualitative, exploratory design was used to study the nurses' experiences of caring for patients afflicted by delirium. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods: A total of fourteen nurses participated in three focus groups. The nurses' narratives were used to elucidate their experiences, perceptions, attitudes and views towards the patient with delirium. The texts were analysed using thematic analysis. Results: The analysis revealed three themes: The relationship with the patient is challenged, expertise is requested, and barriers to cooperation exist. Conclusions: Nurses experienced a relationship with patients with delirium that was influenced by a lack of knowledge about communication with such patients. This resulted in a lack of person‐centred care and knowledge about the patient's habitual condition and life story; hence, nurses did not discover the patient's initial delirium. Inadequate and unstructured documentation did the nursing effort initiated late so the patient's delirium was developing. Uncertainty caused lack of dialogue between nurses, which afflicted the partnership and relation between the patient and the nurse. A fast pace workload affected relationships, knowledge, documentation and collaboration. Thus, the person‐centred approach to the patient was challenged, which made the provision of professional nursing care difficult. Relevance to clinical practice: A continuous focus on patients with delirium, as well as specialised care, based on factual knowledge about delirium is necessary. Hence, communication skills are required to accommodate this group of patients and their need for care. [ABSTRACT FROM AUTHOR]

Abstract: Aims and objectives: To improve the understanding and competence of health personnel when caring for ambivalent pregnant women, the aim of this study was to explore the experiences of encountering women who are unsure whether to complete or terminate pregnancy. Background: Feelings of ambivalence are present in a significant number of women preparing for abortions and may challenge the provision of health care. Health personnel have reported an ideal to be nonjudgemental and supportive. Insufficient attention has been directed to the experiences of health personnel who prepare women for abortions in gynaecological units. Design: Qualitative design with a hermeneutic‐phenomenological approach. Methods: Focus group interviews were conducted with health personnel from four gynaecological outpatient clinics and wards in Norway (n = 20). Results: The health personnel felt responsible for contributing to patient well‐being. This demanded focused attention towards all women being prepared for abortions and meant a consciousness and balancing act towards revealing, handling and being involved in the woman's potential unsureness without influencing her decision. When involved, the health personnel risked being confronted with their own vulnerabilities and values. Conclusions: The health personnel tried to balance their care and support without influencing the woman's decision. Although they viewed the women as fully autonomous and responsible, they became personally involved, to varying degrees, in the uncertainty and were faced with their own vulnerabilities and values. They lacked a possibility for immediate debriefing and regular counselling after complicated consultations. Relevance to clinical practice: Knowledge of the experiences of health personnel can provide input for professional development at gynaecological departments. These findings contribute to discussions about what information should be given and whether the woman's feelings should be discussed in preparation for an abortion. The ability of health personnel to discuss subjects related to ethically challenging encounters with women who are considering abortions should be established, namely, professional education and workshops at the national level and small groups with counselling and case study discussions at hospitals. [ABSTRACT FROM AUTHOR]

Aims and objectives: To synthesise and interpret previous findings with the aim of developing a theoretical framework for patient autonomy in a high‐tech care context. Background: Putting the somewhat abstract concept of patient autonomy into practice can prove difficult as when it is highlighted in healthcare literature, the patient perspective is often invisible. Autonomy presumes that a person has experience, education, self‐discipline and decision‐making capacity. Reference to autonomy in relation to patients in high‐tech care environments could therefore be considered paradoxical, as in most cases, these persons are vulnerable, with impaired physical and/or metacognitive capacity, thus making extended knowledge of patient autonomy for these persons even more important. Design: Theory development. Methods: The basic approaches in theory development by Walker and Avant were used to create a theoretical framework through an amalgamation of the results from three qualitative studies conducted previously by the same research group. Results: A theoretical framework—the control‐partnership‐transition framework—was delineated disclosing different parts cocreating the prerequisites for patient autonomy in high‐tech care environments. Assumptions and propositional statements that guide theory development were also outlined, as were guiding principles for use in day‐to‐day nursing care. Four strategies used by patients were revealed as follows: the strategy of control, the strategy of partnership, the strategy of trust and the strategy of transition. Conclusions: An extended knowledge base, founded on theoretical reasoning about patient autonomy, could facilitate nursing care that would allow people to remain/become autonomous in the role of patient in high‐tech care environments. Relevance to clinical practice: The control‐partnership‐transition framework would be of help in supporting and defending patient autonomy when caring for individual patients, as it provides an understanding of the strategies employed by patients to achieve autonomy in high‐tech care contexts. The guiding principles for patient autonomy presented could be used in nursing guidelines. [ABSTRACT FROM AUTHOR]

Aim and objective: To explore preregistration nursing students’ caring attributes development through a person‐centred focused curriculum. Background: Developing caring attributes in student nurses to the point of registration has historically been challenging. Globally, curricula have not yet demonstrated the ability to sustain and develop caring attributes in this population, despite its centrality to practice. Design and methods: This longitudinal cohort study tracked how University preregistration nursing students (N = 212) developed their caring attributes over the 3 years of their programme using repeated measures at the end of each year with the same cohort. The Caring Dimensions Inventory (35 item version with 25 caring items under three constructs (technical, intimacy and supporting) and 10 inappropriate or unnecessary construct items) was used and data analysed using Mokken scale analysis to create a hierarchy of actions that students deemed as caring. Repeated measures of analysis of variance enabled evaluation of changes in responses over time. Results: Students developed their caring attributes throughout their programme, ranking 22 of 25 items as caring (with statistical significance) at the end of year 1, 18 at the end of year 2 and all 25 caring items at the end of their final year. No unnecessary or inappropriate construct items were ranked as caring at any data collection point. Participants consistently ranked assisting a person with an activity of living, listening to a patient and involving them in their care as the most caring actions. Conclusion: This study found caring attributes can not only be sustained, but can also be developed throughout a preregistration nursing education programme grounded in person‐centredness. Relevance to clinical practice: Internationally, caring attributes are challenging to develop and sustain throughout preregistration education, largely being diminished over time. Little published evidence evidences how person‐centred frameworks are successfully integrated into preregistration nursing curricula to develop person‐centred nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the concept of futurism and the emergence of robotics in relation to the fundamentals of care, highlighting how nurses need a more anticipatory and contemporary position towards technology to maintain relevance in the future. Background: The future of nursing in Western countries will soon be linked with the emergence of robotics for efficient and cost‐effective provision of fundamental care. Their emergence and roles with care of the body and more broadly assisting people with their daily living activities has enormous implications for the profession and health care. Despite this importance, how nursing understands and will respond to technological trends and developments is insufficiently reflected in the professions discourse. Design: A discursive article. Methods: Literature from nursing fundamentals of care/fundamental care, information science, technology, humanities and philosophy informed the arguments in this article. Conclusions: This article examines the intersection of futurism and the fundamentals of care, and how adopting an anticipatory and posthuman perspective towards technological‐care integration is necessary amidst a robot revolution in the techno‐era. Relevance to clinical practice: Nurses are currently challenged to understand, prioritise and deliver fundamental care. Health systems are challenged by a lack of care predicated by shortfalls in skilled staff and deficiencies in staff mobilisation. Both challenges can be compounded or alleviated by further integration of technology, but to maximise benefit requires forethought and understanding. This article can help open needed dialogue around planning for the future and is a call to action for the nursing profession to conceptualise its position on exponential technological growth and fundamental care provision. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To explore the level of and the association between, compassion satisfaction and fatigue of paediatric nurses; to determine the association between personality traits and compassion satisfaction and fatigue; to identify the determinants of compassion satisfaction and fatigue. Background: Paediatric nurses are prone to experiencing compassion fatigue associated with caring for children with illness and their families, yet its connection with nurses' personality traits remains unknown. Design: A cross‐sectional descriptive study design was used. Methods: The data collection used three instruments measuring socio‐demography, responses to the compassion satisfaction and fatigue test and the revised NEO personality inventory. The study used descriptive, correlation and multiple regression analysis for the data collected between April ‐ July 2014. Results: From 173 female paediatric nurses, two‐thirds worked in critical care units and indicated a satisfactory level of compassion satisfaction and a low level of compassion fatigue, despite a lack of association between the two concepts. Four determinants—agreeableness, extraversion, conscientiousness and engaging with outdoor activities—were predictive and explained 43.6% of total variance of compassion satisfaction. Two risk factors of compassion fatigue identified were less emotional stability and singlehood (marital status) and these explained 26.1% of total variance of compassion fatigue. Conclusion: Support for improving agreeableness and emotional stability in paediatric nurses' workplaces including involvement in the outdoor activities and an increase in social connection may enhance compassion satisfaction and prevent exhaustive compassion fatigue. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study aimed to identify and describe the experience of parents of children diagnosed with early onset scoliosis living in Australia. Background: Chronic childhood disease has a major impact on health‐related quality of life. Caring for a child with a chronic illness is well documented but the specific experiences of parents who care for children with early onset scoliosis, a rare but devastating illness, has not been explored. Numerous studies have described the interrelated psychological, financial, social, physical and logistical factors that impact the experience of the caregiver role with various diseases, but in the case of early onset scoliosis, limited studies have been conducted about the parental experience. Methods: A qualitative descriptive design was used. A snowball sampling technique assisted in the recruitment. Parents invited to the study included mothers, fathers and guardians. Data were collected through semistructured interviews and transcribed verbatim. Transcripts were analysed thematically. Data collection complied with the Consolidated criteria for reporting qualitative research guidelines. Findings: Twelve mothers of children with early onset scoliosis were interviewed, as only mothers consented to participate. Four major themes emerged: emotional rollercoaster ride, a lack of resources, money talks and pervasive burden. Factors that impacted on the participants’ ability to confront, manage and endure caring for a child with early onset scoliosis emerged from the data. Conclusion: The findings suggest there are multiple factors that influence the experience of mothers’ caring for a child with early onset scoliosis. The recognition and appropriate management of these factors by healthcare professionals have the potential to improve the quality of life of parents who care for a child with early onset scoliosis. Relevance to clinical practice: Healthcare professionals have first‐line contact with parents of children with early onset scoliosis and are well placed to provide parents with evidence‐based education and increased support. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the experiences of female spousal caregivers in the care of husbands with severe mental illness. Background: Family involvement in the care of patients with chronic illness is essential to provide a backbone of support for them. However, little is known about how female spousal caregivers are confronted with challenges while taking care of their husbands with severe mental illness. Design: An exploratory qualitative study. Methods: Fourteen female spousal caregivers of people with severe mental illness (defined here as schizophrenia, schizoaffective disorders and bipolar affective disorders) were recruited using purposive sampling and were interviewed using a semistructured in‐depth interview method. Data were analysed by conventional content analysis until data saturation was achieved. Results: Care of a husband with severe mental illness had a disruptive influence on the emotional relationships of the family and resulted in emotional detachment over time. Despite the caregivers’ struggle to protect their families, the lack of supportive resources caused emotional exhaustion. Caregiving tasks interfering with their many other responsibilities, along with being a reference for family matters, led to loss of self. Consequently, they experienced psychological distress because of the transition to a caregiver role without any supportive resources. Conclusion: Constant caring, without supportive resources, forced them to do various roles and manage other issues within the family. Being unprepared for a caregiving role led to the psychological distress of female spousal caregivers. Therefore, adequate information, education and supportive resources must be provided for spouses to facilitate their transition to caregiving roles. Relevance to clinical practice: It is necessary to pay close attention to the spousal caregivers’ own mental health problems while they care for their mentally ill husbands. Mental health professionals should adopt a new approach to the prioritisation and planning of policies that support both family caregivers and patients. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To gain an understanding towards the perspectives of hospitalized inpatients in Indonesia regarding maintaining dignity during clinical care. Background: Dignity is a basic human right that is crucial for an individual's well‐being. Respect for a person as a valuable human is a concept that is comparable to treating a person with dignity. Maintaining patient's dignity is an ethical goal of nursing care. Nevertheless, the concept is highly dependent on cultural context. This issue has not been well studied in Indonesia. Design: This study used a qualitative descriptive design. Methods: Thirty‐five participants were recruited by purposive sampling from medical to surgical wards of six public hospitals in Eastern Java, Indonesia. Data were collected in 2016 through individual face‐to‐face semi‐structured interviews. Inductive content analysis was applied to the data. Findings: Four major categories which described qualities of nursing care essential for maintaining a patient's dignity in clinical care settings were revealed: (1) responsiveness; (2) respectful nurse–patient relationships; (3) caring characteristics and (4) personalized service. Conclusions: Our findings provide a cultural viewpoint of dignity for care recipients in Indonesia. The findings provide empirical support for linking dignified care and person‐centred care principles with regards to cultural sensitivity. Nurses must not only be clinically competent but also culturally competent. The ability to provide culturally competent care is important for nurses as a strategy to maintain patient dignity during hospitalized care. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To examine how clinicians practise the principles of beneficence when deciding to allow or deny family presence during resuscitation. Background: Family presence during resuscitation has important benefits for family and is supported by professional bodies and the public. Yet, many clinicians restrict family access to patients during resuscitation, and rationales for decision‐making are unclear. Design: Secondary analysis of an existing qualitative data set using deductive category application of content analysis. Methods: We analysed 20 interview transcripts from 15 registered nurses, two doctors and three paramedics who had experienced family presence during resuscitation in an Australian hospital. The transcripts were analysed for incidents of beneficent decision‐making when allowing or denying family presence during resuscitation. Results: Decision‐making around family presence during resuscitation occurred in time poor environments and in the absence of local institutional guidelines. Clinicians appeared to be motivated by doing “what's best” for patients and families when allowing or denying family presence during resuscitation. However, their individual interpretations of “what's best” was subjective and did not always coincide with family preferences or with current evidence that promotes family presence during resuscitation as beneficial. Conclusions: The decision to allow or deny family presence during resuscitation is complex, and often impacted by personal preferences and beliefs, setting norms and tensions between clinicians and consumers. As a result, many families are missing the chance to be with their loved ones at the end of life. The introduction of institutional guidelines and policies would help to establish what safe and effective practice consists of, reduce value‐laden decision‐making and guide beneficent decision‐making. Relevance to Clinical Practice: These findings highlight current deficits in decision‐making around FPDR and could prompt the introduction of clinical guidelines and policies and in turn promote the equitable provision of safe, effective family‐centred care during resuscitation events. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Children of parent with severe mental illness are often carrying a caring burden; they keep the illness in the family, are documented to be stigmatized, bullied and to take special attention to their mentally ill parent's health and well‐being. Little is however known about these children's experiences when growing up in a small‐scale society. What this study adds to existing knowledge?: Children's experiences of living with a parent with severe mental illness in the small‐scale society (Faroe Islands) are paradoxical, life is often unreasonable and evidently contradictory but anyway connected. The results show that “everybody knows everybody” which refers to that, in the small‐scale society, it is difficult to be anonymous. The children were familiar with that people talked and had a prejudiced attitude; this resulted that the participants were constantly reminded of their mental ill parent's difference, and they were feeling less worthy than their pals. Children of parents with severe mental illness in a small‐scale society need to support from the close family as well as mental healthcare professionals. What are the implications for practice?: The study adds knowledge about the challenges that children of mental ill parents have to go through. Dialogue among mental healthcare colleagues not only about caring for the sick parent but also about modes of caring for the children and the family at large would deepen the staff's knowing of the need for family‐centred care within mental health care. Abstract: Introduction: An estimated 23% of children worldwide live with a parent experiencing mental illness. These children are exposed to emotional and psychosocial challenges. Little is known about these children when living in small‐scale societies. Aim: To explore how adults, who as children lived with parents experiencing mental illness in a small‐scale society, recalled their childhood life. Method: Individual interviews with 11 adults were analysed using content analysis. Results: Living as a child with a parent experiencing mental illness in a small‐scale society was described as “living in a paradox” which emerged from three categories: “intergenerational help and caring,” “barriers understanding parental illness” and “everybody knows everybody”. The children received little or no support from family members, nor from health and education professionals. Discussion: In a small‐scale society, stigma surrounding mental illness is notable. Families often attempt to conceal mental illness from outsiders with negative or adverse effects on children. Implications for practice: Mental healthcare professionals need to consider the needs of children who have parents experiencing mental illness. It is imperative for the well‐being of the patients’ children to support them in understanding what is happening, turn gossiping in a positive direction and address stigma in the communities. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To examine the relationship between baseline emotional intelligence and prior caring experience with completion of pre‐registration nurse and midwifery education. Background: Selection and retention of nursing students is a global challenge. Emotional intelligence is well‐conceptualized, measurable and an intuitive prerequisite to nursing values and so might be a useful selection criterion. Previous caring experience may also be associated with successful completion of nurse training. Design: Prospective longitudinal study. Method: Self‐report trait and ability emotional intelligence scores were obtained from 876 student nurses from two Scottish Universities before they began training in 2013. Data on previous caring experience were recorded. Relationships between these metrics and successful completion of the course were calculated in SPSS version 23. Results: Nurses completing their programme scored significantly higher on trait emotional intelligence than those that did not complete their programme. Nurses completing their programme also scored significantly higher on social connection scores than those that did not. There was no relationship between “ability” emotional intelligence and completion. Previous caring experience was not statistically significantly related to completion. Conclusion: Students with higher baseline trait emotional intelligence scores were statistically more likely to complete training than those with lower scores. This relationship also held using “Social connection” scores. At best, previous caring experience made no difference to students' chances of completing training. Caution is urged when interpreting these results because the headline findings mask considerable heterogeneity. Neither previous caring experience or global emotional intelligence measures should be used in isolation to recruit nurses. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To discuss representations of nursing in popular culture using the Contemporary Gothic theory. Background: Nursing is stereotypically known as a caring profession. Caring in both the natural and professional perspectives is inextricably attached to love and love, we are told, is universal. In popular culture, however, there are numerous examples of nurses being portrayed in ways where love—its expression and its practice—has been transgressed or tainted. Exploring this dark side of nursing, even if fictitious, is significant because it illuminates social and cultural tensions. Design: Discussion paper. Data sources: CINAHL, Scopus and Humanities International Databases were searched for terms related to nursing, love, abject and the gothic, published between 1990–2016. Four popular culture texts which ranged in genre and gothic elements were selected for analysis. Implications for nursing: The types of transgressive love these nurses express to patients ranges from the obsessive and the pornographic, to the monstrous. We suggest this positioning illuminates a hidden reality that nursing work is at once intimate and personal but also hidden, profane, repellent, horrifying and feared. Nursing's allure for storytellers may rest in its association with the abject. How nurses find redemption, satisfaction and meaning in these locations is relevant for how we can imbue our lives and work with greater humanity. Conclusion: The Contemporary Gothic is a useful tool in exposing and exploring ambiguous, challenging and taboo aspects of nursing in society. Such and analysis helps to explain phenomena—including nursing itself—which exists in the shadow of dominant and often stereotyped discourses. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The aim of this study was to explore the work‐life narratives of nurses through a thematic analysis of the nursing accounts they post in their publicly accessible, anonymous blogs. Background: Many nurses participate on social media. Blogs have been advocated as a self‐reflective tool in nursing practice, yet as far as the authors are aware, no previous studies have explored nurses’ individual blogs for their potential to reveal nurses’ perceptions of nursing work. Design: The research design was qualitative description. Methods: Between May–August 2015, Internet search engines were used to discover lists of nursing blogs recommended by organizations representing nurses’ interests. Recommended blogs were purposively sampled. Four anonymous blogs written by nurses from different nursing specialties met the sampling criteria. All 520 of their entries from 2014 were read and copied into NVivo 10, where an inductive coding process was followed. Findings: Three major themes arose in these nurses’ online discussions of their work lives: they truly care about and value their nursing work, but they are feeling stressed and burnt out and they are using their anonymous blogs to share factors that frustrate them in their nursing work. Three main areas of frustration were revealed: teamwork problems, challenging patients and families, and management issues. Conclusion: Anonymous nursing blogs offer valuable, longitudinal insights into nurses’ perceptions of their work lives. Nursing blogs should be further explored for ongoing insights into nurses’ experiences of nursing work, as well as nurses’ recommendations for addressing issues causing them to feel frustrated in their work environments. [ABSTRACT FROM AUTHOR]

Aims and objectives To describe the perspectives of healthcare professionals caring for intubated patients on implementing augmentative and alternative communication ( AAC) in critical care settings. Background Patients in critical care settings subjected to endotracheal intubation suffer from a temporary functional speech disorder and can also experience anxiety, stress and delirium, leading to longer and more complicated hospitalisation and rehabilitation. Little is known about the use of AAC in critical care settings. Method The design was informed by interpretive descriptive methodology along with the theoretical framework symbolic interactionism, which guided the study of healthcare professionals ( n = 48) in five different intensive care units. Data were generated through participant observations and 10 focus group interviews. Results The findings represent an understanding of the healthcare professionals' perspectives on implementing AAC in critical care settings and revealed three themes. Caring Ontology was the foundation of the healthcare professionals' profession. Cultural Belief represented the actual premise in the interactions during the healthcare professionals' work, saving lives in a biomedical setting whilst appearing competent and efficient, leading to Triggered Conduct and giving low priority to psychosocial issues like communication. Conclusion Lack of the ability to communicate puts patients at greater risk of receiving poorer treatment, which supports the pressuring need to implement and use AAC in critical care. It is documented that culture in biomedical paradigms can have consequences that are the opposite of the staffs' ideals. The findings may guide staff in implementing AAC strategies in their communication with patients and at the same time preserve their caring ontology and professional pride. Relevance to clinical practice Improving communication strategies may improve patient safety and make a difference in patient outcomes. Increased knowledge of and familiarity with AAC strategies may provide healthcare professionals with an enhanced feeling of competence. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the similarities and differences in factors that influence nurses' and physicians' decision-making related to family presence during resuscitation. Background Despite the growing acceptance of family presence during resuscitation worldwide, healthcare professionals continue to debate the risks and benefits of family presence. As many hospitals lack a policy to guide family presence during resuscitation, decisions are negotiated by resuscitation teams, families and patients in crisis situations. Research has not clarified the factors that influence the decision-making processes of nurses and physicians related to inviting family presence. This is the first study to elicit written data from healthcare professionals to explicate factors in decision-making about family presence. Design Qualitative exploratory-descriptive. Methods Convenience samples of registered nurses ( n = 325) and acute care physicians ( n = 193) from a Midwestern hospital in the United States of America handwrote responses to open-ended questions about family presence. Through thematic analysis, decision-making factors for physicians and nurses were identified and compared. Results Physicians and nurses evaluated three similar factors and four differing factors when deciding to invite family presence during resuscitation. Furthermore, nurses and physicians weighted the factors differently. Physicians weighted most heavily the family's potential to disrupt life-saving efforts and compromise patient care and then the family's knowledge about resuscitations. Nurses heavily weighted the potential for the family to be traumatised, the potential for the family to disrupt the resuscitation, and possible family benefit. Conclusions Nurses and physicians considered both similar and different factors when deciding to invite family presence. Physicians focused on the patient primarily, while nurses focused on the patient, family and resuscitation team. Relevance to clinical practice Knowledge of factors that influence the decision-making of interprofessional colleagues can improve collaboration and communication in crisis events of family presence during resuscitation. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the Italian-language Nurse Caring Behaviours Scale, a short measure of nurse caring behaviour as perceived by inpatients. Background Patient perceptions of nurses' caring behaviours are a predictor of care quality. Caring behaviours are culture-specific, but no measure of patient perceptions has previously been developed in Italy. Moreover, existing tools show unclear psychometric properties, are burdensome for respondents, or are not widely applicable. Design Instrument development and psychometric testing. Method Item generation included identifying and adapting items from existing measures of caring behaviours as perceived by patients. A pool of 28 items was evaluated for face validity. Content validity indexes were calculated for the resulting 15-item scale; acceptability and clarity were pilot tested with 50 patients. To assess construct validity, a sample of 2,001 consecutive adult patients admitted to a hospital in 2014 completed the scale and was split into two groups. Reliability was evaluated using nonlinear structural equation modelling coefficients. Measurement invariance was tested across subsamples. Results Item 15 loaded poorly in the exploratory factor analysis ( n = 983) and was excluded from the final solution, positing a single latent variable with 14 indicators. This model fitted the data moderately. The confirmatory factor analysis ( n = 1018) returned similar results. Internal consistency was excellent in both subsamples. Full scalar invariance was reached, and no significant latent mean differences were detected across subsamples. Conclusion The new instrument shows reasonable psychometric properties and is a promising short and widely applicable measure of inpatient perceptions of nurse caring behaviours. [ABSTRACT FROM AUTHOR]

Aims and objectives To critically examine the conceptual, methodological and validity issues with the 'caring cultures' construct. Background Post the Francis Report, 'caring cultures' and alternative terminology such as 'culture/s of care/caring/compassionate care' have gained prominence in the literature, especially within a UK policy context. However, in order to understand the value these 'caring cultures' hold in terms of clinical practice, the concept itself first needs to be understood. Design A discussion and critical examination of the concept of 'caring cultures' and associated terminology. Methods Grey literature, database, library and reference list searches were conducted. Results It is implied that 'caring cultures' influence patient care. However, evidence which verifies this assertion is limited. In this article, the concept of 'caring cultures' is deconstructed and its validity explored. An alternative to 'caring cultures' is proposed in terms of research, whereby the concept of culture is instead explored in detail, on a microsystem level, using appropriate methodology. Conclusion The concept of 'caring cultures', although attractive in terms of its apparent simplicity, is not considered the most useful nor appropriate phrases in terms of advancing research. Instead, research which examines the established concept of 'culture' in relation to outcomes such as patient care, doing so with an appropriate methodology, is viewed as a more suitable alternative. Relevance to clinical practice Clarifying concepts and terminology relating to 'caring cultures' is essential for research to progress and the impact of culture on clinical practice to be better understood. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the characteristics of and interactions between clinicians, patients and family members during management of the deteriorating adult patient in the emergency department. Background Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over the last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration. Despite the decrease in cardiac arrests, research related to family presence continues to focus on care during resuscitation rather than care during acute deterioration. Design Descriptive exploratory study using nonparticipatory observation. Methods Five clinical deterioration episodes were observed within a 50-bed, urban, Australian emergency department. Field notes were taken using a semistructured tool to allow for thematic analysis. Results Presence, roles and engagement describe the interactions between clinicians, family members and patients while family are present during a patient's episode of deterioration. Presence was classified as no presence, physical presence and therapeutic presence. Clinicians and family members moved through primary, secondary and tertiary roles during patients' deterioration episode. Engagement was observed to be superficial or deep. There was a complex interplay between presence, roles and engagement with each influencing which form the other could take. Conclusions Current practices of managing family during episodes of acute deterioration are complex and multifaceted. There is fluid interplay between presence, roles and engagement during a patient's episode of deterioration. Relevance to clinical practice This study will contribute to best practice, provide a strong foundation for clinician education and present opportunities for future research. [ABSTRACT FROM AUTHOR]

Aims and objectives To discuss and explore the levels of support provided to perioperative nurses when participating in multi-organ procurement surgery and the impact to their overall well-being. Background Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace. Design A qualitative grounded theory method. Methods The study was informed by perioperative nurses ( n = 35) who had previous participatory experience in these surgical procedures from two Australian states. Theoretical sampling directed the collection of data via semistructured in-depth interviews. Data were analysed using the constant comparative method. Results Three components of levels of support were identified from the data: lacking support within the operating room organisation; surgical team support and access to external professional support. Conclusion These findings offer new insights into how nurses manage and cope with their participation in organ procurement surgical procedures and what types of support resources can be seen as barriers or enablers to their overall experiences. The need for timely and adequate support is vital to their overall well-being and future participation in organ procurement surgery. These findings have the potential to guide further research with implications for clinical initiatives and practices, looking at new ways of supporting perioperative nurses within the clinical environment both locally and internationally. Relevance to clinical practice Healthcare organisations need to acknowledge the emotional, psychosocial and psychological health and well-being of nurses impacted by these surgical procedures and provide appropriate and timely clinical support within the work environment. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop a theory that offered an evidence-based insight into the use of teleconsultation by nurses. Background Teleconsultation is the use of video to facilitate real-time, remote interaction between healthcare practitioners and patients. Although its popularity is growing, there is little understanding of how teleconsultation impacts on the role of nurses. Design The study adopted a constructivist grounded theory method, supplemented by the use of Straussian analytical approaches. Methods Using selective and theoretical approaches, registered nurses with experience of using video in health care were sampled. Data were collected using semi-structured interviews exploring experiences, knowledge and feelings surrounding teleconsultation. Interviews were recorded, transcribed and subjected to three-stage, nonlinear manual analysis (open, axial and selective coding). Results Theoretical saturation occurred after 17 interviews. The core category identified from the data was 'nursing presence' Four subcategories of nursing presence were identified: operational, clinical, therapeutic and social. The degree to which presence could be achieved was dependent upon three influencing factors - enablers, constraints and compensation. Conclusions Nurses provide different types of presence during teleconsultation, with the degree of presence dependent on specific characteristics of video-mediated communication. Where the use of video constrains the delivery of presence, nurses use a range of compensatory mechanisms to enhance patient care. Relevance to clinical practice Teleconsultation provides an innovative approach to enhancing the delivery of health care. This study provides nurses with insight into the impact of teleconsultation on their professional role, and an understanding of how best to use video-mediated communication to support patient care. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify and describe nursing actions performed by nurses that create a sense of good nursing care in patients with wet age-related macular degeneration. Background People who suffer from wet age-related macular degeneration risk central vision loss. Treatment with antivascular endothelial growth factor is the only available option at present that preserves vision and no definitive cure currently exists. Patients feel that they are compelled to accept this treatment because they might otherwise become blind. Design An explorative and descriptive design based on the critical incident technique was used. Method Interviews with 16 Swedish patients who all had received intravitreal treatment for wet age-related macular degeneration. Results Two main areas of good nursing care were identified: 'Being perceived as an individual' and 'Being empowered'. The first area was divided into two categories: being respectful and being engaged. Being respectful was observed when nurses had a benevolent attitude towards their patients and answered questions kindly and politely. Patients saw themselves as individuals when nurses were available for conversation and focused on them. The second area was divided into two categories: encouraging participation and creating confidence. Encouraging participation refers to when nurses provided information continuously. Nurses instilled confidence and trust in their patients by keeping promises and by being honest. Conclusions A respectful interaction between patients and caregivers is necessary for patients to obtain beneficial health care. Relevance to clinical practice Patient interviews revealed important information about nursing actions that created a sense of good nursing care in patients with wet age-related macular degeneration. Nurses acknowledged people as individuals and created trust by building partnerships and sharing decision-making. To address each patient's concerns, nurses need to prioritise each patient's narrative and participation by documenting agreements in their medical record. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of the study is to deepen the understanding of abused women's vulnerability in relation to how the abuse and encounters with health care professionals affect life. A further aim is to highlight abused women's vulnerability with a caring science perspective. Background Experience of abuse has consequences for the mental health of women and girls. Abused women may experience health care as unsupportive, and as a result, often chose not to disclose their experiences of abuse. Design and methods The results of two qualitative empirical studies were analysed along with a phenomenological meaning analysis in accordance with the methodological principles of Reflective Lifeworld Research. Findings Living one's life with experiences of abuse implies vulnerability, which can prevent abused women from achieving good health. This vulnerability results from insecurity regarding identity, along with the sense that one could have been a different individual if it were not for the abuse and thereby have a more fair chance in life. Being cared for within general psychiatric care could further increase this vulnerability. The healthcare professional's ability to care for the women who have experienced abuse leads to either an encounter of trust or else further suffering for the women. Conclusion A lifeworld-oriented caring science perspective as a foundation for care can contribute to care for abused women which reaches the existential dimensions of their vulnerability and vulnerable life situation. Relevance to clinical practice It is evident that healthcare professionals should deepen their understanding of how abused women live, within a general psychiatric context. This study enables a deeper understanding of abused women's vulnerability in relation to how the abuse and encounters with healthcare professionals affect life. [ABSTRACT FROM AUTHOR]

The author reports on developments pertaining to nursing as of July 1, 2017. Topics discussed include the proposed reform of the education and training of registered nurses and care assistants in Great Britain, the tension between ordinary care and nursing care, and sustainable research and innovation around care and nursing such as the Clinical Nursing Research Units in Denmark.

Aim The aim of this study was to find out if student nurses feel comfortable in caring by providing support for Lesbian, Gay, Bisexual or Questioning adolescents and what factors influence their level of comfort. Background Research indicates that nurses and nursing students experience varying levels of comfort when caring for adults who are Lesbian, Gay, Bisexual or Questioning: adult patients feel that nurse's attitudes change towards them once they disclose their sexuality. There has been minimal research to date on nursing attitudes to working with adolescents who are Lesbian, Gay, Bisexual or Questioning. Design Both quantitative and qualitative methods were used in this descriptive study. Questionnaires were completed by 152 nursing students and nine took part in semi-structured focus groups. Method A two-way ANOVA was used to analyse the questionnaires. Thematic analysis was used to identify the themes arising from the focus groups. Data were collected between August 2013 - July 2014. Results/Findings The results and findings of the study were that student nurse's felt discomfort in providing support; due to a lack of knowledge of Lesbian, Gay or Bisexual sexuality, personal and religious beliefs and the perceptions of others. However, all students indicated they had a positive attitude towards Lesbian, Gay, Bisexual and Questioning adolescents. Conclusion More needs to be done to raise self-awareness and improve the level of knowledge in relation to Lesbian, Gay and Bisexual issues amongst student nurses. Educational institutions and practice areas need to recognize this fact and reflect this in their educational programmes. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore and describe how young adults between 18-25 years of age experienced growing up with a parent with multiple sclerosis and how these experiences continue to influence their daily lives. Background Chronic parental illness is occurring in about 10% of families worldwide, but little is known about how the children experience growing up with a parent with multiple sclerosis during their childhood and into young adulthood. Design We chose a qualitative design using a phenomenological approach based on Giorgi. Methods Exploratory and open-ended interviews with 14 young adults were conducted. Results The essence of the phenomenon of having a parent with multiple sclerosis was synthesized into 'Striving for balance between caring and restraint' from two themes 'caring' and 'restraint' and eight subthemes. Participants' experiences of caring for parents with multiple sclerosis continued influencing their other close relationships, in which they tended to assume responsibility while concealing some of their feelings and desires. Most participants showed restraint among parents with and without multiple sclerosis, friends and partners. Conclusion It seems that one of the greatest challenges of having a parent with multiple sclerosis is achieving a balance between caring for others and asserting one's own desires. Relevance to clinical practice Healthcare professionals can support the family by encouraging family members to participate in consultations and to assist the parents in providing information about multiple sclerosis and its symptoms to the children. Parents might need assistance in applying for help with domestic chores or referrals to support groups for their children or other family members. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the impact of implementing an electronic health record system on staff at a Scottish hospice. Background Electronic health records are broadly considered preferable to paper-based systems. However, changing from one system to the other is difficult. This study analysed the impact of this change in a Scottish hospice. Design Naturalistic prospective repeated-measures mixed-methods approach. Methods Data on the usability of the system, staff engagement and staff experience were obtained at four time points spanning 30 months from inception. Quantitative data were obtained from surveys, and qualitative from concurrent analysis of free-text comments and focus group. Participants were all 150 employees of a single hospice in Scotland. Results Both system usability and staff engagement scores decreased for the first two years before recovering at 30 months. Staff experience data pointed to two main challenges: (1) Technical issues, with subthemes of accessibility and usability. (2) Cultural issues, with subthemes of time, teamwork, care provision and perception of change. Conclusions It took 30 months for system usability and staff engagement scores to rise, after falling significantly for the first two years. The unintended outcomes of implementation included challenges to the way the patient story was both recorded and communicated. Nevertheless, this process of change was found to be consistent with the 'J-curve' theory of organisational change, and as such, it is both predictable and manageable for other organisations. Relevance to clinical practice It is known that implementing an electronic health record system is complex. This paper puts parameters on this complexity by defining both the nature of the complexity ('J' curve) and the time taken for the organisation to begin recovery from the challenges (two years). Understanding these parameters will help health organisations across the world plan more strategically. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to identify the distinctive foundations of the care culture and how nurse leaders ( NL) can manage and strengthen these in a quest for ethically sustainable caring cultures. Background Sustainability presupposes an ethical leadership, a management of the good care and a well-educated staff, but research on NLs as managers of ethically sustainable caring cultures is not available. Design The study has a quantitative design with elements of a qualitative research approach. Method Data were collected through a web-based questionnaire sent to staff at eight selected units at a hospital in western Finland during September 2013; the reply rate was 32%. The data material was comprised of opinion questions, the ranking of values and two open-ended questions on lodestars in care and ethical principles in care work. Results NLs manage a care culture that rests on a solid foundation, where staff are co-creators of an ethically sustainable caring culture that includes good traditions for the praxis of care. NLs as managers are therefore responsible for realizing and passing on ethically sustainable caring cultures and creating prerequisites for staff's growth and development. Conclusion The basis of good care, patient safety and sustainability is comprised of ethics with a respectful and dignified care that is evidence-based and economically stable. Through their management NLs have a responsibility to nurture and protect the core of caring and create contextual, professional and cultural prerequisites to maintain the core and art of caring as well as care staff's ethical and professional competence. [ABSTRACT FROM AUTHOR]