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Objectives: The prevalence of self-immolation is significantly higher in some Middle Eastern and Central Asian Islamic countries than in Western countries. Self-immolation typically occurs among females and can be either an attempt at suicide or an act of protest. This systematic review examined the drivers and consequences of self-immolation in Asian Islamic countries from the perspective of those affected by it, including survivors, family and health care staff in order to understand its higher prevalence in these countries., Method: A systematic review of qualitative studies was conducted in June 2018, using five electronic databases: PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), EMBASE, Scopus and PsycINFO. Of the 236 papers identified, seven met the inclusion criteria. Authors independently rated the reporting of included qualitative studies and thematic analysis was used to analyse the data., Results: The drivers of self-immolation included marital and familial conflict, male-dominated culture, mental health disorders and economic and social factors. Survivors chose self-immolation in order to express their sense of a lack of control and mostly utilised this method due to its accessibility. The consequences of self-immolation were social isolation, regret, and physical and psychological impacts., Conclusions: The reasons for self-immolation, its prevalence and the demographics of those who choose this means vary significantly between Asian Islamic and Western countries. This review confirmed the impact of culture, tradition, and societal structures and relationships on people's decisions to self-immolate. Education about the consequences of self-immolation may reduce the use of this method., (Copyright © 2019 Elsevier Ltd and ISBI. All rights reserved.)

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession Impact Reporting Method Patient or Public Contribution To provide a worked example informed by relevant literature and related studies that novice and early career researchers may use to reflect on, prepare and conduct a thoughtful and rigorous qualitative descriptive study.Methodological discussion of qualitative descriptive design.Seminal work and recent related literature were reviewed to situate the discussion and identify the concepts and steps to conduct a qualitative descriptive study.Qualitative descriptive design is widely used in nursing and health science research. This design offers flexible use of qualitative methods, which presents a double‐edged sword, posing challenges in preparing a well‐developed study and achieving methodological rigour. The design often borrows methods from other qualitative traditions, which may need to be clarified for novice and early career researchers, wherein studies may be conducted using a mix and match of methods without giving justice to the heart of qualitative descriptive design. In this paper, we present a step‐by‐step guide, using a worked example, to demonstrate how to conduct a qualitative descriptive study.Qualitative descriptive design may be confusing due to its flexibility, which may limit the scope of research and subsequently, the quality and impact of the findings. With the appropriate application of research methods producing high‐quality and relevant findings, qualitative descriptive design is a valuable qualitative method in its own right.Novice and early career researchers may increase the impact of their findings through rigorously conducting their studies. Clarifying steps for thoughtful execution may inform novice and early career researchers, allowing for a rigorous application of the method, which, in turn, may contribute to impactful findings.A clear presentation of steps, supported by a worked example and related studies, may support novice and early career researchers in conducting a qualitative descriptive study with methodological rigour.Not applicable.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Cancer survivors often experience physical and psychological symptoms that may affect their daily activities and quality of life. A mindfulness-based psychoeducation for cancer survivors, (MindCAN) program, has been established to help cancer survivors manage their physical and psychological symptoms. This study aimed to explore perceptions of participants who attended the MindCAN program. Methods: A descriptive qualitative study was conducted at a tertiary hospital in Singapore. Purposive sampling was used to recruit adult cancer survivors. They attended the MindCAN program that was conducted once a week for 8 weeks, comprising education and mindfulness practice. Two focus group interviews were conducted to elicit the participants' perceptions of the program. The interviews were audio-recorded and transcribed verbatim. A thematic analysis was performed to identify essential themes and subthemes. Trustworthiness, including creditability, confirmability, dependability, and transferability were ascertained. Results: A total of 13 participants were recruited. Most of whom were Chinese, female, and single. The participants' perceptions were documented in five major themes: heightened awareness of the self, enriching body experiences through mindfulness practice, cultivating powerful minds and positive emotions, integrating mindfulness to daily life, and embracing interpersonal mindfulness. Conclusion: Overall, the MindCAN program received positive comments from cancer survivors. They reported increased self-awareness, pleasant body experiences, positive thinking and emotions, and relaxation. Future research is required to test the effectiveness of the program. [ABSTRACT FROM AUTHOR]

Volunteerism contributes significantly to the social development of a country. Although the rate of volunteerism has steadily increased over the years, the numbers of regular volunteers remains small. While the existing literature has elucidated individuals' motivations for volunteerism, research is lacking on their motivations and challenges in sustaining long‐term volunteerism. A focused ethnographic approach was adopted in this study to explore 20 participants' motivations and challenges towards long‐term volunteerism. Purposive sampling was used to recruit participants in one single‐family service centre in Singapore from October to December 2018. Data were collected through covert observations and semi‐structured interviews. Field notes, observational data and findings from the interviews were triangulated and analysed through thematic analysis. In this study, a central exhaustive description of the volunteers 'providing help while receiving good deeds' is established. This was supported with three main themes revolving around the volunteers: fulfilling life goals, deriving meaning from experiences and striking a balance in the life. These themes characterised the motivations and challenges faced by them amidst their voluntary works. They reported that the satisfaction and fulfilment through volunteering had brought personal growth, well‐being and happiness to them. The sense of purpose through volunteering further enhanced their experiences. Finally, some volunteers reported that volunteering enabled them to strike a balance in their own life by engaging it as a form of solace. The findings suggest that sustained volunteerism is a multidimensional construct involving the interplay of different factors in the individual's life. By understanding motivations underlying long‐term volunteerism, voluntary organisations can create volunteering opportunities that dovetail with volunteers' personal goals, thus boosting their satisfaction and incentivising their sustained engagement. Additionally, the organisations can hold regular bonding activities to promote rapport among their volunteers, beneficiaries and staff, thus encouraging the volunteers to persevere on their volunteering journey. [ABSTRACT FROM AUTHOR]

Purpose: To explore the experiences of haematopoietic stem cell transplant survivors attending the long-term follow-up unit.Methods: A descriptive qualitative study of eight post-haematopoietic stem cell transplant survivors which were interviewed guided by the sense of coherence framework. Thematic analysis was used to extract meaningful explication of the survivors' experiences.Results: The post-haematopoietic stem cell transplant survivors interviewed were five females and three males with age ranging from 27 to 67 years and had the stem cell transplant between 4 and 20 years. Three main themes emerged from the data including (1) comprehending the experience, (2) acknowledging the meaningfulness of the experience and (3) managing threats to a new life after the transplant. The experiences of post-haematopoietic stem cell transplant survivors were initially difficult but they were able to make re-adjustments to their new life by reconciling with their new identity, refocusing on meaningful activities, strengthening their resilience and navigating the healthcare system.Conclusion: In spite of the difficulties faced by the survivors, they were able to face the challenges and made adjustment in a positive light by focusing on the valuable aspects of their experiences. Health care practitioners need to continually support them throughout their survivorship journey no matter how long it takes. Any long-term follow-up unit is a step in the right direction to meet the complex needs of the survivors by integrating and adapting clinical guidelines into routine oncologic and transplant care so that survivors are not lost in transition following treatment. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore patients' understanding of the role of an advanced practice nurse (APN). Background: The increasing prevalence of multimorbidities among people living with cardiovascular disease (CVD) has increased the complexity of their clinical care. Implementing the role of APNs in new models of care has been shown to improve outcomes in the CVD population. However, the CVD population's understanding of and experiences with the APN role have not been examined in Singapore. Methods: An exploratory descriptive qualitative design using semi‐structured face‐to‐face individual interviews was undertaken (November 2017–March 2018). Fourteen participants were purposively sampled from an outpatient clinic in one of Singapore's national heart centres. Thematic analysis was undertaken. The COREQ guidelines were adhered to. Findings: The multi‐ethnic sample included ten males and four females. Two main themes were identified: (1) APNs play a complementary role to doctors and (2) the acceptance of the APN role takes time. Each theme was supported by three subthemes to further elucidate the role and acceptance of APNs. Conclusion: A lack of understanding of the role of APNs is present, thereby causing the less than optimal patient acceptance of APNs. As patients with CVD experience improvements to their health through APN‐led services, they may gain confidence in APNs' skills and knowledge. Relevance to clinical practice: When introducing new roles, fully explaining these roles to the target population is pertinent as it will be facilitative to patient engagement and optimisations of care. The findings support the call for APNs to explain the value and essence of advanced practice nursing more effectively. There should be a greater emphasis on teaching APNs to introduce and explain the role of APNs through APN preparatory education and incorporating this practice in APN practice standards, especially in contexts where APN development is premature. [ABSTRACT FROM AUTHOR]

Introduction: Transition from childhood to adulthood is an important and challenging period for both adolescents and their parents, particularly in societies undergoing development and change. In Iran, cultural and social change is inextricably linked to, and strongly impacts on, family units. Aim: To explore the experiences of parents and the strategies they use in interacting with their adolescent children. Method: Qualitative descriptive research using in-depth interviews was conducted with 23 parents of adolescents in Iran. Transcribed data were subjected to thematic analysis. Results: Parents used two key approaches to effectively interact with their adolescent children. The first, "transformed parenting" involved the parents changing their parenting style and practices. The second approach, "child orientation" involved the parents trying to control, educate, and guide their child. Implication for transcultural practice: Understanding how parents experience interactions with adolescents in the context of Iranian culture and increasing modernity will guide nurses to foster effective parenting strategies for optimal adolescent development. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore patients and carers' experience and perceptions of different modalities of long‐term enteral feeding. Background: With an ageing population in Singapore, there is a concomitant increase in number of patients with dysphagia and hence increase in prevalence of enteral feeding. It is essential to understand experiences of patients and home carers with long‐term home enteral feeding and perceptions of different modalities to better provide support. Design: A qualitative descriptive approach fulfilling the COREQ checklist criteria (See File S1). Nine patients who were receiving long‐term enteral feeding and nine carers were recruited over the period of August to December 2017. One‐to‐one interviews were conducted and audio‐recorded. An inductive content analysis approach, with open coding, creation of categories and abstraction of data, was adopted. Results: Three themes were generated: (a) factors influencing choice of mode of enteral feeding; respondents narrated factors such as need to "conceal" illness, need to be independent and previous bad experience with alternative modality (b) identified informational, emotional and physical needs. Respondents reported the need for support in terms of information on the different modalities, and training on how to self‐care or provide care and (c) individual perception and attitude towards life with enteral feeding. Most respondents portrayed a positive outlook to life, despite that they could no longer participate in communal eating. Conclusion and Relevance to clinical practice: Understanding patients and carers' experience and perceptions will inform the development of strategies to empower future patients and carers in choice of modality for enteral feeding. Patients with percutaneous endoscopic gastrostomy (PEG) found it easier to integrate enteral tube feeding into daily lives. Carers played a pivotal role in choice of modality, as well as in care of patients on enteral feeding. [ABSTRACT FROM AUTHOR]

Objective: To understand health professionals' perspectives of burn care and rehabilitation. Design: Qualitative and semi-structured interviews. Setting: Australian burn and rehabilitation units. Participants: Twenty-two clinicians working in burns units across disciplines and healthcare settings. Results: The data portrayed the health professionals' perspectives of burn care and rehabilitation in Australia. Three themes were identified: (1) interprofessional collaboration; (2) integrated community care, and (3) empowering patients to self-care. Conclusion: Burn care and rehabilitation remains a complex and a challenging area of care with limited access to burn services especially in rural and remote areas. Interprofessional training and education of health professionals involved with the complex care of burn injury remains a key element to support and sustain the long-term rehabilitation requirements for patients and their families. Empowering patients to develop independence early in their rehabilitation is fundamental to their ongoing recovery. A burns model of care that embraces a multidisciplinary collaboration and integrated care across the continuum has the potential to positively impact recovery and improve health outcomes. Implications for rehabilitation: Burn care and rehabilitation remains a complex and challenging area of care. Managing the rehabilitation phase after burn injury can be as complex as managing the acute phase. Interprofessional collaboration, integrated community care, and empowering patients to self-care are key elements for sustaining the rehabilitation of adults with burn injuries. [ABSTRACT FROM AUTHOR]

Aim: To explore the meaning of resilience to nurses and their perceived resilience enhancing factors. Background: With challenges faced at work, nurses' professional quality of life is adversely affected with nurses experiencing compassion fatigue, depression, burnout and even signs of post‐traumatic stress disorder. Degree of resilience can determine job satisfaction and nursing attrition. Methods: The study adopted a descriptive qualitative design using Photovoice. Eight nurses from an academic medical centre in Singapore participated in focus group interviews and data were analysed with inductive content analysis approach. Results: Four themes were generated: (a) resilience is performing nursing duties despite adversities; (b) resilience is a dynamic process that develops over time; (c) religion and faith help build resilience; and (d) support of others is important in overcoming work‐related stress. Conclusions: Knowledge on resilience is vital to understand influencing factors of personal resilience and relationship to stress and burnout. Building nurses' resilience is significant to improve and sustain healthy and effective functioning of nurses. Implications for nursing management: With sufficient external resources and psychosocial support from hospital administrators, early resilience‐based approach may provide the buffer and protective factor in facing workplace stress, to improve overall job satisfaction and improve nurses' retention. [ABSTRACT FROM AUTHOR]

It is well‐recognized that nurses are exposed to high levels of stress, thus resilience has been postulated as a key trait in enabling nurses to cope successfully and remain in the profession. In this qualitative study, we used Glaser's approach to grounded theory. Nine nurses who scored low and nine nurses who scored high on the Connor–Davidson Resilience Scale were recruited for one‐on‐one semistructured interviews of the factors contributing to their work‐related stress and how they overcome these stressors. Three categories emerged from the data: outlook on work, self‐efficacy, and coping responses. These categories led to the emergence of the theory "differing pathways to resiliency". Despite the stresses experienced at work, some nurses were highly resilient, while others were not. Highly‐resilient nurses tend to adopt active coping mechanisms, whereas nurses who have low resilience tend to undertake passive measures to let nature runs its course. The emerging theory provided an understanding of the different pathways to resiliency and how nurse leaders can potentially develop and grow the level of resiliency among nurses. [ABSTRACT FROM AUTHOR]

In Iran, as in other nations, adolescence can be a challenging period for both parents and their children. Typically, mothers assume the main role of parenting, which can have a negative impact either directly or indirectly on paternal involvement, or conversely, play a positive role of mediation between fathers and their adolescent children. In the present study, we report on a qualitative study conducted in 2016 that explored the perceptions of Iranian parents toward the paternal role in raising adolescent children. Twenty three mothers and fathers of adolescent children were interviewed to explore their views and experiences with paternal roles in raising adolescent children. Four themes emerged from the data: (i) limited father–child interactions; (ii) mother‐led parenting; (iii) father–child conflict; and (iv) united front parenting. The findings suggest that mothers maintain a prime role in parenting, but that the involvement of fathers can have a negative or positive impact on adolescent development, depending on the level and quality of that involvement. Strategies need to be explored for how parents can best support one another to engage in the development of adolescent children. [ABSTRACT FROM AUTHOR]

This paper explored the support needs of family caregivers of people living with a mental illness in Iran. This descriptive study focused on the experiences of 20 family caregivers as well as the views of 29 professional support workers through individual face-to-face interviews. From these interviews three key themes emerged in regards to the care needs of family caregivers: (i) social support; (ii) emotional support; and (iii) safety and security. These themes highlighted the complex role of caring for a family member with a mental illness and the emotional, social and economic challenges that these caregivers experienced as a result. Iranian caregivers garnered support not only from other family members but also from neighbors and religious leaders but lacked the much needed respite care found in western countries. This research study highlighted the importance of ensuring that the caregivers themselves receive appropriate and adequate support to fulfill their caregiving role. [ABSTRACT FROM AUTHOR]

Introduction: Heart failure–related hospitalization is preventable through self-care but remains a common cardiovascular reason for rehospitalization. The purpose of this study was to explore the promotion of self-care in Singaporean patients with heart failure. Method: A descriptive qualitative design was adopted using Photovoice. Sixteen participants with heart failure were recruited from an outpatient cardiology clinic in Singapore. The participants were asked to take photographs that represented their promotion of self-care and used them in the subsequent interviews. Data were transcribed verbatim and analyzed using thematic analysis. Results: Four themes emerged: (1) accepting life; (2) appreciating life; (3) maintaining meaning in life; and (4) establishing a new normal life. The four themes provided insights into how they empowered themselves to self-care. Discussion: Participants were empowered to self-care through active and passive processes. Self-reflection served as an active process internally. Support from health care providers served as a passive process externally. [ABSTRACT FROM AUTHOR]

When a theoretical framework (and its components) is not clearly linked to research methods, researchers risk designing flawed studies, wherein the stated research question is inconsistent with the research design. Explicitly identifying one’s theoretical orientation can provide an orderly schematic for linking observations from separate investigations (i.e. qualitative, quantitative) thereby facilitating understandings and guiding research designs particularly in fields of social and health sciences where complex phenomena are an aspect of the subject of inquiry. Although this has been established, how researchers might position their research theoretically to guide mixed methods research is less clear. In this paper, we propose the Before Design Theoretical Placement as a general guide for specifying and locating studies in a broader theoretical grounding, and discuss how it may inform overall study considerations. We then use this approach to illustrate how theories and methods can work together to facilitate professional knowledge development from a relational perspective. [ABSTRACT FROM AUTHOR]

Abstract: Recovery‐oriented principles underpin modern‐day mental health care and are enhanced by consumer participation in decision‐making. Understanding how consumer participation can be maximized is central to promoting recovery‐oriented care. This study explored the key strategies used by mental health registered nurses and perceived by nurses to be used by peer support workers in facilitating consumer decision‐making to determine similarities, differences, and possible tensions. A qualitative descriptive approach using semi‐structured interviews was conducted with nine nurses employed in mental health care. Thematic analysis was conducted using open coding. Frequency of views expressed and prevalence of these amongst participants were noted to determine the most common strategies and challenges. Registered nurses use strategies aimed at empowerment, self‐management, and managing expectations to facilitate decision‐making but are challenged by entrenched coercion within the system. These same nurses view peer support workers as using their lived experience to build rapport, role model, and advocate for consumers. Tensions arise in how the peer support workers’ lived experience should be used and how this impacts on professional and therapeutic boundaries. Nurses expressed support for the role of peer support workers and viewed their inclusion in facilitating consumer decision‐making positively. Their own role is perceived as being caught between modern‐day service principles of empowerment and long‐standing practices based on coercion. [ABSTRACT FROM AUTHOR]

Abstract: In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision‐making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers’ participation in decision‐making and recovery. Semi‐structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor‐centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision‐making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery‐oriented care. [ABSTRACT FROM AUTHOR]

Abstract: The nursing profession is focused on serving others and has high expectations that each member behaves professionally and ethically, as articulated in nursing codes of practice and conduct. Where these are not upheld, inappropriate and unprofessional workplace behaviors follow. Regrettably, unprofessional behavior is neither new nor constrained to the nursing profession, but is known to negatively impact staff and workplace relationships, and importantly, patient safety and care. The aim of this qualitative study was to explore Iranian nurses’ experiences of professional communication between colleagues in the emergency department. Fifteen individual interviews were conducted. The overarching theme to emerge from the data was workplace communication, supported by two subthemes: unprofessional behavior and stressors in the workplace. Individually and collectively, these subthemes demonstrated staff attitudes and behaviors that are inconsistent with expectations of professional behavior and practice. Management proactively addressing unprofessional workplace behaviors is fundamental to establishing and maintaining positive workplace environments and supporting safe, quality patient care. [ABSTRACT FROM AUTHOR]

The use of drugs predominantly among Iranian men leads to health and social problems. Iran has established methadone maintenance therapy centres but there is limited research exploring the experiences of men who make use of this therapy. The aim of this qualitative study was to explore the experiences of men on methadone maintenance therapy in Urmia, Iran. Sixteen opioid-dependent males on methadone syrup substitution therapy were interviewed. Transcribed data were subjected to thematic analysis. Three themes emerged from the data: (1) the role of family in drug addiction; (2) the role of environment in drug addiction; and (3) the support needed to overcome drug addiction. While drug rehabilitation programmes in Iran can help the person, their family is seen as the most important support that they need together with sociocultural acceptance to overcome stigmatisation. [ABSTRACT FROM AUTHOR]

Homelessness is a collective societal problem, and people who are homeless are often treated as society's underclass, stigmatised and excluded. These issues are often exacerbated among homeless people from countries other than the one in which they are currently living. In this article we report findings from a qualitative study of homeless women, case managers and health professionals from a Maintenance Support Program and their personal accounts and insights into their experiences of the program. This article presents the third and last sub-theme “societal factors” of the study where the overarching theme was “A life-changing event: I have the power to change.” This sub-theme is supported by three categories including gender, race and ethnicity, and environment. The findings highlight the impact of the societal factors that linked women's experiences with domestic violence and abuse. Further cultural views regarding the role of women in society hinder their capacity to recognise that they should not be treated differently and that they should be supported to access health and social services to improve their lives in a safe and supportive environment. [ABSTRACT FROM PUBLISHER]

People who are homeless tend to have a number of complex needs. A housing maintenance support program (MSP) for women from the perspectives of clients, case managers and health professionals within the program was explored in this qualitative descriptive study. Interviews were conducted, and data were analysed using thematic analysis. The overarching theme that emerged from the data was “A life-changing event: I have the power to change.” This theme was supported by three sub-themes: personal, situational and societal dimensions. In this article, the sub-theme – situational factors, is presented and refers to poverty, resources and services, as well as social support systems. These aspects all impinged on the client's ability to face life changes with optimism towards a better future. Their experiences of disconnection with the community changed for the clients after being part of the MSP. The MSP enabled the clients to feel part of society again, and empowered them to participate in the world around them. Key aspects of inclusion in the world are relationships based on acceptance, connecting with others, being involved and creating a sense of home/community. [ABSTRACT FROM PUBLISHER]

In this article, a qualitative study of homeless women and their experiences attending a Maintenance Support Programme (MSP) is discussed. The overarching theme that emerged from the study of women in the MSP was ‘A life-changing event: I have the power to change’. The article focuses on the first of the sub-themes: personal factors including: (a) health status, (b) beliefs and attitudes, (c) knowledge, and (d) life and interpersonal skills. Findings demonstrate the influence that these factors have on the capacity of homeless women to change their lives. The MSP was instrumental in supporting these women to manage personal issues, by assisting with accessing health and social services, and developing life skills and achieving life goals. Understanding the homeless women's experiences may inform the development of future programmes and services in order to support and empower them to break the cycle of homelessness and help them to lead meaningful lives within society. [ABSTRACT FROM PUBLISHER]

Background: The National Cancer Institute Singapore initiated the NUH2 Home program in January 2014, referred to as "Caring Across the Cancer Continuum," a nurse-led cancer transitional care service (CTCS) that provides home care to patients with cancer and their caregivers. The study aimed to explore the transition experiences of patients with cancer and their caregivers.Method: Using a purposive sampling, 12 patients with cancer and 12 caregivers were recruited. Audiotape interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and thematic analyses were performed to extract significant themes and subthemes.Results: Four themes emerged from the data including (1) ongoing concerns, (2) needing timely help, (3) resuming control and normality of life, and (4) appreciating the transition care. The transition journey of patients and caregivers provided them with an ability to regain control and normality in their lives, be reassured and confident in being able to care for themselves and manage the physiological and psychological strains associated with the multiple vicissitudes associated with having cancer and its treatment while at home.Conclusion: Our study addressed the nature, patterns, conditions, and responses to transition care. Our findings provided relevant contextual knowledge to further improve the transition care service based on the recommendations of the patients with cancer and their caregivers who first experienced the new service. [ABSTRACT FROM AUTHOR]

In Singapore, anecdotal evidence suggests that nurses are concerned about managing aggressive incidents in the emergency department. In this study, registered nurses' perceptions of managing aggressive patients in an emergency department were explored. Ten registered nurses from the emergency department of an acute public hospital in Singapore were interviewed. Four overarching themes emerged from the thematic analysis: (i) impact of aggressive patients on nurses; (ii) nursing assessment of aggressive behaviors; (iii) nursing management of aggressive behaviors; and (iv) organizational support and responsiveness. Further research is required to better support nurses to deliver optimal care for aggressive patients and achieve positive and effective outcomes. [ABSTRACT FROM AUTHOR]

Singapore has an aging population that is projected to increase by 32% in 2100. The majority of older couples live alone. 'Aging in Place' is an initiative that is widely promoted by the government, in which older people are supported to live in their own homes. In this qualitative study, we explored the perceptions of older people living with their spouse in Singapore. Fifteen community-dwelling older participants were interviewed. Four themes emerged from the thematic analysis: (i) maintaining health and mobility; (2) maintaining relationships with spouse; (iii) maintaining relationship with others; and (iv) living the last leg of the race. The older people living on their own were generally content about maintaining their interdependence and complementary roles. Insights gathered from this study have relevance to implementation of the Aging-in- Place policy to ensure that older people receive the support they need to maintain their physical and psychosocial well-being while living on their own. [ABSTRACT FROM AUTHOR]

Childbirth is a unique experience in women's life. Various factors including human and non-human environment are involved in shaping the experience of childbirth.This study investigated the role of the environment on the psychological birth trauma from the perceptions of Iranian mothers. A qualitative descriptive study was conducted from September 2011 to February 2012, using audiotaped interviews with 23 Iranian women recruited from Tehran and Isfahan. The interviews were transcribed verbatim and analysed using the content analysis. Two themes were extracted from the data: human and non-human environment; and several categories also emerged from the data, which are communication with mother, awareness of mother's needs, support for mother, medical clinical competence, professional responsibility, hospital's physical structure, hospital's equipment, routine care in hospital and rules governing the hospital's environment, respectively. Considering the significant role of environment in psychological birth trauma of the mother, an appropriate intervention must be developed to enhance both human and non-human environment in order to reduce the psychological birth trauma. [ABSTRACT FROM AUTHOR]

Objectives Achieving optimal control and reduction in coronary heart disease ( CHD) risks in Hong Kong ( HK) remains significant and requires exploring. This article addresses the ability to reduce CHD risks among the HK Chinese. Design and Sample Through secondary analysis, a qualitative descriptive design using focus group interviews and content analysis were adopted. Older and younger adults were invited for the study. Measures An interview schedule was used to guide discussions during focus group interviews. Results Four categories emerged from the data: planning of health actions, control of risk-reducing behavior, perceived opportunities for understanding CHD, and chest pain appraisal. Conclusions Local culture and population needs play a central role in disease perception and prevention. The findings are essential to target strategies for initiating health acts for younger adults and establish public education resources that underscore understanding of CHD risk, symptom recognition, and disease management, particularly among those middle-aged and older people at high risk and with the diseased populations. [ABSTRACT FROM AUTHOR]

Objective: Childbirth is one of the most vulnerable moments and the most important and memorable events in the lives of women that despite of bringing happiness, it can be associated with psychological trauma and endanger the mother and neonate health. Mothers' perception of the psychological birth trauma is a highly subjective process that depends on the cultural, social and biological conditions of mothers that is not achievable except with examination of their views. This study aimed to understand psychological birth trauma from the perceptions of Iranian mothers . Methods: A qualitative research design using in-depth interviews of 23 Iranian mothers was conducted from Tehran and Isfahan health centers. The interviews were transcribed and analyzed using conventional content analysis . Results: Two themes were extracted from the data: impact of psychological birth trauma and trends of psychological birth trauma. Several categories and sub-categories also emerged from the data. Feelings of fear, anxiety, helplessness and sense of impending death (collapse) were reported by the mothers. Conclusions: By considering the unforgettable experience of mothers from the psychological birth trauma, a plan for supportive care before, during and after birth is critical. [ABSTRACT FROM AUTHOR]

This study explored the perceptions of 35 Chinese women on the impact of stress urinary incontinence on their life and their adherence to pelvic floor muscle exercise program. Audiotaped interviews were conducted at a time and place convenient to them. Content analysis was used to extract significant categories that described their experience. The five major categories that emerged were: (i) perceptions of stress urinary incontinence; (ii) living with urinary incontinence; (iii) emotions and feelings; (iv) factors facilitating pelvic floor muscle exercise and (v) factors inhibiting pelvic floor muscle exercise program. The women who adhered and those who did not adhere to pelvic floor muscle exercised were similar in the two categories of living with urinary incontinence, and emotions and feelings. However, there were great differences between the perceptions of the two groups in three categories on perceptions of urinary incontinence, factors facilitating and inhibiting the performance of pelvic floor muscle exercise. [ABSTRACT FROM AUTHOR]

cubit k. & lopez v. (2012) Qualitative study of Enrolled Nurses' transition to Registered Nurses. Journal of Advanced Nursing 68(1), 206-211. Abstract Aim. This paper is a report of a study which aimed to explore the transition experiences of graduate Registered Nurses (RN) who had previously practised as Enrolled Nurses. Background. The literature suggests that graduate RN who have previously practised as Enrolled Nurses (EN) have specific support needs during their first year of clinical practice. Methods. A qualitative descriptive study using focus group interviews was undertaken in the Australian Capital Territory, Australia in 2009. Eight graduate nurses (GN) were interviewed 1 week after the graduate nurses programme (GNP) had commenced and five GN at the middle and four GN at the end of the programme. Content analysis of the transcribed data was used to explicate themes. Results. Three main categories were identified from the data: stepping out of their comfort zone, being taken advantage of and needing support like any other new RN. The GN pleaded that they need to be treated as any other new nurses undertaking the graduate nurse programme and for staff to forget that they used to be Enrolled Nurses. Conclusion. Registered Nurses who had previously practised as Enrolled Nurses preferred not to be identified as having previous nursing experience as they feared being treated by their nurse managers as already capable of practicing as RN when in fact they needed support similar to any new graduate. [ABSTRACT FROM AUTHOR]

In Chinese society, the specific set of postnatal practices called 'doing the month' constitutes an integrated set of postnatal behaviors that provides cultural and maternal protection and identity. This study examines the cultural practice of 'doing the month' by Chinese mothers for two generations of matrilineal datasets. Ethnographic interviews were undertaken with new mothers and their mother and/or mother-in-law. Then, the coded data were compared within matrilineal dyads, as well as within age cohorts. The new mothers highlighted a range of attitudinal and behavioral practices that was informed and enforced by the female family members. They found highly individualized ways of negotiating traditional practices. In contrast, their mothers and mothers-in-law testified to a custom-bound approach. Support from family members appeared to be instrumental and was underscored by traditional notions of filial duty in the older generation of mothers. In comparison, their daughters and daughters-in-law indicated more autonomously directed behaviors. Recommendations are made in order to provide healthcare professionals with a more-informed understanding of Chinese postnatal belief systems. [ABSTRACT FROM AUTHOR]

Chest pain is a common symptom of coronary heart disease and people with chest pain are in danger of developing an acute myocardial infarction. There is some evidence that ethnicity is associated with coronary symptom recognition and descriptions of chest pain vary across ethnic groups. As coronary heart disease is increasing in the Chinese population, there are limited studies on chest pain descriptions and recognition among Chinese people. The aim of this study was to explore chest pain descriptions and recognition among Chinese people with coronary problems. A qualitative exploratory design using convenience sampling was used to recruit participants with coronary problems from a cardiac rehabilitation and prevention centre of a community-based hospital in Hong Kong. Focus group interviews were used to collect data and content analysis was used to code and categorise the qualitative data. Forty-three participants (24 men and 19 women) participated in the focus groups. Two categories in respect of chest pain emerged from the interview data: chest pain description and chest pain recognition. The Chinese participants used a broader variety of descriptive words and analogies to report chest pain. Misperception of chest pain for other non-cardiac problems was reported. This study provides information about various descriptors and descriptions used by the Chinese participants to describe the chest pain, about which little information was found in the literature. It highlights the fact that the use of analogies might imply difficulties in articulating the pain experienced by the Chinese participants. An accurate detection of chest pain could increase the patient's awareness of being at risk for coronary disease. These results provide clinicians with some chest pain descriptors that Chinese patients are likely to express that could aid in the diagnosis of coronary heart disease. To render prompt management to alleviate any adverse cardiac disease-causing consequences, more research among the Chinese people regarding chest pain recognition and descriptions is recommended. [ABSTRACT FROM AUTHOR]