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Aim: To generate, test and refine programme theories that emerged from a rapid realist review investigating practising UK Nurses' and Midwives' experiences of effective leadership strategies during the COVID‐19 pandemic. Background: The realist review of literature generated six tentative theories of healthful leadership practices reflecting, working with people's beliefs and values; being facilitative; multiple means of communication and; practical support. The review yielded little insight into the actual impact of the leadership approaches advocated. Methods: A realist study, informed by person‐centredness using mixed‐methods. Online survey (n = 328) and semi‐structured interviews (n = 14) of nurses and midwives across the UK in different career positions/specialities. Quantitative data analysed using descriptive statistics and exploratory factor analysis. Framework analysis for qualitative data using context (C), mechanism (M), outcome (O) configurations of the tentative theories. Results: Three refined theories were identified concerning: Visibility and availability; embodying values and; knowing self. Healthful leadership practices are only achievable within organisational cultures that privilege well‐being. Conclusions: Leaders should intentionally adopt practices that promote well‐being. 'Knowing self' as a leader, coaching and mentoring practice development is important for leadership development. Implications for Clinical Practice: Nurses who feel valued, heard, cared for and safe are more likely to remain in clinical practice. Job satisfaction and being motivated to practice with confidence and competence will impact positively on patient outcomes. Impact: The study addresses the role of leadership in developing healthful workplace cultures. The main findings were six leadership practices that promote healthful cultures. The research will have an impact on strategic and clinical leaders, nurses and midwives. Reporting Method: This study used EQUATOR checklist, RAMASES II as reporting standards for realist evaluations. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

BACKGROUND: The majority of American women juggle careers and the demands of mothering. The experiences of midlife mothers on the issues of work and motherhood are important to explore because birth rates for older women continue to rise in the United States and in other countries including the UK and Canada. OBJECTIVE: To present a unique viewpoint on work and mothering from the perspectives and experiences of older first-time mothers. METHODS: A purposive sample of thirteen women aged 45-56 years old participated in two in-depth interviews. Findings emerged in the context of a larger hermeneutic phenomenological study that aimed to understand older first-time mothers' perceptions of health and mothering during the transition to menopause. RESULTS: A paradox emerged in which the realities of motherhood did not meet the women's expectations. They were surprised by the centrality of commitment they felt towards the child and voiced strong ideals about how to do mothering right that included making changes to work schedules to be more available to their children.CONCLUSION: Health care professionals should be aware of specific issues that exist for older first-time mothers including adjustments to work. This knowledge will inform the support, education and care provided for these women. [ABSTRACT FROM AUTHOR]

Mealtimes in residential care homes are fundamentally social occasions, providing temporal structure to the day and opportunities for conversation and companionship. Food and drink are imbued with social meanings and used to express and create relationships between people. There is a dearth of research exploring care home residents' mealtime experiences in the United Kingdom. This paper reports on particular findings from a qualitative study which investigated factors influencing nutritional care provided to residents in two different types of residential care settings in South Wales, UK. Data were generated through focus group interviews with relevant staff members (N = 15), individual interviews with managers (N = 4) and residents (N = 16) of the care homes and their informal carers (N = 10), observation of food preparation and mealtimes throughout the day, and analysis of appropriate documents. Data were analysed using thematic analysis. This paper's focus is on the ways in which care home residents' experiences and understandings of mealtimes were influenced by various environmental factors, such as the home's geographical location, physical lay-out and ambience. Moreover, the shared meaning of mealtimes for residents, informal carers and staff was constructed from each group's socio-cultural background, family experiences and memories, and was integral to residents' sense of normality, community and identity. [ABSTRACT FROM PUBLISHER]

The article discusses a qualitative study exploring in-depth interpretation of women's experiences as older firt-time mothers. Four main themes, including achieving first-time motherhood at midlife, intensive mothering, out of sync and perimenopause as a state of uncertainty are presented. The study provides essential clinical implications for nurses and nurse midwives who will be caring for this growing population of women. INSET: Suggested Clinical Implications.

In the UK and Europe, malnutrition in older people is a significant and continuing problem. Malnutrition predisposes to disease, impedes recovery from illness, increases mortality and is costly to society. Despite the high number of older people potentially at risk, malnutrition in care homes has been under explored. There is concern that national guidelines regarding the nutritional care of older people in residential care homes are not always implemented. This qualitative study explored the factors that influence the nutritional care provided to residents in two different types of local authority residential care homes (providing personal care) in Wales. One home had communal dining rooms; the other had eight bedded units with their own kitchen and dining facilities. The sample of 45 participants, comprised 19 staff (managers, care and catering staff), 16 residents and 10 residents' relatives. Data were collected using semi-structured interviews, focus groups, observation and documentary review between August 2009 and January 2010. This paper focuses on how staff assessed and addressed residents' nutritional needs. In both care homes, staff strove to be responsive to residents' dietary preferences, provided person-centred care and worked in partnership with residents and their families to provide nutritious food in a homely environment. Neither home conducted nutritional screening to identify those at risk of malnutrition, contrary to national guidelines, but relied on ad hoc observation and monitoring. The staff's knowledge of special dietary needs was limited. A need for further training for care home staff regarding the importance of nutrition in maintaining health in older people, use of nutritional screening and special dietary needs was identified. Shared nutrition training between health and social care staff needs expansion and policy implications in terms of an enhanced regulatory focus on maintaining nutritional needs in care homes are proposed. [ABSTRACT FROM AUTHOR]

Aim To investigate factors that influenced nutritional care provided in two different types of residential care settings. Methods The study used qualitative methods, including focus group interviews with relevant staff members, individual interviews with managers and residents of the care homes and their informal carers, observation of food preparation and mealtimes throughout the day and analysis of appropriate documents.Findings Data were analysed thematically, and this article describes one of the four main themes that emerged: the relationship between social context and residents' eating and drinking experiences. Conclusion Greater understanding of the sociocultural context of eating and drinking in residential care settings may be used to inform nursing practice in relation to meeting older people's nutritional needs in other settings. [ABSTRACT FROM AUTHOR]