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Aim: To develop and explore the validity of a Patient Reported Experience Measure (PREM) for adult inpatient diabetes care. Method: 27 in‐depth interviews were conducted to inform the development of the 42‐item PREM which was cognitively tested with 10 people. A refined 38‐item PREM was piloted with 228 respondents completing a paper (n = 198) or online (n = 30) version. The performance of the PREM was evaluated by exploring (i) uptake/number of responses and (ii) survey validity by investigating whether the PREM data were of adequate quality and delivered useful information. Results: The PREM had low drop‐out or missing data rates suggesting it was appropriately constructed. Analysis of item frequencies and variances, and problem score calculations concluded that questions provided sufficient score differentiation. Conclusions: This new PREM allows for experiences of inpatient diabetes care to be measured, understood and reported on to help identify priority areas for improving care quality. [ABSTRACT FROM AUTHOR]

Background: There is an active strategy to recruit international nurses and midwives to help manage vacancy gaps in the United Kingdom's healthcare system. However, there is little evidence detailing how recruiting organisations prepare new recruits for the Objective Structured Clinical Exam (OSCE) they are required to pass. Aims and objectives: To gather and analyse feedback from recruiting organisations on the preparation offered to international nurses and midwives on arrival in the United Kingdom, prior to undertaking an OSCE in order to gain Nursing and Midwifery Council professional registration. Design and methods: An online cross-sectional questionnaire. The data was analysed using thematic analysis. Results: Four main themes were generated from thematic analysis of the qualitative data: SAME IDEAS DIFFERENT PRACTICE; PASSING THE OSCE; INDIVIDUALISED SUPPORT; SUPPORT NETWORKS. Conclusion: Differences in how organisations prepare and support international nurses and midwives to undertake the OSCE suggest standardised approaches could benefit new recruits. Impact statement: Addressing an evidence gap, this research suggests recruits may benefit from standardised support around working and living in the UK. [ABSTRACT FROM AUTHOR]

Aims The aim of this study was to provide deep insights into the pain associated with pressure injuries in home-dwelling individuals using narrative accounts. Background Pressure injuries or pressure ulcers are burdensome and costly. Prevalence data, surveys and systematic reviews demonstrate that pain associated with pressure injury is widespread, but voices of home-dwelling patients have remained largely unheard. Design Concurrent mixed methods case study of a UK community of approximately 50,000 adults. Methods Qualitative interviews, conducted in 2016, of 12 home-dwelling adult participants with a current pressure injury ( n = 10), or a recently healed pressure injury ( n = 2). Findings Pain had an adverse impact on activities of daily living, mobility and sleep. Participants described days that were clouded in pain; a pain they felt was poorly understood and often out of control. Thematic content analysis revealed two major themes; these are: Poorly controlled pain: 'I just want the pain to go away'; and, Uncertainty for the future: 'it almost seems insurmountable.' Conclusion Findings of our study support the need to develop an appropriate assessment tool for pressure injury patients in the community to enable healthcare professionals and patients to recognize and manage pressure injury-related pain effectively. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore how patients with Chronic Heart Failure describe their experiences of breathlessness, the pattern of their breathlessness, how daily life is affected and how they adjust to and manage these symptoms. Background Chronic Heart Failure is a highly prevalent syndrome often with poor outcomes and in a patient group who are predominately elderly. Breathlessness is the main symptom experienced by patients and often relates to decompensation and hospitalisation, yet subtle changes described by patients are often not discussed with health care professionals. Design A descriptive qualitative design. Methods Twenty-five participants with heart failure with reduced ejection fraction ( HF- rEF) from a tertiary referral centre in England were recruited. Each participant took part in a semi-structured interview exploring the effect of breathlessness had on their lives. Data was analysed through Braun and Clarke's framework for thematic analysis. Results All participants reported experiencing breathlessness daily. Four sub-themes were identified in their accounts: nature of breathlessness, emotional impact of breathlessness, impact of breathlessness on daily life and managing breathlessness. Conclusion Participants were able to give vivid descriptions of breathlessness and the way it affected their lives. Relevance to clinical practice Health care professionals need to take account of each patient's personal assessment of their own breathlessness and how this is having an effect on their life and ability to undertake activities of daily living. Self-care management strategies need to be developed so that subtle changes can be assessed by the patient and reviewed by the healthcare professional to avoid hospitalisation and increased mortality risks. [ABSTRACT FROM AUTHOR]

Background: Health care within the home setting is a vital and growing component of pressure injury (PI) prevention and management. Objectives: To describe the use of health services and pressure-redistributing devices in community dwelling patients with PI's. Design: Mixedmethods collective case study of a defined, diverse geographic postcode area in the United Kingdom. Methods: Quantitative retrospective analysis of electronic and paper medical records of adult PI patients from 2015 district nursing reports. Qualitative semi-structured interviews of community dwelling adult patients receiving, or received, treatment for PI in 2016. Results: Mandatory reports (n = 103) revealed that 90 patients were supplied with a variety of pressure-redistributing devices but only one-third of patients used the equipment as recommended. Qualitative interviews (n = 12), reported to COREQ guidelines, revealed that patients felt reliant on community health services, and were concerned about the consistency of their care. Conclusions: Authentic patient involvement is required to provide care and interventions that are acceptable to PI patients and can be incorporated into self-care strategies and effectively monitored. [ABSTRACT FROM AUTHOR]

In recent years there has been an increase in international nurses and midwives (trained outside of the European Economic Area) recruited to work in the UK. The aim of this review was to synthesise the most recent qualitative research exploring the experiences of international nurses and midwives as they transition and adapt to living and working in the UK. A systematic literature search using the databases psycINFO, CINAHL, MEDline, Web of Science, as well as Google Scholar, resulted in six studies meeting the criteria of primary qualitative research published since 2010 and focussing on the UK as the host country. A lack of research into the experiences of midwives meant that the participants in each of these six studies were international nurses. The findings of these six studies were synthesised into 4 analytical themes: (1) Cultural integration; (2) Individual challenges; (3) Support networks, and; (4) Communication issues. Participants reported difficulties adapting to their new life in the UK, including within their role as a nurse, but also in finding and building positive relationships that would help to ease their transition. Instances of discrimination, an undervaluing of international nurses' skillset, and problems around communication were all detrimental to this process. These studies are in line with earlier findings that suggest international nurses face a challenging integration process when recruited to work in the UK, indicating no improvement in international nurse experience. With an increasing number of international nurses being recruited to work in the UK, this review raises concerns based on the need to effectively support these nurses to successfully integrate into work and the wider society. [ABSTRACT FROM AUTHOR]