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Advancements in information technology and computer science have resulted in the development of computerized healthcare information systems. Information technology can optimize patient care through providing immediate electronic education. The purpose of this mixed-methods systematic review was to synthesize evidence from studies exploring nurses and nursing students' attitudes and beliefs regarding the use of technology in patient care. Electronic databases Academic Search Complete, CINAHL, MEDLINE, Education Full Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, and ERIC were searched. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. Convergent integrated synthesis was conducted. Eight studies were included. Technologies used in the reviewed studies include smartphones (n = 4) and Web-based information/educational resources (n = 4). Overall, nurses and nursing students' attitudes and beliefs regarding the use of smartphone applications were positive. When compared with other healthcare professionals, nurses were more likely to have access to Web-based resources and to appraise the importance of such resources in patient education. Nurses and nursing students are in a prime position to use technology in patient care and education. It is important therefore that nurses' positive attitudes toward technology be reinforced to increase the use and application of Web-based and smartphone technologies in clinical practice.

This study investigated caring behaviors and anxiety levels among registered nurses (N = 280) working in acute hospitals. The Theory of Human Caring guided the study. A correlational design was employed. The Caring Behaviors Inventory-24 measured caring and the State Trait Anxiety Inventory measured anxiety. Nurses reported high levels of caring and low levels of anxiety. A statistically significant relationship was found between caring and anxiety, caring and supportive work environment, and caring and job satisfaction. Recommendations to support nurses working in acute hospitals are offered.

Supplemental digital content is available in the text., Objectives Patients are unintentionally, yet frequently, harmed in situations that are deemed preventable. Incident reporting systems help prevent harm, yet there is considerable variability in how patient safety incidents are reported. This may lead to inconsistent or unnecessary patterns of incident reporting and failures to identify serious patient safety incidents. This systematic review aims to describe international approaches in relation to defining serious reportable patient safety incidents. Methods Multiple electronic and gray literature databases were searched for articles published between 2009 and 2019. Empirical studies, reviews, national reports, and policies were included. A narrative synthesis was conducted because of study heterogeneity. Results A total of 50 articles were included. There was wide variation in the terminology used to represent serious reportable patient safety incidents. Several countries defined a specific subset of incidents, which are considered sufficiently serious, yet preventable if appropriate safety measures are taken. Terms such as “never events,” “serious reportable events,” or “always review and report” were used. The following dimensions were identified to define a serious reportable patient safety incident: (1) incidents being largely preventable; (2) having the potential for significant learning; (3) causing serious harm or have the potential to cause serious harm; (4) being identifiable, measurable, and feasible for inclusion in an incident reporting system; and (5) running the risk of recurrence. Conclusions Variations in terminology and reporting systems between countries might contribute to missed opportunities for learning. International standardized definitions and blame-free reporting systems would enable comparison and international learning to enhance patient safety.

Background Compassionate care delivery is a key feature of nursing and midwifery and a marker of quality healthcare delivery. Training nurses and midwives in compassionate care is known to yield positive nursing, midwifery, and patient outcomes such as increased job satisfaction, reduced burnout, improved patient satisfaction, and enhanced quality of life. Aim To explore nurses’ and midwives’ views of a three-day program entitled “The Leaders for Compassionate Care Program” from the perspective of participating nursing/midwifery leaders, directors of nursing/midwifery, chief directors of nursing/midwifery, and program facilitators. Methods A qualitative descriptive design was adopted. Purposive sampling was used to recruit participants (n = 15). Individual and focus group interviews were conducted via telephone and teleconferencing using a semi-structured interview protocol. Data were analyzed using inductive content analysis. Findings Participants perceived the program as innovative since it involved teamwork and networking and helped reiterate the human element of care. Participants identified the knowledge and expertise of the program facilitators as enablers to learning. The facilitators were committed to delivering a program that met the needs of individual leaders. Discussion Findings suggest the need to explore the long-term impact of the program, offer similar programs to junior and senior nursing/midwifery leaders, and maintain the networking that took place during the program. This could be achieved through conducting follow-up sessions and masterclasses. Conclusion The program served as an opportunity for the leaders to take time out, reflect on their practice using a compassionate care lens, network with colleagues from different institutions, and develop leadership skill.

AIMS AND OBJECTIVES This study explored nursing students' views of using virtual reality in healthcare. BACKGROUND The popularity and use of virtual reality in healthcare delivery and education is on the rise. Yet, the views of future nurses regarding this technology remain underexplored. DESIGN This is a qualitative descriptive study guided by a naturalistic inquiry and reported using the Standards for Reporting Qualitative Research checklist. METHODS Nursing students (n = 26) were recruited using convenience and snowball sampling. They were first exposed to a virtual reality intervention aimed to enhance men's awareness of testicular diseases. This was attempted to familiarise participants with the technology and initiate conversations around its use in healthcare. Participants were then interviewed face-to-face, either individually or within focus groups. Data were analysed using thematic analysis. RESULTS Four themes were identified: (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality. Participants described this technology as novel, enjoyable, immersive, memorable and inclusive. They questioned, however, the suitability of virtual reality for older adults, reported minor technical difficulties and stressed the importance of prior preparation in the use of the technology. Virtual reality was recommended for use in outpatient healthcare settings, schools and the community. Participants suggested using virtual reality in health promotion, disease prevention and management, and to promote nurses' empathy towards patients. CONCLUSIONS Findings highlight the potential role of virtual reality in assisting nurses in promoting health and managing disease. Future research is needed to establish the long-term effect of virtual reality interventions among more diverse participants. RELEVANCE TO CLINICAL PRACTICE Virtual reality can be implemented in outpatient, educational and community settings in order to promote health, prevent disease, enhance disease and self-management, and increase nurses' empathy towards patients.

Health outcomes among men are poorer than women and little efforts have been made by health organizations to promote men’s health. Testicular disorders can have a negative effect on men’s health and are rarely addressed in pre-existing men’s health policies. Findings from the empirical literature on men’s awareness of testicular disorders suggest that men’s knowledge of testicular disorders is lacking and their intentions to seek timely medical attention for testicular symptoms are low. This paper aims to introduce the concept of ‘testicular awareness’ and explore its implications for health research, practice, and education. The key attributes of ‘testicular awareness’ include: (i) familiarity with own testes; (ii) knowing what is normal versus abnormal; (iii) ability to detect an abnormality; and (iv) knowing own risk factors. Testicular awareness is an all-encompassing concept since it helps men become familiar with a body part that is seldom discussed and enables them to detect testicular abnormalities and to seek timely medical attentions for testicular symptoms, regardless of the ultimate diagnosis. Testicular awareness can be promoted using a number of strategies; these include but are not limited to: (i) involving men in drafting men’s health policies that address testicular awareness; (ii) partnering with men to develop and test interventions promoting testicular awareness; (iii) being cognizant of the learning needs of men who are at risk of health disparities including those with low literacy and health literacy; (iv) promoting testicular awareness in clinical practice and health education; and (v) using men’s daily spheres of information (e.g. workplaces, universities, gyms, and community organizations) to promote testicular awareness.

Aims and objectives To systematically identify, summarise and compare evidence from studies related to the non-pharmacological interventions used to manage pain in patients with dementia. Secondly, this study aims to provide evidence on the effectiveness of non-pharmacological interventions used to manage pain in patients with dementia. Background The number of people diagnosed with dementia is rising rapidly in the context of ageing. Pain is considered to be one of the most common neuropsychiatric symptoms of dementia. To date, little research has focused on non-pharmacological interventions to manage pain in patients with dementia. Therefore, a systematic review on the non-pharmacological interventions used to manage pain in patients with dementia and how effective these interventions are, is warranted. Method The extensive search strategy included electronic database searches for CINAHL, MEDLINE and PsycINFO from January 2009 to February 2020. A mixed-methods systematic review was undertaken in accordance with the PRISMA statement and relevant papers were chosen based on inclusion criteria and quality assessment measures. Eligibility criteria defined the characteristics of inclusion studies using the PICO framework. Results were extracted to a synthesis table. The quality appraisal was conducted using JBI and CASP checklist. Results Eight studies met the inclusion criteria. These included six randomised controlled trials, one quasi-experimental study and one qualitative descriptive study. The current review identified various non-pharmacological interventions for pain management in patients with dementia including singing, painting, massage, ear acupressure, play activities program and robot. The most common intervention was massage while the most effective intervention was play activities program. All studies provided evidence that non-pharmacological interventions have an effect on pain management in patients with dementia or that there was a tendency for non-pharmacological intervention to reduce pain in patients with dementia. Overall, the quality of the included studies was interpreted as strong (n = 8). Conclusions Overall, interactive pharmacological interventions were more effective than non-interactive non-pharmacological interventions. While this review highlighted a limited number of studies investigating the use of non-pharmacological interventions to manage pain in patients with dementia, it did however uncover a range of non-pharmacological interventions used to manage pain in these patients along with their level of effectiveness. Relevance to clinical practice Further research is required to explore which non-pharmacological interventions are most effective in the management of pain in patients with varying degrees of cognitive impairment. Further qualitative research is also needed to explore nurses' views on the use of non-pharmacological interventions to manage pain in patients with dementia.

Background Recent challenges to nurse education have resulted in an increased use of virtual reality which serves as an immersive and effective medium for skill and knowledge acquisition. Virtual reality technology is being included in nurse curricula at undergraduate level. This technology remains a relatively new experience for many nursing students with limited evidence regarding students' perspectives regarding virtual reality. Objective To explore nursing students' perspectives of incorporating virtual reality in nurse education. Design Qualitative descriptive study using thematic analysis. Setting Public university in Ireland. Participants Undergraduate nursing students were recruited using purposive and snowball sampling. Methods Students (n = 26) participated in face-to-face semi-structured individual interviews and focus groups in January and February 2020. Data were analysed using inductive thematic analysis. Results Three themes were constructed from the interviews: captivating, innovative, and empowering nature of virtual reality; contextual transfer; and challenges and threats to actualisation. Participants believed that virtual reality affords a novel, fun, memorable, inclusive, and engaging means of learning. Many believed that virtual reality would complement current teaching and learning approaches, help build learners' confidence, and provide nursing students with a safe space for trial, error, and problem-solving. The use of virtual reality was recommended to practise various nursing skills and learn about human anatomy, physiology, problem-solving, and clinical decision-making. Participants identified the resources incurred by the technology as challenges to implementing virtual reality in nurse education and stressed the need for continuous face-to-face feedback. Conclusions Findings suggest that virtual reality technology has the potential to facilitate learning, complement current educational approaches, and provide nurse educators with novel and engaging means of content delivery.

Purpose To examine international approaches to the ethical oversight and regulation of quality improvement and clinical audit in healthcare systems Data sources We searched grey literature including websites of national research and ethics regulatory bodies and health departments of selected countries. Study selection National guidance documents were included from six countries: Ireland, England, Australia, New Zealand, the United States of America and Canada. Data extraction Data were extracted from 19 documents using an a priori framework developed from the published literature. Results We organized data under five themes: ethical frameworks; guidance on ethical review; consent, vulnerable groups and personal health data. Quality improvement activity tended to be outside the scope of the ethics frameworks in most countries. Only New Zealand had integrated national ethics standards for both research and quality improvement. Across countries, there is consensus that this activity should not be automatically exempted from ethical review but requires proportionate review or organizational oversight for minimal risk projects. In the majority of countries, there is a lack of guidance on participant consent, use of personal health information and inclusion of vulnerable groups in routine quality improvement. Conclusion Where countries fail to provide specific ethics frameworks for quality improvement, guidance is dispersed across several organizations which may lack legal certainty. Our review demonstrates a need for appropriate oversight and responsive infrastructure for quality improvement underpinned by ethical frameworks that build equivalence with research oversight. It outlines aspects of good practice, especially The New Zealand framework that integrates research and quality improvement ethics.

The aim of this is paper is to propose Benner’s “Novice to Expert” Framework to underpin learning for students as they progress through the clinical components of an undergraduate nursing educational program. Steinaker and Bell’s “Experiential Taxonomy” is presented as a practical medium for itemizing the nursing activities novices are exposed to at the initiation of clinical experience and to the clinical competencies expected of nurses on completion of their educational program. The authors also propose a range of theories of learning applicable to the clinical education of undergraduate nursing students, which can be maximized to enhance clinical learning.

To explore the influences on nursing practice in acute hospital care.A Classic Grounded Theory study.Data collection (2013-2015) was through interviews and non-participant observations. Analysis was undertaken using constant comparative data analysis and theoretical sampling. Memo writing was used as an aid to understanding and conceptualizing data during analysis. Theoretical coding served to integrate emerging concepts.This theory explains core nursing as a nebulous intention, an idea which acute care nurses retain throughout each shift, that they will nurse their patients fully when they have the opportunity. It reveals this as the resolution of their main problem which is the constant deferral of core nursing care. This study explains its two sub-core categories, accommodating and integrity eroding.The theory highlights nurses' attitudes towards their role, demonstrated by deferring it to accommodate the work of others, but offers a new perspective on the significant contribution nurses make to the safe and cohesive transition of patients through the acute healthcare system.The theory adds a new understanding of the unique contribution nurses make to patient health and safety in acute care environments. It also provides insight into nurses' attitudes towards their own professional work. It explains the consequences of attitudes which undermine core nursing when it competes for priority with accommodating. Accommodating indicates a greater workload for nurses than has been previously understood in explaining the activities, additional to core nursing care, which nurses undertake to contribute safety and cohesion to the patient's acute care journey. These new insights suggest a role for managers in recognizing accommodating in decisions about staffing and resources and for educators in improving the profession's regard for its theoretical underpinnings and for its self-image.目的: 探讨急症医院护理对护理实践的影响。 设计: 典型扎根理论研究。 方法: 通过访谈和非参与者观察的方式收集数据(2013-2015年)。采用持续性比较数据分析和理论抽样方法,对相关数据进行分析。在分析过程中使用备忘录,帮助理解和概念化数据。此外,采用理论编码法,用于整合新提出的概念。 结果: 根据这一理论,核心护理为潜在意图,具体而言,急性护理护士在每次轮班过程中都会想,如果有机会,他们将对患者进行充分护理。这表明,上述措施是解决其核心护理服务持续延迟的主要方法。研究过程中,对两个子核心范畴进行解释和分析:即适应和完整侵蚀。 结论: 这一理论强调护士对其角色的态度,一般情况下,护士推迟工作以适应其他人员,但同样,护士使用急性医疗系统,从而确保患者安全,并提高其内部凝聚力。 影响: 通过这个理论,人们强化对护士的认识,充分了解护士在急性护理环境中对患者健康和安全的独特贡献。此外,人们可以通过这个理论深入了解护士对自身专业工作的态度。这一理论对在适应竞争优先权时破坏核心护理的后果进行解释。提供住宿表示护士的工作量较之前解释活动内容时更大,除核心护理工作外,护士还应为患者提供安全的急性护理服务,并应保证其内部凝聚力。上述新见解表明,管理者已经认识到人员配置和资源决策方面的灵活性,并认为教育工作者需要提高对其理论基础和自我形象的重视。.

Testicular cancer is the most common cancer among men younger than 50, and benign testicular disorders such as torsion and epididymitis can be life-threatening if left untreated. Men’s awareness of testicular disorders is lacking, and their intentions to see help for symptoms of testicular disease are low. This study aimed to describe the development, feasibility, and usability of a virtual reality (VR) intervention designed to enhance men’s awareness of testicular disorders (E-MAT). We designed E-MAT as a three-level VR experience and tested its feasibility and usability with 15 men recruited from a university. Following exposure to the intervention, participants filled a 43-item questionnaire. Participants agreed that the technology was comfortable to use, testicular disorders were well represented, the use of light humor was appropriate, and the scientific facts were easy to understand. Participants also agreed that the intervention was suited for men from different sociodemographic backgrounds and felt confident using VR. Overall, participants perceived the intervention as user-friendly, enjoyable, and aesthetically appealing. To the best of our knowledge, VR has not been used to promote men’s health in the past, let alone increasing their awareness and help seeking for testicular disorders. We recommend testing the effectiveness of E-MAT and making it available on public platforms that men can access at their own leisure. VR can be used in future interventions to educate men about various health topics.

Background The incidence of benign and malignant testicular disorders is on the rise. Three literature reviews and one qualitative study found that men’s awareness of testicular disorders was lacking, and their intentions to seek help for symptoms of testicular disease were low. Objectives The aim of the study was to enhance men’s awareness of testicular disorders, help-seeking intentions for testicular symptoms, and intention and behavior to feel their testes. Methods Men aged 18–50 years were recruited from a university and asked to engage in a three-level, educational, virtual reality experience. The Medical Research Council framework guided the development and pilot testing of the intervention. Knowledge, awareness, perceived risk, implementation intentions, help-seeking intentions, and behaviors were measured at pretest (T0), immediately posttest (T1), and 1 month posttest (T2). Results Data were available from 49 participants. In comparison to T0, a significant increase in knowledge (mean difference [ MD ] = 3.5, 95% CI [2.8, 4.26]); testicular awareness ( MD = 0.2, 95% CI [0.01, 0.41]); implementation intentions ( MD = 0.6, 95% CI [0.33, 0.90]); and help-seeking intentions for testicular swelling ( MD = 0.3, 95% CI [0.12, 0.51]), lumpiness ( MD = 0.3, 95% CI [0.08, 0.46]), and pain ( MD = 0.6, 95% CI [0.25, 1.01]) was noted at T1. This increase was maintained at T2. Participants who expressed an intention to feel their testes at T0 were more likely to report performing this behavior at T2. Discussion The intervention succeeded in promoting knowledge, testicular awareness, implementation intentions, help-seeking intentions, and behaviors. A randomized controlled trial of the Enhancing Men’s Awareness of Testicular Disorders intervention with a larger sample size is warranted.

This paper explicates how Orem's Self-care Deficit Theory of Nursing (Orem, 1995) was selected to guide a study to explore and measure cancer related fatigue (CRF), and determine the most effective self-care strategies used to combat CRF in a cohort of patients with a diagnosis of cancer (breast cancer, colorectal cancer, Hodgkin's and Non-Hodgkin's lymphoma). The secondary aim was to explore self-care agency and its relationship to CRF.

Compassionate care delivery enhances patient satisfaction and quality of life and reduces nurse burnout. This study measured the perceptions of nursing and midwifery leaders regarding the impact of the ‘Leaders for Compassionate Care Programme’ on their personal development, learning experience, service and care delivery, programme quality, and satisfaction with the programme. Seventy-nine leaders were surveyed using the Leaders for Compassionate Care Outcomes Evaluation Questionnaire and the Leaders for Compassionate Care Evaluation Questionnaire. Participants' perceived ability to support peer learning, manage conflict, and build trust with patients increased significantly following the programme (P≤0.001). Over 80% of participants reported that they were able to apply to practice what they had learnt from the programme and reported an increase in their motivation to lead in compassionate care delivery. Various strategies are needed to improve compassionate care leadership and further research is needed to explore the long-term impact of the programme.

To identify, describe, and summarize evidence from quantitative, qualitative, and mixed-method studies conducted to prepare nurses and nursing students to lead on and/or deliver compassionate care.Mixed-method systematic review.CINAHL, Medline, PsychINFO, and SocINDEX (January 2007-February 2018).Papers were screened by two independent reviewers using an online screening tool and data were extracted using a standardized data extraction table. Parallel-results convergent synthesis was used to synthesize evidence from included qualitative, quantitative, and mixed-method studies. Quality appraisal and risk of bias assessment were conducted.Fifteen studies were included with three main themes and six sub-themes: (a) programme impact (impact on ward-level and senior nurses and impact on nursing students and educators); (b) programme characteristics (characteristics leading to positive outcomes and characteristics leading to negative outcomes); and (c) programme implementation (implementation barriers and implementation facilitators). Compassionate care education programmes helped enhance nurses' ability to engage in reflective practice, deal with clinical challenges, and gain confidence. The importance of nurturing compassionate care delivery in nursing education was highlighted in the literature. Various nursing-level, patient-level, and organizational barriers to compassionate care delivery were identified.The impact of compassionate care educational programmes on nurses was predominantly positive. Further evaluation of the long-term impact of these programmes on nurses, patients, and organizations is warranted.Optimal delivery of compassionate care can be achieved by building organizational infrastructures that support nurses from all levels to attend education programmes and lead on compassionate care delivery.目的: 在于确定、描述和总结来自定量、定性和混合方法研究的证据,这些研究旨在帮助护士和护理学生引导和/或提供人文护理。 设计: 混合方法型系统综述。2018). 资料来源: CINAHL、Medline、PsychINFO和SocINDEX (2007年1月至2018年2月)。 综述方法: 两名独立审查员使用在线筛选工具筛选了各种文件,并使用标准化的数据提取表提取了相关数据。采用了平行结果 汇聚式合成法来综合纳入的定性、定量和混合方法研究相关证据。进行了质量评定和偏差风险评估。 结果: 纳入了15项研究,和三大主题和六个子主题:(a)方案影响(对病房和高级护士的影响以及对护理学生和教育工作者的影响);(b)方案特征(促成积极结果的特征和引发消极结果的特征);以及(c)方案执行(实施的不利因素和有利因素)。人文关怀护理教育计划有助于提高护士参与反思实践、应对临床挑战和获得信心的能力。相关文献强调了在护理教育中鼓励人文关怀护理的重要性。已确定各种护理层面、患者层面和机构层面的人文关怀护理相关不利因素。 结论: 人文关怀护理教育计划对护士的影响主要是积极的。有必要进一步评估这些计划对护士、患者和机构的长期影响。 影响: 通过建立支持各级护士参加教育方案和促成人文关怀护理的机构性基础设施,可以有助于最好的实施人文关怀护理。.

Background Health outcomes among men are markedly poorer than women. Testicular disorders can be life-threatening if left untreated. Few studies promoting awareness of testicular disorders have been underpinned by theory. Theory-based interventions are more likely to achieve positive health outcomes than interventions that lack a theoretical foundation. Objectives The purpose of the study is to present a theory-focused analysis of the preconscious awareness to action framework (PAAF), developed to enhance testicular awareness and help-seeking intentions and behaviors among men. Methods The following approach was used to develop the PAAF: The empirical literature on men’s awareness of testicular disorders was reviewed. A qualitative study was conducted to explore men’s awareness of testicular disorders, help-seeking intentions for testicular symptoms, and preferred learning strategies in relation to testicular disorders and symptoms. An iterative narrative review process of the theoretical literature on health promotion and symptom appraisal was undertaken. Results The PAAF comprises seven steps: preconscious awareness, unconscious awareness, conscious awareness, unconscious appraisal, conscious appraisal, intention, and behavior. The concept of testicular awareness was developed to familiarize men with their own testes and promote timely help-seeking. Discussion Researchers are encouraged to use the PAAF to design health-promoting interventions aimed at enhancing testicular awareness, symptom appraisal, and help-seeking.

Background: Testicular cancer (TC) is commonly diagnosed among men aged 15-40 years. The incidence of TC is on the rise. Benign testicular disorders such as testicular torsion and epididymitis can lead to testicular ischemia, sepsis, and infertility if left untreated. This systematic review aims to evaluate the effectiveness of studies promoting men’s knowledge and awareness of testicular disorders and/or self-examination, behaviours and/or intentions to examine their testes, and help-seeking behaviours and/or intentions for testicular symptoms. Methods: Academic Search Complete, Medline, CINAHL, PsychINFO, ERIC, the Cochrane Library, the World Health Organisation International Clinical Trials Registry Platform, Clinicaltrials.gov, Grey Literature Report, and Open Grey were searched for studies published between November 2014 and April 2018. The methodological quality and level of evidence per outcome were assessed. Results: There were five papers included: two were experimental studies, two were systematic reviews, and one was an integrative review. The majority of the reviewed interventions were successful in increasing men’s awareness of TC and self-examination. Examples include a television show featuring a celebrity with TC, a university campaign, and interactive educational sessions. The impact of the reviewed interventions on health beliefs (i.e. perceived susceptibility, severity, benefits, barriers, and self-efficacy) varied across the reviewed literature. Studies promoting help-seeking for testicular symptoms and awareness of benign testicular disorders were lacking. Conclusions: This review highlights the importance of evaluating educational interventions aimed at younger men, whilst raising their awareness of testicular disorders and increasing their help-seeking intentions for testicular symptoms. Given the lack of consensus around scheduled testicular self-examination among younger men, clinicians are encouraged to instruct men to familiarise themselves with the look and feel of their own testes and to seek timely medical attention for abnormalities. Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42018093671.

Minimal cross-national comparisons of nurse caring behaviors are available. A descriptive correlational study was conducted to describe and compare caring behaviors between nurses in Ireland (n = 74) and the United States (US) (n = 74). Significant differences were found between the samples on both educational background and years of nursing experience. US nurses had higher mean caring behavior scores compared to Irish nurses. However, when controlling for the two background variables, the difference was not statistically significant. This study is the first to compare nurses’ caring behaviors in these two countries. The findings have research, education, and practice implications.

Aims and objectives To investigate patients’ bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer and the relationship between bowel symptom experiences and the self-care strategies used. Background Earlier diagnosis of rectal cancer allows for less invasive surgical treatments such as sphincter-saving procedures to be performed. Although a permanent stoma is generally not required, patients experience changes in bowel function following this surgery. However, limited research exists on patients’ bowel symptom experiences and the self-care strategies used to manage symptoms following sphincter-saving surgery of rectal cancer. Design Quantitative descriptive correlational. Methods A convenience sample of 143 patients aged 30 to over 70 years was used. Data were collected (April 2010–December 2010) using the Illness Perception Questionnaires, the Difficulties of Life Scale and a researcher developed Self-care Strategy Measure. The research was underpinned by the Symptom Management Theory. Findings Relating to the four most effective self-care strategies used respondents reporting more bowel symptom were more likely to use the self-care strategy proximity/knowing the location of a toilet at all times. Females, respondents with high timeline cyclical scores and respondents with high physiological responses scores were more likely to use protective clothing. Respondents reporting more bowel symptom and with high social responses scores were more likely to use bowel medication. Females were more likely to wear incontinence pads. Conclusion This research provides insights into the daily bowel symptom experiences of patients following sphincter-saving surgery for rectal cancer. It demonstrates the range of self-care strategies that individuals use to manage their bowel symptoms and the self-care-strategies that were most effective for them. Relevance to clinical practice Patients should be encouraged to report on-going bowel problems following sphincter-saving surgery for rectal cancer. Supportive care for patients should be comprehensive and tailored to meet individual needs.

The aim of this research was to explore the concept of caring from the perspectives of undergraduate BSc general student nurses midway through their educational program. Data were collected through written narratives. Participants (N = 21) were asked to respond in writing to three semistructured questions. Data were analysed using content analysis. Analysis yielded three categories: altruism, authentic presence, and therapeutic care. Findings show that nurse educators need to capitalize on the experiences that help students who are midway through their educational program, to internalize the concept of caring, and to develop competency in providing therapeutic caring.

Purpose Men's awareness of testicular disorders is lacking and their intention to seek help for testicular symptoms is sub-optimal. Studies conducted to explore and raise men's awareness of testicular disorders did not address their preferred learning strategies and failed to include men who are at risk for health inequities. The aim of this study was to explore, in-depth, the preferred strategies for learning about testicular disorders inclusive of testicular cancer among men who self-identify as heterosexual, gay, or bisexual. Methods Maximum variation and snowball sampling were used to recruit 29 men aged 18–47 years. Participation was sought from community and youth organizations and a university in the Republic of Ireland. Semi-structured individual interviews and focus groups were conducted. Interviews were audio-recorded and transcribed verbatim. Inductive analysis of manifest content was used. Results Seventeen informants self-identified as heterosexual, 11 as gay, and one as bisexual. Four main categories emerged, namely: strategies to enhance awareness (television, internet, campaigns, print media), educational dos and don'ts (tailoring effective messages, drawbacks of national initiatives, ineffective learning strategies), implications of raising awareness (risks and benefits of increasing awareness), and learning among gay and bisexual men (learning needs and strategies). Conclusion Future studies promoting awareness of testicular disorders should take into account men's preferred learning strategies. National campaigns should be delivered frequently and altered occasionally in order to achieve a top-up effect. Clinicians are encouraged to educate young men about the seriousness of testicular symptoms and the importance of seeking timely medical attention for any abnormalities.

Background The incidence of malignant and benign testicular disorders among young men is on the rise. Evidence from three reviews suggest that men’s knowledge of these disorders is lacking and their help-seeking intention for testicular symptoms is suboptimal. Qualitative studies have addressed men’s awareness of testicular cancer, with none exploring their awareness of non-malignant diseases such as epididymitis, testicular torsion, and varicocele and none including sexual minorities. Objective To explore, in-depth, heterosexual, gay, and bisexual men’s awareness of testicular disorders and their help-seeking intentions for testicular symptoms in the Irish context. Design This study used a qualitative descriptive approach. Data were collected via face-to-face individual interviews and focus groups. Settings Participation was sought from a number of community and youth organisations and one university in Southern Ireland. Participants Maximum variation and snowball sampling were used to recruit a heterogeneous sample. A total of 29 men partook in this study. Participants were men, aged between 18 and 50 years, and residents of the Republic of Ireland. Methods All interviews were audio-recorded and transcribed verbatim. Reflective field notes were taken following each interview. A summary of the interview was shared with selected participants for member-check. Data were analysed and validated by three researchers. Inductive qualitative analysis of manifest content was used. Latent content was captured in the field notes. Data analysis yielded two key themes. Results The themes that emerged from the interviews were: Awareness of testicular disorders and their screening, and help-seeking intentions for testicular symptoms. Although most participants heard of testicular cancer, most did not know the different aspects of this malignancy including its risk factors, symptoms, treatments, and screening. Several men had a number of misconceptions around testicular disorders which negatively impacted their intentions to seek prompt help. Intentions to delay help-seeking for testicular symptoms were often linked to a number of emotional factors including fear and embarrassment, and social normative factors such as machoism and stoicism. In this study, culture was perceived by some participants as a barrier to awareness and help-seeking. In contrast, many believed that young men, especially those who self-identify as gay, are becoming increasingly interested in their own health. Conclusion Findings suggest the need to educate young men about testicular disorders and symptoms. This could be achieved through conducting health promotion campaigns that appeal to younger men, drafting national men’s health policies, and normalising open discussions about testicular health at a young age.

Background Testicular cancer (TC) is a relatively curable malignancy that predominantly affects young males. Key decision makers discourage TC screening because of lack of evidence about the benefits of this practice, whereas others argue that men must be aware of normal versus abnormal testicular findings. Despite the debate on TC surveillance, a number of research efforts are still being made to increase men's awareness of TC and its screening. Objective The aim of this study was to systematically review studies that were conducted to enhance men's knowledge and awareness regarding TC and its screening and increase their TC screening intentions and practices. Methods Studies published in English between 2004 and 2014 were reviewed using 3 e-databases, and interventions that were in line with the review aims were selected. Results A total of 3076 records were screened for eligibility, and 11 studies met the inclusion criteria. The majority of the reviewed interventions successfully enhanced men's awareness of TC and its screening and increased their intentions to perform testicular self-examination. Examples include videos about TC, shower gel sachets, stickers, and posters, a television show, a university campaign, and high self-efficacy messages about TC screening. Men at risk of health disparities were underrepresented in the reviewed literature. Conclusions A number of interesting channels through which men can learn about TC were identified. Examples include social media and mass media. Implications for practice Given the controversy that surrounds TC screening, nurses can play a key role in increasing men's awareness of TC rather than advising periodical TC self-examination.

Aim: the purpose of this paper is to present some of the challenges found to be problematic in recruiting individuals following sphincter-saving surgery for rectal cancer for a multi-centre study. While the focus of the study is on symptom experience and self-care strategies of bowel symptoms following colo-rectal surgery, the paper will concentrate solely on the challenges experienced in recruiting a sample for the study. Background: recruitment of an adequate number of participants is a challenge for researchers in any area of research involving patients. Enrolment of patients treated for rectal cancer poses particular challenges, because the total population of this group in a given country can be small. The use of multiple centres was required to obtain the required number of participants for the current study. Findings: in multi-centre studies, researchers can encounter substantial challenges in obtaining ethical approval, accessing clinical sites and gaining direct access to patients. These challenges are embedded in a convoluted process involving many systems of communication, which can vary from one centre to another. Conclusions: the process of obtaining ethical approval is prolonged in the absence of a central ethical review committee. A central review process based on a standard application for researchers seeking ethical approval for multi-centred studies is necessary. Establishing and maintaining access to clinical sites requires co-operation from many individuals during the development of the proposal and continuing throughout the data collection process.

Colo-rectal cancer is reported as the second most common cancer among both males and females in Ireland with approximately 2,700 patients diagnosed annually. There has been a dramatic improvement in colo-rectal cancer survival over the last 15 years with approximately 50% of patients now expected to survive this cancer in Ireland National Cancer Registry (2009). Earlier diagnosis lends toward more effective and less invasive surgical treatments such as anal sphincter saving surgery. Sphincter saving surgery is now viewed as an advance over the traditional approach involving abdominal perineal surgery which typically leaves patients with a permanent colostomy for life. Sphincter saving surgery preserves the anal sphincter and therefore a permanent colostomy can be avoided. A colostomy is a surgical procedure in which a stoma (or opening) is formed by bringing the end of the large intestine or colon through an incision in the abdominal wall and suturing it into place. ...

This column presents an analysis of McCormack's conceptual framework for person-centered practice with older people as a theoretical basis for the delivery of care of older adults in an Irish context. The evaluative process is guided by the framework proposed by Fawcett (2000) for the analysis and evaluation of conceptual models of nursing. The historical evolution, philosophical claims, and an overview of the content of the model are addressed. The following criteria are then applied: logical congruence, the generation of the theory, the credibility of the model, and the contribution of the model to the discipline of nursing.

Purpose/objectives To critically appraise empirical evidence gathered from studies that (a) explored men's knowledge, awareness, and attitudes toward testicular cancer (TC) and its screening; (b) addressed their testicular self-examination (TSE) practice; and/or (c) highlighted barriers and facilitators to this practice. . Data sources MEDLINE®, CINAHL®, and EMBASE®. . Data synthesis 25 articles met the inclusion criteria. Knowledge deficits regarding TC and its screening were seen. Participants who did not perform TSE often were uninformed about this practice. The majority of men perceived TC education as a positive step toward raising awareness about this malignancy. . Conclusions Very few men were informed about TC and TSE. Future studies should include valid and reliable tools to assess TC knowledge and screening, address the means through which TC knowledge is delivered, explore the individual's experience with TC screening, and focus on TC awareness and screening among minority groups. . Implications for nursing Although regular screening for TC is a controversial issue, nurses should encourage young men to seek medical attention in the event of discovering scrotal abnormalities.

A paucity of research is available on patients' bowel symptom experiences and self-care strategies following sphincter-saving surgery for rectal cancer. Most research undertaken to date on patients' bowel symptoms following surgery for rectal cancer has been largely atheoretical. The purpose of this paper is to describe the process of choosing a theoretical framework to guide a study of patients' bowel symptoms and self-care strategies following sphincter-saving surgery for rectal cancer. As a result of a thorough literature review, we determined that the Symptom Management Theory provided the most comprehensive framework to guide our research.

The primary aim of this article is to identify the self-care strategies that patients use to manage bowel symptoms experienced following sphincter-saving surgery for rectal cancer. Comparisons will be made with self-care strategies used by patients to manage chronic fecal incontinence and the bowel symptoms associated with other chronic bowel diseases, such as irritable bowel syndrome and inflammatory bowel disease. Published studies and conceptual literature from 2000-2010 were the data sources. Three major themes emerged from the literature reflecting the self-care strategies used by patients to manage bowel symptoms: functional self-care strategies (e.g., taking medication), social activity-related self-care strategies (e.g., planning social events), and alternative self-care strategies (e.g., complementary therapies). An analysis of studies highlighted that, through the process of trial and error, patients learned the strategies that were most effective in the management of their bowel symptoms. Knowledge of such strategies will be beneficial to healthcare professionals when educating patients about effective management of bowel symptoms following sphincter-saving surgery.

Purpose of the research The aim of this research was to explore participants’ qualitative perspectives on bowel symptom experiences and management strategies following sphincter saving surgery for rectal cancer. Methods and sample The data presented in this paper were gleaned from a semi-structured question that formed part of a larger multi-site quantitative correlational study. From a sample of 143 participants, a total of 77 (62.6%) males and 46 (37.3%) females provided qualitative comments. Participants were aged 30–70 years and over, had undergone sphincter saving surgery for rectal cancer in the past 3–42 months. Data were analysed using pre-determined semi-structured categories. Key results The study demonstrated the subjective nature of the bowel symptoms experienced. It also highlighted the bowel symptoms that were most problematic and the effect of these symptoms on participants’ daily lives. In addition, the self-care strategies that worked best for individual participants in the management of bowel symptoms were identified. Conclusions There is a need to educate patients on the short-term as well as the long-term bowel symptoms experienced following sphincter saving surgery for rectal cancer. Nurses have an important contribution to make in facilitating patients to choose from a range of self-care strategies to help them manage their bowel symptoms postoperatively.

A model of personhood for nursing in Ireland based on Celtic society, Irish language, Irish customs, and the Catholic religion is discussed. Concepts central to the model are presented bilingually as a means of capturing the essence of nursing care in an Irish context. The adequacy of the model is considered from the perspective of the following evaluative criteria: social utility, social congruence, and social significance.

We have isolated and characterized three monoclonal antibodies that preferentially recognize the pathogen Listeria monocytogenes . Mouse monoclonal antibodies were produced by fusion of spleen cells from a Balb/c mouse, which was immunized with live L. monocytogenes , to an NS-1 myeloma partner. Hybridomas that produced antibodies which preferentially reacted with L. monocytogenes were identified by a direct binding enzyme-linked immunoabsorbent assay (ELISA) using a panel of bacteria which included L. ivanovii, Streptococcus faecalis, L. seeligeri, L. innocua and L. monocytogenes Scott A. Three hybridomas, Mab 20-10-2, Mab 36-6-12 and Mab 56-9-16 which preferentially reacted with L. monocytogenes were selected for further analysis. An indirect ‘sandwich’ ELISA was developed and used to further confirm that these hybridomas reacted with a number of L. monocytogenes isolates and not with other common cross-reacting bacteria including Kurthia sp.

Summary Aim of paper This paper will report a research study conducted to compare the perceptions of nurses and relatives of critically ill patients on the importance of the caring behaviours of critical care nurses. Background The concept of caring is central to the nature of nursing with many approaches to defining and describing it in the nursing literature. Caring in critical care nursing involves affective, cognitive and action processes. It is the action processes or caring behaviours that are most evident to nurses, patients and relatives. Method This descriptive, comparative, quantitative study was conducted in an Irish critical care setting. Convenience sampling was used to recruit n = 40 nurses and n = 30 relatives of critically ill patients. Data were collected over a 3-week period in 2006 using an adapted version of the Caring Behaviours Assessment Tool. Descriptive statistics were used to analyse the data. Findings There was congruence between nurses and relatives on the most and least important caring behaviours of critical care nurses. Both groups placed a higher value on caring behaviours which demonstrate technical competence, the altruistic and emotional aspects of caring. Conclusion The results of this study have demonstrated that there are more similarities than differences between the perceptions of nurses and relatives on the importance of the caring behaviours of critical care nurses. The results of this study will give critical care nurses a greater understanding of how their caring behaviours are perceived by others. Incorporating the views of relatives into the delivery of care in the context of critical care will allow nurses to create a patient-centered service.

The increasingly complex requirements of today's nursing practitioners, have been accompanied by demands on nurse educators to look at new ways to facilitate learning in the clinical area (Camiah 1996). In recent years nursing education has undergone a period of major change in many countries through integrating with universities. While nurse educators are striving to respond to changes in education the dichotomy between the theoretical input taught in the classroom and what is practised or experienced on the wards remains a problem (Ashworth & Longmate 1993, Ferguson & Jinks 1994). Dale (1994) postulates that theory provides the basis for understanding the reality of nursing, it would seem reasonable, therefore, to assume that the content studied in the classroom correlates with what the student experiences on the ward. It should also follow that if a gap exists between theory and practice, efforts should be taken for its reduction (Rafferty et al. 1996). According to MacNeil (1997) many initiatives have been introduced in an effort to bridge the theory-practice gap and these have focused around the role of the nurse teacher. These changes in education are redefining the role of the nurse teacher, therefore, the part that they currently play and will play in the future needs to be carefully considered (Phillips et al. 1996b). The aim of this paper is to provide an overview of the literature on the theory-practice divide in nursing. First, some of the reasons cited for its existence will be explored. Second, suggested ways of bridging the divide will be considered focusing on the role of the nurse teacher.