Conectar
Gain insight into the process of shared decision-making (SDM) in daily hospital care for patients with dementia from nurses' perspectives.
Explorative qualitative design.
In-depth digital interviews were conducted with 14 registered nurses between June and November 2022. A phenomenological approach was applied using Colaizzi's seven-step method.
Five themes were identified in the data: (1) SDM in daily care: How shared decision-making is applied; (2) Nurses' perceptions and competence: How nurses perceive and manage SDM; (3) Nurses' roles and advocacy: The evolving roles of nurses and their advocacy efforts, (4) Recognition of dementia and its impact: How nurses recognize and manage dementia; and (5) Interventions to support SDM: Strategies and interventions to facilitate SDM.
This study highlights the complexity of SDM in patients with dementia. It demonstrates the importance of the involvement of relatives, omission of patient goals in discussions and perceived deficiencies of nurses. The early identification of dementia, evaluation of nuanced capacity and targeted communication are essential. Further research and enhanced training are required to improve care in this context.
Potential areas for further research on SDM in nurses involving patients with dementia include investigating the effects of integrating goal discussions into SDM training for nurses, overcoming barriers to SDM competence, and challenging the idea that SDM is solely the responsibility of physicians. These findings highlight the need for policies that encourage interdisciplinary collaboration, address misconceptions and recommend training programmes that focus on applying SDM to the daily care of patients with dementia, thereby improving the overall quality of patient care.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used for reporting.
No patient or public contribution.
To examine the main effects and interaction effects of outcome expectations (e.g., anticipated satisfactory salary and benefits), nurse identity (a sense of membership in the nursing profession), and information-access efficiency of the electronic medical record system (how the system enables nurses to quickly retrieve the needed information) on nurses' retention.
This study uses a cross-sectional survey and adopts proportionate random sampling to recruit a representative sample of nurses of a medical centre in Taiwan.
This study successfully obtained completed questionnaires from 430 nurses during December 2021 to January 2022. Data are analysed by using hierarchical regressions.
Positive outcome expectations and identification as a member in the nursing profession are associated with retention. Information-access efficiency strengthens the link between outcome expectations and retention, while nurse identity weakens this link.
Outcome expectations can help retain nurses, particularly those who perceive high levels of information-access efficiency and possess weak nurse identity. That is, outcome expectations have a complementary role with nurse identity in retaining nurses.
Nurse managers should devise means to build positive outcome expectations for nurses. In addition, either strengthening nurses' identification with the nursing profession or improving the information-access efficiency of the electronic medical system may also help retain nurses.
This study examined how to transform outcome expectation to nurse retention, offering nurse managers to devise new means to retain nurses.
STROBE statement was chosen as EQUATOR checklist.
No patient or public contribution.
To analyse the concept of eating experiences in people living with dementia.
Rodgers' evolutionary method of concept analysis was used as a framework for the paper.
The literature was searched using electronic databases PubMed, Google Scholar, CINHAL, PsycInfo, Web of Science, Embase and Elsevier databases. These databases cover a variety of disciplines, including but not limited to nursing, medicine and occupational therapy. The relevant literature published from 1989 to April 2023 was thoroughly examined. Any quantitative or qualitative studies published in English focused on eating or dining experiences in people with dementia were included.
Rodgers' evolutionary method for concept analysis was used. The attributes, antecedents, consequences and case examples of the concept were identified.
Twenty-two articles met the inclusion criteria, identifying key attributes of self-connection, the special journey of life and self-interpretation. Antecedents, as framed by the socio-ecological model, were categorized to represent intrapersonal (personal preferences, individual culture, mealtime routines), interpersonal (social interaction) and environmental (dining room environment, policies) factors. Consequences were divided into external (nutritional health, physical health and quality of life) and internal (personhood, autonomy and independence, dignity and feeling valued and mental well-being) domains.
A theoretical definition and conceptual model of eating experiences in people living with dementia was developed. The identified attributes, antecedents and consequences can be utilized in nursing education, research and intervention approaches.
This article allows nurses and other healthcare professionals to better understand people living with dementia through the relationship between eating and interpersonal, intrapersonal and environmental aspects to develop personalized interventions and care strategies to achieve an optimal quality of life.
Not applicable.
To identify the nature, degree and contributing factors of workplace violence (WPV) incidents experienced by Australian nursing students during clinical placement.
Descriptive cross-sectional study.
Data were collected from 13 September to 25 November 2022. Eligible participants included all nursing students enrolled in nursing degrees at any Australian university who had completed at least one clinical placement. An adapted version of the WPV in the Health Sector Country Case Study survey was used.
A total of 381 nursing students across eight states of Australia completed the survey. More than half of the students had experienced an episode of WPV; patients were the most frequent perpetrators. Personal factors of patients, staff and students, organizational factors and cultural norms within the workplace supported acts of WPV.
Student nurses (SNs) most often experience violence from patients during direct care. Patient encounters are the core component of clinical placement. Education providers have a responsibility to effectively prepare students to be able to identify escalating situations and manage potentially violent situations. Registered nurses who supervise students during clinical placement require support to balance their clinical role with student supervision.
Experiencing WPV can negatively impact relationships between students, healthcare professionals and care recipients. This results in personal distress, decreased job satisfaction and potentially the decision to leave the nursing profession.
What already is known: SNs are exposed to WPV during clinical placement.
What this paper adds: More than half the SNs in this study experienced violence inclusive of physical, verbal, racial and sexual harassment. Patients were the predominant perpetrators.
Implications for practice/policy: Interventions at individual and systemic levels are required to mitigate WPV.
This study is reported using the STROBE guidelines.
This study explores the experiences of interprofessional collaboration of Canadian midwives and obstetricians from midwives' perspective.
A concurrent mixed-methods approach that combined a small validation study and qualitative thematic analysis was used to provide evidence of the nature and importance of collaboration between Registered Midwives (RMs) and obstetricians.
Eighteen RMs across Canada completed a demographic survey and the Midwifery-Obstetrician Collaboration (MOC) scale in 2023. The quantitative analyses were conducted to assess the reliability of the Midwifery-Obstetrician Collaboration (MOC) and accumulate preliminary evidence to support its validity. Semi-structured interviews were conducted with 13 participants. After completing the interviews, themes were identified using thematic analysis.
The primary themes identified were knowledge of midwifery scope affects collaboration, collaboration is necessary for effective patient care, midwife-physician collaboration is impacted by power differentials and hierarchies, and proposed methods to improve physician-midwife collaboration. Although a small sample size did not permit extensive statistical testing, the quantitative results supported the reliability of the MOC scale. In addition, a strong correlation between the MOC and the communication subscale of the Inter-Professional Collaboration (IPC) scale provided evidence of the MOC's concurrent validity as a measure of collaboration between midwives and physicians.
This study provides support for the Midwifery-Obstetrics Collaboration (MOC) Scale as an assessment tool to evaluate collaboration between midwives and OB/GYNs in obstetrics care. While the 18 RMs recruited for this study provided a fulsome analysis for the qualitative portion, a larger study is necessary to provide more extensive quantitative analysis to validate the MOC scale for continued use among RMs and OBs.
The implications of this study are to foster strong interprofessional relationships between midwives and OBs and to improve the health outcomes of pregnant women and newborns.
The authors adhered to Consolidated criteria for reporting qualitative research (COREQ).
To explore healthcare professionals' perceptions and experiences of take-home naloxone initiatives in acute care settings to gain an understanding of issues facilitating or impeding dispensing.
Systematic literature review.
Cochrane, MEDLINE and CINAHL were searched from 15/03/2021 to 18/03/2021, with a follow-up search performed via PubMed on 22/03/2021. The years 2011 to 2021 were included in the search.
A systematic literature review focused on qualitative studies and quantitative survey designs. Synthesis without meta-analysis was undertaken using a thematic analysis approach.
Seven articles from the United States of America (5), Australia (1) and Canada (1) with 750 participants were included in the review. Results indicate ongoing stigma towards people who use drugs with preconceived moral concerns regarding take-home naloxone. There was confusion regarding roles and responsibilities in take-home naloxone dispensing and patient education. Similarly, there was a lack of clarity over logistical and financial issues.
Take-home naloxone is a vital harm reduction initiative. However, barriers exist that prevent the optimum implementation of these initiatives.
What is already known: Deaths due to opioid overdose are a global health concern, with take-home naloxone emerging as a key harm reduction scheme. Globally, less than 10% of people who use drugs have access to treatment initiatives, including take-home naloxone. An optimum point of distribution of take-home naloxone is post-acute hospital care.
What this paper adds: There is role confusion regarding responsibility for the provision of take-home naloxone and patient education. This is exacerbated by inconsistent provision of training and education for healthcare professionals. Logistical or financial concerns are common and moral issues are prevalent with some healthcare professionals questioning the ethics of providing take-home naloxone. Stigma towards people who use drugs remains evident in some acute care areas which may impact the use of this intervention.
Implications for practice/policy: Further primary research should examine what training and education methods are effective in improving the distribution of take-home naloxone in acute care. Education should focus on reduction of stigma towards people who use drugs to improve the distribution of take-home naloxone. Standardized care guidelines may ensure interventions are offered equally and take-home naloxone ‘champions’ could drive initiatives forward, with support from harm reduction specialists.
This has adhered to the PRISMA reporting guidelines for systematic reviews.
No patient or public contribution.
To describe the current state of the literature on nurses' and midwives' knowledge, perceptions and experiences of managing parental postnatal depression (PPND).
The Joanna Briggs Institute scoping review method and the PRISMA extension for Scoping Reviews guided the work.
A systematic search of PubMed, CINAHL, Embase, MEDLINE, PsycINFO and Scopus databases was conducted in January and February 2023.
Peer-reviewed primary research articles published in English between 2012 and 2023 that involved nurses or midwives managing PPND were included. Rayyan was used to screen titles, abstracts and full-text articles. A spreadsheet was used to organize extracted data and synthesize results.
Twenty-nine articles met the inclusion criteria. Most study samples were of mothers, and few were from middle- and lower-income countries. Nurses and midwives lacked knowledge about PPND, yet they felt responsible for its management. Nurses and midwives faced significant organizational and systems-level challenges in managing PPND. However, nurses and midwives facilitated PPND care in collaboration with other healthcare providers.
The review highlights significant gaps in the nurses' and midwives' care of PPND. Educational programmes are necessary to increase nurse and midwife knowledge of PPND and strategies for its management, including facilitating collaboration across the healthcare system and eliminating organizational and systemic-related barriers. Additional focused research is needed on nurses' and midwives' knowledge, perception of and experience with PPND beyond mothers, such as with fathers, sexually and gender-minoritized parents and surrogate mothers. Finally, additional research is needed in middle- and lower-income countries where nurses and midwives may face a higher burden of and unique cultural considerations in managing PPND.
PPND can affect the parent's mental and physical health and relationship with their child. If left untreated, PPND can lead to long-term consequences, including child developmental delays, behavioural problems and difficulties with parental–child attachment.
This scoping review adheres to PRISMA Extension for Scoping Review guidelines and the Joanna Briggs Institute scoping review method.
This research is a scoping review of published peer-reviewed studies.
To evaluate the outcomes of a low-cost hospital-grade breast pump hire program for women experiencing financial hardship with infants in neonatal intensive care.
A multi-method evaluation including data audits and surveys.
Twenty-four electric breast pumps were purchased and rented to mothers at a cost of $1/day. To be eligible, mothers needed to have given birth to an infant <32 weeks and/or <1500 g and self-identified as experiencing financial hardship. Data were collected by (1) a retrospective audit to evaluate infant feeding and clinical outcomes at hospital discharge; (2) prospective telephone surveys to evaluate women's satisfaction with the program; and (3) analysis of the breast pump register to determine any loss or damages.
Twenty-four mothers of 26 infants participated in the program. More than half of the infants were exclusively breastmilk fed at hospital discharge, and more than three-quarters were fed a combination of breastmilk and formula. Women who intended to formula feed were supported to provide breastmilk to their infants in the first few weeks of life.
Most participants were highly satisfied with the program. Women reported that accessibility to a hospital-grade breast pump improved their ability to provide expressed breastmilk to their infants. Most participants were ‘extremely satisfied’ with the performance of the breast pump. One-quarter of the women reported that they would have exclusively formula-fed if they did not have access to the breast pump hire program. The audit of the equipment register showed no reported technical issues, loss or damages.
The findings suggested that the low-cost breast pump hire program supported equitable care, increasing women's ability to provide expressed breastmilk for their infants.
Providing access to low-cost hospital-grade breast pumps to mothers of vulnerable infants is likely to prevent poor infant clinical outcomes and improve women's care satisfaction.
Nil.
This study explored the knowledge and confidence levels of nursing academics in teaching both the theories and practical skills of digital health in undergraduate nursing programs.
A cross-sectional study.
A structured online survey was distributed among nursing academics across Australian universities. The survey included two sections: (1) the participants' demographics and their nursing and digital health teaching experience; (2) likert scales asking the participants to rate their knowledge and confidence to teach the theories and practical skills of four main themes; digital health technologies, information exchange, quality and digital professionalism.
One hundred and nineteen nursing academics completed part one, and 97 individuals completed part two of the survey. Only 6% (n = 5) of the participants reported having formal training in digital health. Digital health was mainly taught as a module (n = 57, 45.9%), and assessments of theory or practical application of digital health in the nursing curriculum were uncommon, with 79 (69.9%) responding that there was no digital health assessment in their entry to practice nursing programs. Among the four core digital health themes, the participants rated high on knowledge of digital professionalism (22.4% significant knowledge vs. 5.9% no knowledge) but low on information exchange (30% significant knowledge vs. 28.3% no knowledge). Statistically significant (p < .001) associations were found between different themes of digital health knowledge and the level of confidence in teaching its application. Nursing academics with more than 15 years of teaching experience had a significantly higher level of knowledge and confidence in teaching digital health content compared with those with fewer years of teaching experience.
There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Nursing academics need to upskill in digital health to prepare the future workforce to be capable in digitally enabled health care settings.
Nursing academics have a limited level of digital knowledge and confidence in preparing future nurses to work in increasingly technology-driven health care environments. Addressing this competency gap and providing sufficient support for nursing academics in this regard is essential.
What problem did the study address? Level of knowledge and confidence among nursing academics to teach digital health in nursing practice. What were the main findings? There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Where and on whom will the research have an impact? Professional nursing education globally.
The STROBE guideline was used to guide the reporting of the study.
The call for participation from nursing academics across Australia provided an introductory statement about the project, its aim and scope, and the contact information of the principal researcher. A participant information sheet was shared with the call providing a detailed explanation of participation. Nursing academics across Australia participated in the survey through the link embedded in the participation invite.
To determine the impact of home-based management on hospital re-admission rates in patients with chronic obstructive pulmonary disease (COPD).
Systematic review methodology was utilized, combining meta-analysis, where appropriate, or a narrative analysis of the data from included studies.
Electronic databases CINAHL, MEDLINE, PubMed, Embase and SAGE journals for primary papers, 2015 to 2021, were searched between December 2020 and March 2021, followed by hand-searching key journals, and reference lists of retrieved papers.
The review followed the guidance of PRISMA. Data were extracted using a predesigned data extraction tool. Quality appraisal was undertaken using RevMan ‘risk of bias’ tool. Meta-analysis was undertaken using RevMan software.
This review integrates evidence from eight studies, five Random Control Trials, two observational studies and one retrospective study. The studies span three continents, Asia, Europe and North America, and include 3604 participants with COPD. Home-based management in patients with COPD resulted in a statistically significant reduction in rates of hospital readmission. For the outcomes, length of stay and mortality, while slightly in favour of home-based management, the results were not statistically significant.
Given the burden of COPD on healthcare systems, and crucially on individuals, this review identified a reduction in hospital re-admission rate, a clinically important outcome.
This study focused on the impact on hospital re-admission rates among the COPD patient cohort when home-based management was involved. A statistically significant reduction in rates of re-admission to the hospital was identified. This is positive for the patient, in terms of hospital avoidance, and reduces the burden on hospital systems. Further research is needed to determine the impact on cost-effectiveness and to quantify the most ideal type of care package that would be recommended for home-based management.
To explore the published evidence describing the impact of short-notice accreditation assessments on hospitals' patient safety and quality culture.
Arksey and O'Malley (2005)'s scoping study framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping reviews (PRISMA-ScR).
A scoping review was conducted to identify papers that provided an evaluation of short-notice accreditation processes. All reviewers independently reviewed included papers and thematic analysis methods were used to understand the data.
PubMed/MEDLINE, CINAHL, and ProQuest databases were searched to identify papers published after 2000.
Totally, 3317 records were initially identified with 64 full-text studies screened by the reviewers. Five studies were deemed to meet this scoping review's inclusion criteria. All five studies reported variable evidence on the validity of health service or hospital accreditation processes and only three considered the concept of patient safety and quality culture in the context of accreditation. None of the five included studies report the impact of a short-notice accreditation process on a hospital's patient safety and quality culture.
Limited evidence exists to report on the effectiveness of hospital short-notice accreditation models. No study has been undertaken to understand the impact of short-notice accreditation on patient safety and quality cultures within hospital settings.
Understanding this topic will support improved hospital quality, safety, policy, and governance.
To provide an understanding of the current knowledge base of short-notice accreditation models and its impact on hospital patient safety and quality culture.
PRISMA reporting guidelines have been adhered to.
No patient or public contribution.
To understand the strategies used to continue providing psychosocial support to cancer patients during the pandemic, including outcomes and implications beyond the pandemic.
A systematic review of original research.
ProQuest Health & Medicine, CINAHL Complete (via EBSCOhost), Scopus, and PubMed were searched for original work published between January 2020 and December 2022.
Abstract and title screening identified eligible articles for full-text review. Following a full-text review, data were extracted from eligible articles, and a risk of bias assessment was conducted. A synthesis without meta-analysis was performed.
Thirty-four articles met the selection criteria. These articles provide evidence that systematic adaptations during the pandemic improved the assessment and screening of psychological needs and/or increased the number of clients accessing services. Additionally, while the pandemic was associated with decreased psychosocial well-being for cancer patients, five intervention studies reported improvements in psychosocial well-being. Barriers, strategies, and recommendations were described.
Adapting psychosocial support during a pandemic can be successful, achieved relatively quickly, and can increase the uptake of support for people experiencing cancer.
It is imperative that these adaptations continue beyond the pandemic to maximize adaptive psychosocial outcomes for a group vulnerable to ongoing mental health concerns.
While the COVID-19 pandemic was associated with increased psychosocial need for cancer patients, evidence in the review suggested that adaptations made to service delivery facilitated increased access for patients who may not previously have been able to access support. Additionally, improvements in psychosocial well-being were achieved. These findings are relevant for clinicians and decision-makers who fund and design psychosocial support services for cancer patients.
The review was guided by PRISMA Guidelines and the SWiM Reporting Guideline.
No patient or public contribution.
The aim of the study was to investigate the mediating effect of patient-reported missed care in the relationship between care dependency, adverse events, trust in nurses and satisfaction with nursing care.
A cross-sectional and correlational study.
A total of 374 patients were recruited from the medical and surgical inpatient units of two public university hospitals in Türkiye using a convenience sampling method from May to August 2022. The data were collected using the Care Dependency Scale, MISSCARE Survey-Patient, Trust in Nurses Scale and Newcastle Satisfaction with Nursing Care Scale. The relationships between the variables were analysed using a sequential mediation model (Model 6) in Hayes' PROCESS macro.
Care dependency was found to have a significant negative effect on misscare-communication; however, it had no significant effect on misscare-basic care. Misscare-communication had a significant positive effect on the experience of adverse events, while misscare-basic care had no significant effect. Misscare-communication and basic care had a significant negative effect on trust in nurses and satisfaction with nursing care. Misscare-communication was found to have a partial mediating effect on the relationship between care dependency and experiencing adverse events, trust in nurses and satisfaction with nursing care.
The results emphasize the importance of misscare-basic care, communication and patients' care dependency in improving patient outcomes such as experiencing adverse events, trust in nurses and satisfaction with nursing care, and they extend existing nursing studies by addressing missed care and care dependency together from the perspective of patients.
We urge nurse managers to consider the role of misscare in the impact of patients' level of care dependency on patient outcomes. Accordingly, nurse managers should focus first on interventions to eliminate misscare-communication. Effective interventions to address factors that impact communication and fulfilment of basic care are necessary to achieve better patient outcomes.
EQUATOR guidelines were followed using the STROBE reporting method.
No patient or public contribution. Patients only contributed to data collection. Data were obtained from patients hospitalized in the medical and surgical inpatient units of two public university hospitals.
To explore parents' experiences of unsettled babies and medical labels.
Qualitative systematic review, thematic synthesis and development of a conceptual model.
Systematic review and thematic synthesis of primary, qualitative research into parents' experiences of unsettled babies <12 months of age. ‘Unsettled’ was defined as perception of excessive crying with additional feature(s) such as vomiting, skin or stool problems. The Critical Appraisal Skills Programme (CASP) checklist was used to assess trustworthiness.
Structured searches completed in CINAHL, Medline, Embase, PsychINFO and CochraneCT on 23 March 2022 and rerun on 14 April 2023.
Ten eligible studies were included across eight countries contributing data from 103 mothers and 24 fathers. Two analytical themes and eight descriptive themes were developed.
Firstly, parents expressed fearing judgement, feeling guilty and out of control as a result of babies' unsettled symptoms and seeking strategies to construct an ‘Identity as a “Good Parent”’.
This desire for positive parenting identity underpinned the second analytical theme ‘Searching for an explanation’ which included seeking external (medical) causes for babies' unsettled behaviours.
Parents can become trapped in a cycle of ‘searching for an explanation’ for their baby's unsettled behaviours, experiencing considerable distress which is exacerbated by feelings of guilt and failure.
Insight gained from this review could inform interventions to support parents, reducing inaccurate medicalization.
Health visiting teams supporting parents with unsettled baby behaviour could focus on supporting a positive parenting identity by managing expectations, normalizing the continuum of infant behaviours, reducing feelings of guilt or uncertainty and helping parents regain a feeling of control.
ENTREQ guidelines were adhered to in the reporting of this review.
Parent input was crucial in the design phase; shaping the language used (e.g., ‘unsettled babies’) and in the analysis sense-checking findings.
To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways.
A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China.
Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism.
A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant.
The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement.
The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence.
What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers‘ understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence.
The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines.
No patient or public contribution.
This study outlines a protocol aimed at identifying and mapping health promotion practices in need of development from the perspectives of key sectors responsible for it at the local level and from an intersectoral perspective across four Spanish regions.
A complementary multi-method study combining survey methods and qualitative interviews will be adopted.
Purposive snowball sampling will be employed to select potentially rich informants from city councils, primary care centres, primary and secondary schools, and public health and civil society organizations in 12 municipalities sensitive to local health. Data on the degree of execution of health promotion activities, the level of intersectorality in their implementation, and their origins will be collected using PromoACTIVA questionnaires, an intersectoral typology model and an interview protocol. A parallel mixed analysis encompassing descriptive statistics and a ‘framework analysis’ will be performed.
This study is expected to yield thorough and reliable insights into health promotion practices and omissions at the local level by focusing on key stakeholders, both individually and collaboratively. This information can enhance health promotion planning and improve its effectiveness, efficiency and contextual relevance. The development and testing of a methodology for the integration and interpretation of these data will ensure sustainable capacity building.
Managers and practitioners interested in health promotion planning in the researched settings can benefit from a comprehensive map of the current state of their practices and insights into the starting points of collaboration. In addition, planners from other local settings will gain access to tools and methodologies to replicate and expand these maps to their own contexts.
Engaging key stakeholders with experience working in or with primary care centres, public health organizations, primary and secondary schools, civil society organizations, and city councils was vital to ensure the study's relevance and feasibility.
The aim of the study was to establish the feasibility of delivering a structured post-diagnosis information and support program to dyads (persons living with dementia or mild cognitive impairment and family carers) in two primary care settings.
A two-phase explanatory mixed-method approach guided by the Bowen Feasibility Framework focused on acceptability, implementation, adaptation, integration and efficacy of a five-part programme. In phase 1, the quantitative impact of the programme on the dyadic programme recipients' self-efficacy, quality of life, dyadic relationship and volume of care was measured. In phase 2, inductive content analysis focused on nurse and dyad participant experiences of the programme. Quantitative and qualitative data were reviewed to conclude each element of feasibility.
Four registered nurses working within the participating sites were recruited, trained as programme facilitators and supported to deliver the programme. Eligible dyads attending the respective primary health clinics were invited to participate in the programme and complete surveys at three time points: recruitment, post-programme and 3-month follow-up. Post-programme semi-structured interviews were conducted with dyads and programme facilitators.
Twenty-nine dyads completed the program; the majority were spousal dyads. The programme proved acceptable to the dyads with high retention and completion rates. Implementation and integration of the programme into usual practice were attributed to the motivation and capacity of the nurses as programme facilitators. Regarding programme efficacy, most dyads reported they were better prepared for the future and shared the plans they developed during the programme with family members.
Implementing a structured information and support programme is feasible, but sustainability requires further adaptation or increased staff resources to maintain programme fidelity. Future research should consider selecting efficacy measures sensitive to the unique needs of people living with dementia and increasing follow-up time to 6 months.
This study established the feasibility of registered nurses delivering a post-diagnosis information and support programme for people living with early-stage dementia or mild cognitive impairment and their informal carers in primary care settings. The motivation and capacity of nurses working as programme facilitators ensured the integration of the programme into usual work, but this was not considered sustainable over time. Family carer dyads reported tangible outcomes and gained confidence in sharing their diagnosis with family and friends and asking for assistance. Findings from this study can be used to provide direction for a clinical trial investigating the effectiveness of the structured information and support programme in the primary care setting.
The authors have adhered to the EQUATOR STROBE Statement.
A public hospital memory clinic and general medical practice participated in project design, study protocol development and supported implementation.
Master's degrees for nurses have various foci including clinical practice, leadership and education, with some programs consisting of coursework, while others offer hybrid study that combines coursework and research. Multiple formats are associated with offering the research component. The research component is often termed the minor thesis. Limited knowledge exists regarding the supervision of the research component.
To capture the practices and perspectives of experienced nurse academics regarding effective supervision of the masters-level minor thesis in nursing coursework master degrees.
Qualitative descriptive.
Semi-structured interviews with 28 experienced nurse academics recruited from 15 Australian and three New Zealand universities linked to the Council of Deans in Australia and New Zealand. Inclusion criteria were having experience of supervising masters-level minor theses and higher degrees. Interviews were face-to-face using the internet platform Zoom©. Thematic analysis was undertaken.
The analysis revealed three themes and associated sub-themes: (i) establishing the framework (setting up the student's research; building the student–supervisor relationship; setting clear expectations), (ii) supervisors' knowledge and actions: driving for success (supervisors' knowledge for a satisfactory and timely outcome; supervisors' actions to develop students' capabilities; supervisors' actions of drawing in other expertise) and (iii) supervisor savviness: Attending to the finer points of supervision for student success (using your attributes as a supervisor; being savvy to teach and engage students; creatively seeking a smooth process for student success).
The findings highlight three themes crucial to effective supervision of masters-level minor theses in nursing: Establishing a strong research framework, emphasizing supervisors' knowledge and proactive engagement and attending to nuanced aspects of supervision for student success. These insights contribute to deeper understanding of the multifaceted nature of supervising minor theses, providing a valuable foundation for refining supervisory practices and enhancing the educational experience within coursework nursing master degree programs.
The findings highlight the supervisors' pivotal practices in guiding students through the minor thesis. These insights will be useful for inexperienced and experienced supervisors and for degree program directors. The findings should inform supervision training and supervision practices in the future.
The study addressed a gap in knowledge about what experienced supervisors do to be effective and achieve success in the research component in a hybrid master degree for registered nurses. Effective supervision for student success in the minor thesis requires supervisors to establish and maintain a project and supervisory framework with appropriate boundaries and that is attuned to both the supervisor and student capabilities and preferences. Supervisors have an active role in directing the focus, scale and scope of a minor theses in keeping with university requirements and the short timeframe. Supervisors pay attention to the development of multiple student literacies (research, academic, professional, feedback and cultural) as core aspects of the masters research journey. Supervisors use their savviness and customize supervision to student contexts and capabilities as they guide development to achieve student success. The research findings have implications for targeted supervisor training and enhancing educational strategies for research supervision of minor thesis students.
COREQ reporting was adhered to as the relevant EQUATOR guideline.
No patient or public contribution.
The aim of this study was to explore home care nurses' experience of enablers and barriers for planned home death in municipal health care.
A focused ethnography.
This qualitative study collected data from 20 semi-structured interviews of home care nurses and 8.5 h of participant observations. Data was analyzed using thematic analysis.
The findings in our study show that home care nurses consider supportive cultures, a commitment to safety and continuity when facilitating planned home deaths and family rotations to be enablers for planned home deaths. Barriers to planned home deaths involve a lack of palliative experience affecting confidence, shortages of nurses and medical supplies and night shift challenges.
This study underscores the need for supportive organizational cultures, ongoing education and improved communication and staffing policies to enhance the quality of care and the experiences of patients and home care nurses, especially in the context of planned home deaths.
The study adds knowledge to the evidence base of the practice of facilitating planned home deaths. The findings of the study could offer valuable insights for shaping future policies or devising effective implementation strategies.
Adherence to the COREQ guidelines for reporting qualitative research was maintained.
No patient or public contribution.
Identified enablers and barriers provide a new perspective, contributing to a comprehensive understanding of planning home deaths. The study emphasizes supportive cultures, safety commitment and family rotations as crucial for planned home deaths, guiding healthcare professionals to adopt best practices and enhance palliative care quality.
FreshRSS 