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AnteayerInternacionales

Transforming outcome expectations into retention among hospital nurses: A cross‐sectional study

Abstract

Aim

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.

Design

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.

Methods

This study successfully obtained completed questionnaires from 430 nurses during December 2021 to January 2022. Data are analysed by using hierarchical regressions.

Results

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.

Conclusion

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.

Implications for the Profession

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.

Impact

This study examined how to transform outcome expectation to nurse retention, offering nurse managers to devise new means to retain nurses.

Reporting Method

STROBE statement was chosen as EQUATOR checklist.

Patient or Public Contribution

No patient or public contribution.

The efficacy of mindfulness‐based programs in reducing anxiety among nurses in hospital settings: A systematic review

Abstract

Background

The increasing pressure of their professional duties has led to a notable concern regarding the mounting anxiety levels among nurses. The ongoing discussion revolves around the efficacy of mindfulness as a means to alleviate anxiety in nurses.

Aim

This systematic review evaluated the effectiveness of mindfulness in reducing anxiety among nurses.

Methods

The evaluation followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. An extensive and comprehensive search was conducted across eight databases to identify studies that utilized randomized controlled trials (RCTs) and were published in English between 2011 and 2022. Independently, two reviewers assessed the validity of the randomized controlled trials using the Consolidated Standards of Reporting Trials criteria. Additionally, two authors independently employed the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-2) method to evaluate the potential bias in the RCTs.

Results

Eight randomized controlled trial studies that were deemed eligible were included in the current analysis. Based on the literature review, it was determined that mindfulness-based training can assist nurses in reducing their anxiety levels. Furthermore, the effectiveness of mindfulness-based programs in enhancing nurses' mindfulness and self-compassion has been firmly established.

Conclusions

Based on existing literature, mindfulness-based interventions have proven to be effective in reducing anxiety levels among nurses. However, in order to enhance the overall quality of research, it is necessary to implement more rigorous controlled designs that include randomization. Additionally, larger sample sizes with a diverse range of participants are needed to establish and validate the effectiveness of mindfulness-based programs in alleviating anxiety among nurses.

Linking Evidence to Action

Implementing mindfulness-based training in healthcare organizations can offer numerous benefits. One such advantage is that it can help nurses in reducing anxiety and enhancing their ability to handle the pressures associated with their profession.

Study Registration

PROSPERO Protocol registration ID: CRD42023475157.

How healthy dietary patterns have an impact on overall and cause-specific mortality?

Por: Nguyen · N. T. H. · Duong · T. V.

Commentary on: Shan Z, Wang F, Li Y, Baden MY, Bhupathiraju SN, Wang DD, Sun Q, Rexrode KM, Rimm EB, Qi L, Tabung FK, Giovannucci EL, Willett WC, Manson JE, Qi Q, Hu FB. Healthy Eating Patterns and Risk of Total and Cause-Specific Mortality. JAMA Intern Med. 2023 Feb 1;183(2):142-153. doi: 10.1001/jamainternmed.2022.6117. Erratum in: JAMA Intern Med. 2023 Jun 1;183(6):627.

Implications for practice and research

  • Wholesome eating diets can be customised to align with person’s culinary traditions and tastes in accordance with the Dietary Guidelines for Americans to decrease the mortality risk.

  • Provide updated scientific evidences on the benefits of maintaining a healthy diet throughout the life course to take appropriate strategies and policies.

  • Context

    Healthy eating patterns play a prominent role in preserving public health. The association between dietary patterns with the mortality risk has been investigated in numerous countries.1 2

    Clinicians signal the need to improve competency in the care of patients who identify as LGBTQ+

    Por: Ryan Schultz · T.

    Commentary on: Kelleher ST, Barrett MJ, Durnin S, Fitzpatrick P, Higgins A, Hall D. Staff competence in caring for LGBTQ+ patients in the paediatric emergency department. Arch Dis Child. 2023 Jul;108(7):525–529. doi: 10.1136/archdischild-2022-325151. Epub 2023 Apr 24.

    Implications for practice and research

  • Emergency department staff self-identified the need for training in the care of youth who identify as LGBTQ+ to close a gap in knowledge and clinical preparedness.

  • Intervention studies, using evidence-based science, are needed to improve competency and advance health equity for LGBTQ+ youth.

  • Context

    Individuals who identify as LGBTQ+ report discrimination in healthcare settings.1 Clinicians describe a lack of formal education in LGBTQ+ care needs.2 Adolescence is complex; adolescents who identify as LGBTQ+ are among our most vulnerable. International statistics illuminate that these youth are at exponentially higher risk for suicide.3 This study by Kelleher and...

    Factors that enable or hinder the rebuilding of the therapeutic relationship following an episode of physical restraint in acute forensic services

    Por: Askola · R. · Lantta · T.

    Commentary on: Moyles J, Hunter A, Grealish A. Forensic mental health nurses’ experiences of rebuilding the therapeutic relationship after an episode of physical restraint in forensic services in Ireland: A qualitative study. Int J Ment Health Nurs. 2023 May 26. doi: 10.1111/inm.13176. Epub ahead of print.

    Implications for practice and research

  • Ensuring routine postrestraint-focused clinical supervision, experiential training for forensic mental health nurses involved in rebuilding therapeutic relationships postphysical restraint, effective debriefing and positive role modelling from senior staff is needed.

  • Studies on models to combine goals of the therapeutic relationship and maintain safety are needed, besides establishing the effectiveness of different methods to facilitate a therapeutic relationship.

  • Context

    Forensic mental health nurses (FMHNs) are expected to manage potentially serious levels of risk while maintaining a proportionate balance between therapeutic care and potentially restrictive security.1 The use of coercion in mental health...

    Trajectory patterns of self-care behaviour over 1 year provide nurses insights to tailor individualised care for patients with heart failure

    Por: Chang · W.-T. · Chen · H.-M.

    Commentary on: Son YJ, Jang I. One-year trajectories of self-care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study. J Clin Nurs. 2023 Sep;32(17-18):6427-6440. doi: 10.1111/jocn.16658. Epub 2023 Feb 23.

    Implications for practice and research

  • Timely identifying self­care behaviour patterns over time may reduce the risk of hospital readmissions in patients with heart failure (HF).

  • Further research studies are required to examine the effects of every 3–6 months self-care intervention on hospital readmissions among patients with HF.

  • Context

    Unplanned readmissions within 30 days and 6 months postdischarge are notably common in patients with HF.1 2 Effective self-care behaviours are essential to lower readmissions. However, the trajectories of self-care behaviours throughout the HF progression can vary among patients.3 Limited research studies have examined the relationships among the influencing variables, self-care behaviours and readmissions over...

    Does nursing leaders' humility leadership associate with nursing team members' psychological safety? A cross‐sectional online survey

    Abstract

    Aims

    The leader's ability to act with self-awareness, lead with generosity, and consider others' opinions is what defines humility leadership. In recent healthcare literature, there has been extensive exploration of humility leadership and psychological safety, but these studies were non-nursing. It is crucial to understand how humble leaders can empower their staff's psychological safety, as inclusivity is a key aspect of humility leadership and is closely linked to psychological safety. Therefore, this study examined the association between nursing leaders' humility leadership and team members' psychological safety.

    Design

    A quantitative cross-sectional design was used in the current study.

    Methods

    To assess the studied variables, 245 nursing academics, nurses, and nursing leaders were recruited from different universities and hospitals using the convenience snowball sampling technique, yielding a response rate of 70%. After a pilot study, an online survey using Google Forms was hosted in 2022.

    Findings

    The psychological safety of nursing team members was not found to be associated with the humility leadership of nursing leaders. Despite the participants' reports of their nursing leaders exhibiting humility leadership (mean = 3.57/5, SE = 0.055), the participants also reported that psychological safety was borderline (mean = 3.09/5, SE = 0.041).

    Conclusion

    The borderline nursing team members' psychological safety implies that different types of leadership may have an impact on the psychological safety of nursing team members. The lack of association between nursing leaders' humility leadership and the psychological safety of nursing team members highlights the need for further understanding and effort from nursing leaders to establish psychologically safe work environments.

    Impact

    This research offers valuable insights into how the humility of nursing leaders impacts the psychological safety of nursing team members. The psychological safety of the nursing team members highlights the specific responsibilities that nursing leaders should assume to establish psychologically safe work environments.

    Patient or Public Contribution

    There was no Patient or Public Contribution, as the sample included nursing academics, nurses, and nursing leaders recruited from different universities and hospitals.

    Implications for Practice/Policy

    A simple intervention that humble leaders can initiate is inclusivity, where subordinates' positive worth, strengths, and contributions are acknowledged. Inclusivity is a characteristic of humility leadership. Improving teams'’ psychological safety calls to promote a culture of civility in the workplace. A random and larger sample is needed, including other types of universities and hospitals, using other research designs across other cultures.

    How and where does “care” fit within seminal life‐course approaches? A narrative review and critical analysis

    Abstract

    Aims

    To map the concepts of the caring life-course theory that are used in life-course approaches from different disciplines; establish whether there is a common recognition of, or language used, to describe care in those life-course approaches; and identify the role and contribution of care to the life-course literature.

    Design

    This discursive paper uses a narrative review process to explore points of convergence and divergence between life-course approaches and the caring life-course theory.

    Methods

    Categories for analysis were developed deductively and inductively, focusing on the constructs of fundamental care, capacity and capability, care network, care transition, care trajectory and care biography.

    Results

    We identified four disciplinary perspectives: (1) life-course sociology; (2) life-course epidemiology; (3) lifespan developmental psychology; and (4) life-course health development. While six core constructs of the caring life-course theory were described, either explicitly or implicitly, in existing life-course approaches, no single approach fully describes the role and contribution of care across the lifespan.

    Conclusion

    Life-course approaches have largely neglected the contribution and role of care in informing the life-course discourse. This review highlights the significance of care beyond traditional healthcare settings and recognizes it as a fundamental human need for well-being and development, which can contribute to existing life-course literature.

    Implication for the Profession and/or Patient Care

    There is a need to understand care as a complex system and embrace a whole-system, life-course approach to enable nurses and other healthcare professionals to provide high-quality, patient-centred care.

    Impact

    Incorporating care within a life-course approach provides opportunities to integrate and deliver care centred around the person, their life transitions, trajectories and care networks, including informal carers and healthcare professionals.

    No Patient or Public Contribution

    Patients or members of the public were not involved in this study as it is a discursive paper based on the relevant literature.

    Missed care and equitable breastfeeding support: An integrative review of exposure to in‐hospital care by patient characteristics and breastfeeding outcomes

    Abstract

    Aim

    To synthesize the literature on breastfeeding outcomes associated with exposure to internationally recognized best practices, such as the Baby-Friendly Hospital Initiative, for patients in the United States during the postpartum period, contextualized within the Missed Care Model.

    Design

    The authors employed Whittemore and Knafl's integrative review framework and the 2020 PRISMA guidelines for data extraction, synthesis, reporting and assessment.

    Methods

    Five electronic databases were searched for articles published between 2007 and 2023. Eligible articles reported on exposure to breastfeeding best practices and outcomes or the experiences, views, perceptions and attitudes of parents, nurses or lactation consultants regarding hospital breastfeeding support. Extracted data were compared to identify in-hospital exposure to breastfeeding best practices and breastfeeding outcomes, and differences in exposure and outcomes based on patient and provider characteristics.

    Results

    Twenty-one quantitative, qualitative and mixed methods articles met inclusion criteria. A higher reported adherence to best practices was associated with greater odds of breastfeeding; some practices demonstrated greater effects overall or for specific groups. Higher exposures to best practices and higher breastfeeding rates were found for non-Hispanic white patients, and those with more education, private insurance and who live in urban areas. Disparities in support and outcomes were related to patients' race/ethnicity, language, weight and age. Qualitative findings reflected missed care concepts, such as internal processes related to habits and group norms, relevant to breastfeeding support.

    Conclusion

    Review findings also include an adapted Missed Care Model specific to breastfeeding support, which can inform future research related to providers' internal processes that may influence breastfeeding or equitable breastfeeding care.

    Implications for the Profession and/or Patient Care

    Missed care can be influenced by a variety of factors, including providers' internal values and beliefs. Study findings suggest the existence of inequities in breastfeeding care and underscore the need to address and eliminate breastfeeding disparities.

    Impact

    This study addressed how patient exposure to best practices in breastfeeding support relates to breastfeeding outcomes and whether exposure and outcomes differ by patient or provider characteristics, connecting this to the Missed Care in Breastfeeding Support Model. The main findings were that higher reported exposure to best practices in breastfeeding support related to improved breastfeeding outcomes; inequities exist in exposure to best practices; and patients and providers identify the importance of providers' internal processes in the delivery of breastfeeding support, which aligns with the Missed Care in Breastfeeding Support Model. Study findings will have the potential to impact how nurses, lactation consultants and other providers who deliver breastfeeding support in the postpartum hospital setting.

    Reporting Method

    The authors adhered to relevant 2020 PRISMA reporting guidelines.

    Patient or Public Contribution

    No patient or public contribution.

    The Nurse‐Police Assistance Crisis Team (N‐PACT): A new role for nursing

    Abstract

    Aim

    This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response.

    Design

    This study used a descriptive, qualitative exploratory design and was informed by Systems Theory.

    Methods

    The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed.

    Reporting Method

    The Standards for Reporting Qualitative Research (SRQR) guidelines were used.

    Results

    Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation.

    Conclusion

    This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response—the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents.

    Implications

    Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system.

    Impact

    The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises.

    Patient or Public Contribution

    No patient or public contribution.

    Long‐term care planning and the influencing factors among sexual minority older women: A qualitative study

    Abstract

    Aims

    The aim of the study was to explore plans, considerations and factors influencing long-term care among older sexual minority (SM) women.

    Design

    Qualitative interview study.

    Methods

    Semi-structured in-depth interviews were conducted with 37 older Taiwanese SM women between May and September 2019. This study analysed interview data using a socio-ecological model and constant comparative analysis.

    Results

    The most frequently reported long-term care plans were housing and institutions, private medical or long-term care insurance, financial planning and medical decisions. Factors associated with women's long-term care plans were categorized using the socio-ecological model level: (1) intrapersonal factors: current physical and mental health status, ageing signs and women's attitudes towards ageing; (2) interpersonal-level factors: receiving support from partners, child(ren), siblings or significant others, concerns about being a caregiver for parents and worries regarding social isolation; (3) community-level factors: receiving support from lesbian, gay, bisexual and transgender (LGBT) organizations; private lesbian online groups; or religious groups; (4) societal-level factors: concerns about negative social environments, concerns about the healthcare system and healthcare providers, inappropriate policies and insufficient resources.

    Conclusion

    This study identified multi-level factors related to long-term care plans and concerns among older Taiwanese SM women. Recommendations for nurses, managers of long-term care and healthcare settings, policymakers, and governments have been provided to diminish health disparities and reduce anxiety among older SM women.

    Impact

    This study assists nurses in understanding older SM women's long-term care concerns and worries when accessing long-term care and healthcare services and helps nurses provide SM-sensitive services and care for women.

    Patient or Public Contribution

    SM older women were recruited from LGBT organizations, LGBT-friendly bookstores, restaurants, coffee shops and LGBT online chatrooms using purposive and snowball sampling.

    Cultural acceptability of STI screening guidelines and sexual positioning assessments among black sexual minority men

    Abstract

    Aim

    To identify attitudes towards HIV/STI screening guidelines and explore the acceptability of assessing sexual positioning practices among Black sexual minority men (SMM).

    Background

    Risks for HIV/STIs vary by sexual positioning practices. However, clinicians and Black SMM do not always discuss sexuality with each other. Therefore, HIV/STI screening and testing remain suboptimal.

    Design

    Qualitative study using focus groups.

    Methods

    Data were obtained from 12 focus groups and one in-depth interview conducted in Baltimore, MD among HIV-negative Black SMM between October 2019 and May 2020 (N = 39). Groups were stratified into three age categories: 18–24, 25–34 and 35+. Participants were given the “5 P's” from the CDC's 2015 Sexual History Screening Guidelines and asked to discuss attitudes towards existing questions regarding sexual positioning practices. Themes were identified using an electronic pile sorting approach.

    Results

    Most identified as homosexual/gay/same gender-loving (68%), were employed (69%) and single (66%). Additionally, 34% had ever been diagnosed with an STI, of whom 38% had a history of repeated STI acquisition in their lifetime. Participants across age groups said clinicians should use the words “top” and “bottom” to demonstrate cultural familiarity and build trust. Some said that screening for sexual positioning was unnecessary and intrusive; others said that questions should be justified. Younger men wanted clinicians to ask questions in ways that make them feel cared for.

    Discussion

    Guidelines should include language for clinicians to use culturally specific language and better ways to prepare Black SMM patients for screening.

    Impact to Nursing Practice

    Some Black SMM will not discuss sexual positioning practices without clinicians' demonstration of cultural understanding and respect. Screening should incorporate culturally responsive language, justification and convey care.

    Reporting Method

    Consolidated criteria for reporting qualitative research (COREQ).

    No Patient or Public Contribution

    There was no patient or public involvement in the design or drafting of this discursive paper.

    Minimum Unit Pricing in Scotland 32 months on: evidence demonstrates a significant reduction in alcohol related deaths

    Por: Avades · T. · Dhanda · A.

    Commentary on: Wyper GMA, Mackay DF, Fraser C, Lewsey J, Robinson M, Beeston C, Giles L. Evaluating the impact of alcohol minimum unit pricing on deaths and hospitalisations in Scotland: a controlled interrupted time series study. Lancet. 2023 Apr 22;401(10385):1361-1370. doi: 10.1016/S0140-6736(23)00497-X. Epub 2023 Mar 20.

    Implications for practice and research

  • Data will inform the decision of the Scottish Parliament whether to keep the minimum unit pricing (MUP) policy, which expires on 30 April 2024.

  • Further study is needed exploring the enduring effects of MUP on chronic alcohol conditions, including alcohol-related cancer deaths.

  • Context

    In 2021, the rate of alcohol-related deaths in the UK increased by 7.4% from 2020 (14.8/100 000), with the highest rate (22.4/100 000) in Scotland.1 There are inequalities in those affected by alcohol with more admissions and deaths in males and people from lower socioeconomic groups.

    MUP is...

    Communication between families and hospital staff is important in understanding nutrition and hydration problems in dementia patients

    Por: Ontan · M. S. · Isik · A. T.

    Commentary on: Anantapong K, Davies N, Sampson EL. Communication between the multidisciplinary team and families regarding nutrition and hydration for people with severe dementia in acute hospitals: a qualitative study. Age Ageing 2022;51:afac230. doi: 10.1093/ageing/afac230.

    Implications for practice and research

  • Hydration and nutrition issues in dementia should be discussed primarily by experienced health professionals, considering the beliefs, culture and expectations of the patient and her family, from the diagnosis. Moreover, these problems may show different characteristics in the acute hospital and at the end of life.

  • Further studies with larger and interrelated study groups may emphasise more on the importance of communication in hydration and nutrition problems in dementia.

  • Context

    Eating and drinking difficulties are known sources of health problems in people with dementia. It is essential to increase the awareness of patients and family carers for these problems. Healthy communication with family carers...

    Opening up conversations: Collaborative working across sociomaterial contexts in nursing in London

    Abstract

    Aim

    To discuss nurses' use of networks to address nursing recruitment and retention in London, UK.

    Design

    Qualitative evaluation of the Capital Nurse programme reporting on 30 narrative interviews with executive, clinical and student nurses in 2019.

    Results

    Executive nurses within the Capital Nurse programme recognized the importance of sociomaterial contexts in the health and social care system in London and worked strategically across these contexts to achieve change. Supported through the Capital Nurse programme, executive nurses from health organizations across London initiated collaborative working to improve recruitment and retention. Primarily by designing and delivering sociomaterial products (organizational and educational) to support nurses to build a career in London. Drawing on ideas from actor network theory, in particular sociomaterial contexts, nurses' actions at all levels to develop and sustain networks to address nursing recruitment and retention across the NHS in London are described.

    Conclusions

    Capital Nurse supported collaborative working both within single organizations and across organizations in London. There is evidence of change in how nurses across the capital work together to improve patient care, improve recruitment and retention. Findings may resonate with nurses in other settings who seek to address the problem of recruitment and retention. They show how nurses coming together in networks to effect changes in practice can work successfully.

    Impact

    Nurses' use of networks led to novel models of communication and action to address the problems of recruitment and retention in London. We argue that sociomateriality should be considered outside the clinical practice setting, as part of nurses' professional development and organizational practice, that is how they plan their career, how they address recruitment and retention, how they communicate across organizations about nursing issues.

    No Patient or Public Contribution

    This was an evaluation of a staff development project in London, which sought to elicit nurses' experiences of participation in Capital Nurse.

    Bariatric surgery stigma from the perspective of patients: A scoping review

    Abstract

    Aims

    To explore the experiences and consequences of bariatric surgery stigma from the perspective of bariatric surgery patients and to identify knowledge gaps in the literature.

    Design

    A scoping review.

    Data Sources

    Studies published between December 2002 and January 2022 were identified from the following databases: PubMed, Web of Science, PsycINFO and MEDLINE.

    Review Methods

    We screened 3092 records and included 28 studies. Findings were grouped thematically using the health stigma discrimination framework.

    Results

    Patients experienced several types of stigmas, including perceived, experienced, anticipated and internalized stigma, related to undergoing bariatric surgery. Patients were confronted with negative comments and judgement from others when they disclosed their decision to have surgery or when they revealed that they had undergone surgery. These experiences led to conflicts in the decision-making process, such as delaying the choice for surgery, seeking surgery abroad or opting out. Patients who internalized stigma often reported feelings of shame and embarrassment for choosing surgery and felt the need for secrecy or selective disclosure. Stigma experiences were influenced by gender and differed between different subgroups of patients.

    Conclusion

    The stigma surrounding bariatric surgery has detrimental consequences for eligible individuals and bariatric surgery patients. However, the evidence from patients' perspective remains limited. More research into patient's experiences is needed to improve patient care and further educate healthcare professionals. In addition, to better understand the nature and implications of bariatric surgery stigma, future research should be founded on stigma theories and distinguish between the different types of stigmas.

    Impact

    This scoping review contributes to a better understanding of the implications the stigma surrounding bariatric surgery has for bariatric surgery patients before and after surgery. The knowledge generated by this review can inform improvements in the education and management of people living with obesity and bariatric surgery patients.

    Reporting Method

    The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist.

    Patient or Public Contribution

    No Patient or Public Contribution.

    Protocol Registration

    A protocol was not registered for this scoping review.

    Chinese family care partners of older adults in Canada have grit: A qualitative study

    Abstract

    Aim

    To explain the process taken by Chinese family care partners of older adults in the Greater Toronto Area, Canada, to access health and social services in their communities. The research question was: What mechanisms and structures impact the agency of Chinese family care partners of older adults, in the process of assisting them to access health and social services?

    Design

    This qualitative study was informed by critical realism.

    Methods

    Chinese family care partners of older adults in the Greater Toronto Area, Canada, were interviewed from August 2020 to June 2021. Transcripts underwent thematic analysis.

    Findings

    Twenty-eight Chinese family care partners expressed a firm commitment to maintain caregiving conditions and to judiciously access health and social services. Their commitment was made up of three parts: (a) legislative and cultural norms of family, work, and society; (b) their perseverance to fill gaps with limited social and financial resources; (c) the quality of their relationship to, and illness trajectory of the older adults. The social structures created tension in how Chinese family care partners made decisions, negotiated resources, and ultimately monitored and coordinated timely access with older adults.

    Conclusion

    Participants' commitment and perseverance were conceptualized as “grit,” central to their agency to conform to legislative and cultural norms. Moreover, findings support grit's power to motivate and sustain family caregiving, in order for older adults to age in place as long as possible with finite resources.

    Implications for the profession

    This study highlights the importance of cultural awareness education for nurses, enabling continuity of care at a systems level and for a more resilient healthcare system.

    Impact

    Family care partners' grit may be crucial for nurses to harness when together, they face limited access to culturally appropriate health and social services in a system grounded in values of equity and inclusion, as in Canada.

    Reporting method

    When writing this manuscript, we adhered to relevant EQUATOR guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ).

    Patient or public involvement and engagement

    No patient or public involvement.

    Nurses' self‐care strategies: A mapping review

    Abstract

    Objectives

    Nurses have long received recommendations to employ self-care behaviors to ensure their ability to remain in the profession; however, nurses are rarely asked what self-care behaviors are beneficial. This literature review aimed to map studies on nurses' self-care strategies to provide an understanding of how these strategies are addressed in the literature and to identify gaps in need of additional exploration.

    Method

    Searches were conducted in accordance with published mapping review methodologies across MEDLINE, Embase, CINAHL, Scopus, PsycINFO, Web of Science, and identified influential nursing journals. Included studies were from the United States, peer-reviewed, and described self-care strategies related to nurses or the nursing profession.

    Results

    Thirty-five articles were identified for inclusion and were evaluated based on agreed-upon criteria to define how the concept of self-care was studied and applied to nurses. Three main categories were identified in this review: self-care and stress; self-care and burnout; and self-care and leadership, workplace factors, and physical activity.

    Linking Evidence to Action

    This mapping review revealed an abundance of literature related to self-care recommendations for nurses; however, there remains a dearth of studies investigating how nurses utilize self-care behaviors independently to improve their own professional well-being. Recommendations for next steps in research in this area are included.

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