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☐ ☆ ✇ Journal of Advanced Nursing

Success by Design: Senior Leadership Perspectives on Optimising the Role of Clinical Nurse Specialists

ABSTRACT

Aims

To report on the unique perspectives of senior nursing leaders on the value proposition of the Clinical Nurse Specialist (CNS) role, their organisational experience and the barriers and facilitators to optimise and promote the long-term sustainability.

Design

A qualitative sub-study of a larger multi-method study focused on informing policy recommendations to optimise the CNS workforce, informed by integrated knowledge translation.

Methods

Chief Nursing Officers (CNOs) and other senior leaders in all health authorities in British Columbia, Canada, were invited to participate in semi-structured interviews via video call between August–December 2023. We recruited 13 participants from diverse health regions, including 5 CNOs.

Results

Leaders collectively conveyed a renewed interest in the CNS role to support nursing and multidisciplinary teams to better meet patient and system needs, and a sense of urgency to optimise the role in diverse settings. The overarching theme of “success by design” was supported by three thematic priorities: (1) understanding the CNS role, (2) a role that needs protection and connections and (3) moving forward together. Views were aligned to co-construct implementation-ready policy recommendations to guide provincial strategies.

Conclusion

Senior leaders reported a common understanding of the value-add of the CNS workforce and had a shared experience of barriers to optimisation. Contemporary policy guidance is needed to equip health systems to address this gap.

Impact

Across international regions, the role of CNSs is not fully optimised. This is a wasted opportunity to address the pressing need for nursing practice leaders to transform health systems and improve outcomes. This study provides new knowledge about the perspectives of Chief Nursing Officers and other nursing leaders to shape comprehensive and targeted policy recommendations and address enduring and new challenges to realise the full impact of the CNS workforce.

Reporting Methods

We have adhered to COREQ reporting guidelines (See supplemental file).

Patient and Public Involvement

This study did not include patient or public involvement in its design, conduct, or reporting.

☐ ☆ ✇ Journal of Advanced Nursing

Factor Structure and Longitudinal Invariance of the Cancer Behaviour Inventory: Assessing Cancer‐Coping Self‐Efficacy in Patients With Moderate‐to‐High Symptoms

ABSTRACT

Background

The Cancer Behaviour Inventory–Brief Version was designed to assess cancer-coping self-efficacy in clinical and research settings where minimising patient burden is essential. However, there is no evidence of its longitudinal validity. Although widely used in cancer research, the lack of evidence for longitudinal invariance significantly undermines its validity in studies spanning multiple time points. Establishing longitudinal invariance enables valid comparisons over time, enhancing our confidence in applying it in longitudinal research.

Aim

To examine the factor structure of the measurement and test its longitudinal invariance across four time points in cancer patients experiencing moderate-to-high symptoms during curative cancer treatment.

Design

A longitudinal psychometric evaluation.

Methods

This is a secondary data analysis of a randomised controlled trial in patients with moderate-to-high symptoms undergoing cancer treatment (N = 534). We conducted longitudinal invariance tests for the measurement using four time points. Other psychometric tests included confirmatory factor analysis, reliability analyses and correlations.

Results

Our confirmatory factor analysis supported the four-factor, 12-item structure for the Cancer Behaviour Inventory–Brief Version. Items 1 and 6 were found to be moderately correlated. The resulting 12-item measure demonstrated good internal consistency, with convergent and divergent validity supported by correlations with selected instruments. Finally, longitudinal invariance was tested, which revealed strict measurement invariance across four time points (CFI = 0.930, RMSEA = 0.045, SRMA = 0.056).

Conclusion

We found that the factor structure of the Cancer Behaviour Inventory–Brief Version remained stable over four time points in a sample of patients having moderate to high symptoms under cancer treatment. This supports its accountability for examining the changes in cancer-coping self-efficacy among cancer patients over time in longitudinal studies.

Implications

This study confirms that Cancer Behaviour Inventory–Brief Version has adequate internal consistency and demonstrated evidence of construct validity. Our conclusion of strict longitudinal invariance supports its credibility for continuous assessment of cancer-coping self-efficacy to evaluate patient outcomes and intervention processes over time in clinical and research settings.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Advanced Nursing

Defining Life Stages and Mapping Care Trajectories: A Narrative Review of Life‐Course Theories, Models and Frameworks

Por: Michael T. Lawless · Matthew Tieu · Rebecca K. Golley · Alison L. Kitson — Enero 10th 2026 at 08:44

ABSTRACT

Aims

To review how life-course theories, models and frameworks define and classify life stages and transitions; how they characterise trajectories of care needs and care provision; and to consider how these insights might inform future developments of care-focused life-course frameworks.

Design

Narrative review using a theory synthesis approach.

Methods

The review synthesised 56 theories, models and frameworks, drawn from 90 articles published up to 2024, using a three-stage process: extraction and summarisation of conceptual content; comparison to identify convergence and divergence; and interpretive synthesis to generate an overarching account of how frameworks conceptualise life-course development, care transitions and care trajectories.

Results

Earlier life-course perspectives emphasise normative, age-graded stages, while more recent approaches highlight transitional junctures, relational contexts and structural influences on care trajectories. Life stages were defined variably, encompassing developmental phases, chronological age bands, major life transitions, historical and cultural perspectives and diverse lived experiences. Trajectories of care needs and provision were shaped by social networks, socioeconomic conditions, timing of transitions, transgenerational relationships and interdependencies, and intersectionality. Findings suggest that care needs and care provision fluctuate across time and are best understood as interrelated, dynamic processes influenced by life-course biographies, as well as broader social, economic and policy environments at individual (micro), relational (meso) and structural (macro) levels.

Conclusion

Life-course frameworks are shifting from age-based models towards personalised, context-sensitive perspectives that better capture the complexity and diversity of care trajectories.

Implications for the Profession and/or Patient Care

Care planning should incorporate not only developmental stage but also individual, relational and structural factors influencing care needs, care provision and care trajectories over time.

Impact

Applying a personalised, multilevel life-course perspective may improve assessment accuracy, coordination of resources and equity in care delivery.

No Patient or Public Contribution

This narrative review did not involve patients or the public.

☐ ☆ ✇ Journal of Advanced Nursing

Achieving Cancer Prevention Equity: A Policy Analysis of American Cancer Society HPV Vaccination Guidelines

Por: Grace K. Kyei · Evans K. Kyei · Rockson Ansong — Enero 9th 2026 at 12:51

ABSTRACT

Aim

To examine the American Cancer Society's HPV vaccination guidelines through a nursing policy analysis framework, assessing justice and equity outcomes in cancer prevention policy implementation.

Background

Human papillomavirus vaccination remains critical for cancer prevention, yet persistent health disparities undermine equity goals despite evidence-based policy recommendations. Limited research has systematically applied nursing conceptual frameworks to analyse vaccination policy through an explicit equity lens.

Design

Policy Analysis Using the Russell and Fawcett Conceptual Model for Nursing and Health Policy, Focusing on Level 4 Outcomes Addressing Justice, Social Changes and Market Interventions.

Methods

Systematic analysis of policy sources (public, organisational, professional), components (personnel, services, expenditures) and outcomes across quality, cost and access dimensions. Data sources included primary policy documents, implementation reports and peer-reviewed literature from 2015 to 2024. Thematic analysis examined policy effectiveness through distributive and procedural justice lenses.

Results

Critical policy fragmentation creates systematic equity barriers, with only five jurisdictions (Virginia, District of Columbia, Rhode Island, Puerto Rico, Hawaii) achieving > 70% vaccination coverage through school-entry mandates and 46 states and territories demonstrating substantially lower rates. Rural adolescents experience 15%–20% lower vaccination rates, while Black adolescents show 10 percentage points lower coverage than white adolescents despite federal Vaccines for Children (VFC) program investment of $4.2 billion annually. Provider training gaps and cultural competency limitations disproportionately affect communities of colour. Healthcare system transformation remains concentrated in well-resourced organisations, creating two-tiered implementation that reinforces existing disparities.

Conclusion

Achieving cancer prevention equity requires coordinated interventions across multiple policy levels, enhanced provider training emphasising cultural competency, community-based service expansion and equity-focused resource allocation. Federal leadership establishing minimum vaccination requirements linked to education funding, respecting state constitutional authority, sustainable funding models and nursing leadership represent essential actions for advancing health equity.

Impact

Demonstrates nursing frameworks' utility for rigorous health policy analysis while providing evidence-based recommendations for strengthening vaccination policy to achieve cancer prevention equity across diverse populations.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.

☐ ☆ ✇ Journal of Advanced Nursing

Registered Nurse‐Led Assessments in Australian Residential Aged Care Homes: A Scoping Review

ABSTRACT

Aim

To understand the current evidence base regarding holistic nursing assessments performed by registered nurses in residential aged care homes in Australia, and identify the gaps in knowledge and potential areas for future research.

Design

A scoping review informed by JBI guidelines and the PRISMA extension for Scoping Reviews.

Methods

The electronic databases Medline, EMBASE, CINAHL, Scopus and ProQuest Central were searched, alongside citation chaining and manual journal searches. Limits of English language and publication after the year 2000 were applied. Studies were screened against pre-defined eligibility criteria. Data were extracted and analysed using descriptive statistics and a narrative synthesis.

Results

A total of 3987 studies were identified, of which 28 were categorised as comprehensive or multimodal assessment programmes, standalone assessment tools or assessment infrastructure papers. Key outcomes described included staff factors and resident emergency department transfers or hospitalisations. The key feature of existing nursing assessments across studies was education, which was generally associated with improved staff knowledge, confidence and efficiency. Apart from this, there was large heterogeneity among assessment interventions with inconsistent effects. Few studies focused on residents with dementia or palliative care needs.

Conclusion

There is currently no standardised, systematic approach to the holistic assessment of residents by registered nurses in Australia. This gap in assessment is especially evident for residents with dementia or palliative care needs.

Impact

This research highlights the need to develop standardised holistic nursing assessments to bridge this gap in practice.

Patient or Public Contribution

No Patient or Public Contribution.

☐ ☆ ✇ Evidence-Based Nursing

Emerging importance of psychological flexibility mediating psychotic symptom severity to depression as an innovative intervention tool for people with schizophrenia

Por: Chang · C.-K. — Diciembre 15th 2025 at 09:45

Commentary on: Yıldız E, Yıldırım Ö. The mediating role of psychological flexibility in the relationship between psychotic symptom severity and depression in individuals diagnosed with schizophrenia. J Psychiatr Ment Health Nurs. 2024. (in press) doi: 10.1111/jpm.13040.

Implications for practice and research

  • Mental health nurses’ training could be more focused on clinical skills and knowledge in enhancing psychological flexibility to minimize the impact of psychotic symptoms on comorbid depression in people with schizophrenia.

  • Further development of the intervention of building psychological flexibility is of research interest for the clinical management of people with schizophrenia.

  • Context

    Schizophrenia is a mental disorder affecting approximately 23.9 million people worldwide, significantly contributing to the global disease burden, revealing 14.8 (10.9–19.1) million years lived with disability in 2021.1 The lifetime prevalence of schizophrenia was estimated at 0.72%,2 noteworthy for its severe functional impairments and considerable physical and...

    ☐ ☆ ✇ Evidence-Based Nursing

    Parental experiences of congenital heart disease transition care highlight the need for family-centered approaches

    Por: Fox · K. R. · Garg · V. — Diciembre 15th 2025 at 09:45

    Commentary on: Lykkeberg B, Noergaard MW, Bjerrum M. Experiences and expectations of parents when young people with congenital heart disease transfer from pediatric to adult care: A qualitative systematic review. J Child Health Care. doi:10.1177/13674935241231024

    Implications for practice and research

  • To inform family-centred transition programmes, more high-quality qualitative research describing parental experiences should be conducted, particularly in non-European and low- and middle-income countries.

  • Congenital heart disease transition programmes should consider adopting a family-centred approach that incorporates informational and psychosocial support resources for parents.

  • Context

    A growing number of individuals born with congenital heart disease (CHD) are surviving well into adulthood, and a successful transition from paediatric to adult healthcare is essential for their long-term health. However, discontinuity in care is prevalent.1 Parents play an important role in the transition process and may impact transition-related outcomes,2 but their experiences and...

    ☐ ☆ ✇ Journal of Advanced Nursing

    Exploring Experiences, Perceptions and Preferences for Exercise in Australians Living With a Stoma: A Cross‐Sectional Survey

    Por: Monica Stankiewicz · Julie Hides · Nicole Gavin · Joy Parkinson · Samantha Bunzli · Mari Takashima · Brooke K. Coombes — Diciembre 9th 2025 at 08:06

    ABSTRACT

    Aim

    (1) Explore the role of core abdominal exercise in people living with a stoma in Australia; (2) determine whether the presence of a parastomal hernia influenced participant symptoms and complications, health status, experiences with different types of exercise, recall advice given by healthcare professionals; (3) determine whether there is an appetite for supervised/supported exercise programs.

    Design

    A cross-sectional, anonymous survey.

    Methods

    Between August and September 2022. The survey included Likert scales and a single free text response. Logistic regression and Cramer's V were used to explore relationships between variables.

    Results

    Approximately half (45.5%) of 105 participants reported a parastomal hernia. Those with a parastomal hernia were less likely to recall having received advice (15.20%) or demonstration (9.40%) pertaining to exercise. Less than a quarter of all participants completed strengthening (23.80%) or vigorous (22.90%) exercise. Fear of vigorous exercise, abdominal exercise and heavy lifting were high in both groups. Relationships between healthcare advice, exercise-related fears and avoidance of heavy lifting were observed.

    Conclusion

    Many Australians living with a stoma are not achieving physical activity recommendations. While exercise behaviours did not differ between people with and without a parastomal hernia, recall of healthcare advice around exercise did. Fear-avoidance relationships were observed.

    Impact

    Most people living with a stoma do not recall advice about core abdominal exercises. Healthcare practitioners need to be aware of fear-avoidance related to lifting among people living with a stoma. This was the first study in Australia, exploring perspectives and experiences regarding exercise; providing foundations for future research particularly exercise programs.

    Reporting Method

    This study adhered to relevant EQUATOR guidelines and the reporting of survey studies (CROSS).

    Patient or Public Contribution

    This study did not include patient or public involvement in its design, conduct, or reporting.

    ☐ ☆ ✇ Journal of Clinical Nursing

    Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic

    Abstract

    Aims and objectives

    This study aimed to examine the psychosocial impact and identify risk factors for poor psychosocial outcomes in healthcare professionals during the Coronavirus disease 2019 (COVID-19) pandemic in Cyprus.

    Background

    Healthcare professionals are in the forefront of the COVID-19 pandemic facing an unprecedented global health crisis, which can have consequences on their psychosocial health. There is a need to identify risk factors for poor psychosocial outcomes to inform the design of tailored psychological interventions.

    Design

    Cross-sectional online study.

    Methods

    A total of 1071 healthcare professionals completed self-report questionnaires. Measures included sociodemographic information, COVID-19-related characteristics, quality of life (Brief World Health Organization Quality of Life; WHOQOL-Bref), anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire-8; PHQ-8), occupational burnout (Copenhagen Burnout Inventory; CBI), and coping (Brief Coping Orientation to Problems Experienced; Brief COPE). This article follows the STROBE reporting guidelines.

    Results

    The prevalence of moderate to severe anxiety and clinically significant depression was 27.6% and 26.8%, respectively. Significant risk factors for poor psychological outcomes included being female, being a nurse or doctor (vs non-medical professional), working in frontline units (inpatient, intensive care), perceptions of inadequate workplace preparation to deal with the pandemic, and using avoidance coping. Depression and occupational burnout were significant risk factors for poor quality of life.

    Conclusion

    The findings suggest several individual, psychosocial, and organisational risk factors for the adverse psychological outcomes observed in healthcare professionals during the COVID-19 pandemic.

    Relevance to clinical practice

    This study highlights the urgent need for screening for anxiety and depression and psychological interventions to combat an imminent mental health crisis in healthcare professionals during the COVID-19 pandemic. Pandemic response protocols and public health initiatives aiming to improve and prevent mental health problems in healthcare professionals during the current and future health crises, need to account for the various factors at play.

    ☐ ☆ ✇ Journal of Advanced Nursing

    Factors influencing general practice nurse's implementation of culturally responsive care, using normalization process theory: A cross‐sectional study

    Por: S. Oakley · M. Manning · A. Macfarlane · A. Murphy · O. Loftus‐Moran · K. Markey — Octubre 18th 2025 at 19:05

    Abstract

    Aims

    To explore levers and barriers to providing culturally responsive care for general practice nurses (GPNs) using normalization process theory.

    Design

    A self-administered online cross-sectional survey.

    Methods

    A participatory co-designed adapted version of the normalization of complex interventions measure (NoMAD) validated tool was distributed to a convenience sample of GPNs between December 2022 and February 2023. The sample comprised of GPNs working in general practice services in Ireland (n = 122). Data were analysed using descriptive and analytical statistics (Pearson correlations) and principles of content analysis. This study was conducted and reported in line with the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).

    Results

    GPNs in this study indicated their familiarity with, acknowledged the importance of and were committed to, providing culturally responsive care. However, implementing culturally responsive care in daily practice was problematic due to insufficient education and training, scarcity of resources and supports and a lack of organizational leadership. Subsequently, GPNs experience difficulties adapting everyday practices to respond appropriately to the care needs of culturally and linguistically diverse (CaLD) patients.

    Conclusion

    This analysis highlights the necessity of exploring the intricacies of factors that influence capabilities and capacity for providing culturally responsive care. Despite demonstrating awareness of the importance of providing nursing care that responds to the needs of CaLD patients, GPNs do not have full confidence or capacity to integrate culturally responsive care into their daily work practices.

    Impact

    Using normalization process theory, this study elucidates for the first time how GPNs in Ireland make sense of, legitimize, enact and sustain culturally responsive care as a routine way of working. It illuminates the multitude of micro-level (individual), meso-level (organizational) and macro-level (structural) factors that require attention for normalizing culturally responsive care in general practice services.

    Patient or Public Contribution

    The study question was identified in a participatory research prioritization for Irish research about migrant health that involved migrants in the process.

    ☐ ☆ ✇ Evidence-Based Nursing

    Transgender and non-binary adolescents assert individualised treatment goals for gender affirmation

    Por: Kuzma · E. K. · Yingling · C. — Octubre 3rd 2025 at 17:49

    Commentary on: Roden R C, Billman M, Francesco A, Mullin R, Tassi C, Wozolek B, Heppard B, Essayli J, & Stuckey-Peyrot H (2024). Treatment goals of adolescents and young adults for gender dysphoria. Pediatrics, 153(1), e2023062202. https://doi.org/10.1542/peds.2023-062202.

    Implications for practice and research

  • Clinicians should individualise gender-affirming care for transgender and non-binary adolescents, respecting their specific medical and surgical treatment goals as presented at initial healthcare appointments.

  • Future research should separately analyse the distinct treatment aspirations of gender-diverse (‘eclectic’) adolescents to refine clinical guidelines and inform public policy.

  • Context

    An increasing number of adolescents and young adults seek medical care for gender affirmation.1 Approximately 0.6%–2.0% of adolescents and young adults identify as transgender and non-binary (TNB).2 TNB youth and their caregivers need to be engaged in the developmentally appropriate multidisciplinary care that encompasses gender-affirming medical care and support.

    ☐ ☆ ✇ Evidence-Based Nursing

    Supporting parents and families of children with life-limiting conditions: the impact of advance care planning

    Por: Moody · A. · Stocks · K. L. · Tatterton · M. J. — Octubre 3rd 2025 at 17:49

    Commentary on: Lyon, M. E., Fraser, J. L., Thompkins, J. D., et al (2024). Advance Care Planning for Children With Rare Diseases: A Pilot RCT. Pediatrics, 153(6), e2023064557. https://doi.org/10.1542/peds.2023-064557.

    Implications for research and practice

  • Having access to advance care planning, despite social and financial constraints is imperative. It is evident that in the population included in this study, advance care planning was invaluable for those below the 2021 financial poverty line.

  • Further research is required to determine if the current medical model in the USA is meeting the requirements of caregivers and children with rare diseases.

  • Context

    Rare diseases in babies, children and young people (children) are often life-shortening, and children can require constant caregiving. Bösch et al1 report that 82% of children in tertiary hospitals in the USA have a rare disease. This study was designed to establish...

    ☐ ☆ ✇ Journal of Advanced Nursing

    Changes in Breastfeeding Relationships When Frontline Essential Working Mothers Return to Work During the COVID‐19 Pandemic: A Longitudinal Qualitative Online Study

    Por: Natsuko K. Wood · Kathleen R. Helfrich‐Miller — Septiembre 25th 2025 at 07:02

    ABSTRACT

    Aims

    Many frontline essential working mothers returned to work outside of the home after maternity leave during the COVID-19 pandemic. The purpose of this study is to describe the changes in breastfeeding relationships.

    Design

    A longitudinal descriptive qualitative design was used.

    Methods

    Four open-ended questions were asked to explore breastfeeding experiences at home, mothers' thoughts and feelings during direct breastfeeding, strategies to solve their breastfeeding problems, and workplace breastfeeding support. Data were collected by an online survey at 1, 3, 5 and 6 months between June 2022 and August 2023. Data were analysed using inductive content analysis from 21 mothers in the United States who were directly breastfeeding at least once a day for the first 6 months. The trustworthiness of study results involved coding by consensus, peer debriefing, and maintenance of an audit trial.

    Results

    The core construct, “Changes in Breastfeeding Relationships When Frontline Essential Working Mothers Return to Work Outside of the Home” explained mothers' experience in four domains: (1) Breastfeeding changes, (2) Changes in sleep arrangements, (3) Social support to continue breastfeeding, and (4) Physical and emotional distress of mothers and infants.

    Conclusion

    Unrestricted direct breastfeeding upon reunion through the night along with co-sleeping was the strategy mothers used to restore breastfeeding relationships with their infants and continue direct breastfeeding. Scheduled feeding and solitary sleep resulted in less direct breastfeeding, had negative consequences such as low milk supply, slow infant weight gain, and maternal distress.

    Impact

    Even though frontline essential working mothers persevered with the complexities of their work during the COVID-19 pandemic, findings highlight challenges mothers faced with their breastfeeding experience. Nurses need to discuss with mothers expected challenges of less frequent direct breastfeeding along with emotional tolls while being separated from their infant and strategies to develop sustainable breastfeeding relationships and continuation of direct breastfeeding.

    Patient or Public Contributions

    None.

    ☐ ☆ ✇ Journal of Advanced Nursing

    Advance Care Planning in Oncology Nursing: An Interpretive Description Study

    Por: Heather M. Kilgour · Leah K. Lambert · A. Fuchsia Howard · Michael Mckenzie · Sally Thorne — Septiembre 25th 2025 at 07:02

    ABSTRACT

    Aim

    To explore oncology nursing advance care planning practices and understand how to better support nurses in conducting advance care planning with patients and their families.

    Design

    Qualitative interpretive descriptive methodology.

    Methods

    Semi-structured, individual telephone or Zoom interviews with 19 oncology nurses in a Western province of Canada between May and August 2022. Interviews were audio-recorded, transcribed, de-identified, and analysed using inductive, thematic, and constant comparative techniques.

    Results

    Oncology nurses highlighted several factors affecting their ability to engage in advance care planning, including (1) uncertainties related to the nursing role in advance care planning, such as how and when a nurse ought to engage; (2) the educational, experiential, and training environment; and (3) structural barriers, such as a lack of time, space, and privacy; models of care that inhibit nurses from developing longitudinal relationships with their patients; and team dynamics that affect advance care planning interdisciplinary collaboration.

    Conclusion

    To create environments that support oncology nurses to conduct advance care planning, the findings suggest uncertainties be addressed through a clear and cohesive organisational approach to advance care planning and ongoing, integrated educational opportunities. Further, service delivery models may need to be restructured such that nurses have dedicated time and space for nurse-led advance care planning and opportunities to develop trusting relationships with both patients and their interdisciplinary colleagues.

    Implications for the Profession and/or Patient Care

    Impact

    Oncology nurses recognised the value of advance care planning in supporting patient-centred care and shared decision making, yet they reported limited engagement in advance care planning in their practice. To support oncology nurses in conducting advance care planning, healthcare leaders may address (1) advance care planning-related uncertainties and (2) structural barriers that prevent nurses from engaging in advance care planning with patients and their families. Findings may guide modifications to care models, enhancing support for oncology nurses in conducting advance care planning.

    Reporting Method

    We selected and adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) as the most applicable guideline.

    Patient or Public Contribution

    No patient or public contribution.

    ☐ ☆ ✇ Journal of Advanced Nursing

    Structural Resilience Across the Life Course: Perspectives From Older Adults Racialized as Black

    ABSTRACT

    Aim(s)

    This study explored perceptions of older adults racialised as Black on structural resilience across the life course.

    Design

    A qualitative descriptive study.

    Methods

    Using purposive sampling, we recruited 15 Black adults aged 50 and older residing in Baltimore, Maryland, including individuals possessing historical or current knowledge of the community. Semi-structured interviews were conducted to elicit participants' experiences with structural resources during childhood, adulthood and late adulthood. Interviews were audio-recorded, transcribed verbatim and analysed using content analysis.

    Results

    Of the 15 participants, three identified as male (20.0%) and 12 as female (80.0%), with an average age of 70.9 ± 8.2 years. The analysis identified nine categories of structural resilience, confirming its multifaceted and dynamic nature. Common categories present across all life stages included: Built environment, civic engagement, food and housing, healthcare, and social capital and cohesion. Life stage–specific categories included child and family services, educational supports, and workforce development supports during childhood and adulthood, and financial support during adulthood and late adulthood.

    Conclusion

    These categories were interdependent and spanned across life stages, illustrating the dynamic, cumulative and relational qualities of structural resilience. Furthermore, structural resources were identified as key to safeguarding, empowering and restorative responses to adversity.

    Impact

    These findings contribute to the development of a nuanced, life course–informed framework of structural resilience and highlight the need for ecological strategies that address structural forces shaping health and well-being, particularly among older adults racialised as Black.

    Reporting Method

    This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist.

    Patient or Public Contribution

    No patient or public contribution.

    ☐ ☆ ✇ Journal of Advanced Nursing

    A Systematic Review of the Needs of Children and Young People of a Parent Diagnosed With Young‐Onset‐Dementia: Informing a Nursing Intervention

    Por: T. Sobers · E. Wolverson · H. Gardner · P. Joddrell · M. Walpert · A. Pepper · K. Harrison Dening — Septiembre 9th 2025 at 08:33

    ABSTRACT

    Aim

    The aim of this study was to understand the needs of children and young people of a parent with young-onset dementia, to inform the development of a nursing model.

    Background

    Children and young people of a parent diagnosed with young onset dementia have a range of needs that are subject to change and aligned to their stage of development and growth.

    Design

    Systematic review.

    Data Sources

    Searches were conducted in PsycInfo (1806–Jan 2025), Medline (1996–Jan 2025) and CINAHL (1961–Jan 2025); search terms were developed in consultation with an academic librarian.

    Review Methods

    The Preferred Reporting Items for Systematic reviews and Meta-Analyses was used to assess the trustworthiness and applicability of the findings and the Mixed Methods Assessment Tool to assess quality. The review protocol was registered on PROSPERO (CRD42024534104). Needs identified from the literature were matched with the activities and interventions of a specialist nursing model.

    Results

    Searches yielded 223 records of which 17 met the inclusion/exclusion criteria, the majority of which used qualitative methods (N = 16). A thematic synthesis approach was used to analyse data to reveal four emergent themes: (1) finding a way, (2) social connection and peer support, (3) preserving childhood and adolescence and (4) practical support, including the needs relating to education. Identified needs: knowledge and information, emotional support, consistency in education and development, maintaining social connections, physical and psychological well-being, and grief and loss were mapped against a specialist nurse role.

    Conclusion

    Children and young people with a parent diagnosed with young-onset dementia face unique challenges compared to older carers. Despite growing awareness of their needs, this population is often overlooked in national dementia strategies. Developing a specialist nurse role is a positive step, but broader systemic support is essential to safeguard their well-being and future opportunities.

    Reporting Method

    This study adheres to the PRISMA reporting guidelines.

    Patient or Public Contribution

    A bespoke Research Advisory Group, consisting of people with young onset dementia, young family carers, clinicians and academics, guided the review.

    ☐ ☆ ✇ Journal of Advanced Nursing

    Nurse‐Led Innovations for Optimising the Quality and Safety of Care for the Older Person in Residential Aged Care: A Warrant for Action

    ABSTRACT

    Aim

    To canvas the contemporary contextual forces within the Australian residential aged care sector and argue for new research and innovation. There is a pressing need to provide systematised, high-quality and person-centred care to our ageing populations, especially for those who rely on residential care. This paper advances a warrant for establishing a new systematic framework for assessment and management that serves as a foundation for effective person-centred care delivery.

    Design

    Position paper.

    Methods

    This paper promulgates the current dialogue among key stakeholders of quality residential aged care in Australia, including clinicians, regulatory agencies, researchers and consumers. A desktop review gathered relevant literature spanning research, standards and guidelines regarding current and future challenges in aged care in Australia.

    Results

    This position paper explores the issues of improving the quality and safety of residential aged care in Australia, including the lingering impact of COVID-19 and incoming reforms. It calls for nurse-led research and innovation to deliver tools to address these challenges.

    Conclusion

    The paper proposes an appropriate holistic, evidence-based nursing framework to optimise the quality and safety of residential aged care in Australia.

    Patient or Public Contribution

    This study did not include patient or public involvement in its design, conduct, or reporting.

    ☐ ☆ ✇ Nursing Research

    Qualitative Evaluation of Financial Toxicity and Supportive Care Needs of Women Living With Metastatic Breast Cancer

    imageBackground The cost of cancer treatment is higher for breast cancer than any other cancer diagnosis, leaving women with metastatic breast cancer (MBC) vulnerable to challenges given the extended length of cancer treatment, including financial, physical, and psychological burdens. Objective The purpose of this study was to examine the lived experiences of women diagnosed with MBC in the realm of financial concerns and unmet support needs specific to their cancer treatment. Methods This qualitative, phenomenological study included individual interviews that were audio-recorded and transcribed verbatim. Applied thematic analysis was completed using Atlas.ti. Interrater reliability using Cohen’s kappa was established at 0.80. Participants were recruited from a National Cancer Institute–designated cancer center in the United States. Results Sixteen participants were interviewed. A majority were White, non-Hispanic, married, unemployed, and had obtained at least a bachelor’s degree level of education. Nearly 19% of participants reported a gross household income of below $50,000. The mean age of participants was 55.6 years. Two major themes were identified, with each having three corresponding subthemes, including: 1) financial toxicities (cost of cancer treatments and medications, limitations of health insurance, and effect on employment); and 2) unmet support needs (managing usual responsibilities, emotional support, community and organizational support). Discussion The results highlight the financial and psychosocial needs of women with MBC. Treatment costs take a huge financial toll on patients and their families, including insured women with higher household incomes. Participants expressed a desire for specific MBC resources and support.
    ☐ ☆ ✇ Evidence-Based Nursing

    Depressive disorders in children: recent prevalence and future directions

    Por: Nelson · K. M. · Wilson · S. — Junio 19th 2025 at 10:25

    Commentary on: Spoelma MJ, Sicouri GL, Francis DA, Songco AD, Daniel EK, Hudson JL. Estimated prevalence of depressive disorders in children from 2004 to 2019: A systematic review and meta-analysis. JAMA Pediatrics. 2023;177(10):1017–1027.

    Implications for practice and research

  • Clinical practice with young children benefits from knowledge about the prevalence of depressive disorders in childhood and that the well-established sex differences seen for depression in adulthood may not appear until adolescence.

  • Further research is needed to address possible changes in the prevalence of childhood depressive disorders around the world and following the COVID-19 pandemic, and whether these changes are differentially distributed across individuals and communities.

  • Context

    Depression in childhood is a long-documented public health concern.1 A large body of research has considered prevalence rates of depression in children around the world, given its relevance for lifespan mental health and well-being. Meta-analytic research...

    ☐ ☆ ✇ Evidence-Based Nursing

    The complexity of caring for dying residents cannot be understated, nor can its moral significance

    Por: Ma · K. · Wright · D. K. — Junio 19th 2025 at 10:25

    Commentary on: Gilbert R, Lillekroken D. Caring to the end: an empirical application of Swanson’s caring theory to end-of-life care. ANS Adv Nurs Sci. 2023 Oct 13. doi: 10.1097/ANS.0000000000000515. Epub ahead of print.

    Implications for practice and research

  • Nursing theories, like Swanson’s caring theory, can bring visibility to the knowledge and skill harnessed by nurses when caring for dying patients and their families.

  • Further research should explore how nurses’ relational practice is influenced by sociopolitical as well as interpersonal contexts.

  • Context

    ‘Caring’ is a critical concept in nursing discourse and many theories about care in nursing have been developed and applied to a variety of settings. One example is Swanson’s caring theory, an empirically derived middle-range nursing theory that situates caring as a relational way of attending to others to whom we have a sense of commitment and responsibility, through the five specific...

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